WorldWideScience

Sample records for care facilities helps

  1. European network for promoting the physical health of residents in psychiatric and social care facilities (HELPS)

    DEFF Research Database (Denmark)

    Weiser, Prisca; Becker, Thomas; Losert, Carolin;

    2009-01-01

    consisting of 15 European countries has been established and took up the work. As one main result of the project they expect that a widespread use of the HELPS toolkit could have a significant positive effect on the physical health status of residents of mental health and social care facilities, as well...... by promoting behaviour-based and/or environment-based interventions. METHODS AND DESIGN: HELPS is an interdisciplinary European network that aims at (i) gathering relevant knowledge on physical illness in people with mental illness, (ii) identifying health promotion initiatives in European countries that meet...... as to hold resonance for community dwelling people with mental health problems. DISCUSSION: A general strategy on health promotion for people with mental disorders must take into account behavioural, environmental and iatrogenic health risks. A European health promotion toolkit needs to consider...

  2. Digital can help with care.

    Science.gov (United States)

    2016-05-27

    Welcome to the June issue of Nursing Older People. This month, Deidre Wild and colleagues ask the digital question in the second part of their article on digital skills training in care homes ( page 31 ).

  3. Assisted Living Facilities, care facilities, Published in 2006, Washoe County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2006. It is described as 'care facilities'. Data...

  4. Speak Up: Help Prevent Errors in Your Care: Laboratory Services

    Science.gov (United States)

    SpeakUP TM Help Prevent Errors in Your Care Laboratory Services To prevent health care errors, patients are ... making health care safe. That includes doctors, nurses, laboratory technologists, phlebotomists (health care staff who take blood), ...

  5. Urgent Care Facilities, care facilities attribute, Published in 2006, Washoe County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Urgent Care Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2006. It is described as 'care facilities attribute'....

  6. Assisted Living Facilities - MO 2010 Long Term Care Facilities (SHP)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — Long Term Care facilities (nursing homes) in Missouri - Data will not be made available for download via MSDIS. Interested parties should send an email inquiry to...

  7. Health Care Facilities Resilient to Climate Change Impacts

    Directory of Open Access Journals (Sweden)

    Jaclyn Paterson

    2014-12-01

    Full Text Available Climate change will increase the frequency and magnitude of extreme weather events and create risks that will impact health care facilities. Health care facilities will need to assess climate change risks and adopt adaptive management strategies to be resilient, but guidance tools are lacking. In this study, a toolkit was developed for health care facility officials to assess the resiliency of their facility to climate change impacts. A mixed methods approach was used to develop climate change resiliency indicators to inform the development of the toolkit. The toolkit consists of a checklist for officials who work in areas of emergency management, facilities management and health care services and supply chain management, a facilitator’s guide for administering the checklist, and a resource guidebook to inform adaptation. Six health care facilities representing three provinces in Canada piloted the checklist. Senior level officials with expertise in the aforementioned areas were invited to review the checklist, provide feedback during qualitative interviews and review the final toolkit at a stakeholder workshop. The toolkit helps health care facility officials identify gaps in climate change preparedness, direct allocation of adaptation resources and inform strategic planning to increase resiliency to climate change.

  8. Optimization of preventive health care facility locations

    Directory of Open Access Journals (Sweden)

    McGregor S

    2010-03-01

    Full Text Available Abstract Background Preventive health care programs can save lives and contribute to a better quality of life by diagnosing serious medical conditions early. The Preventive Health Care Facility Location (PHCFL problem is to identify optimal locations for preventive health care facilities so as to maximize participation. When identifying locations for preventive health care facilities, we need to consider the characteristics of the preventive health care services. First, people should have more flexibility to select service locations. Second, each preventive health care facility needs to have a minimum number of clients in order to retain accreditation. Results This paper presents a new methodology for solving the PHCFL problem. In order to capture the characteristics of preventive health care services, we define a new accessibility measurement that combines the two-step floating catchment area method, distance factor, and the Huff-based competitive model. We assume that the accessibility of preventive health care services is a major determinant for participation in the service. Based on the new accessibility measurement, the PHCFL problem is formalized as a bi-objective model based on efficiency and coverage. The bi-objective model is solved using the Interchange algorithm. In order to accelerate the solving process, we implement the Interchange algorithm by building two new data structures, which captures the spatial structure of the PHCFL problem. In addition, in order to measure the spatial barrier between clients and preventive health care facilities accurately and dynamically, this paper estimates travelling distance and travelling time by calling the Google Maps Application Programming Interface (API. Conclusions Experiments based on a real application for the Alberta breast cancer screening program show that our work can increase the accessibility of breast cancer screening services in the province.

  9. Elderly care recipients’ perceptions of treatment helpfulness for depression and the relationship with help-seeking

    Science.gov (United States)

    Atkins, Joanna; Naismith, Sharon L; Luscombe, Georgina M; Hickie, Ian B

    2015-01-01

    Objective This study aims to examine perceptions of the helpfulness of treatments/interventions for depression held by elderly care recipients, to examine whether these beliefs are related to help-seeking and whether the experience of depression affects beliefs about treatment seeking, and to identify the characteristics of help-seekers. Method One hundred eighteen aged care recipients were surveyed on their beliefs about the helpfulness of a variety of treatments/interventions for depression, on their actual help-seeking behaviors, and on their experience of depression (current and past). Results From the sample, 32.4% of the participants screened positive for depression on the Geriatric Depression Scale, and of these, 24.2% reported receiving treatment. Respondents believed the most helpful treatments for depression were increasing physical activity, counseling, and antidepressant medication. Help-seeking from both professional and informal sources appeared to be related to belief in the helpfulness of counseling and antidepressants; in addition, help-seeking from informal sources was also related to belief in the helpfulness of sleeping tablets and reading self-help books. In univariate analyses, lower levels of cognitive impairment and being in the two lower age tertiles predicted a greater likelihood of help-seeking from professional sources, and female sex and being in the lower two age tertiles predicted greater likelihood of help-seeking from informal sources. In multivariate analyses, only lower levels of cognitive impairment remained a significant predictor of help-seeking from professional sources, whereas both lower age and female sex continued to predict a greater likelihood of help-seeking from informal sources. Conclusion Beliefs in the helpfulness of certain treatments were related to the use of both professional and informal sources of help, indicating the possibility that campaigns or educational programs aimed at changing beliefs about treatments

  10. Assisted Living Facilities - CARE_LONG_TERM_FACILITIES_ISDH_IN: Residential Care Facilities, Nursing Homes, and Hospices in Indiana in 2007 (Indiana State Department of Health, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — CARE_LONG_TERM_FACILITIES_ISDH_IN is a point shapefile showing the locations of 86 residential care facilities, 525 long-term care facilities (nursing homes), and...

  11. Stress and Coping among Owners and Managers of Residential Care Facilities.

    Science.gov (United States)

    Walker, Hollie; And Others

    Stress and burnout are common in the caregiving professions. Stress negatively affects both the caregivers and patients. In order to help caregivers deal with stress effectively and to improve the care in residential care facilities, it is essential to learn more about the particular stressors that managers of such facilities experience. In this…

  12. Elderly care recipients’ perceptions of treatment helpfulness for depression and the relationship with help-seeking

    Directory of Open Access Journals (Sweden)

    Atkins J

    2015-01-01

    Full Text Available Joanna Atkins,1 Sharon L Naismith,1 Georgina M Luscombe,2 Ian B Hickie1 1Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia; 2School of Rural Health, Sydney Medical School, University of Sydney, Orange, NSW, Australia Objective: This study aims to examine perceptions of the helpfulness of treatments/interventions for depression held by elderly care recipients, to examine whether these beliefs are related to help-seeking and whether the experience of depression affects beliefs about treatment seeking, and to identify the characteristics of help-seekers. Method: One hundred eighteen aged care recipients were surveyed on their beliefs about the helpfulness of a variety of treatments/interventions for depression, on their actual help-seeking behaviors, and on their experience of depression (current and past. Results: From the sample, 32.4% of the participants screened positive for depression on the Geriatric Depression Scale, and of these, 24.2% reported receiving treatment. Respondents believed the most helpful treatments for depression were increasing physical activity, counseling, and antidepressant medication. Help-seeking from both professional and informal sources appeared to be related to belief in the helpfulness of counseling and antidepressants; in addition, help-seeking from informal sources was also related to belief in the helpfulness of sleeping tablets and reading self-help books. In univariate analyses, lower levels of cognitive impairment and being in the two lower age tertiles predicted a greater likelihood of help-seeking from professional sources, and female sex and being in the lower two age tertiles predicted greater likelihood of help-seeking from informal sources. In multivariate analyses, only lower levels of cognitive impairment remained a significant predictor of help-seeking from professional sources, whereas both lower age and female sex continued to predict a greater likelihood of help

  13. Health care help seeking behaviour among prisoners in Norway

    Directory of Open Access Journals (Sweden)

    Nesset Merete

    2011-11-01

    Full Text Available Abstract Background Prisoners are associated with high health care needs compared with the general population. This study aims to investigate prisoners' use of health service. Methods A cross-sectional study of 29 prisons in central and southern parts of Norway. A questionnaire was distributed to 1, 454 prisoners (90% response rate. Multilevel analyses were employed to analyse help seeking behaviour among the prisoners. Results Help seeking was substantially associated with sleep problems and drug problems. There was also a tendency for closed prisons as well as high staffing levels of healthcare professionals to be associated with elevated health care use. Conclusions This study suggests that sleep problems and drug use are most frequently associated with health service use. The differences in health care use between prisons suggest that the implementation of prison health care standards should be addressed.

  14. 21 CFR 58.43 - Animal care facilities.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 1 2010-04-01 2010-04-01 false Animal care facilities. 58.43 Section 58.43 Food... LABORATORY PRACTICE FOR NONCLINICAL LABORATORY STUDIES Facilities § 58.43 Animal care facilities. (a) A testing facility shall have a sufficient number of animal rooms or areas, as needed, to assure proper:...

  15. 42 CFR 440.140 - Inpatient hospital services, nursing facility services, and intermediate care facility services...

    Science.gov (United States)

    2010-10-01

    ... Definitions § 440.140 Inpatient hospital services, nursing facility services, and intermediate care facility... 42 Public Health 4 2010-10-01 2010-10-01 false Inpatient hospital services, nursing facility services, and intermediate care facility services for individuals age 65 or older in institutions...

  16. Psychiatric and Medical Health Care Policies in Juvenile Detention Facilities

    Science.gov (United States)

    Pajer, Kathleen A.; Kelleher, Kelly; Gupta, Ravindra A.; Rolls, Jennifer; Gardner, William

    2007-01-01

    A study aims to examine the existing health care policies in U.S. juvenile detention centres. The results conclude that juvenile detention facilities have many shortfalls in providing care for adolescents, particularly mental health care.

  17. Models of helping and coping in cancer care.

    Science.gov (United States)

    Northouse, L L; Wortman, C B

    1990-02-01

    This paper provides a theoretical analysis of four models of helping and coping as they relate to cancer care. The four conceptual models focus on the issue of whether or not patients should be viewed as responsible for the cause or the treatment of their cancer. The moral model, characterized by the holistic health movement, holds patients responsible for both causing and resolving health problems. The compensatory model, exemplified by cancer education programs, attributes low responsibility to patients for causing health problems but high responsibility for resolving them. The medical model views patients as neither responsible for causing nor for resolving health problems. The enlightenment model, typified by the healing movement, holds people responsible for causing their health problems, but not for resolving them. An attempt is made to examine existing programs in cancer care in light of these models. The present analysis addresses the following questions. Why is each of these models appealing? Why are they sometimes embraced by patients or health care providers? What are the benefits and disadvantages of using each of these models with cancer patients? What happens when the health care provider and patient hold different models regarding the patient's responsibility or participation in the cause of the disease or its treatment? Further research is needed to determine the conditions under which a particular model results in better health outcomes for patients, and to assess how factors such as extent of disease or type of cancer influence the patient's choice of a model.

  18. Using music therapy to help a client with Alzheimer's disease adapt to long-term care.

    Science.gov (United States)

    Kydd, P

    2001-01-01

    The purpose of this case study is to illustrate how music therapy can be used to help the elderly successfully adjust to living in a long-term care (LTC) facility. LTC residents, particularly those with Alzheimer's disease or related dementia, may exhibit behaviors such as depression, withdrawal, anxiety, emotional liability, confusion, and memory difficulties, frequently related to the disorder, but often exacerbated by difficulty in adjustment to the change in lifestyle. The subject of this case study demonstrated these symptoms. Music therapy helped him adjust to life in a LTC setting by improving his quality of life and enhancing his relationships with those around him. As chronicled in this study, music therapy may facilitate a resident's adjustment to life in a LTC facility. N.B. Names and identifying information have been changed to protect privacy.

  19. Caring for nonhuman primates in biomedical research facilities: scientific, moral and emotional considerations.

    Science.gov (United States)

    Coleman, Kristine

    2011-03-01

    Animal care for nonhuman primates (NHPs) in biomedical facilities has undergone major changes in the past few decades. Today, most primate facilities have dedicated and highly trained animal care technicians who go to great efforts to ensure the physiological and psychological well being of the primates in their charge. These caretakers work closely with the animals and, as a result, often develop strong relationships with them. Once discouraged and considered a potential threat to scientific objectivity, such positive relationships are now seen as important components to animal care. Positive interactions between caretakers and primates can benefit the primates by reducing their stress and improving their overall well being which can, in turn, help the scientific endeavor. Further, providing the best possible care is our moral responsibility. However, there can also be emotional costs associated with caring for NHPs in research facilities, particularly when animals become ill or have to be euthanized. Facilities can do much to help ease this conflict. High-quality and conscientious animal care is good for the animals, science, and public perception of research facilities.

  20. Volunteering for Clinical Trials Can Help Improve Health Care for Everyone

    Science.gov (United States)

    ... of this page please turn Javascript on. Feature: Clinical Trials Volunteering for Clinical Trials Can Help Improve Health Care for Everyone Past ... healthy people to help," says Melanie Modlin about clinical trials. "We have a role to play in helping ...

  1. Facility Service Environments, Staffing, and Psychosocial Care in Nursing Homes

    Science.gov (United States)

    Zhang, Ning Jackie; Gammonley, Denise; Paek, Seung Chun; Frahm, Kathryn

    2008-01-01

    Using 2003 Online Survey Certification and Reporting (OSCAR) data for Medicare and Medicaid certified facilities (N=14, 184) and multinomial logistic regression this study investigated if (1) psychosocial care quality was better in facilities where State requirements for qualified social services staffing exceeded Federal minimum regulations and (2) facility service environments are associated with psychosocial care quality. For-profit status and higher percentage of Medicaid residents are associated with lower quality. Staffing, market demand, and market competition are associated with better quality. Psychosocial care quality is more associated with payer status and market forces and less with regulatory requirements. PMID:19361113

  2. Identifying and Analyzing Help Facilities and Capabilities in Iranian Digital Libraries Software

    Directory of Open Access Journals (Sweden)

    Mohammad Zerehsaz

    2014-09-01

    Concerning the format, only three digital libraries (Majlis, Astan Quds Razavi, Ahlolbayt have a score higher than 50% and from a style-related aspect, only five digital libraries (Islamic Document and Information Center, Ahlolbayt, National Library, Tebyan and Human Sciences have a score higher than 50%. Moreover, from an access-related aspect, only three digital libraries (Human Sciences, National Library and Archive and Islamic Document and Information Center have a score higher than 50%. Generally, given all the aforementioned aspects, it was found that two National Libraries and Archive and Islamic Document and Information Center digital libraries having a score of 57% from Help Facilities and Capabilities are ranked first and Human Sciences digital library having 51% from Help Facilities and Capabilities have been ranked second. Other digital libraries having scores lower than averages are in subsequent ranks. Finally, some executive recommendations have been provided to digital library designers to design effective help facilities and capabilities.

  3. Hospitals - MEDICAL_CARE_FACILITIES_MHMP_IN: Medical Care Facilities in Indiana, derived from Essential Facilities Data of the Multi-Hazard Mitigation Planning Data (The Polis Center, Point Shapefile)

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — MEDICAL_CARE_FACILITIES_MHMP_IN.SHP is a point shapefile that shows medical care facilities in Indiana. MEDICAL_CARE_FACILITIES_MHMP_IN.SHP was derived from the...

  4. Residents Living in Residential Care Facilities: United States, 2010

    Science.gov (United States)

    ... of Residential Care Facilities. National Center for Health Statistics. Vital Health Stat 1(54). 2011. SUDAAN, release 10.0 [computer software]. Research Triangle Park, NC: RTI International. 2008. Suggested ...

  5. Antibiotic use and resistance in long term care facilities

    NARCIS (Netherlands)

    Buul, L.W. van; Steen, J.T. van der; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.G.M.; Benthem, B.H. van; Natsch, S.S.; Hertogh, C.M.P.M.

    2012-01-01

    INTRODUCTION: The common occurrence of infectious diseases in nursing homes and residential care facilities may result in substantial antibiotic use, and consequently antibiotic resistance. Focusing on these settings, this article aims to provide a comprehensive overview of the literature available

  6. Antibiotic use and resistance in long term care facilities.

    NARCIS (Netherlands)

    Buul, L.W. van; Steen, J.T. van der; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F.G.; Essink, R.T.G.M.; Benthem, B.H.B. van; Natsch, S.; Hertogh, C.M.P.M.

    2012-01-01

    Introduction: The common occurrence of infectious diseases in nursing homes and residential care facilities may result in substantial antibiotic use, and consequently antibiotic resistance. Focusing on these settings, this article aims to provide a comprehensive overview of the literature available

  7. EMS Stations, care facility attribute, Published in 2006, Washoe County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This EMS Stations dataset, was produced all or in part from Published Reports/Deeds information as of 2006. It is described as 'care facility attribute'. Data by...

  8. Hospitals, care facility attribute, Published in 2006, Washoe County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Hospitals dataset, was produced all or in part from Published Reports/Deeds information as of 2006. It is described as 'care facility attribute'. Data by this...

  9. Standards for Psychological Services in Long-Term Care Facilities.

    Science.gov (United States)

    Morrow-Howell, Nancy; Lichtenberg, Peter A.; Smith, Michael; Frazer, Deborah; Molinari, Victor; Rosowsky, Erlene; Crose, Royda; Stillwell, Nick; Kramer, Nanette; Hartman-Stein, Paula; Qualls, Sara; Salamon, Michael; Duffy, Michael; Parr, Joyce; Gallagher-Thompson, Dolores

    1998-01-01

    Describes the development of standards for psychological practice in long-term care facilities. The standards, which were developed by Psychologists in Long-Term Care, address provider characteristics, methods of referral, assessment practices, treatment, and ethical issues. Offers suggestions for use of the standards. (MKA)

  10. Winning market positioning strategies for long term care facilities.

    Science.gov (United States)

    Higgins, L F; Weinstein, K; Arndt, K

    1997-01-01

    The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application.

  11. Helping hands: caring for the upper extremity transplant patient.

    Science.gov (United States)

    Lovasik, Darlene; Foust, Daniel E; Losee, Joseph E; Lee, W P Andrew; Brandacher, Gerald; Gorantla, Vijay S

    2011-09-01

    Caring for upper extremity transplant recipients can offer challenges and opportunities to nursing staff in combining new patient procedures, new technologies, and complex patient care needs including unique physical care, monitoring and observation, rehabilitation expectations, and psychiatric/psychosocial support. Medical professionals continue to be apprehensive about the risks of immunosuppressive therapy and the possibility of acute and chronic rejection. The sustained development and research into reliable, reduced-dose immunosuppression or immunomodulatory strategies could expand the life-enhancing benefits of reconstructive transplantation.

  12. Take Good Care of Public Facilities

    Institute of Scientific and Technical Information of China (English)

    张冰; 金业祥

    2004-01-01

    However,it is a great pity that in many places,some of the public facilities have been purposely damaged.Some electric bulbs were smashed; some traffic signs were damaged beyond recognition,some public telephones cannot work; some statues stand there without an arm or a leg.What's worse,some people even stole the covers of the sewers.

  13. Caring for juveniles with mental disorders in adult corrections facilities.

    Science.gov (United States)

    Wills, Cheryl D

    2017-02-01

    Although juveniles have developmental, educational, healthcare, and rehabilitation needs that differ from adults, thousands of them have been confined in adult corrections facilities in the past 30 years. This manuscript will review how and why juveniles end up in adult corrections facilities, who they are, their rehabilitative needs, and how they differ from adults in corrections facilities and youths in the juvenile justice system. The importance of providing developmentally-informed mental health services to youths in adult corrections facilities is examined, along with barriers to traditional adolescent psychiatric practice. Recommendations for future directions in adolescent psychiatric care are presented.

  14. How Primary Care Networks Can Help Integrate Academic and Service Initiatives in Primary Care

    Science.gov (United States)

    Thomas, Paul; Graffy, Jonathan; Wallace, Paul; Kirby, Mike

    2006-01-01

    PURPOSE Theory of effective network operation in primary care is underdeveloped. This study aimed to identify how primary care networks can best integrate academic and service initiatives. METHODS We performed a comparative case study of 4 primary care research networks in North London, England, for the years 1998–2002. Indicators were selected to assess changes in (1) research capacity, (2) multidisciplinary collaboration, and (3) research productivity. We compared the profiles of network outcome with descriptions of their contexts and organizational types from a previous evaluation. RESULTS Together, the networks supported 133 viable projects and 30 others; 399 practitioners, managers, and academics participated in the research teams. How the networks organized themselves was influenced by the circumstances in which they were formed. Different ways of organizing were associated with different outcome profiles. Shared projects and learning spaces helped participants to develop trusted relationships. A top-down, hierarchical approach based on institutional alliances and academic expertise attracted more funding and appeared to be stable. The bottom-up, individualistic network with research practices was good at reflecting on practical primary care concerns. Whole-system methods brought together stakeholder contributions from all parts of the system. CONCLUSIONS Networks can help integrate academic research and service development initiatives by facilitating interorganizational interactions and in shared leadership of projects. Researchers and practitioners stand to gain considerably from an integrated approach in both the short and the long term. Success requires agreement about a set of pathways, learning spaces, and feedback mechanisms to harness the insights and efforts of stakeholders throughout the whole system. PMID:16735525

  15. Facilities Management and Health Care at Home

    OpenAIRE

    Lundberg, Stefan

    2007-01-01

    The topic of this thesis is the new requirements that will be put upon the facilities management when the elderly are living longer in their own homes, in spite of illness, impairment and old age. For many reasons, especially demographic ones, this issue has come to the fore and since it has substantial political impact and considerably affects our living conditions, it will most certainly appear on the agenda of most Swedish housing companies in the near future. The growing number of inhabit...

  16. Improving Quality of Care in Primary Health-Care Facilities in Rural Nigeria

    OpenAIRE

    Okoli Ugo; Eze-Ajoku Ezinne; Oludipe Modupe; Spieker Nicole; Ekezie Winifred; Ohiri Kelechi

    2016-01-01

    Background: Nigeria has a high population density but a weak health-care system. To improve the quality of care, 3 organizations carried out a quality improvement pilot intervention at the primary health-care level in selected rural areas. Objective: To assess the change in quality of care in primary health-care facilities in rural Nigeria following the provision of technical governance support and to document the successes and challenges encountered. Method: A total of 6 states were selected...

  17. Theory in Practice: Helping Providers Address Depression in Diabetes Care

    Science.gov (United States)

    Osborn, Chandra Y.; Kozak, Cindy; Wagner, Julie

    2010-01-01

    Introduction: A continuing education (CE) program based on the theory of planned behavior was designed to understand and improve health care providers' practice patterns in screening, assessing, and treating and/or referring patients with diabetes for depression treatment. Methods: Participants completed assessments of attitudes, confidence,…

  18. Sound & Vibration 20 Design Guidelines for Health Care Facilities

    CERN Document Server

    Tocci, Gregory; Cavanaugh, William

    2013-01-01

    Sound, vibration, noise and privacy have significant impacts on health and performance. As a result, they are recognized as essential components of effective health care environments. However, acoustics has only recently become a prominent consideration in the design, construction, and operation of healthcare facilities owing to the absence, prior to 2010, of clear and objective guidance based on research and best practices. Sound & Vibration 2.0 is the first publication to comprehensively address this need. Sound & Vibration 2.0 is the sole reference standard for acoustics in health care facilities and is recognized by: the 2010 FGI Guidelines for the Design and Construction of Health Care Facilities (used in 60 countries); the US Green Building Council’s LEED for Health Care (used in 87 countries); The Green Guide for Health Care V2.2; and the International Code Council (2011). Sound & Vibration 2.0 was commissioned by the Facility Guidelines Institute in 2005, written by the Health Care Acous...

  19. Strategic Facilities Planning: A Focus On Health Care

    Directory of Open Access Journals (Sweden)

    Ellen D. Hoadley

    2011-01-01

    Full Text Available Turbulent market conditions have forced the health care sector to re-examine its business and operational practices.  Health care has become increasingly complex as decisions and planning are reframed in light of the current lagging economy, an increased demand for services, new global competition, and impending legislation reform.  The stress is felt most keenly within the nation’s hospitals and consortia of health care facilitiesFacility planning decisions are no exception.  Hospital administrators are abandoning the once commonplace rules governing aging infrastructure renovations.  Instead, administrators are basing decisions within their respective strategic context and are attempting to align buildings, services, personnel, and technology to an overall plan that looks at markets, operations, and finances as resources for competitive advantage.  This paper reviews the strategic facilities planning literature and applies those best practices which support this organizational alignment for health care.  An application in the mid-Atlantic demonstrates that hospital facilities, by design, need to support the current and future needs of health care delivery systems, while dated structures impede industry advances.  Health care infrastructure improvements must proactively address technological, regulatory, and financial changes facing the sector.

  20. Urgent Care Facilities, Trauma Care Facilities - name, address, certification level, contact info, email address, Published in 2007, Iowa Dept. of Public Health.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Urgent Care Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2007. It is described as 'Trauma Care Facilities -...

  1. Facility charter and quality of care for board and care residents.

    Science.gov (United States)

    Castle, Nicholas G

    2004-01-01

    In this investigation structure, process, and outcome measures of quality in for-profit and not-for-profit board and care homes are compared. We find one structural measure (providing nursing care), three process measures (food quality, staff treat residents with respect, and staff verbally abuse residents), and two outcomes measures (cleanliness of the facility and complaints to Ombudsman) to be significant. Moreover, the directions of these effects are all consistent, with for-profit facilities rated more poorly that not-for-profit facilities. These results are discussed emphasizing their implications for efficient and effective resident care.

  2. Assisted Living Facilities, Licensed Health Care Facilities - long term care facility type identified in attributes, Published in 2007, Iowa Dept. of Public Health.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2007. It is described as 'Licensed Health Care...

  3. Antimicrobial use in long-term-care facilities

    NARCIS (Netherlands)

    Nicolle, LE; Bentley, DW; Garibaldi, R; Neuhaus, EG; Smith, PW

    2000-01-01

    There is intense antimicrobial use in long-term-care facilities (LTCFs), and studies repeatedly document that much of this use is inappropriate. The current crisis in antimicrobial resistance, which encompasses the LTCF, heightens concerns of antimicrobial use. Attempts to improve antimicrobial use

  4. Hospital Palliative Care Teams and Post-Acute Care in Nursing Facilities: An Integrative Review.

    Science.gov (United States)

    Carpenter, Joan G

    2017-01-01

    Although palliative care consultation teams are common in U.S. hospitals, follow up and outcomes of consultations for frail older adults discharged to nursing facilities are unclear. To summarize and critique research on the care of patients discharged to nursing facilities following a hospital-based palliative care consult, a systematic search of PubMed, CINAHL, Ageline, and PsycINFO was conducted in February 2016. Data from the articles (N = 12) were abstracted and analyzed. The results of 12 articles reflecting research conducted in five countries are presented in narrative form. Two studies focused on nurse perceptions only, three described patient/family/caregiver experiences and needs, and seven described patient-focused outcomes. Collectively, these articles demonstrate that disruption in palliative care service on hospital discharge and nursing facility admission may result in high symptom burden, poor communication, and inadequate coordination of care. High mortality was also noted. [Res Gerontol Nurs. 2017; 10(1):25-34.].

  5. Cruise ship care: a proposed alternative to assisted living facilities.

    Science.gov (United States)

    Lindquist, Lee A; Golub, Robert M

    2004-11-01

    Options for elderly patients who can no longer remain independent are limited. Most choices involve assisted living facilities, 24-hour caregivers, or nursing homes. State and federal assistance for payment for individual care is limited, and seniors usually pay for most costs out of pocket. For those patients who have the means to afford assisted living centers or nursing homes, "cruise ship care" is proposed. Traveling alongside traditional tourists, groups of seniors would live on cruise ships for extended periods of time. Cruise ships are similar to assisted living centers in the amenities provided, costs per month, and many other areas. This article begins with an examination of the needs of seniors in assisted living facilities and then explores the feasibility of cruise ship care in answering those needs. Similarities between cruise ship travel and assisted living care, as well as the monetary costs of both options, are defined. A decision tree with selections for non-independent care for seniors was created including cruise ship care as an alternative. Using a Markov model over 20 years, a representative cost-effectiveness analysis was performed that showed that cruises were priced similarly to assisted living centers and were more efficacious. Proposed ways that cruise ship companies could further accommodate the needs of seniors interested in this option are also suggested. Implementation for cruise ship care on the individual basis is also presented. Ultimately, it is wished to introduce a feasible and possibly more desirable option to seniors who can no longer remain independent.

  6. Pneumonia in nursing homes and long-term care facilities.

    Science.gov (United States)

    Loeb, Mark B

    2005-12-01

    This article reviews the epidemiology of pneumonia in residents of nursing homes and other long-term care facilities (LTCFs). Streptococcus pneumoniae is the most important cause of pneumonia in residents of nursing homes and LTCFs. Factors suggestive of aspiration are the most important risk factors for pneumonia in this population. The clinical presentation of pneumonia among long-term care facility residents is challenging; residents tend to be older and more debilitated than their elderly community-dwelling counterparts. Data on optimal antimicrobial therapy in this setting is sparse. Functional status is an important predictor of outcome in this population. There are key management issues, such as site of care, which remain unresolved. Immunization with influenza and pneumococcal vaccines remains the mainstay of prevention.

  7. End-of-Life Care Policies in Flemish Residential Care Facilities Accommodating Persons with Intellectual Disabilities

    Science.gov (United States)

    D'Haene, I.; Pasman, H. R. W.; Deliens, L.; Bilsen, J.; Mortier, F.; Stichele, R. Vander

    2010-01-01

    Objective: This article aims to describe the presence, content and implementation strategies of written policies on end-of-life decisions in Flemish residential care facilities (RCFs) accommodating persons with intellectual disabilities (ID), and to describe training, education and quality assessments of end-of-life care. Methods: A…

  8. Preparedness of elderly long-term care facilities in HSE East for influenza outbreaks.

    LENUS (Irish Health Repository)

    O'Connor, L

    2015-01-01

    Abstract We assessed preparedness of HSE East elderly long-term care facilities for an influenza outbreak, and identified Public Health Department support needs. We surveyed 166 facilities based on the HSE checklist document for influenza outbreaks, with 58% response rate. Client flu vaccination rates were > 75%; leading barriers were client anxiety and consent issues. Target flu vaccine uptake of 40% in staff occurred in 43% of facilities and was associated with staff vaccine administration by afacility-attached GP (p = 0.035), having a facility outbreak plan (p = 0.013) and being anon-HSE run facility (p = 0.013). Leading barriers were staff personal anxiety (94%) and lack of awareness of the protective effect on clients (21%). Eighty-nine percent found Public Health helpful, and requested further educational support and advocacy. Staff vaccine uptake focus, organisational leadership, optimal vaccine provision models, outbreak plans and Public Health support are central to the influenza campaign in elderly long-term care facilities.

  9. Nonlicensed employee turnover in a long-term care facility.

    Science.gov (United States)

    Gaddy, T; Bechtel, G A

    1995-06-01

    The purpose of this study was to analyze nonlicensed employee turnover in a long-term care facility using Maslow's hierarchy of needs as a framework. During exit interviews, a convenience sample of 34 employees completed an attitudes and beliefs survey regarding their work environment. Findings were mixed; 39.6 percent of the employees stated positive personal relationships were a strength of the organization, although 24.3 percent resigned because of personal/staff conflicts. Financial concerns were not a major factor in their resignations. The study suggests that decreasing nonlicensed employee stress and increasing their personal satisfaction with patient care may decrease employee turnover.

  10. How Can Science Help Us Care for Nature? Hermeneutics, Fragility, and Responsibility for the Earth

    Science.gov (United States)

    Joldersma, Clarence W.

    2009-01-01

    In this review essay, Clarence Joldersma argues for a novel role for science in developing an affirmative answer to his title question, "How can science help us care for nature?" He does so in dialogue with Clare Palmer's edited volume, "Teaching Environmental Ethics," Dirk Postma's "Why Care for Nature?" and Michael Bonnett's "Retrieving Nature."…

  11. Antibiotic use and resistance in long term care facilities.

    OpenAIRE

    Buul, L.W. van; Steen, J.T. van der; Veenhuizen, R.B.; Achterberg, W.P.; Schellevis, F G; Essink, R.T.G.M.; VAN BENTHEM, B. H B; Natsch, S. (Stefan); Hertogh, C. M. P. M.

    2012-01-01

    Introduction: The common occurrence of infectious diseases in nursing homes and residential care facilities may result in substantial antibiotic use, and consequently antibiotic resistance. Focusing on these settings, this article aims to provide a comprehensive overview of the literature available on antibiotic use, antibiotic resistance, and strategies to reduce antibiotic resistance. Methods: Relevant literature was identified by conducting a systematic search in the MEDLINE and EMBASE dat...

  12. Helping Children and Youth with Attention-Deficit/Hyperactivity Disorder: Systems of Care

    Science.gov (United States)

    ... Health and Human Services. Children and Adults With Attention-Deficit/ Hyperactivity Disorder www.chadd.org Tel: 301.306.7070 Federation ... information, contact: 4 Helping Children and Youth With Attention-Deficit/Hyperactivity Disorder: Systems of Care Attention -Deficit /Hyperactivity Disorder Helping ...

  13. Health facility service availability and readiness for intrapartum and immediate postpartum care in Malawi: A cross-sectional survey

    Science.gov (United States)

    Oseni, Lolade; Mtimuni, Angella; Sethi, Reena; Rashidi, Tambudzai; Kachale, Fannie; Rawlins, Barbara; Gupta, Shivam

    2017-01-01

    This analysis seeks to identify strengths and gaps in the existing facility capacity for intrapartum and immediate postpartum fetal and neonatal care, using data collected as a part of Malawi’s Helping Babies Breath program evaluation. From August to September 2012, the Maternal and Child Health Integrated Program (MCHIP) conducted a cross-sectional survey in 84 Malawian health facilities to capture current health facility service availability and readiness and health worker capacity and practice pertaining to labor, delivery, and immediate postpartum care. The survey collected data on availability of equipment, supplies, and medications, and health worker knowledge and performance scores on intrapartum care simulation and actual management of real clients at a subset of facilities. We ran linear regression models to identify predictors of high simulation performance of routine delivery care and management of asphyxiated newborns across all facilities surveyed. Key supplies for infection prevention and thermal care of the newborn were found to be missing in many of the surveyed facilities. At the health center level, 75% had no clinician trained in basic emergency obstetric care or newborn care and 39% had no midwife trained in the same. We observed that there were no proportional increases in available transport and staff at a facility as catchment population increased. In simulations of management of newborns with breathing problems, health workers were able to complete a median of 10 out of 16 tasks for a full-term birth case scenario and 20 out of 30 tasks for a preterm birth case scenario. Health workers who had more years of experience appeared to perform worse. Our study provides a benchmark and highlights gaps for future evaluations and studies as Malawi continues to make strides in improving facility-based care. Further progress in reducing the burden of neonatal and fetal death in Malawi will be partly predicated on guaranteeing properly equipped and

  14. Older adult drivers living in residential care facilities

    Science.gov (United States)

    Lum, Hillary D.; Ginde, Adit A.; Betz, Marian E.

    2015-01-01

    Residential care facilities (RCF) provide assistance to older adults who cannot live independently, but it is unclear whether these residents have retired from driving. Here, we characterize older adults living in RCFs who still drive from a national cross-sectional survey of residents (2010 National Survey of Residential Care Facilities), representing ~733,000 adults living in RCFs such as assisted living facilities and personal care homes. Key resident characteristics were health, function, mobility and community activity indicators, which could be associated with increased driving risk. Of 8,087 residents, 4.5% (95%CI=3.9-5.1) were current drivers. Many drivers were older than 80 years (74%, 95%CI=67-79), in very good health (31%, 95%CI=25-38) or good health (35%, 95%CI=29-42), and had a median of two medical conditions. Most were independent with activities of daily living, though some needed assistance with walking and used gait devices. Given these results, RCF staff and healthcare providers need a heightened awareness of factors associated with driving risk to promote safety of older drivers and provide resources for likely transition to other transportation. PMID:26366125

  15. Management considerations in the care of elderly heart failure patients in long-term care facilities.

    Science.gov (United States)

    Heckman, George A; Boscart, Veronique M; McKelvie, Robert S

    2014-07-01

    Heart failure, a condition that affects up to 20% of older persons residing in long-term care facilities, is an important cause of morbidity, health service utilization and death. Effective and interprofessional heart failure care processes could potentially improve care, outcomes and quality of life and delay decline or hospital admission. This article reviews the clinical aspects of heart failure, and the challenges to the diagnosis and management of this condition in long-term care residents who are frail and are affected by multiple comorbidities.

  16. NIH Research: Children Research Volunteers Receive Care and Help Advance Knowledge | NIH MedlinePlus the Magazine

    Science.gov (United States)

    ... Children Research Volunteers Receive Care and Help Advance Knowledge Past Issues / Winter 2012 Table of Contents Dr. ... Children research volunteers receive care and help advance knowledge I f one smile can light up a ...

  17. 42 CFR 409.85 - Skilled nursing facility (SNF) care coinsurance.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Skilled nursing facility (SNF) care coinsurance... Coinsurance § 409.85 Skilled nursing facility (SNF) care coinsurance. (a) General provisions. (1) SNF care coinsurance is the amount chargeable to a beneficiary after the first 20 days of SNF care in a benefit...

  18. Residential care : Dutch and Italian residents of residential care facilities compared

    NARCIS (Netherlands)

    de Heer-Wunderink, Charlotte; Caro-Nienhuis, Annemarie D.; Sytema, Sjoerd; Wiersma, Durk

    2008-01-01

    Aims - Characteristics of patients living in residential care facilities and the availability of mental hospital- and residential beds in Italy and The Netherlands were compared to assess whether differences in the process of deinstitutionalisation have influenced the composition of their residentia

  19. Human resource development in rural health care facilities.

    Science.gov (United States)

    Johnson, L

    1991-01-01

    In this paper, human resource development problems facing rural health care facilities are identified and it is recognised that, particularly in the face of escalating demands for training arising from environmental pressures such as implementation of the structural efficiency principle, a coordinated approach to meet these problems is desirable. Such coordination is often sought via a regional staff development service. Accordingly, using the organisational life cycle as a conceptual framework, staff development services in five NSW health regions are examined. Ranging from a cafeteria style to a results-orientation, a diversity of strategic approaches to staff development is reflected.

  20. Food security practice in Kansas schools and health care facilities.

    Science.gov (United States)

    Yoon, Eunju; Shanklin, Carol W

    2007-02-01

    This pilot study investigated perceived importance and frequency of specific preventive measures, and food and nutrition professionals' and foodservice directors' willingness to develop a food defense management plan. A mail questionnaire was developed based on the US Department of Agriculture document, Biosecurity Checklist for School Foodservice Programs--Developing a Biosecurity Management Plan. The survey was sent to food and nutrition professionals and foodservice operators in 151 acute care hospitals, 181 long-term-care facilities, and 450 school foodservice operations. Chemical use and storage was perceived as the most important practice to protect an operation and was the practice implemented most frequently. Results of the study indicate training programs on food security are needed to increase food and nutrition professionals' motivation to implement preventive measures.

  1. Measuring the diffusion of palliative care in long-term care facilities – a death census

    Directory of Open Access Journals (Sweden)

    Santos-Eggimann Brigitte

    2009-01-01

    Full Text Available Abstract Background The dissemination of palliative care for patients presenting complex chronic diseases at various stages has become an important matter of public health. A death census in Swiss long-term care facilities (LTC was set up with the aim of monitoring the frequency of selected indicators of palliative care. Methods The survey covered 150 LTC facilities (105 nursing homes and 45 home health services, each of which was asked to complete a questionnaire for every non-accidental death over a period of six months. The frequency of 4 selected indicators of palliative care (resort to a specialized palliative care service, the administration of opiates, use of any pain measurement scale or other symptom measurement scale was monitored in respect of the stages of care and analysed based on gender, age, medical condition and place of residence. Results Overall, 1200 deaths were reported, 29.1% of which were related to cancer. The frequencies of each indicator varied according to the type of LTC, mostly regarding the administration of opiate. It appeared that the access to palliative care remained associated with cancer, terminal care and partly with age, whereas gender and the presence of mental disorders had no effect on the indicators. In addition, the use of drugs was much more frequent than the other indicators. Conclusion The profile of patients with access to palliative care must become more diversified. Among other recommendations, equal access to opiates in nursing homes and in home health services, palliative care at an earlier stage and the systematic use of symptom management scales when resorting to opiates have to become of prime concern.

  2. Does collaborative care help in the treatment of anxiety in primary health care?

    OpenAIRE

    Leonardo Moscovici; João Mazzoncini de Azevedo Marques; Antonio Waldo Zuardi

    2013-01-01

    Objective: Anxiety disorders represent an important part of mental health problems in primary care. This literature review seeks to find out whether collaborative care (called “matrix support” in Brazil) assists the treatment of anxiety disorders and/or anxiety symptoms. Methods: We performed a literature search with no time period restriction using PubMed, ISI, and LILACS PSYCINFO databases. The descriptors sought were “collaborative care”, “shared care”, “primary care”, “anxiety”, “generali...

  3. Pneumonia in older residents of long-term care facilities.

    Science.gov (United States)

    Furman, Christian Davis; Rayner, Abi V; Tobin, Elisabeth Pelcher

    2004-10-15

    Compared with community-dwelling persons, residents in long-term care facilities have more functional disabilities and underlying medical illnesses and are at increased risk of acquiring infectious diseases. Pneumonia is the leading cause of morbidity and mortality in this group. Risk factors include unwitnessed aspiration, sedative medication, and comorbidity. Recognition may be delayed because, in this population, pneumonia often presents without fever, cough, or dyspnea. Accurate identification of the etiologic agent is hampered because most patients cannot produce a suitable sputum specimen. It is difficult to distinguish colonization from infection. Colonization by Staphylococcus aureus and gram-negative organisms can result from aspiration of oral or gastric contents, which could lead to pneumonia. Aspiration of gastric contents also can produce aspiration pneumonitis. This condition is not infectious initially and may resolve without antibiotics. Antibiotics for the treatment of pneumonia should cover Streptococcus pneumoniae, Haemophilus influenzae, gram-negative rods, and S. aureus. Acceptable choices include quinolones or an extended-spectrum beta-lactam plus a macrolide. Treatment should last 10 to 14 days. Pneumonia is associated with significant mortality for up to two years. Dementia is related independently to the death rate within the first week after pneumonia, regardless of treatment. Prevention strategies include vaccination against S. pneumoniae and influenza on admission to the care facility. This article focuses on recent recommendations for the recognition of respiratory symptoms and criteria for the designation of probable pneumonia, and provides a guide to hospitalization, antibiotic use, and prevention.

  4. Does collaborative care help in the treatment of anxiety in primary health care?

    Directory of Open Access Journals (Sweden)

    Leonardo Moscovici

    2013-07-01

    Full Text Available Objective: Anxiety disorders represent an important part of mental health problems in primary care. This literature review seeks to find out whether collaborative care (called “matrix support” in Brazil assists the treatment of anxiety disorders and/or anxiety symptoms. Methods: We performed a literature search with no time period restriction using PubMed, ISI, and LILACS PSYCINFO databases. The descriptors sought were “collaborative care”, “shared care”, “primary care”, “anxiety”, “generalized anxiety disorder”, “panic disorder”, “phobia”, “social phobia”, “post-traumatic stress disorder”, “obsessive compulsive disorder” and “anxiety disorder, Not Otherwise Specified - NOS.” Results: A total of 106 articles were found and after the application of exclusion criteria, seven articles were selected for the present analysis. Conclusion: Despite the different types of collaborative care used, results show greater improvement in anxiety symptoms in patients that received collaborative care compared with those in the control groups, who did not receive such intervention.

  5. Dialysis Facility Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — Dialysis Facility Compare helps you find detailed information about Medicare-certified dialysis facilities. You can compare the services and the quality of care that...

  6. Charging for Ambulatory Care in Military Health Care Facilities: An Evaluation and Analysis

    Science.gov (United States)

    1983-04-25

    health care facilities, with resulting income used to subsidize CHAMPUS. This proposal, calling for $5.00 per visit as submitted by Senator Daniel...Analysis of Current Methods and Their Development," Inquiry, 16, Fall 1979, 230-246. 32 Jack Hadley, John Holahan , and William Scanlon, "Can Fee-for...other) were combined into a single category called "commercial insurance". An additional category, "Do Not Know", was added to reflect those

  7. Long-Term Care Facilities: A Cornucopia of Viral Pathogens

    Science.gov (United States)

    Falsey, Ann R.; Dallal, Gerard E.; Formica, Maria A.; Andolina, Gloria G.; Hamer, Davidson H.; Leka, Lynette L.; Meydani, Simin Nikbin

    2010-01-01

    Objectives To determine the frequency and types of respiratory viruses circulating in Boston long-term care facilities (LTCFs) during a 3-year period. Design Observational. Setting Thirty-three Boston-area LTCFs over a 3-year period. Participants Residents of long-term care who had previously participated in a trial of vitamin E supplementation and had paired serum samples available for viral analysis. Measurements Viral antibody titers to eight respiratory viruses (influenza A and B, respiratory syncytial virus (RSV), parainfluenza virus serotype three (PIV-3), PIV-2, human metapneumovirus (hMPV), and coronaviruses 229E and OC43) were measured using enzyme immunoassay at baseline and 53 weeks. Infection was defined as a more than quadrupling of viral titers. Clinical data on respiratory illnesses were collected throughout the study period. Results A total of 617 persons were enrolled in the trial. Of these, 382 (62%) had sera available for viral analysis. A total of 204 viral infections were documented in 157 subjects. Serological responses to all eight viruses were documented, with hMPV (12.8%) and coronavirus 229E (10.5%) being the most common and PIV-2 (2.4%) the least common. The occurrence of bronchitis (P = .007), pneumonia (P = .02), and any lower respiratory tract infection (P = .002) was significantly associated with having a viral diagnosis. Conclusion A wide range of respiratory viruses cocirculates in LTCFs and contributes to respiratory illness morbidity in these populations. PMID:18557966

  8. Factors promoting resident deaths at aged care facilities in Japan: a review.

    Science.gov (United States)

    Sugimoto, Kentaro; Ogata, Yasuko; Kashiwagi, Masayo

    2016-10-03

    Due to an increasingly ageing population, the Japanese government has promoted elderly deaths in aged care facilities. However, existing facilities were not designed to provide resident end-of-life care and the proportion of aged care facility deaths is currently less than 10%. Consequently, the present review evaluated the factors that promote aged care facility resident deaths in Japan from individual- and facility-level perspectives to exploring factors associated with increased resident deaths. To achieve this, MEDLINE, CINAHL, Web of Science and Ichushi databases were searched on 23 January 2016. Influential factors were reviewed for two healthcare services (insourcing and outsourcing facilities) as well as external healthcare agencies operating outside facilities. Of the original 2324 studies retrieved, 42 were included in analysis. Of these studies, five focused on insourcing, two on outsourcing, seven on external agencies and observed facility/agency-level factors. The other 28 studies identified individual-level factors related to death in aged care facilities. The present review found that at both facility and individual levels, in-facility resident deaths were associated with healthcare service provision, confirmation of resident/family end-of-life care preference and staff education. Additionally, while outsourcing facilities did not require employment of physicians/nursing staff to accommodate resident death, these facilities required visits by physicians and nursing staff from external healthcare agencies as well as residents' healthcare input. This review also found few studies examining outsourcing facilities. The number of healthcare outsourcing facilities is rapidly increasing as a result of the Japanese government's new tax incentives. Consequently, there may be an increase in elderly deaths in outsourcing healthcare facilities. Accordingly, it is necessary to identify the factors associated with residents' deaths at outsourcing facilities.

  9. [What kind of help do parents with newborns in the neonatal intensive care unit seek?].

    Science.gov (United States)

    Patiño-Masó, Josefina; Reixach-Bosch, María

    2009-01-01

    The aim of this article was to identify the kind of help that parents with newborns admitted to the neonatal intensive care unit seek from health professionals in general and from nurses specifically. Two personal interviews were conducted with the parents (father or mother) of four hospitalized neonates. The parents volunteered to participate. Through the use of previously-established, open-ended questions and under conditions facilitating a supportive relationship, the parents were interviewed by a nurse who listened actively, tried to understand, and validated their feelings. During the interview, the parents had the opportunity to express their feelings and experiences. At the same time, these interviews increased the data available on the type of help needed by parents, taking into account both nursing care planning and the type of nursing interventions to be performed in these families. The results show that most of the help required by families is related to their own needs: communication, learning and feeling occupied. We present a standardized care plan that follows the NANDA, NOC and NIC taxonomies and shows how these needs could be managed by nursing professionals, based on a supportive relationship that includes three main elements: respect, understanding, and empathy.

  10. Urgent Care Facilities, Urgent Care Facilities in Iredell County, NC, Published in 2007, 1:2400 (1in=200ft) scale, Iredell County GIS.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Urgent Care Facilities dataset, published at 1:2400 (1in=200ft) scale, was produced all or in part from Orthoimagery information as of 2007. It is described as...

  11. Care Facilities Licensed by LDHH, Geographic NAD83, LDHH (2006) [LDHH_care_facilities_06_07_full_LDHH_2006

    Data.gov (United States)

    Louisiana Geographic Information Center — A portion of the facilities licensed by the Louisiana Department of Health and Hospitals, Health Standards Section. This database includes Adult Day Cares, Adult Day...

  12. From Cure to Care: Assessing the Ethical and Professional Learning Needs of Medical Learners in a Care-Based Facility

    Science.gov (United States)

    Hall, Pippa; O'Reilly, Jane; Dojeiji, Sue; Blair, Richard; Harley, Anne

    2009-01-01

    The purpose of this study was to assess the ethical and professional learning needs of medical trainees on clinical placements at a care-based facility, as they shifted from acute care to care-based philosophy. Using qualitative data analysis and grounded theory techniques, 12 medical learners and five clinical supervisors were interviewed. Five…

  13. Oral health care in older people in long term care facilities : A systematic review of implementation strategies

    NARCIS (Netherlands)

    Weening-Verbree, L.; Huisman-de Waal, G.; van Dusseldorp, L.; van Achterberg, T.; Schoonhoven, L.

    2013-01-01

    Objectives: Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the imp

  14. Assisted Living Facilities, Licensed Health Care Facilities - assisted living facility type identified in attributes, Published in 2007, Iowa Dept. of Public Health.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, was produced all or in part from Published Reports/Deeds information as of 2007. It is described as 'Licensed Health Care...

  15. The Fracture of Relational Space in Depression: Predicaments in Primary Care Help Seeking

    Science.gov (United States)

    Bromley, Elizabeth; Kennedy, David; Miranda, Jeanne; Sherbourne, Cathy Donald; Wells, Kenneth B.

    2015-01-01

    Primary care clinicians treat the majority of cases of depression in the United States. The primary care clinic is also a site for enactment of a disease-oriented concept of depression that locates disorder within an individual body. Drawing on theories of the self and stigma, this article highlights problematics of primary care depression treatment by examining the lived experience of depression. The data come from individuals who screened positive for depressive symptoms in primary care settings and were followed over ten years. After iterative mixed-methodological exploration of a large dataset, we analyzed interviews from a purposive sample of 46 individuals using grounded and phenomenological approaches. We describe two major results. First, we note that depression is experienced as located within and inextricable from relational space and that the self is experienced as relational, rather than autonomous, in depression. Second, we describe the ways in which the experience of depression contradicts a disease-oriented concept such that help-seeking intensifies rather than alleviates the relational problem of depression. We conclude by highlighting that an understanding of illness experience may be essential to improving primary care depression treatment and by questioning the bracketing of relational concerns in depression within the construct of stigma. PMID:27990025

  16. Communities Putting Prevention to Work: Results of an Obesity Prevention Initiative in Child Care Facilities

    Science.gov (United States)

    Natale, Ruby; Camejo, Stephanie; Sanders, Lee M.

    2016-01-01

    Obesity is a significant public health issue affecting even our youngest children. Given that a significant amount of young children are enrolled in child care, the goal of this project was to evaluate the effectiveness of a child care facility-based obesity prevention program. Over 1,000 facilities participated in the study. The intervention…

  17. Development and implementation of the internal audit mechanisms to be used in the health care facilities.

    Science.gov (United States)

    Smeyanov, V; Tarasenko, S; Smeyanova, O

    2013-06-01

    Issues concerning the quality of care service improvement have become of national importance in the health-care system for both developed and developing countries. Internal audit is effective and efficient method to improve the quality of care in various health care facilities. Data from 452 outpatient cards of the case patients with arterial hypertension were analyzed, the level of awareness and patient compliance were defined. The stages of internal audit mechanisms implementation in the health care facilities were developed. As a result of medical records audit and awareness monitoring of patients with arterial hypertension ways to improve quality of medical care were defined.

  18. Breaking down silos: engaging students to help fix the US health care system

    Directory of Open Access Journals (Sweden)

    Kumarasamy MA

    2015-02-01

    Full Text Available Mathu A Kumarasamy,1 Fred P Sanfilippo1–3 1Emory–Georgia Tech Healthcare Innovation Program, 2Department of Pathology and Laboratory Medicine, School of Medicine, 3Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA Problem: The field of health care is becoming a team effort as patient care becomes increasingly complex and multifaceted. Despite the need for multidisciplinary education, there persists a lack of student engagement and collaboration among health care disciplines, which presents a growing concern as students join the workforce. Approach: In October 2013, the Emory–Georgia Tech Healthcare Innovation Program organized a student driven symposium entitled “US Healthcare: What's Broken and How to Fix It: The Student Perspective”. The symposium engaged students from multiple disciplines to work together in addressing problems associated with US health care delivery. The symposium was organized and carried out by a diverse group of student leaders from local institutions who adopted a multidisciplinary approach throughout the planning process. Outcomes: The innovative planning process leading up to the symposium revealed that many of the student-discipline groups lacked an understanding of one another's role in health care, and that students were interested in learning how to work together to leverage each other's profession. The symposium was widely attended and positively received by students and faculty from the Atlanta metropolitan area, and has since helped to promote interdepartmental collaboration and multidisciplinary education across institutions. Next steps: The student symposium will become an annual event and incorporate broader discipline representation, as well as a patient perspective. Proposals for additional institution-wide, multidisciplinary educational offerings are being addressed with the help of faculty and health care providers across the network

  19. Differences in essential newborn care at birth between private and public health facilities in eastern Uganda

    Directory of Open Access Journals (Sweden)

    Peter Waiswa

    2015-03-01

    Full Text Available Background: In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective: To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design: Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results: The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007. Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p<0.001. Women delivering in private facilities were more likely to have higher parity, lower socio-economic status, less education, to seek antenatal care later in pregnancy, and to have a normal delivery compared to women delivering in public facilities. Conclusions: In this setting, private health facilities serve a vulnerable population and provide access to service for those who might not otherwise have it. However, provision of essential newborn care practices was

  20. Older Residents' Perspectives of Long-Term Care Facilities in China.

    Science.gov (United States)

    Wang, Jing; Wang, Junqiao; Cao, Yuling; Jia, Shoumei; Wu, Bei

    2016-08-01

    China's formal long-term care (LTC) system is in its developmental stage due to lack of standardized health assessments for resident admission, limited government funding, an acute shortage of qualified staff at all levels, and regional disparities in quality of care. Relocation to LTC facilities changes the lives of older adults because they have to leave behind their homes and previous social networks. The current study aimed to provide an in-depth exploration of 25 older adult residents' lives in four LTC facilities in China. A conventional content analysis approach was used to interpret participant interviews. Residents experienced losses and gains from residential life. Three themes emerged: (a) influences of cultural beliefs, (b) basic care needs fulfilled in LTC facilities, and (c) lack of quality care in LTC facilities. Findings show that residents' basic needs were met in Chinese LTC facilities, but there is room for improvement in delivering quality care. [Journal of Gerontological Nursing, 42(8), 34-43.].

  1. Quality along the continuum: a health facility assessment of intrapartum and postnatal care in Ghana.

    Directory of Open Access Journals (Sweden)

    Robin C Nesbitt

    Full Text Available To evaluate quality of routine and emergency intrapartum and postnatal care using a health facility assessment, and to estimate "effective coverage" of skilled attendance in Brong Ahafo, Ghana.We conducted an assessment of all 86 health facilities in seven districts in Brong Ahafo. Using performance of key signal functions and the availability of relevant drugs, equipment and trained health professionals, we created composite quality categories in four dimensions: routine delivery care, emergency obstetric care (EmOC, emergency newborn care (EmNC and non-medical quality. Linking the health facility assessment to surveillance data we estimated "effective coverage" of skilled attendance as the proportion of births in facilities of high quality.Delivery care was offered in 64/86 facilities; only 3-13% fulfilled our requirements for the highest quality category in any dimension. Quality was lowest in the emergency care dimensions, with 63% and 58% of facilities categorized as "low" or "substandard" for EmOC and EmNC, respectively. This implies performing less than four EmOC or three EmNC signal functions, and/or employing less than two skilled health professionals, and/or that no health professionals were present during our visit. Routine delivery care was "low" or "substandard" in 39% of facilities, meaning 25/64 facilities performed less than six routine signal functions and/or had less than two skilled health professionals and/or less than one midwife. While 68% of births were in health facilities, only 18% were in facilities with "high" or "highest" quality in all dimensions.Our comprehensive facility assessment showed that quality of routine and emergency intrapartum and postnatal care was generally low in the study region. While coverage with facility delivery was 68%, we estimated "effective coverage" of skilled attendance at 18%, thus revealing a large "quality gap." Effective coverage could be a meaningful indicator of progress towards

  2. A new strategy for regulating long-term care facilities.

    Science.gov (United States)

    Ruchlin, H S

    1977-01-01

    This study analyzes the failure of current regulatory efforts to elicit an acceptable level of performance in long-term care facilities and proposes a strategy for correcting that failure. Seven factors are identified as being responsible for the failure of current regulatory efforts: inadequate financing, inadequate knowledge, bureaucratic apathy, legal constraints, political constraints, a fragmentation of agency responsibility, and a shortage of conforming beds. Public utility status, market regulation, and non-profit control are reviewed and rejected as alternatives to the current approach. A new strategy aimed at improving the regulatory process and environment is proposed. The process can be improved by adopting a program rather than taking a functional approach to agency organization; linking the inspection and rate-setting processes; creating a role for consumer groups in the inspection process; and exposing the process and results of regulation to public scrutiny. Five proposals are offered for improving the regulatory environment. These focus on eliminating barriers to entry, supporting alternatives to institutionalization, federalizing the Medicaid program, abandoning exclusive reliance on the medical model as the guide for regulatory standards, and changing the focus of regulation from structure-process to out-come.

  3. Uses of inorganic hypochlorite (bleach) in health-care facilities.

    Science.gov (United States)

    Rutala, W A; Weber, D J

    1997-01-01

    Hypochlorite has been used as a disinfectant for more than 100 years. It has many of the properties of an ideal disinfectant, including a broad antimicrobial activity, rapid bactericidal action, reasonable persistence in treated potable water, ease of use, solubility in water, relative stability, relative nontoxicity at use concentrations, no poisonous residuals, no color, no staining, and low cost. The active species is undissociated hypochlorous acid (HOCl). Hypochlorites are lethal to most microbes, although viruses and vegetative bacteria are more susceptible than endospore-forming bacteria, fungi, and protozoa. Activity is reduced by the presence of heavy metal ions, a biofilm, organic material, low temperature, low pH, or UV radiation. Clinical uses in health-care facilities include hyperchlorination of potable water to prevent Legionella colonization, chlorination of water distribution systems used in hemodialysis centers, cleaning of environmental surfaces, disinfection of laundry, local use to decontaminate blood spills, disinfection of equipment, decontamination of medical waste prior to disposal, and dental therapy. Despite the increasing availability of other disinfectants, hypochlorites continue to find wide use in hospitals. PMID:9336664

  4. The role of civil society in strengthening intercultural maternal health care in local health facilities: Puno, Peru

    Directory of Open Access Journals (Sweden)

    Jeannie Samuel

    2016-12-01

    Full Text Available Background and objective: Peru's Ministry of Health has made efforts to increase the cultural inclusiveness of maternal health services. In 2005, the Ministry adopted an intercultural birthing policy (IBP that authorizes and encourages the use of culturally acceptable birthing practices in government-run health facilities. However, studies suggest that indigenous women may receive inconsistent benefits from these kinds of policies. This article examines whether a grassroots accountability initiative based on citizen monitoring of local health facilities by indigenous women can help to promote the objectives of the IBP and improve intercultural maternal health care. Design: Findings are drawn from a larger qualitative research study completed in 2015 that included fieldwork done between 2010 and 2011. Semi-structured interviews were conducted with 23 women working as citizen monitors in local health facilities in Puno and 30 key informants, including frontline health workers, health officials, and civil society actors in Puno and Lima, and human rights lawyers from the Defensoría del Pueblo Office in Puno. Results: Monitors confirmed from their own personal experiences in the 1990s and early 2000s that respect for intercultural aspects of maternal health care, including traditional indigenous birthing practices, were not readily accepted in publicly funded health facilities. It was also common for indigenous women to face discrimination when seeking health service provided by the state. Although the government's adoption of the IBP in 2005 was a positive step, considerable efforts are still needed to ensure high-quality, culturally appropriate maternal health care is consistently available in local health facilities. Conclusions: Despite important progress in the past two decades, policies aimed at improving intercultural maternal health care are unevenly implemented in local health facilities. Civil society, in particular indigenous women

  5. A rapid assessment of the availability and use of obstetric care in Nigerian healthcare facilities.

    Directory of Open Access Journals (Sweden)

    Daniel O Erim

    Full Text Available BACKGROUND: As part of efforts to reduce maternal deaths in Nigeria, pregnant women are being encouraged to give birth in healthcare facilities. However, little is known about whether or not available healthcare facilities can cope with an increasing demand for obstetric care. We thus carried out this survey as a rapid and tactical assessment of facility quality. We visited 121 healthcare facilities, and used the opportunity to interview over 700 women seeking care at these facilities. FINDINGS: Most of the primary healthcare facilities we visited were unable to provide all basic Emergency Obstetric Care (bEmOC services. In general, they lack clinical staff needed to dispense maternal and neonatal care services, ambulances and uninterrupted electricity supply whenever there were obstetric emergencies. Secondary healthcare facilities fared better, but, like their primary counterparts, lack neonatal care infrastructure. Among patients, most lived within 30 minutes of the visited facilities and still reported some difficulty getting there. Of those who had had two or more childbirths, the conditional probability of a delivery occurring in a healthcare facility was 0.91 if the previous delivery occurred in a healthcare facility, and 0.24 if it occurred at home. The crude risk of an adverse neonatal outcome did not significantly vary by delivery site or birth attendant, and the occurrence of such an outcome during an in-facility delivery may influence the mother to have her next delivery outside. Such an outcome during a home delivery may not prompt a subsequent in-facility delivery. CONCLUSIONS: In conclusion, reducing maternal deaths in Nigeria will require attention to both increasing the number of facilities with high-quality EmOC capability and also assuring Nigerian women have access to these facilities regardless of where they live.

  6. The Edinburgh Malawi Cancer Partnership: helping to establish multidisciplinary cancer care in Blantyre, Malawi.

    Science.gov (United States)

    Brown, E; Gorman, D; Knowles, G; Taylor, F; Jere, Y; Bates, J; Masamba, L

    2016-03-01

    In response to the growing incidence of cancer in Malawi, a new oncology unit was established at the Queen Elizabeth Central Hospital, Blantyre. The unit opened in 2010, the first in the country, and is led by a single consultant oncologist. In 2012, a healthcare partnership was formed between the oncology and palliative care unit at Queen Elizabeth Central Hospital and the Edinburgh Cancer Centre, UK. The principal objective of the partnership is to help develop high quality multidisciplinary cancer care in Malawi. Methods A needs assessment identified three priority areas for further improvement of cancer services: nurse-led treatment delivery; management of clinical data; and multidisciplinary working. The partnership received grant funding from the Scottish Government Malawi Development Programme in 2013 and a three year project plan was implemented. This has been conducted through a series of reciprocal training visits. Results Key achievements have been completion of a programme of oncology nursing education attended by 32 oncology nurses and other healthcare professionals, which has resulted in increased experience in cancer practice and standardisation of chemotherapy delivery procedures; development of a clinical database that enables prospective collection of data of all new patients with cancer and which links to the Malawi Cancer Registry; development of weekly multidisciplinary meetings involving oncology, gynaecology and surgery that has enabled a cross-specialty approach to patient care. Conclusion The Edinburgh Malawi Cancer Partnership is supporting nursing education, data use and cross-specialty collaboration that we are confident will improve cancer care in Malawi. Future work will focus on the further development of multidisciplinary breast cancer care and the development of a radiotherapy service for patients in Malawi.

  7. Organizational factors influencing health information technology adoption in long-term-care facilities.

    Science.gov (United States)

    Wang, Tiankai; Wang, Yangmei; Moczygemba, Jackie

    2014-01-01

    Long-term care (LTC) is an important sector of the health care industry. However, the adoption of health information technology (HIT) systems in LTC facilities lags behind that in other sectors of health care. Previous literature has focused on the financial and technical barriers. This study examined the organizational factors associated with HIT adoption in LTC facilities. A survey of 500 LTC facilities in Texas enabled researchers to compile HIT indexes for further statistical analyses. A general linear model was used to study the associations between the clinical/administrative HIT indexes and organizational factors. The empirical outcomes show that the size of an LTC facility has a significant association with HIT adoption. Rural LTC facilities, especially freestanding ones, adopt less HIT than their urban counterparts, whereas freestanding LTC facilities have the lowest HIT adoption overall. There is not enough evidence to support ownership status as a significant factor in HIT adoption. Some implications are proposed, but further research is necessary.

  8. Optimizing pain care delivery in outpatient facilities: experience in NCI, Cairo, Egypt.

    Science.gov (United States)

    Hameed, Khaled Abdel

    2011-04-01

    As a result of increasing waiting lists of patients attending National Cancer Institute of Cairo, we are faced to provide high-quality pain care service through our outpatient pain clinic. The program description presented here shows the capacity of a 24 hours/7 days outpatient cancer pain management service to provide rapidly accessible, high-quality care to patients with complex pain and palliative care symptom burdens. In addition, this model avoids inpatient hospital admissions. Pain clinics of cancer are committed to helping patients and families identify and implement the treatments necessary to achieve optimum functional ability and the best possible quality of life. These clinics also help to communicate and work with the family physician, surgeon, and other physicians associated with patient treatment. Cancer pain is complex in its causes, and affects all parts of the body. It involves the tissues, body systems , and the mind. Being multidimensional, it is never adequately addressed with unidimensional treatment. Pain management must extend beyond physical approaches to include the psychological, social, and even spiritual aspects of the patient. Effective integrated treatment fosters self awareness and teaches appropriate and effective self care. With time, complex issues are managed, pain is reduced, and the patient moves toward peak physical and psychological functioning. These goals can be achieved by providing the highest quality pain management services. Patients attending the clinic get treated medically for their physical ailments. Their emotional and psychological problems also need to be attended with an atmosphere of love and care. The mission of the highest quality service is to obtain customer satisfaction with reduction of cost in a multidisciplinary (or better interdisciplinary) approach. This can be reached by proper identification of the customers either internal or external, assessing their needs, and implementing plans for their

  9. Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review.

    Science.gov (United States)

    Jusela, Cheryl; Struble, Laura; Gallagher, Nancy Ambrose; Redman, Richard W; Ziemba, Rosemary A

    2017-03-01

    HOW TO OBTAIN CONTACT HOURS BY READING THIS ARTICLE INSTRUCTIONS 1.3 contact hours will be awarded by Villanova University College of Nursing upon successful completion of this activity. A contact hour is a unit of measurement that denotes 60 minutes of an organized learning activity. This is a learner-based activity. Villanova University College of Nursing does not require submission of your answers to the quiz. A contact hour certificate will be awarded once you register, pay the registration fee, and complete the evaluation form online at http://goo.gl/gMfXaf. To obtain contact hours you must: 1. Read the article, "Communication Between Acute Care Hospitals and Skilled Nursing Facilities During Care Transitions: A Retrospective Chart Review" found on pages 19-28, carefully noting any tables and other illustrative materials that are included to enhance your knowledge and understanding of the content. Be sure to keep track of the amount of time (number of minutes) you spend reading the article and completing the quiz. 2. Read and answer each question on the quiz. After completing all of the questions, compare your answers to those provided within this issue. If you have incorrect answers, return to the article for further study. 3. Go to the Villanova website listed above to register for contact hour credit. You will be asked to provide your name; contact information; and a VISA, MasterCard, or Discover card number for payment of the $20.00 fee. Once you complete the online evaluation, a certificate will be automatically generated. This activity is valid for continuing education credit until February 29, 2020. CONTACT HOURS This activity is co-provided by Villanova University College of Nursing and SLACK Incorporated. Villanova University College of Nursing is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation. ACTIVITY OBJECTIVES 1. Discuss problematic barriers during care transitions

  10. Model Child Care Standards Act--Guidance to States to Prevent Child Abuse in Day Care Facilities.

    Science.gov (United States)

    Department of Health and Human Services, Washington, DC.

    The document offers guidelines to states regarding review and revision of child care statutes, standards, and policies to address the prevention of child sexual abuse in day care facilities. General information is also provided on changes in state standards in recent years. Each of six sections examines findings of the 1981 Comparative Licensing…

  11. Getting Help

    Science.gov (United States)

    ... Parents & Students Home > Special Features > Getting Help Getting Help Resources from NIAAA Treatment for Alcohol Problems: Finding ... and find ways to make a change. Professional help Your doctor. Primary care and mental health practitioners ...

  12. Prevention by Design: Construction and Renovation of Health Care Facilities for Patient Safety and Infection Prevention.

    Science.gov (United States)

    Olmsted, Russell N

    2016-09-01

    The built environment supports the safe care of patients in health care facilities. Infection preventionists and health care epidemiologists have expertise in prevention and control of health care-associated infections (HAIs) and assist with designing and constructing facilities to prevent HAIs. However, design elements are often missing from initial concepts. In addition, there is a large body of evidence that implicates construction and renovation as being associated with clusters of HAIs, many of which are life threatening for select patient populations. This article summarizes known risks and prevention strategies within a framework for patient safety.

  13. AAI coherence predicts caregiving and care seeking behavior: secure base script knowledge helps explain why.

    Science.gov (United States)

    Waters, Theodore E A; Brockmeyer, Susan L; Crowell, Judith A

    2013-01-01

    Previous research has demonstrated significant links between the Adult Attachment Interview (AAI) and secure base use and support in marital interactions. The mechanisms underlying such findings have not been examined in detail. This paper examines the hypothesis that script-like attachment representations shape both attachment narratives and attachment-related caregiving behavior and thus helps explain the correlation between them. Crowell et al. ( 2002 ) reported that AAI transcript coherence is significantly related to adults' caregiving and care seeking in couple problem solving interactions. In a random selection of 60 cases from that study, we assessed the extent to which interviewees conceptualized their early attachment experiences in terms of a secure base script. A series of regression analyses demonstrated that approximately 80% of the correlation between AAI coherence and laboratory caregiving and care seeking reported by Crowell et al. ( 2002 ) is accounted for by secure base script knowledge. Scoring secure base script knowledge from AAI transcripts is a useful step toward understanding links between early experience, adult attachment representations, and adults' ability to provide and seek support in close relationships.

  14. Implementing emergency manuals: can cognitive aids help translate best practices for patient care during acute events?

    Science.gov (United States)

    Goldhaber-Fiebert, Sara N; Howard, Steven K

    2013-11-01

    In this article, we address whether emergency manuals are an effective means of helping anesthesiologists and perioperative teams apply known best practices for critical events. We review the relevant history of such cognitive aids in health care, as well as examples from other high stakes industries, and describe why emergency manuals have a role in improving patient care during certain events. We propose 4 vital elements: create, familiarize, use, and integrate, necessary for the widespread, successful development, and implementation of medical emergency manuals, using the specific example of the perioperative setting. The details of each element are presented, drawing from the medical literature as well as from our combined experience of more than 30 years of observing teams of anesthesiologists managing simulated and real critical events. We emphasize the importance of training clinicians in the use of emergency manuals for education on content, format, and location. Finally, we discuss cultural readiness for change, present a system example of successful integration, and highlight the importance of further research on the implementation of emergency manuals.

  15. 75 FR 37463 - Dispensing of Controlled Substances to Residents at Long Term Care Facilities

    Science.gov (United States)

    2010-06-29

    ... Facilities With specific regard to nursing homes and other Long Term Care Facilities (LTCFs), DEA has made a... check to verify professional competence, ethics, and character. To operate a hospital, States generally... extent to which registered nurses (rather than licensed practical nurses or nursing assistants)...

  16. Coverage and quality of antenatal care provided at primary health care facilities in the 'Punjab' province of 'Pakistan'.

    Directory of Open Access Journals (Sweden)

    Muhammad Ashraf Majrooh

    Full Text Available BACKGROUND: Antenatal care is a very important component of maternal health services. It provides the opportunity to learn about risks associated with pregnancy and guides to plan the place of deliveries thereby preventing maternal and infant morbidity and mortality. In 'Pakistan' antenatal services to rural population are being provided through a network of primary health care facilities designated as 'Basic Health Units and Rural Health Centers. Pakistan is a developing country, consisting of four provinces and federally administered areas. Each province is administratively subdivided in to 'Divisions' and 'Districts'. By population 'Punjab' is the largest province of Pakistan having 36 districts. This study was conducted to assess the coverage and quality antenatal care in the primary health care facilities in 'Punjab' province of 'Pakistan'. METHODS: Quantitative and Qualitative methods were used to collect data. Using multistage sampling technique nine out of thirty six districts were selected and 19 primary health care facilities of public sector (seventeen Basic Health Units and two Rural Health Centers were randomly selected from each district. Focus group discussions and in-depth interviews were conducted with clients, providers and health managers. RESULTS: The overall enrollment for antenatal checkup was 55.9% and drop out was 32.9% in subsequent visits. The quality of services regarding assessment, treatment and counseling was extremely poor. The reasons for low coverage and quality were the distant location of facilities, deficiency of facility resources, indifferent attitude and non availability of the staff. Moreover, lack of client awareness about importance of antenatal care and self empowerment for decision making to seek care were also responsible for low coverage. CONCLUSION: The coverage and quality of the antenatal care services in 'Punjab' are extremely compromised. Only half of the expected pregnancies are enrolled and

  17. Can We Help Care Providers Communicate More Effectively With Persons Having Dementia Living in Long-Term Care Homes?

    Science.gov (United States)

    Rochon, Elizabeth; Sidani, Souraya; Shaw, Alexander; Ben-David, Boaz M.; Saragosa, Marianne; Boscart, Veronique M.; Wilson, Rozanne; Galimidi-Epstein, Karmit K.

    2016-01-01

    Background: Effective communication between residents with dementia and care providers in long-term care homes (LTCHs) is essential to resident-centered care. Purpose: To determine the effects of a communication intervention on residents’ quality of life (QOL) and care, as well as care providers’ perceived knowledge, mood, and burden. Method: The intervention included (1) individualized communication plans, (2) a dementia care workshop, and (3) a care provider support system. Pre- and postintervention scores were compared to evaluate the effects of the intervention. A total of 12 residents and 20 care providers in an LTCH participated in the feasibility study. Results: The rate of care providers’ adherence to the communication plans was 91%. Postintervention, residents experienced a significant increase in overall QOL. Care providers had significant improvement in mood and perceived reduced burden. Conclusion: The results suggest that the communication intervention demonstrates preliminary evidence of positive effects on residents’ QOL and care providers’ mood and burden. PMID:27899433

  18. Rapid assessment of infrastructure of primary health care facilities – a relevant instrument for health care systems management

    OpenAIRE

    2015-01-01

    Background Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health informatio...

  19. Supply-side barriers to maternity-care in India: a facility-based analysis.

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    Full Text Available BACKGROUND: Health facilities in many low- and middle-income countries face several types of barriers in delivering quality health services. Availability of resources at the facility may significantly affect the volume and quality of services provided. This study investigates the effect of supply-side determinants of maternity-care provision in India. METHODS: Health facility data from the District-Level Household Survey collected in 2007-2008 were analyzed to explore the effects of supply-side factors on the volume of delivery care provided at Indian health facilities. A negative binomial regression model was applied to the data due to the count and over-dispersion property of the outcome variable (number of deliveries performed at the facility. RESULTS: Availability of a labor room (Incidence Rate Ratio [IRR]: 1.81; 95% Confidence Interval [CI]: 1.68-1.95 and facility opening hours (IRR: 1.43; CI: 1.35-1.51 were the most significant predictors of the volume of delivery care at the health facilities. Medical and paramedical staff were found to be positively associated with institutional deliveries. The volume of deliveries was also higher if adequate beds, essential obstetric drugs, medical equipment, electricity, and communication infrastructures were available at the facility. Findings were robust to the inclusion of facility's catchment area population and district-level education, health insurance coverage, religion, wealth, and fertility. Separate analyses were performed for facilities with and without a labor room and results were qualitatively similar across these two types of facilities. CONCLUSIONS: Our study highlights the importance of supply-side barriers to maternity-care India. To meet Millennium Development Goals 4 and 5, policymakers should make additional investments in improving the availability of medical drugs and equipment at primary health centers (PHCs in India.

  20. Investigating Preterm Care at the Facility Level: Stakeholder Qualitative Study in Central and Southern Malawi.

    Science.gov (United States)

    Gondwe, Austrida; Munthali, Alister; Ashorn, Per; Ashorn, Ulla

    2016-07-01

    Objectives Malawi is estimated to have one of the highest preterm birth rates in the world. However, care of preterm infants at facility level in Malawi has not been explored. We aimed to explore the views of health stakeholders about the care of preterm infants in health facilities and the existence of any policy protocol documents guiding the delivery of care to these infants. Methods We conducted 16 in-depth interviews with health stakeholders (11 service providers and 5 policy makers) using an interview guide and asked for any existing policy protocol documents guiding care for preterm infants in the health facilities in Malawi. The collected documents were reviewed and all the interviews were digitally recorded, transcribed and translated. All data were analysed using content analysis approach. Results We identified four policy protocol documents and out of these, one had detailed information explaining the care of preterm infants. Policy makers reported that policy protocol documents to guide care for preterm infants were available in the health facilities but majority (63.6 %) of the service providers lacked knowledge about the existence of these documents. Health stakeholders reported several challenges in caring for preterm infants including lack of trained staff in preterm infant care, antibiotics, space, supervision and poor referral system. Conclusions Our study highlights that improving health care service provider knowledge of preterm infant care is an integral part in preterm child birth. Our findings suggests that policy makers and health decision makers should retain those trained in preterm new born care in the health facility's preterm unit.

  1. Unaccompanied minors in the Netherlands and the care facility in which they flourish best

    NARCIS (Netherlands)

    Kalverboer, Margrite; Zijlstra, Angenietha; van Os, Carla; Zevulun, Daniëlle; ten Brummelaar, Mijntje; Beltman, Daan

    2016-01-01

    Abstract This study compares the views of unaccompanied minors living in four different types of care facilities in the Netherlands: namely in foster care, small living units, children's living groups and campuses on their wellbeing, living circumstances and place in Dutch society. Interviews with 1

  2. Parkinson Disease in Long Term Care Facilities : A Review of the Literature

    NARCIS (Netherlands)

    Weerkamp, Nico J.; Tissingh, Gerrit; Poels, Petra J. E.; Zuidema, Syste U.; Munneke, Marten; Koopmans, Raymond T. C. M.; Bloem, Bastiaan R.

    2014-01-01

    Parkinson disease (PD) is common in long term care (LTC) facilities. The number of institutionalized patients with PD will rise sharply in the coming decades because of 2 concurrent phenomena: aging of the population leads to an increased PD prevalence and improved quality of care has led to a prolo

  3. Educational Needs of Health Care Providers Working in Long-Term Care Facilities with Regard to Pain Management

    Directory of Open Access Journals (Sweden)

    Yannick Tousignant-Laflamme

    2012-01-01

    Full Text Available BACKGROUND: The prevalence of chronic pain ranges from 40% to 80% in long-term care facilities (LTCF, with the highest proportion being found among older adults and residents with dementia. Unfortunately, pain in older adults is underdiagnosed, undertreated, inadequately treated or not treated at all. A solution to this problem would be to provide effective and innovative interdisciplinary continuing education to health care providers (HCPs.

  4. Should the provision of home help services be contained?: Validation of the new preventive care policy in Japan

    Directory of Open Access Journals (Sweden)

    Ishibashi Tomoaki

    2010-08-01

    Full Text Available Abstract Background To maintain the sustainability of public long-term care insurance (LTCI in Japan, a preventive care policy was introduced in 2006 that seeks to promote active improvement in functional status of elderly people who need only light care. This policy promotes the use of day care services to facilitate functional improvement, and contains the use of home help services that provide instrumental activity of daily living (IADL support. However, the validity of this approach remains to be demonstrated. Methods Subjects comprised 241 people aged 65 years and over who had recently been certified as being eligible for the lightest eligibility level and had began using either home help or day care services between April 2007 and October 2008 in a suburban city of Tokyo. A retrospective cohort study was conducted ending October 2009 to assess changes in the LTCI eligibility level of these subjects. Cox's proportional hazards model was used to calculate the relative risk of declining in function to eligibility Level 4 among users of the respective services. Results Multivariate analysis adjusted for factors related to service use demonstrated that the risk of decline in functional status was lower for users of home help services than for users of day care services (HR = 0.55, 95% CI: 0.31-0.98. The same result was obtained when stratified by whether the subject lived with family or not. Furthermore, those who used two or more hours of home help services did not show an increase in risk of decline when compared with those who used less than two hours. Conclusions No evidence was obtained to support the effectiveness of the policy of promoting day care services and containing home help services for those requiring light care.

  5. Quality of Tuberculosis Care in Private Health Facilities of Addis Ababa, Ethiopia

    Directory of Open Access Journals (Sweden)

    Gezahegn Gebrekidan

    2014-01-01

    Full Text Available Ensuring provision of good quality tuberculosis (TB care, especially in private for profit health facilities, is an important component of TB control strategy to reduce poor medical practice which results in multidrug resistant TB (MDR-TB. The aim of this study was to investigate quality of TB care in private health facilities of Addis Ababa. A facility based cross-sectional study was conducted based on Donabedian’s structure-process-outcome model of health care quality. Quality of care was determined by adherence to National TB Program guidelines, treatment success rate, and client satisfaction. Exit interview was conducted on 292 patients on the intensive phase of treatment and 384 patient records were reviewed in eight private health facilities. Initial diagnostic AFB test was done for 95.4% of pulmonary TB patients. Most important components of TB care recommended by national guidelines were delivered for a significant proportion of patients. Majority (75% of the clients were found to be satisfied with each component of TB care. The treatment success rate was 90.9%. The quality of TB care was fairly good. However, only 77.7% of the patients were counseled for HIV testing. Strengthening HIV counseling and testing, tackling shortage of streptomycin and laboratory reagent at private TB clinic is crucial.

  6. Use of Antiviral Prophylaxis in Influenza Outbreaks in Long Term Care Facilities

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    Allison McGeer

    2000-01-01

    Full Text Available Influenza is a major cause of illness and death in residents of long term care facilities for the elderly, in part because residents' age and underlying illness increase the risk of serious complications, and in part because institutional living increases the risk of influenza outbreaks. The administration of antiviral medications active against influenza to persons exposed to influenza has been shown to protect them effectively from illness, and mass antiviral prophylaxis of residents is an effective means of terminating influenza A outbreaks in long term care facilities. The only antiviral currently licensed in Canada for influenza prophylaxis is amantadine, a medication active against influenza A but not influenza B. The National Advisory Committee on Immunization recommends that amantadine prophylaxis be offered to residents when influenza A outbreaks occur in long term care facilities. However, there remain a number of unanswered questions about how best to use amantadine for controlling influenza A outbreaks in long term care facilities. In addition, two members of a new class of antivirals called neuraminidase inhibitors have recently been licensed in Canada for the treatment of influenza, and are effective in prophylaxis. Issues in the use of amantadine in the control of outbreaks of influenza A in long term care facilities for the elderly are reviewed, and the potential uses of neuraminidase inhibitors in this setting are discussed.

  7. Enhancing the sustainability and climate resiliency of health care facilities: a comparison of initiatives and toolkits.

    Science.gov (United States)

    Balbus, John; Berry, Peter; Brettle, Meagan; Jagnarine-Azan, Shalini; Soares, Agnes; Ugarte, Ciro; Varangu, Linda; Prats, Elena Villalobos

    2016-09-01

    Extreme weather events have revealed the vulnerability of health care facilities and the extent of devastation to the community when they fail. With climate change anticipated to increase extreme weather and its impacts worldwide-severe droughts, floods, heat waves, and related vector-borne diseases-health care officials need to understand and address the vulnerabilities of their health care systems and take action to improve resiliency in ways that also meet sustainability goals. Generally, the health sector is among a country's largest consumers of energy and a significant source of greenhouse gas emissions. Now it has the opportunity lead climate mitigation, while reducing energy, water, and other costs. This Special Report summarizes several initiatives and compares three toolkits for implementing sustainability and resiliency measures for health care facilities: the Canadian Health Care Facility Climate Change Resiliency Toolkit, the U.S. Sustainable and Climate Resilient Health Care Facilities Toolkit, and the PAHO SMART Hospitals Toolkit of the World Health Organization/Pan American Health Organization. These tools and the lessons learned can provide a critical starting point for any health system in the Americas.

  8. Referral of children seeking care at private health facilities in Uganda

    DEFF Research Database (Denmark)

    Mbonye, Anthony K.; Buregyeya, Esther; Rutebemberwa, Elizeus

    2017-01-01

    Background In Uganda, referral of sick children seeking care at public health facilities is poor and widely reported. However, studies focusing on the private health sector are scanty. The main objective of this study was to assess referral practices for sick children seeking care at private health...... children to higher levels of care in the two weeks prior to the survey. The main constraints to follow referral advice as perceived by caretakers were: not appreciating the importance of referral, gender-related decision-making and negotiations at household level, poor quality of care at referral...

  9. Assessment of disease profiles and drug prescribing patterns of health care facilities in Edo State, Nigeria

    Directory of Open Access Journals (Sweden)

    Ehijie F.O. Enato

    2012-10-01

    Full Text Available Few studies have systematically characterized drug-prescribing patterns, particularly at the primary care level in Nigeria, a country disproportionately burdened with disease. The aim of this study was to assess the disease profiles and drug-prescribing pattern in two health care facilities in Edo State, Nigeria. The medical records of 495 patients who attended a primary or secondary health care facility in Owan-East Local Government Area of Edo State, Nigeria, between June and November 2009 were reviewed. Disease profiles and drug prescribing patterns were assessed. Data were analyzed based on the World Health Organization Anatomic Therapeutic Chemical classification system, and core drug prescribing indicators. Five hundred and twelve clinical conditions were identified. Infectious disease was most prevalent (38.3%, followed by disorder of the alimentary tract (16.4%. Malaria was responsible for 55.6% of the infectious diseases seen, and 21.3% (109/512 of the total clinical conditions managed at the two health facilities during the study period. Consequently, anti-infective medications were the most frequently prescribed medicines (21.5%, followed by vitamins (18.2%. Use of artesunate monotherapy at both facilities (15.7%, and chloroquine at the primary health facility (24.9% were common. Paracetamol (41.8% and non-steroidal anti-inflammatory drugs (24.9% were the most frequently used analgesic/antipyretic. At the primary health care facility, dipyrone was used in 21.6% of cases. The core drug prescribing use indicators showed inappropriate prescribing, indicating poly-pharmacy, overuse of antibiotics and injectio. Inappropriate drug use patterns were identified at both health care facilities, especially with regard to the use of ineffective antimalarial drugs and the use of dipyrone.

  10. Self-care/self-help strategies for persons with Ménière’s disease: a systematic review

    Directory of Open Access Journals (Sweden)

    Long AF

    2015-11-01

    Full Text Available Andrew F Long,1 Alison Brettle2 1Health Systems Research, School of Healthcare, University of Leeds, Leeds, UK; 2School of Nursing, Midwifery and Social Work, University of Salford, Salford, UK Abstract: In recent years, health care practitioners and researchers have become increasingly interested in finding ways to help persons with long-standing health problems cope and live their everyday lives. This article presents the findings of the first systematic review of empirical research on the self-care strategies that persons with one such condition, Ménière’s disease (MD, find helpful. It aims to provide evidence-informed guidance to persons with MD on self-help/self-care approaches they might pursue. Searches were undertaken on three databases (MEDLINE, CINAHL, and PsycINFO, locating 239 potentially relevant references relating to MD or symptoms associated with the condition. Following a screening and critical appraisal process undertaken by the authors, eight papers were included in the review and were judged to be of high or good quality. The papers were synthesized in a narrative form, with individual papers summarized in evidence tables. No single self-help/self-care strategy or coping mechanism was evident. The review found evidence of the potential of a diverse range of helpful self-care approaches, including a cognitive behavioral therapy–self-help intervention, changes in lifestyle, developing and adopting positive approaches and/or avoidance of precipitating factors, and complementary and alternative medicine. The key message, for persons with MD and their caring health practitioners, is to become aware of the multiplicity of potential strategies and to try with support from others to "find what works, why and how" for themselves in their own psycho-socio-cultural lifeworld. More research is needed to examine people’s search for self-care strategies and obtain insight into how and why these work for them, drawing on notions of

  11. Dual indices for prioritizing investment in decentralized HIV services at Nigerian primary health care facilities.

    Science.gov (United States)

    Fronczak, Nancy; Oyediran, Kola' A; Mullen, Stephanie; Kolapo, Usman M

    2016-04-01

    Decentralizing health services, including those for HIV prevention and treatment, is one strategy for maximizing the use of limited resources and expanding treatment options; yet few methods exist for systematically identifying where investments for service expansion might be most effective, in terms of meeting needs and rapid availability of improved services. The Nigerian Government, the United States Government under the President's Emergency Plan for AIDS Relief (PEPFAR) program and other donors are expanding services for prevention of mother-to-child transmission (PMTCT) of HIV to primary health care facilities in Nigeria. Nigerian primary care facilities vary greatly in their readiness to deliver HIV/AIDS services. In 2012, MEASURE Evaluation assessed 268 PEPFAR-supported primary health care facilities in Nigeria and developed a systematic method for prioritizing these facilities for expansion of PMTCT services. Each assessed facility was scored based on two indices with multiple, weighted variables: one measured facility readiness to provide PMTCT services, the other measured local need for the services and feasibility of expansion. These two scores were compiled and the summary score used as the basis for prioritizing facilities for PMTCT service expansion. The rationale was that using need and readiness to identify where to expand PMTCT services would result in more efficient allocation of resources. A review of the results showed that the indices achieved the desired effect-that is prioritizing facilities with high need even when readiness was problematic and also prioritizing facilities where rapid scale-up was feasible. This article describes the development of the two-part index and discusses advantages of using this approach when planning service expansion. The authors' objective is to contribute to development of methodologies for prioritizing investments in HIV, as well as other public health arenas, that should improve cost-effectiveness and

  12. 75 FR 65515 - NRC Corporation, USPS Help Desk of Customer Care Center, Including On-Site Leased Workers of Volt...

    Science.gov (United States)

    2010-10-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF LABOR Employment and Training Administration NRC Corporation, USPS Help Desk of Customer Care Center, Including On-Site Leased Workers of Volt Consulting, West Columbia, SC; Notice of Affirmative...

  13. Continuing in Foster Care Beyond Age 18: How Courts Can Help. Issue Brief 116

    Science.gov (United States)

    Peters, Clark; Bell, Katie S. Claussen; Zinn, Andrew; Goerge, Robert M.; Courtney, Mark E.

    2008-01-01

    Research has found that foster youth who remain in care beyond age 18 are more likely to participate in services and tend to have better outcomes than those who do not. However, not all youth eligible to remain in care beyond age 18 do so. This study examines Illinois, one of the few states that extends care up to age 21, to identify the major…

  14. Defense Health: Actions Needed to Help Ensure Combat Casualty Care Research Achieves Goals

    Science.gov (United States)

    2013-02-01

    Department of Health and Human Services JPC -6 Joint Program Committee for Combat Casualty Care MRMC Army Medical Research and...and development.) Note: The JPC -6 includes representatives from each military service (Army, Navy, Air Force, and Marine Corps) and is chartered...care, which is managed by the Joint Program Committee for Combat Casualty Care ( JPC -6). The JPC -6 includes representatives from the DOD biomedical

  15. [The guideline Oral Health Care for dependent residents in long term care facilities, 2007: dire necessity!

    NARCIS (Netherlands)

    Putten, GJ van der; Visschere, L De; Obbergen, J. van; Schols, J.G.J.H.; Baat, C. de

    2008-01-01

    The oral health status of residents in Dutch nursing homes is rather poor, especially of those depending on caregivers for their oral health care. Moreover, when care dependency is rising, the provision of good oral health care becomes more difficult. With more elderly people still having (parts of)

  16. Prevalence of oral pain and barriers to use of emergency oral care facilities among adult Tanzanians

    Directory of Open Access Journals (Sweden)

    Kahabuka Febronia

    2008-09-01

    Full Text Available Abstract Background Oral pain has been the major cause of the attendances in the dental clinics in Tanzania. Some patients postpone seeing the dentist for as long as two to five days. This study determines the prevalence of oral pain and barriers to use of emergency oral care in Tanzania. Methods Questionnaire data were collected from 1,759 adult respondents aged 18 years and above. The study area covered six urban and eight rural study clusters, which had been selected using the WHO Pathfinder methodology. Chi-square tests and logistic regression analyses were performed to identify associations. Results Forty two percent of the respondents had utilized the oral health care facilities sometimes in their lifetime. About 59% of the respondents revealed that they had suffered from oral pain and/or discomfort within the twelve months that preceded the study, but only 26.5% of these had sought treatment from oral health care facilities. The reasons for not seeking emergency care were: lack of money to pay for treatment (27.9%; self medication (17.6%; respondents thinking that pain would disappear with time (15.7%; and lack of money to pay for transport to the dental clinic (15.0%. Older adults were more likely to report that they had experienced oral pain during the last 12 months than the younger adults (OR = 1.57, CI 1.07–1.57, P dental clinics far from home (OR = 5.31, CI = 2.09–13.54, P and being treated by traditional healer (OR = 5.31, CI = 2.25–12.49, P as reasons for not seeking emergency care from the oral health care facilities than their counterparts from urban areas. Conclusion Oral pain and discomfort were prevalent among adult Tanzanians. Only a quarter of those who experienced oral pain or discomfort sought emergency oral care from oral health care facilities. Self medication was used as an alternative to using oral care facilities mainly by rural residents. Establishing oral care facilities in rural areas is recommended.

  17. Epidemiological investigation of a norovirus GII.4 Sydney outbreak in a China elder care facility.

    Science.gov (United States)

    Zheng, Qing-ming; Zeng, Hua-tang; Dai, Chuan-wen; Zhang, Shun-xiang; Zhang, Zhen; Mei, Shu-jiang; He, Ya-qing; Ma, Han-wu

    2015-01-01

    An outbreak of norovirus GII.4/Sydney_2012 affected a China elder care facility in December 2012. A total of 39 elderly people and staff met the outbreak case definition. The attack rates in the elderly and the staff were 15.9% (31/195) and 23.2% (19/82), respectively, including 13 asymptomatic cases in the staff. The result of gene sequencing revealed that the outbreak was caused by norovirus GII.4 Sydney. The mode of transmission of this outbreak was proven to be person-to-person. The first case (a self-cared elder) was affected outside the elder care facility and was not isolated after returning. Norovirus was transmitted via close contact among the self-cared elderly. Then, through service-related close contact, the attendants promoted the cross-transmission between the self-cared elderly and the nursed elderly. The virus was also spread among the staff via daily contact. In the elder care facility, the asymptomatic cases in the attendants played an important role in the transmission of norovirus, which deserves high attention.

  18. Violence towards health care workers in a Public Health Care Facility in Italy: a repeated cross-sectional study

    Directory of Open Access Journals (Sweden)

    Magnavita Nicola

    2012-05-01

    Full Text Available Abstract Background Violence at work is one of the major concerns in health care activities. The aim of this study was to identify the prevalence of physical and non-physical violence in a general health care facility in Italy and to assess the relationship between violence and psychosocial factors, thereby providing a basis for appropriate intervention. Methods All health care workers from a public health care facility were invited to complete a questionnaire containing questions on workplace violence. Three questionnaire-based cross-sectional surveys were conducted. The response rate was 75 % in 2005, 71 % in 2007, and 94 % in 2009. The 2009 questionnaire contained the VIF (Violent Incident Form for reporting violent incidents, the DCS (demand/control/support model for job strain, the Colquitt 20 item questionnaire for perceived organizational justice, and the GHQ-12 General Health Questionnaire for the assessment of mental health. Results One out of ten workers reported physical assault, and one out of three exposure to non-physical violence in the workplace in the previous year. Nurses and physicians were the most exposed occupational categories, whereas the psychiatric and emergency departments were the services at greatest risk of violence. Workers exposed to non-physical violence were subject to high job strain, low support, low perceived organizational justice, and high psychological distress. Conclusion Our study shows that health care workers in an Italian local health care facility are exposed to violence. Workplace violence was associated with high demand and psychological disorders, while job control, social support and organizational justice were protective factors.

  19. Culturally Competent Palliative and Hospice Care Training for Ethnically Diverse Staff in Long-Term Care Facilities.

    Science.gov (United States)

    Kataoka-Yahiro, Merle R; McFarlane, Sandra; Koijane, Jeannette; Li, Dongmei

    2016-03-29

    Between 2013 and 2030, older adults 65 years and older of racial/ethnic populations in the U.S. is projected to increase by 123% in comparison to the Whites (Non-Hispanics). To meet this demand, training of ethnically diverse health staff in long-term care facilities in palliative and hospice care is imperative. The purpose of this study was to evaluate a palliative and hospice care training of staff in two nursing homes in Hawaii - (a) to evaluate knowledge and confidence over three time periods, and (b) to compare staff and family caregiver satisfaction at end of program. The educational frameworks were based on cultural and communication theories. Fifty-two ethnically diverse staff, a majority being Asian (89%), participated in a 10-week module training and one 4 hour communication skills workshop. Staff evaluation included knowledge and confidence surveys, pre- and post-test knowledge tests, and FAMCARE-2 satisfaction instrument. There were nine Asian (89%) and Pacific Islander (11%) family caregivers who completed the FAMCARE-2 satisfaction instrument. The overall staff knowledge and confidence results were promising. The staff rated overall satisfaction of palliative care services lower than the family caregivers. Implications for future research, practice, and education with palliative and hospice care training of ethnically diverse nursing home staff is to include patient and family caregiver satisfaction of palliative and hospice care services, evaluation of effectiveness of cross-cultural communication theories in palliative and hospice care staff training, and support from administration for mentorship and development of these services in long term care facilities.

  20. Adjusting to motherhood: maternity care assistance during the postpartum period: how to help new mothers cope.

    NARCIS (Netherlands)

    Wiegers, T.A.

    2006-01-01

    The overall aim of postpartum care is to detect health problems of the mother and/or baby at an early stage, to encourage breastfeeding and to give families a good start. This paper presents an overview of recent literature about postpartum care in several developed countries and elaborates on the D

  1. Puppy Love. Animal Care Helps Los Angeles Middle Schoolers Practice Patience and Cooperation.

    Science.gov (United States)

    Pollyea, Alexandra

    1997-01-01

    Describes Teaching Love and Compassion (TLC), a program designed to teach patience, respect, and cooperation to middle school students as they learn to care for and train dogs. TLC graduates can continue in a Peer Leadership program to train other dogs or teach elementary school students about animal care. (SLD)

  2. Oral health champions in long-term care facilities-a pilot study.

    Science.gov (United States)

    Amerine, Carol; Boyd, Linda; Bowen, Denise M; Neill, Karen; Johnson, Tara; Peterson, Teri

    2014-01-01

    This preintervention/postintervention pilot study examined impact of onsite support by a dental hygiene champion (DHC) on oral health and quality of life (QOL) of elderly residents in three long-term care facilities (LTCFs) in Arkansas. Oral health and oral health-related QOL were operationalized using the Oral Health Assessment Tool (OHAT) and Geriatric Oral Health Assessment Index (GOHAI), respectively. CNAs in Facility A received standardized oral health education/materials with onsite DHC support. Facility B received education/materials only. Facility C served as control. Data analyses included Wilcoxon-signed rank tests (OHAT) and repeated measures ANOVA (GOHAI) (p ≤ .05). OHAT postintervention data in Facility A showed significant improvements in three measured areas (tongue health, denture status, and oral cleanliness); in Facility B, one area (tongue health); and none in Facility C. No significant differences were found in GOHAI scores across facilities. Findings suggest that the presence of DHCs in LTCFs may positively impact the oral health of CNA-assisted residents.

  3. Insomnia, Sleepiness, and Depression in Adolescents Living in Residential Care Facilities

    Science.gov (United States)

    Moreau, Vincent; Belanger, Lynda; Begin, Gilles; Morin, Charles M.

    2009-01-01

    The main objective of this study was to document sleep patterns and disturbances reported by youths temporarily living in residential care facilities. A secondary objective was to examine the relationships between sleep disturbances and mood and daytime sleepiness. A self-reported questionnaire on sleep patterns and habits assessing duration,…

  4. [3D printing in health care facilities: What legislation in France?].

    Science.gov (United States)

    Montmartin, M; Meyer, C; Euvrard, E; Pazart, L; Weber, E; Benassarou, M

    2015-11-01

    Health care facilities more and more use 3D printing, including making their own medical devices (MDs). However, production and marketing of MDs are regulated. The goal of our work was to clarify what is the current French regulation that should be applied concerning the production of custom-made MDs produced by 3D printing in a health care facility. MDs consist of all devices used for diagnosis, prevention, or treatment of diseases in patients. Prototypes and anatomic models are not considered as MDs and no specific laws apply to them. Cutting guides, splints, osteosynthesis plates or prosthesis are MDs. In order to become a MD manufacturer in France, a health care facility has to follow the requirements of the 93/42/CEE directive. In addition, custom-made 3D-printed MDs must follow the annex VIII of the directive. This needs the writing of a declaration of conformity and the respect of the essential requirements (proving that a MD is secure and conform to what is expected), the procedure has to be qualified, a risk analysis and a control of the biocompatibility of the material have to be fulfilled. The documents proving that these rules have been respected have to be available. Becoming a regulatory manufacturer of MD in France is possible for a health care facility but the specifications have to be respected.

  5. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    DEFF Research Database (Denmark)

    Ahiabu, Mary-Anne; Tersbøl, Britt Pinkowski; Biritwum, Richard

    2016-01-01

    assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern...

  6. Post-Acute Care Facility as a Discharge Destination for Patients in Need of Palliative Care in Brazil.

    Science.gov (United States)

    Soares, Luiz Guilherme L; Japiassu, André M; Gomes, Lucia C; Pereira, Rogéria

    2017-01-01

    Patients with complex palliative care needs can experience delayed discharge, which causes an inappropriate occupancy of hospital beds. Post-acute care facilities (PACFs) have emerged as an alternative discharge destination for some of these patients. The aim of this study was to investigate the frequency of admissions and characteristics of palliative care patients discharged from hospitals to a PACF. We conducted a retrospective analysis of PACF admissions between 2014 and 2016 that were linked to hospital discharge reports and electronic health records, to gather information about hospital-to-PACF transitions. In total, 205 consecutive patients were discharged from 6 different hospitals to our PACF. Palliative care patients were involved in 32% (n = 67) of these discharges. The most common conditions were terminal cancer (n = 42, 63%), advanced dementia (n = 17, 25%), and stroke (n = 5, 8%). During acute hospital stays, patients with cancer had significant shorter lengths of stay (13 vs 99 days, P = .004), a lower use of intensive care services (2% vs 64%, P care. Further studies are necessary to understand the trajectory of posthospitalized patients with life-limiting illnesses and what factors influence their decision to choose a PACF as a discharge destination and place of death. We advocate that palliative care should be integrated into the portfolio of post-acute services.

  7. Simply the best: teaching gerontological nursing students to teach evidence-based practice. Creating tip sheets can help achieve the goal of implementing EBP in clinical facilities.

    Science.gov (United States)

    Schoenfelder, Deborah Perry

    2007-08-01

    This article describes a teaching strategy used in an undergraduate gerontological nursing clinical course to familiarize students with evidence-based practice. Students are required to read and summarize an assigned evidence-based practice guideline published by The University of Iowa Gerontological Nursing Interventions Research Center. They then develop a "tip sheet," based on the assigned guideline, to disseminate to health care staff at their practicum sites, which is either a long-term care facility or a hospital-based skilled nursing facility. Nursing students' reactions to the assignment and nursing staff's responses to the tip sheets are discussed.

  8. Hamilton Park Care Facility, Balrothery, Balbriggan, Co. Dublin.

    LENUS (Irish Health Repository)

    Feeney, Sinéad

    2016-02-01

    High rates of psychological distress, depression and suicide have been reported among doctors. Furthermore, many doctors do not access healthcare by conventional means. This study aimed to increase understanding regarding non-consultant hospital doctors\\' (NCHDs\\') response to stress and barriers to accessing supports, and identify possible solutions. Medical manpower departments in 58 hospitals distributed a 25-item questionnaire to 4,074 NCHDs; we received 707 responses (response rate, 17.4%). 60% of NCHDs were unable to take time off work when unwell; \\'letting teammates down\\' (90.8%) and \\'difficulty covering call\\' (85.9%) were the leading reasons. \\'Being too busy\\' (85%), \\'self-prescription\\' (66.6%) and \\'self-management\\' (53.1%) were ranked highest in deterring NCHDs from visiting a general practitioner (GP). 22.9% of NCHDs would not attend a GP with anxiety or depression until they began to feel hopeless, helpless or suicidal. 12.2% would not seek help at all. 55% of respondents (n = 330) had to move away from partners or dependants due to work, negatively affecting the social supports of 82.9%. Possible practical solutions were explored. NCHDS are a vulnerable population and have a particularly challenging lifestyle. Key recommendations include improved GP and counselling access for NCHDs, and addressing the culture of self-treatment and poor health behaviours through undergraduate and postgraduate education.

  9. Diabetes: Good Diabetes Management and Regular Foot Care Help Prevent Severe Foot Sores

    Science.gov (United States)

    ... diabetes care is probably why the rates of lower limb amputations have gone down by more than 50 ... and teach you how to use an artificial (prosthetic) limb, wheelchair or other devices to improve your ...

  10. Taking care of business: self-help and sleep medicine in american corporate culture.

    Science.gov (United States)

    Brown, Megan

    2004-01-01

    This article argues that corporate management in the United States has expanded its scope beyond office walls and encompasses many aspects of workers' daily lives. One new element of corporate training is the micromanagement of sleep; self-help books, newspaper reports, magazine articles, and consulting firms currently advise workers and supervisors on optimizing productivity by cultivating certain sleep habits. Although consultants and self-help books make specific recommendations about sleep, most medical research is inconclusive about sleep's benefits for human performance. Using the ideas of Michel Foucault and Gilles Deleuze as a philosophical backdrop, this article examines the complex and often contradictory links between self-help, medicine, and corporate governance.

  11. Alignment between chronic disease policy and practice: case study at a primary care facility.

    Directory of Open Access Journals (Sweden)

    Claire A Draper

    Full Text Available Chronic disease is by far the leading cause of death worldwide and of increasing concern in low- and middle-income countries, including South Africa, where chronic diseases disproportionately affect the poor living in urban settings. The Provincial Government of the Western Cape (PGWC has prioritized the management of chronic diseases and has developed a policy and framework (Adult Chronic Disease Management Policy 2009 to guide and improve the prevention and management of chronic diseases at a primary care level. The aim of this study is to assess the alignment of current primary care practices with the PGWC Adult Chronic Disease Management policy.One comprehensive primary care facility in a Cape Town health district was used as a case study. Data was collected via semi-structured interviews (n = 10, focus groups (n = 8 and document review. Participants in this study included clinical staff involved in chronic disease management at the facility and at a provincial level. Data previously collected using the Integrated Audit Tool for Chronic Disease Management (part of the PGWC Adult Chronic Disease Management policy formed the basis of the guide questions used in focus groups and interviews.The results of this research indicate a significant gap between policy and its implementation to improve and support chronic disease management at this primary care facility. A major factor seems to be poor policy knowledge by clinicians, which contributes to an individual rather than a team approach in the management of chronic disease patients. Poor interaction between facility- and community-based services also emerged. A number of factors were identified that seemed to contribute to poor policy implementation, the majority of which were staff related and ultimately resulted in a decrease in the quality of patient care.Chronic disease policy implementation needs to be improved in order to support chronic disease management at this facility. It is possible

  12. Critical action research applied in clinical placement development in aged care facilities.

    Science.gov (United States)

    Xiao, Lily D; Kelton, Moira; Paterson, Jan

    2012-12-01

    The aim of this study was to develop quality clinical placements in residential aged care facilities for undergraduate nursing students undertaking their nursing practicum topics. The proportion of people aged over 65 years is expected to increase steadily from 13% in 2006 to 26% of the total population in Australia in 2051. However, when demand is increasing for a nursing workforce competent in the care of older people, studies have shown that nursing students generally lack interest in working with older people. The lack of exposure of nursing students to quality clinical placements is one of the key factors contributing to this situation. Critical action research built on a partnership between an Australian university and five aged care organisations was utilised. A theoretical framework informed by Habermas' communicative action theory was utilised to guide the action research. Multiple research activities were used to support collaborative critical reflection and inform actions throughout the action research. Clinical placements in eight residential aged care facilities were developed to support 179 nursing students across three year-levels to complete their practicum topics. Findings were presented in three categories described as structures developed to govern clinical placement, learning and teaching in residential aged care facilities.

  13. Urgent Care Facilities, Licensed Healthcare Facilities, Published in 2007, 1:24000 (1in=2000ft) scale, State of California - Office of the State Chief Information Officer.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Urgent Care Facilities dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Published Reports/Deeds information as of 2007. It is...

  14. Salmonella enterica serotype enteritidis outbreak at a long-term care facility, Connecticut, 2012.

    Science.gov (United States)

    Styles, Timothy; Phan, Quyen; Rabatsky-Ehr, Therese; Applewhite, Christine; Sosa, Lynn; Cartter, Matthew

    2013-01-01

    In May of 2012, the Connecticut Department of Public Health (DPH) was notified of three hospitalized residents of a long-term care facility (LTCF) who had gastrointestinal illness, one of whom had a stool culture positive for Salmonella enterica. A multiagency outbreak investigation was initiated and identified a total of 21 possible salmonellosis cases; nine were culture-confirmed Salmonella serotype Enteritidis with an indistinguishable pulsed-field gel electrophoresis pattern (PFGE). This report describes the epidemiologic, environmental, and laboratory investigation conducted as part of DPH's response. Undercooked raw shell eggs were the likely source of infection. This investigation reemphasizes the vulnerabilityof certain populations to severe illness from Salmonella and further stresses previous recommendations in the literature to use only pasteurized egg products in long-term care and other health care facilities.

  15. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South AfricaExperiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

    Directory of Open Access Journals (Sweden)

    Dudu G. Sokhela

    2013-07-01

    Full Text Available Background: Comprehensive Primary Health Care (PHC, based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans.Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources

  16. Everybody matters. 1: How getting to know your patients helps to promote dignified care.

    Science.gov (United States)

    Nicholson, Caroline; Flatley, Mary; Wilkinson, Charlotte; Meyer, Julienne; Dale, Patricia; Wessel, Lucinda

    The Dignity in Care Project aims to develop practical interventions to promote dignified care in hospitals, embedded in the project slogan: "Everybody matters: sustaining dignity in care." It is a nurse led research collaboration with Royal Free Hampstead and Barnet and Chase Farm Hospitals Trusts and City University. Practical interventions devised by the project are presented around three main themes that emerged from the views of older people and their relatives (Bridges et al, 2010; 2009). The first theme of "maintaining identity--see who I am" focuses on knowing about people, while the second of "creating community--connect with me" recognises that in the act of caring, nurses receive as well as give. The last theme of "shared decision making--involve me" looks at how decisions about care are made. This first article in a three part series summarises the project and focuses on the first theme. It reports on practical initiatives to enhance dignity in hospitals by enabling nurses and patients/carers to know and value each other as people.

  17. Availability of emergency obstetric care (EmOC) among public and private health facilities in rural northwest Bangladesh

    OpenAIRE

    Sikder, Shegufta S.; Labrique, Alain B; Ali, Hasmot; Hanif, Abu AM; Klemm, Rolf DW; Mehra, Sucheta; West, Keith P; Christian, Parul

    2015-01-01

    Background Although safe motherhood strategies recommend that women seek timely care from health facilities for obstetric complications, few studies have described facility availability of emergency obstetric care (EmOC). We sought to describe and compare availability and readiness to provide EmOC among public and private health facilities commonly visited for pregnancy-related complications in two districts of northwest Bangladesh. We also described aspects of financial and geographic access...

  18. Effectiveness of Qigong in promoting the health of wheelchair-bound older adults in long-term care facilities.

    Science.gov (United States)

    Kuan, Shu-Chien; Chen, Kuei-Min; Wang, Chi

    2012-04-01

    Institutional wheelchair-bound older adults often do not get regular exercise and are prone to health problems. The aim of this study was to test the effects of a 12-week qigong exercise program on the physiological and psychological health of wheelchair-bound older adults in long-term care facilities. Study design was quasi-experimental, pre-post test, nonequivalent control group. Participants comprised a convenience sample of 72 wheelchair-bound older adults (qigong = 34; control = 38). The qigong group exercised 35 min/day, 5 days/week for 12 weeks. Measures for physical health (blood pressure, heart rate variability, and distal skin temperature) and psychological health (Brief Symptom Rating Scale-5) were collected before and during study Weeks 4, 8, and 12. The qigong group participants' blood pressure, distal skin temperature, and psychological health were significantly improved (all p qigong exercise is a suitable daily activity for elderly residents in long-term care facilities and may help in the control of blood pressure among older adults.

  19. Resilience and Its Contributing Factors in Adolescents in Long-Term Residential Care Facilities Affiliated to Tehran Welfare Organization

    Directory of Open Access Journals (Sweden)

    Manijeh Nourian

    2016-10-01

    Full Text Available Background: Resilience is a quality that affects an individual’s ability to cope with tension. The present study was conducted to determine resilience and its contributing factors in high-risk adolescents living in residential care facilities affiliated to Tehran Welfare Organization in order to help develop effective preventive measures for them. Methods: The present descriptive study was conducted on 223 adolescents living in 15differentgovernmental residential care centers in 2014. Participants were selected through convenience sampling. The data required were collected via the Wagnild and Young Resilience Scale with content validity (S-CVI=0.92 and a reliability of α=0.77 and r=0.83 (P<0.001. The data obtained were analyzed in SPSS-20 using descriptive and inferential statistics including Chi-square test, independent t-test and ANOVA. Results: The adolescents’ mean score of resilience was 84.41±11.01. The level of resilience was moderate in 46.2% of the participants and was significantly higher in the female than in the male adolescents (P=0.006; moreover, the score obtained was lower in primary school children as compared to middle school and high school students (P<0.001. Conclusion: Directors of care facilities and residential care personnel should adopt preventive resilience-based strategies in order to optimize resilience among adolescents, particularly the male. It is important to provide a basis to prevent adolescents’ academic failure and place a stronger value on education than the past.

  20. Experiences of Fast Queue health care users in primary health care facilities in eThekwini district, South Africa

    Directory of Open Access Journals (Sweden)

    Dudu G. Sokhela

    2013-01-01

    Full Text Available Background: Comprehensive Primary Health Care (PHC, based on the principles of accessibility, availability, affordability, equity and acceptability, was introduced in South Africa to address inequalities in health service provision. Whilst the Fast Queue was instrumental in the promotion of access to health care, a major goal of the PHC approach, facilities were not prepared for the sudden influx of clients. Increased access resulted in long waiting times and queues contributing to dissatisfaction with the service which could lead to missed appointments and non-compliance with established treatment plans. Objectives: Firstly to describe the experiences of clients using the Fast Queue strategy to access routine healthcare services and secondly, to determine how the clients’ experiences led to satisfaction or dissatisfaction with the Fast Queue service.Method: A descriptive qualitative survey using content analysis explored the experiences of the Fast Queue users in a PHC setting. Setting was first identified based on greatest number using the Fast Queue and geographic diversity and then a convenience sample of health care users of the Fast Queue were sampled individually along with one focus group of users who accessed the Queue monthly for medication refills. The same interview guide questions were used for both individual interviews and the one focus group discussion. Five clinics with the highest number of attendees during a three month period and a total of 83 health care users of the Fast Queue were interviewed. The average participant was female, 31 years old, single and unemployed.Results: Two themes with sub-themes emerged: health care user flow and communication, which highlights both satisfaction and dissatisfaction with the fast queue and queue marshals, could assist in directing users to the respective queues, reduce waiting time and keep users satisfied with the use of sign posts where there is a lack of human resources

  1. Hospital readmission from post-acute care facilities: risk factors, timing, and outcomes

    Science.gov (United States)

    Burke, Robert E.; Whitfield, Emily A.; Hittle, David; Min, Sung-joon; Levy, Cari; Prochazka, Allan V.; Coleman, Eric A.; Schwartz, Robert; Ginde, Adit A.

    2016-01-01

    Objectives Hospital discharges to post-acute care (PAC) facilities have increased rapidly. This increase may lead to more hospital readmissions from PAC facilities, which are common and poorly understood. We sought to determine the risk factors and timing for hospital readmission from PAC facilities and evaluate the impact of readmission on patient outcomes. Design Retrospective analysis of Medicare Current Beneficiary Survey (MCBS) from 2003–2009. Setting The MCBS is a nationally-representative survey of beneficiaries matched with claims data. Participants Community-dwelling beneficiaries who were hospitalized and discharged to a PAC facility for rehabilitation. Intervention/Exposure Potential readmission risk factors included patient demographics, health utilization, active medical conditions at time of PAC admission, and PAC characteristics. Measurements Hospital readmission during the PAC stay, return to community residence, and all-cause mortality. Results Of 3246 acute hospitalizations followed by PAC facility stays, 739 (22.8%) included at least 1 hospital readmission. The strongest risk factors for readmission included impaired functional status (HR 4.78, 95% CI 3.21–7.10), markers of increased acuity such as need for intravenous medications in PAC (1.63, 1.39–1.92), and for-profit PAC ownership (1.43, 1.21–1.69). Readmitted patients had a higher mortality rate at both 30 days (18.9 vs. 8.6%, p<0.001) and 100 days (39.9 vs. 14.5%, p<0.001) even after adjusting for age, comorbidities, and prior health care utilization (30 days: OR 2.01, 95% CI 1.60–2.54; 100 days: OR 3.79, 95% CI 3.13–4.59). Conclusions Hospital readmission from PAC facilities is common and associated with a high mortality rate. Readmission risk factors may signify inadequate transitional care processes or a mismatch between patient needs and PAC resources. PMID:26715357

  2. Caring for Grandparents with Alzheimer's Disease: Help from the "Forgotten" Generation

    Science.gov (United States)

    Hamill, Sharon Boland

    2012-01-01

    This study examined adolescent grandchildren's contributions to caregiving for grandparents with Alzheimer's disease. It was predicted that grandchildren would provide more care when parents experienced greater burden, and when adolescents had higher quality relationships with parents and grandparents. It was also hypothesized that these factors…

  3. Examining the role of information exchange in residential aged care work practices-a survey of residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Gaskin Sarah

    2012-08-01

    Full Text Available Abstract Background The provision of residential aged care is underpinned by information, and is reliant upon systems that adequately capture and effectively utilise and communicate this information. The aim of this study was to explicate and quantify the volume and method by which information is collected, exchanged within facilities and with external providers, and retrieved from facility information systems and hospitals. Methods A survey of staff (n = 119, including managers, health informatics officers (HIOs, quality improvement staff, registered nurses (RNs, enrolled nurses (ENs/endorsed enrolled nurses (EENs and assistants in nursing (AINs was carried out in four residential aged care facilities in New South Wales and Victoria, Australia. Sites varied in size and displayed a range of information technology (IT capabilities. The survey investigated how and by whom information is collected, retrieved and exchanged, and the frequency and amount of time devoted to these tasks. Descriptive analysis was performed using SPSS, and open responses to questions were coded into key themes. Results Staff completed a median of six forms each, taking a median of 30 min per shift. 68.8% of staff reported transferring information from paper to a computer system, which took a median of 30 min per shift. Handover and face-to-face communication was the most frequently used form of information exchange within facilities. There was a large amount of faxing and telephone communication between facility staff and General Practitioners and community pharmacists, with staff reporting sending a median of 2 faxes to pharmacy and 1.5 faxes to General Practitioners, and initiating 2 telephone calls to pharmacies and 1.5 calls to General Practitioners per shift. Only 38.5% of respondents reported that they always had information available at the point-of-care and only 35.4% of respondents reported that they always had access to hospital stay information of residents

  4. Elder mistreatment in U.S. residential care facilities: the scope of the problem.

    Science.gov (United States)

    Phillips, Linda R; Guo, Guifang; Kim, Haesook

    2013-01-01

    Many in the United States believe elder mistreatment in long-term care is serious and widespread, but until recently few studies focused on the problem. This study was designed to describe the scope of mistreatment in assisted living facilities (ALFs) in Arizona during a 3-year period. Findings showed that receiving citations for elder mistreatment was relatively rare. However, analysis of narrative reports from only 7% of facilities showed 598 allegations of mistreatment in complaint investigations, of which 372 (62.2%) were substantiated and given citations for something other than mistreatment. Results show that elder mistreatment in ALFs is seriously underidentified, even by state inspectors.

  5. Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda

    Directory of Open Access Journals (Sweden)

    Gertrude Namazzi

    2015-03-01

    Full Text Available Background: In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective: This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design: This health system strengthening study, part of the Uganda Newborn Study (UNEST, aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results: Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with

  6. Facility-Level Factors Influencing Retention of Patients in HIV Care in East Africa

    Science.gov (United States)

    Easterbrook, Philippa; Genberg, Becky; Braithwaite, Ronald Scott; Cohen, Craig R.; Bukusi, Elizabeth A.; Kambugu, Andrew; Bwana, Mwebesa Bosco; Somi, Geoffrey R.; Geng, Elvin H.; Musick, Beverly; Yiannoutsos, Constantin T.; Wools-Kaloustian, Kara; Braitstein, Paula

    2016-01-01

    Losses to follow-up (LTFU) remain an important programmatic challenge. While numerous patient-level factors have been associated with LTFU, less is known about facility-level factors. Data from the East African International epidemiologic Databases to Evaluate AIDS (EA-IeDEA) Consortium was used to identify facility-level factors associated with LTFU in Kenya, Tanzania and Uganda. Patients were defined as LTFU if they had no visit within 12 months of the study endpoint for pre-ART patients or 6 months for patients on ART. Adjusting for patient factors, shared frailty proportional hazard models were used to identify the facility-level factors associated with LTFU for the pre- and post-ART periods. Data from 77,362 patients and 29 facilities were analyzed. Median age at enrolment was 36.0 years (Interquartile Range: 30.1, 43.1), 63.9% were women and 58.3% initiated ART. Rates (95% Confidence Interval) of LTFU were 25.1 (24.7–25.6) and 16.7 (16.3–17.2) per 100 person-years in the pre-ART and post-ART periods, respectively. Facility-level factors associated with increased LTFU included secondary-level care, HIV RNA PCR turnaround time >14 days, and no onsite availability of CD4 testing. Increased LTFU was also observed when no nutritional supplements were provided (pre-ART only), when TB patients were treated within the HIV program (pre-ART only), and when the facility was open ≤4 mornings per week (ART only). Our findings suggest that facility-based strategies such as point of care laboratory testing and separate clinic spaces for TB patients may improve retention. PMID:27509182

  7. Job role quality and intention to leave current facility and to leave profession of direct care workers in Japanese residential facilities for elderly.

    Science.gov (United States)

    Nakanishi, Miharu; Imai, Hisato

    2012-01-01

    The aim of the present study is to examine job role quality relating to intention to leave current facility and to leave profession among direct care workers in residential facilities for elderly in Japan. Direct care workers completed a paper questionnaire on October 2009. From 746 facilities in three prefectures (Tokyo, Shizuoka, and Yamagata) 6428 direct care workers with complete data were included in the analyses. The Job Role Quality (JRQ) scale was translated into Japanese language to assess job role quality. Hierarchical multiple regression analysis showed that intention to leave current facility was primarily associated with job role quality: poor skill discretion, high job demand, and poor relationship with supervisor. Intention to leave profession was primarily associated with poor skill discretion. The results of the present study imply the strategies to direct care worker retention for each facility and policy efforts. Each facility can implement specific strategies such as enhanced variety of work and opportunity for use of skills, adequate job allocation, and improvement of supervisor-employee relationship in work place. Policy efforts should enhance broader career opportunities in care working such as advanced specialization and authorized medical practice.

  8. The Longitudinal Elder Initiative: helping students learn to care for older adults.

    Science.gov (United States)

    Davis, Rebecca L; Beel-Bates, Cindy; Jensen, Susan

    2008-04-01

    This paper describes an educational innovation called the Longitudinal Elder Initiative (LEI), which was developed by a BSN program to improve students' knowledge about the health needs and nursing care of older adults. In the LEI, new nursing students are paired with older adults in the community and develop a relationship with them over the duration of the nursing program. Students complete a variety of assignments designed to facilitate learning gerontological nursing concepts. They also complete specific assessments designed to target common problems in aging. Students develop nursing care plans and interventions during the course of the project and monitor progress toward goals over time. Through the LEI, students develop relationships with older adults in the community and view their health changes longitudinally. In addition, students can observe how social, financial, and health-related factors affect health and well-being over time.

  9. Prevalence of type 2 diabetes mellitus in elderly in a primary care facility: An ideal facility

    Directory of Open Access Journals (Sweden)

    Archana Jain

    2013-01-01

    Full Text Available In 2011 census, 5.3% of the Indian population was > 65 years of age. This number has steadily grown over past few years and is steeply growing. Healthcare burden of elderly diabetics is immense and proper diagnosis and treatment alone can prevent further complications. According to the most recent surveillance data in U.S., the prevalence of diabetes among U.S. adults aged ≥65 years varies from 22 to 33%, depending on the diagnostic criteria used. In CSIR-NEERI, India, we have healthcare system wherein a fixed and limited number of patients are treated for their lifetime by qualified practitioners with negligible financial burden of the treatment costs. The patients have regular monthly follow up and hence we diagnose Diabetes and evaluate the control and diagnose micro vascular and macro vascular complications in all patients. We did retrospective analysis of all elderly patients following up in NEERI Hospital to find the exact prevalence of T2DM in elderly. It was observed that from total 585 elderly people, 178 had T2DM (30.42%- Prevalence.The sex ratio of Diabetic males to females was almost equal (1:0.97.Obesity was present in 114 people (64%.High prevalence of hypertension was found in Diabetic elderly population (80%. Comparing our prevalence rates with few other studies, it was found that our prevalence rates are quite high. The contributing factors may be urban living, with high prevalence of central obesity and Asian ethnicity, over and above, data of all patients undergoing treatment is available. We treated all diabetics with persistent values of Systolic BP > 130 mm of Hg and Diastolic values of BP > 80mm of Hg as Hypertensives, in order to achieve reduction in cardiovascular mortality and morbidity. This paper is for awareness of disease burden, in real primary care setup. It is not cross-sectional study but study with 100% inclusion of beneficiaries′. This is real world urban diabetes prevalence, also associated hypertension

  10. Long-term care and hospital collaboration. To survive in a reformed healthcare system, long-term care facilities can initiate hospital-based SNFs.

    Science.gov (United States)

    Hume, S K

    1993-06-01

    Establishing relationships with hospitals may be critical for long-term care facilities facing financial pressures and uncertain futures. One option is to initiate collaborative efforts to develop hospital-based skilled nursing facilities (SNFs). Hospitals, under pressure to move patients to less intensive settings and to diversify, are naturally drawn to long-term care as a related business where they can make limited personnel and financial commitments and extend their continuum of care. Before approaching hospitals to initiate collaborative efforts, long-term care providers should understand how they think and what their strengths and weaknesses are. Long-term and acute care providers have many options for collaboration, including management contracts and joint ventures. In a traditional management contract, the long-term care provider furnishes the administrator and a few key staff in exchange for direct reimbursement for those staff plus a management fee. Another option is for the long-term care facility to provide all the staff for a fee or percentage of revenue. Joint venture options are to form a subsidiary corporation to renovate a floor of the hospital or to have the hospital buy a large percentage of the long-term care facility and share the profits. All these options have potential pitfalls, including differing financial expectations and the threat of unionization at the SNF. Nevertheless, for long-term care facilities struggling under reimbursement cutbacks and other pressures, the benefits may outweigh the risks.

  11. Quality of care and its determinants in longer term mental health facilities across Europe; a cross-sectional analysis

    NARCIS (Netherlands)

    Killaspy, Helen; Cardoso, Graca; White, Sarah; Wright, Christine; Caldas de Almeida, Jose Miguel; Turton, Penny; Taylor, Tatiana L.; Schuetzwohl, Matthias; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Adamowski, Tomasz; Ploumpidis, Dimitris; Gonidakis, Fragiskos; King, Michael

    2016-01-01

    Background: The Quality Indicator for Rehabilitative Care (QuIRC) is an international, standardised quality tool for the evaluation of mental health facilities that provide longer term care. Completed by the service manager, it comprises 145 items that assess seven domains of care: living environmen

  12. Facility Delivery, Postnatal Care and Neonatal Deaths in India: Nationally-Representative Case-Control Studies.

    Directory of Open Access Journals (Sweden)

    Shaza A Fadel

    Full Text Available Clinical studies demonstrate the efficacy of interventions to reduce neonatal deaths, but there are fewer studies of their real-life effectiveness. In India, women often seek facility delivery after complications arise, rather than to avoid complications. Our objective was to quantify the association of facility delivery and postnatal checkups with neonatal mortality while examining the "reverse causality" in which the mothers deliver at a health facility due to adverse perinatal events.We conducted nationally representative case-control studies of about 300,000 live births and 4,000 neonatal deaths to examine the effect of, place of delivery and postnatal checkup on neonatal mortality. We compared neonatal deaths to all live births and to a subset of live births reporting excessive bleeding or obstructed labour that were more comparable to cases in seeking care.In the larger study of 2004-8 births, facility delivery without postnatal checkup was associated with an increased odds of neonatal death (Odds ratio = 2.5; 99% CI 2.2-2.9, especially for early versus late neonatal deaths. However, use of more comparable controls showed marked attenuation (Odds ratio = 0.5; 0.4-0.5. Facility delivery with postnatal checkup was associated with reduced odds of neonatal death. Excess risks were attenuated in the earlier study of 2001-4 births.The combined effect of facility deliveries with postnatal checks ups is substantially higher than just facility delivery alone. Evaluation of the real-life effectiveness of interventions to reduce child and maternal deaths need to consider reverse causality. If these associations are causal, facility delivery with postnatal check up could avoid about 1/3 of all neonatal deaths in India (~100,000/year.

  13. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

    DEFF Research Database (Denmark)

    Niwata, Satoko; Yamada, Yukari; Ikegami, Naoki

    2006-01-01

    conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC) facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified...... on the basis of the 2003 Beers criteria. Results The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1%) of the patients were treated with potentially inappropriate medication independent of disease or condition...... medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries....

  14. Challenges Associated With Managing Suicide Risk in Long-Term Care Facilities

    Science.gov (United States)

    O'Riley, Alisa; Nadorff, Michael R.; Conwell, Yeates; Edelstein, Barry

    2016-01-01

    Little information about suicidal ideation and behavior in long-term care (LTC) facilities is available. Nonetheless, the implementation of the Minimum Data Set 3.0 requires that LTC facilities screen their residents for suicide risk and have protocols in place to effectively manage residents’ responses. In this article, the authors briefly discuss the risk factors of suicide in the elderly and the problems that suicidal ideation and behavior pose in the LTC environment. The authors explain issues that arise when trying to manage suicide risk in the elderly LTC population with general, traditional approaches. These inherent issues make it difficult to develop an effective protocol for managing suicide risk in LTC facilities, leading the authors to propose their own framework for assessing and managing suicide risk in the LTC setting. PMID:27610048

  15. EURO-CARES: European Roadmap for a Sample Return Curation Facility and Planetary Protection Implications.

    Science.gov (United States)

    Brucato, John Robert

    2016-07-01

    A mature European planetary exploration program and evolving sample return mission plans gathers the interest of a wider scientific community. The interest is generated from studying extraterrestrial samples in the laborato-ry providing new opportunities to address fundamental issues on the origin and evolution of the Solar System, on the primordial cosmochemistry, and on the nature of the building blocks of terrestrial planets and on the origin of life. Major space agencies are currently planning for missions that will collect samples from a variety of Solar Sys-tem environments, from primitive (carbonaceous) small bodies, from the Moon, Mars and its moons and, final-ly, from icy moons of the outer planets. A dedicated sample return curation facility is seen as an essential re-quirement for the receiving, assessment, characterization and secure preservation of the collected extraterrestrial samples and potentially their safe distribution to the scientific community. EURO-CARES is a European Commission study funded under the Horizon-2020 program. The strategic objec-tive of EURO-CARES is to create a roadmap for the implementation of a European Extraterrestrial Sample Cu-ration Facility. The facility has to provide safe storage and handling of extraterrestrial samples and has to enable the preliminary characterization in order to achieve the required effectiveness and collaborative outcomes for the whole international scientific community. For example, samples returned from Mars could pose a threat on the Earth's biosphere if any living extraterrestrial organism are present in the samples. Thus planetary protection is an essential aspect of all Mars sample return missions that will affect the retrival and transport from the point of return, sample handling, infrastructure methodology and management of a future curation facility. Analysis of the state of the art of Planetary Protection technology shows there are considerable possibilities to define and develop

  16. Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities

    OpenAIRE

    Genao, Liza; Buhr, Gwendolen T.

    2012-01-01

    Urinary tract infections (UTIs) are commonly suspected in residents of long-term care (LTC) facilities, and it has been common practice to prescribe antibiotics to these patients, even when they are asymptomatic. This approach, however, often does more harm than good, leading to increased rates of adverse drug effects and more recurrent infections with drug-resistant bacteria. It also does not improve genitourinary symptoms (eg, polyuria or malodorous urine) or lead to improved mortality rate...

  17. Indoor Environmental Quality Audit and Investigation of Ceiling Fans in an Aged Care Facility

    OpenAIRE

    2016-01-01

    This thesis project involved research into the thermal comfort of the occupants and staff at the Warrigal aged care facility at Warilla, NSW, Australia. An Indoor Environmental Quality (IEQ) Audit has been completed with a focus on parameters of luminance, noise levels, concentrations of CO2, NO2, formaldehyde and CO, and air velocity. An extensive investigation of the distribution of indoor air temperature and relative humidity has been performed. Small sensors called ‘iButtons’ were install...

  18. Determinants of life satisfaction among Japanese elderly women attending health care and welfare service facilities

    OpenAIRE

    Onishi, Chiemi; Yuasa, Kyoko; Sei, Masako; EWIS, ASHRAF; Nakano, Takuro; Munakata, Hokuma; Nakahori, Yutaka

    2010-01-01

    Prolonged life expectancy must be recognized as an excellent achievement of modern medicine, but not all the elderly people are satisfied with their lives. Life satisfaction is a multi-dimensional issue that depends on many objective and subjective characteristics. In this study, we aimed at investigating the factors affecting life satisfaction of 314 elderly Japanese women attending in 28 elderly-care and welfare facilities at Tokushima Prefecture, Japan. Our results indicated...

  19. Surveillance definitions of infections in long-term care facilities: revisiting the McGeer criteria.

    Science.gov (United States)

    Stone, Nimalie D; Ashraf, Muhammad S; Calder, Jennifer; Crnich, Christopher J; Crossley, Kent; Drinka, Paul J; Gould, Carolyn V; Juthani-Mehta, Manisha; Lautenbach, Ebbing; Loeb, Mark; Maccannell, Taranisia; Malani, Preeti N; Mody, Lona; Mylotte, Joseph M; Nicolle, Lindsay E; Roghmann, Mary-Claire; Schweon, Steven J; Simor, Andrew E; Smith, Philip W; Stevenson, Kurt B; Bradley, Suzanne F

    2012-10-01

    (See the commentary by Moro, on pages 978-980 .) Infection surveillance definitions for long-term care facilities (ie, the McGeer Criteria) have not been updated since 1991. An expert consensus panel modified these definitions on the basis of a structured review of the literature. Significant changes were made to the criteria defining urinary tract and respiratory tract infections. New definitions were added for norovirus gastroenteritis and Clostridum difficile infections.

  20. Part 1: Evidence-based facility design using Transforming Care at the Bedside principles.

    Science.gov (United States)

    Devine, Deborah A; Wenger, Barb; Krugman, Mary; Zwink, Jennifer E; Shiskowsky, Kaycee; Hagman, Jan; Limon, Shelly; Sanders, Carolyn; Reeves, Catherine

    2015-02-01

    An academic hospital used Transforming Care at the Bedside (TCAB) principles as the framework for generating evidence-based recommendations for the design of an expansion of the current hospital. The interdisciplinary team used the table of evidence-based data to advocate for a patient- and family-centered, safe, and positive work environment. A nurse project manager acted as liaison between the TCAB design team, architects, and facilities and design consultants. Part 2 of this series describes project evaluation outcomes.

  1. Infection Control in Acute Care Facilities: Evidence-Based Patient Safety

    OpenAIRE

    2001-01-01

    Infection control in acute care facilities has a noble history. These programs were born of the nosocomial penicillin-resistant Staphylococcus aureus outbreaks in the post-World War II era. Over the past four decades, an impressive body of evidence has emerged that documents the effectiveness of infection control programs and systematically evaluates specific program components. Fumigation, tacky floor mats, shoe covers and 'reverse' isolation have disappeared. They are replaced by focused su...

  2. Infection control in acute care facilities: Evidence-based patient safety

    OpenAIRE

    2001-01-01

    Infection control in acute care facilities has a noble history. These programs were born of the nosocomial penicillin-resistant Staphylococcus aureus outbreaks in the post-World War II era. Over the past four decades, an impressive body of evidence has emerged that documents the effectiveness of infection control programs and systematically evaluates specific program components. Fumigation, tacky floor mats, shoe covers and 'reverse' isolation have disappeared. They are replaced by focused su...

  3. Australians with osteoarthritis: satisfaction with health care providers and the perceived helpfulness of treatments and information sources

    Directory of Open Access Journals (Sweden)

    Basedow M

    2016-08-01

    Full Text Available Martin Basedow,1 Peter Hibbert,1 Tamara Hooper,1 William Runciman,1 Adrian Esterman,2 1School of Psychology, Social Work and Social Policy, 2School of Nursing and Midwifery, University of South Australia, Adelaide, SA, Australia Objective: The aim of this study was to evaluate the satisfaction of Australian patients who suffer from osteoarthritis (OA with their health care providers and the perceived helpfulness of treatments and information sources. Methods: A self-administered questionnaire was conducted with a sample of 560 Australian patients who suffer from OA with questions about satisfaction with health care providers and the helpfulness of different treatment options and information sources. Logistic regression models were used to assess potential predictors of satisfaction. Thematic analysis was undertaken for attitudinal factors associated with satisfaction. Results: A total of 435 participants returned questionnaires (response rate 78%. Most respondents were highly satisfied with the care provided by their general practitioner (GP (84%, communication with their GP (88%, time spent with their GP (84%, and their ability to talk freely with their GP about their medical problem (93%, but less satisfied with their ability to talk freely about associated emotional problems (77%. Satisfaction with pharmacists (80%, rheumatologists (76%, and orthopedic surgeons (72% was high. Joint replacement surgery (91%, prescription anti-inflammatory medications (66%, aids and assistive devices (65%, intra-articular injections (63%, and prescription painkiller medications (62% were perceived as effective treatments. Less highly rated treatments were exercise (48%, physiotherapy (43%, and complementary medicines (29%. A majority of patients were satisfied with the information to manage their OA (65%. From the multivariable logistic regression analysis, four GP satisfaction factors were found to be predictors of overall satisfaction with GP care: the amount

  4. Facility type and primary care performance in sub-district health promotion hospitals in Northern Thailand

    Science.gov (United States)

    Kitreerawutiwong, Nithra; Jordan, Sue; Hughes, David

    2017-01-01

    Background Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses. The Ministry of Public Health (MoPH) designated three categories of THPH, defined according to whether they were regularly staffed by a medical practitioner, a qualified nurse or non-clinical public health officers. This study aimed to compare the performance of primary care offered by the three different types of primary care facilities in one public health region of Northern Thailand (Public Health Region 2). Methods A cross-sectional survey was undertaken in 2013. Data were collected on accessibility, continuity, comprehensiveness, co-ordination and community orientation of care from 825 patients attending 23 primary care facilities. These were selected to include the three officially-designated types of Tambon (sub-district) health promotion hospitals (THPHs) led by medical, nursing or public health personnel. Survey scores were compared in unadjusted and adjusted analyses. Results THPHs staffed only by public health officers achieved the highest performance score (Mean = 85.14, SD. = 7.30), followed by THPHs staffed by qualified nurses (Mean = 82.86, SD. = 7.06). THPHs staffed by a doctor on rotation returned the lowest scores (Mean = 81.63, SD. = 7.22). Conclusions Differences in overall scores resulted mainly from differences in reported accessibility, continuity, and comprehensiveness of care, rather than staff skill-mix per se. Policy on quality improvement should therefore focus on improving performance in these areas. PMID:28339494

  5. The lived experiences of resilience in Iranian adolescents living in residential care facilities: A hermeneutic phenomenological study

    Directory of Open Access Journals (Sweden)

    Manijeh Nourian

    2016-03-01

    Full Text Available Background: Resilience is one of the main factors affecting human health, and perceiving its meaning for high-risk adolescents is of particular importance in initiating preventive measures and providing resilience care. Objectives: This qualitative study was conducted to explain the meaning of resilience in the lived experiences of Iranian adolescents living in governmental residential care facilities. Materials and methods: This study was conducted using the hermeneutic phenomenological method. Semi-structured interviews were conducted with eight adolescents aged 13–17 living in governmental residential care facilities of Tehran province affiliated to the Welfare Organization of Iran who articulated their experiences of resilience. Sampling lasted from May 2014 to July 2015 and continued until new themes were no longer emerging. The researchers analyzed the verbatim transcripts using Van Manen's six-step method of phenomenology. Results: The themes obtained in this study included “going through life's hardships,” “aspiring for achievement,” “self-protection,” “self-reliance,” and “spirituality.” Conclusion: Our study indicates that the meaning of resilience coexists with self-reliance in adolescents’ lived experiences. Adolescents look forward to a better future. They always trust God in the face of difficulties and experience resilience by keeping themselves physically and mentally away from difficulties. Adverse and bitter experiences of the past positively affected their positive view on life and its difficulties and also their resilience. The five themes that emerged from the findings describe the results in detail. The findings of this study enable nurses, health administrators, and healthcare providers working with adolescents to help this vulnerable group cope better with their stressful life conditions and improve their health through increasing their capacity for resilience.

  6. Guided self-help cognitive behavioural therapy for depression in primary care: a randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Christopher Williams

    Full Text Available BACKGROUND: Access to Cognitive behavioural therapy (CBT for depression is limited. One solution is CBT self-help books. Trial Objectives: To assess the impact of a guided self-help CBT book (GSH-CBT on mood, compared to treatment as usual (TAU. HYPOTHESES: GSH-CBT will have improved mood and knowledge of the causes and treatment of depression compared to the control receiving TAUGuided self-help will be acceptable to patients and staff. METHODS AND FINDINGS: PARTICIPANTS: Adults attending seven general practices in Glasgow, UK with a BDI-II score of ≥14. 141 randomised to GSH-CBT and 140 to TAU. INTERVENTIONS: RCT comparing 'Overcoming Depression: A Five Areas Approach' book plus 3-4 short face to face support appointments totalling up to 2 hours of guided support, compared with general practitioner TAU. PRIMARY OUTCOME: The BDI (II score at 4 months. Numbers analysed: 281 at baseline, 203 at 4 months (primary outcome, 117 at 12 months. OUTCOME: Mean BDI-II scores were lower in the GSH-CBT group at 4 months by 5.3 points (2.6 to 7.9, p<0.001. At 4 and 12 months there were also significantly higher proportions of participants achieving a 50% reduction in BDI-II in the GSH-CBT arm. The mean support was 2 sessions with 42.7 minutes for session 1, 41.4 minutes for session 2 and 40.2 minutes of support for session 3. Adverse effects/Harms: Significantly less deterioration in mood in GSH-CBT (2.0% compared to 9.8% in the TAU group for BDI-II category change. LIMITATIONS: Weaknesses: Our follow-up rate of 72.2% at 4 months is better than predicted but is poorer at 12 months (41.6%. In the GSH-CBT arm, around 50% of people attended 2 or fewer sessions. 22% failed to take up treatment. CONCLUSIONS: GSH-CBT is substantially more effective than TAU. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN13475030.

  7. Feasibility of guided cognitive behaviour therapy (CBT) self-help for childhood anxiety disorders in primary care.

    Science.gov (United States)

    Creswell, Cathy; Hentges, Francoise; Parkinson, Monika; Sheffield, Paul; Willetts, Lucy; Cooper, Peter

    2010-03-01

    Anxiety disorders in childhood are common, disabling and run a chronic course. Cognitive behaviour therapy (CBT) is effective but expensive and trained therapists are scarce. Guided self-help treatments may be a means of widening access to treatment. This study aimed to examine the feasibility of guided CBT self-help in primary care for childhood anxiety disorders, specifically in terms of therapist adherence, patient and therapist satisfaction and clinical gain.Participants were children aged between five and 12 years referred to two primary child and adolescent mental health services (PCAMHSs) in Oxfordshire, UK, who met diagnostic criteria for a primary anxiety disorder. Of the 52 eligible children, 41 anxious children were assessed for anxiety severity and interference before and after receiving CBT self-help delivered via a parent (total therapy time = five hours) by primary mental health workers (PMHWs). Therapy sessions were rated for treatment adherence and parents and PMHWs completed satisfaction questionnaires after treatment completion. Over 80% of therapy sessions were rated at a high level of treatment adherence. Parents and PMHWs reported high satisfaction with the treatment. Sixty-one percent of the children assessed no longer met the criteria for their primary anxiety disorder diagnosis following treatment, and 76% were rated as 'much'/'very much' improved on the Clinical Global Impression-Improvement (CGI-I) scale. There were significant reductions on parent and child report measures of anxiety symptoms, interference and depression. Preliminary exploration indicated that parental anxiety was associated with child treatment outcome. The findings suggest that guided CBT self-help represents a promising treatment for childhood anxiety in primary care.

  8. Rolling out of kangaroo mother care in secondary level facilities in Bihar-Some experiences

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    Sutapa B Neogi

    2016-01-01

    Full Text Available Background: Preterm birth is one of the leading causes of under-five child deaths worldwide and in India. Kangaroo mother care (KMC is a powerful and easy-to-use method to promote health and well-being and reduce morbidity and mortality in preterm/low birth weight (LBW babies. Objective: As the part of the roll-out of India Newborn Action Plan interventions, we implemented KMC in select facilities with an objective to assess the responsiveness of public health system to roll out KMC. Methods: KMC intervention was implemented in two select high priority districts, Gaya and Purnea in Bihar over the duration of 8 months from August 2015 to March 2016. The implementation of intervention was phased out into; situation analysis, implementation of intervention, and interim assessment. KMC model, as envisaged keeping in mind the building blocks of health system, was established in 6 identified health-care facilities. A pretested simple checklist was used to assess the awareness, knowledge, skills, and practice of KMC during baseline situational analysis and interim assessment phases for comparison. Results: The intervention clearly seemed to improve the awareness among auxiliary nurse midwives/nurses about KMC. Improvements were also observed in the availability of infrastructure required for KMC and support logistics like facility for manual expression of breast milk, cups/suitable devices such as paladi cups for feeding small babies and digital weighing scale. Although the recording of information regarding LBW babies and KMC practice improved, still there is scope for much improvement. Conclusion: There is a commitment at the national level to promote KMC in every facility. The present experience shows the possibility of rolling out KMC in secondary level facilities with support from government functionaries.

  9. Role of Human Health Care Providers and Medical Treatment Facilities in Military Working Dog Care and Accessibility Difficulties with Military Working Dog Blood Products.

    Science.gov (United States)

    Giles Iii, James T

    2016-01-01

    The use of military working dogs (MWDs) in support of military operations has increased dramatically over recent years, as they have proven to be our most reliable deterrent to improvised explosive devices. Healthcare delivery for MWDs in combat presents unique challenges and requires extensive collaboration between veterinarians and human health care providers (HCPs). A successful example is the incorporation of MWD emergency care for nonveterinary HCPs into the Joint Trauma System Clinical Practice Guidelines, which has proven to be a helpful product. Additional challenges that need further solutions include MWDs as patients in human medical treatment facilities (MTFs) and the procurement of appropriate canine blood components in an operational environment. It is often necessary for MWDs to be treated as patients in human MTFs, however, there is no Department of Defense guidance to support this activity. Access to MWD blood products is limited to collection of fresh whole blood in the operational setting. Similar to humans, specific blood component therapy, such as fresh frozen plasma, is often indicated for sick or injured MWDs. Currently there is no formal system in place to deliver any blood products for MWDs or to facilitate collection in theater.

  10. Romance and help-seeking among college women: "it hurts so much to care".

    Science.gov (United States)

    Riessman, C K; Whalen, M H; Frost, R O; Morgenthau, J E

    1991-01-01

    Although previous research shows that adult women in intimate relations tend to enjoy better health than women without partners, this study finds the opposite tends to be true for late adolescent women. We followed a college entering class prospectively for 4 years and measured romantic involvement and various aspects of health and illness behavior in a questionnaire. Health service use was determined from the medical record, and disaggregated into distress and health maintenance visits, as well as visits expressly for psychological counseling. First year students who were romantically involved had more physical symptoms, more medical visits, but not more counseling visits, than non-involved women. At senior year, they continued to have more health maintenance, more counseling, but not more distress visits, and they tended to experience greater interference in social role performance due to illness when compared to non-involved women. When several mediators of the relationship between romantic involvement and health service use were controlled-number and intensity of physical symptoms, sexual activity, stress in the relationship, and social network characteristics--the differences persisted. Romance appears to motivate help-seeking among late adolescent women for reasons that are not easily explained empirically. Recent work on adolescent women's development offers theoretical leads that can guide future investigations.

  11. Can short-term residential care for stroke rehabilitation help to reduce the institutionalization of stroke survivors?

    Directory of Open Access Journals (Sweden)

    Chau PH

    2014-02-01

    Full Text Available Pui Hing Chau,1 Maria WS Tang,2 Fannie Yeung,2 Tsz Wai Chan,1 Joanna OY Cheng,1 Jean Woo2 1School of Nursing, University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China; 2Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong, Special Administrative Region of the People's Republic of China Background: Stroke survivors may not be receiving optimal rehabilitation as a result of a shortage of hospital resources, and many of them are institutionalized. A rehabilitation program provided in a short-term residential care setting may help to fill the service gap. Objectives: The primary objectives of this study were, first, to examine whether there were significant differences in terms of rehabilitation outcomes at 1 year after admission to the rehabilitation program (defined as baseline between those using short-term residential care (intervention group and those using usual geriatric day hospital care (control group, and, second, to investigate whether lower 1-year institutionalization rates were observed in the intervention group than in the control group. Participants: 155 stroke survivors who completed at least the first follow-up at 4 months after baseline. Intervention: The intervention group was stroke survivors using self-financed short-term residential care for stroke rehabilitation. The control group was stroke survivors using the usual care at a public geriatric day hospital. Measurements: Assessments were conducted by trained research assistants using structured questionnaires at baseline, 4 months, and 1 year after baseline. The primary outcome measures included Modified Barthel Index score, Mini-Mental Status Examination score, and the institutionalization rate. Results: Cognitive status (as measured by Mini-Mental Status Examination score of patients in both groups could be maintained from 4 months to 1 year, whereas functional status (as measured by Modified Barthel

  12. Urgent Care Facilities, DPH, Published in 2007, 1:24000 (1in=2000ft) scale, Massachusetts Emergency Managment Agency.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Urgent Care Facilities dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Orthoimagery information as of 2007. It is described...

  13. 78 FR 16795 - Medicare and Medicaid Programs; Requirements for Long-Term Care (LTC) Facilities; Notice of...

    Science.gov (United States)

    2013-03-19

    ... the current requirements for LTC facilities under the provisions of section 1128I(h) of the Social... addressing health care inequalities for racial and ethnic minorities that rely on Medicare and Medicaid...

  14. Psychoeducative groups help control type 2 diabetes in a primary care setting

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Cervantes Cuesta

    2013-04-01

    Full Text Available Introduction: The purpose of this study is to measure the impact of a psychoeducational group intervention in diabetes using glycosylated haemoglobin (HbA1c, the body mass index (BMI and cardiovascular risk factors (CVRF compared with conventional educational measures provided individually. Methods: A quasi-experimental study (pre/post-intervention with a non-equivalent control group was conducted, including 72 type 2 individuals with diabetes (mean data: age 63.08 years, HbA1C 6.98%, BMI 30.48 kg/m². The beneficial effect of psychoeducational group therapy in the study group (PGT was compared with conventional diabetes education in the control group (CG. Results: The PGT had a higher mean HbA1c reduction (-0.51 ± 1.7 vs. -0.06 ± 0.53%, p 0.003, met the objectives of optimal control of HbA1c to a higher degree (80% vs. 48%, p 0.005 and greater mean weight reduction (-1.93 ± 3.57 vs. 0.52 ± 1.73 kg, p 0002 than the CG.A significant improvement in total cholesterol, LDL cholesterol, triglycerides, systolic and diastolic blood pressure was achieved in PGT (all p < 0.05. Conclusions: PGT patients achieved a significant improvement in HbA1C, BMI and CVRF, and outperformed the conventional diabetes education group in achieving the optimal diabetes control objectives. Structural changes in the assistance programs should be considered to introduce these more efficient therapies for diabetes education in primary care.

  15. Robotic Seals as Therapeutic Tools in an Aged Care Facility: A Qualitative Study

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    Melanie Birks

    2016-01-01

    Full Text Available Robots, including robotic seals, have been used as an alternative to therapies such as animal assisted therapy in the promotion of health and social wellbeing of older people in aged care facilities. There is limited research available that evaluates the effectiveness of robot therapies in these settings. The aim of this study was to identify, explore, and describe the impact of the use of Paro robotic seals in an aged care facility in a regional Australian city. A qualitative, descriptive, exploratory design was employed. Data were gathered through interviews with the three recreational therapists employed at the facility who were also asked to maintain logs of their interactions with the Paro and residents. Data were transcribed and thematically analysed. Three major themes were identified from the analyses of these data: “a therapeutic tool that’s not for everybody,” “every interaction is powerful,” and “keeping the momentum.” Findings support the use of Paro as a therapeutic tool, revealing improvement in emotional state, reduction of challenging behaviours, and improvement in social interactions of residents. The potential benefits justify the investment in Paro, with clear evidence that these tools can have a positive impact that warrants further exploration.

  16. Breast cancer stories on the internet : improving search facilities to help patients find stories of similar others

    NARCIS (Netherlands)

    Overberg, Regina Ingrid

    2013-01-01

    The primary aim of this thesis is to gain insight into which search facilities for spontaneously published stories facilitate breast cancer patients in finding stories by other patients in a similar situation. According to the narrative approach, social comparison theory, and social cognitive theory

  17. The Influence of Organizational Systems on Information Exchange in Long-Term Care Facilities: An Institutional Ethnography.

    Science.gov (United States)

    Caspar, Sienna; Ratner, Pamela A; Phinney, Alison; MacKinnon, Karen

    2016-06-01

    Person-centered care is heavily dependent on effective information exchange among health care team members. We explored the organizational systems that influence resident care attendants' (RCAs) access to care information in long-term care (LTC) settings. We conducted an institutional ethnography in three LTC facilities. Investigative methods included naturalistic observations, in-depth interviews, and textual analysis. Practical access to texts containing individualized care-related information (e.g., care plans) was dependent on job classification. Regulated health care professionals accessed these texts daily. RCAs lacked practical access to these texts and primarily received and shared information orally. Microsystems of care, based on information exchange formats, emerged. Organizational systems mandated written exchange of information and did not formally support an oral exchange. Thus, oral information exchanges were largely dependent on the quality of workplace relationships. Formal systems are needed to support structured oral information exchange within and between the microsystems of care found in LTC.

  18. Social and cultural dimensions of hygiene in Cambodian health care facilities

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    Faurand-Tournaire Anne-Laure

    2011-02-01

    Full Text Available Abstract Background The frequency of bloodborne pathogen healthcare-associated infections is thought to be high in developing Southeast Asian Countries. The underlying social-cultural logics contributing to the risks of transmission are rarely studied. This report provides some insights on the social and cultural factors that shape hygiene practices in Cambodian health care settings. Methods We conducted qualitative surveys in various public and private health facilities in Phnom Penh, the capital city and in provinces. We observed and interviewed 319 participants, health care workers and patients, regarding hygiene practices and social relationships amongst the health care staff and with patients. We also examined the local perceptions of hygiene, their impact on the relationships between the health care staff and patients, and perceptions of transmission risks. Data collection stem from face to face semi-structured and open-ended interviews and focus group discussions with various health care staffs (i.e. cleaners, nurses, midwives and medical doctors and with patients who attended the study health facilities. Results Overall responses and observations indicated that hygiene practices were burdened by the lack of adequate materials and equipements. In addition, many other factors were identified to influence and distort hygiene practices which include (1 informal and formal social rapports in hospitals, (2 major infection control roles played by the cleaners in absence of professional acknowledgment. Moreover, hygiene practices are commonly seen as an unessential matter to be devoted to low-ranking staff. Conclusion Our anthropological findings illustrate the importance of comprehensive understanding of hygiene practices; they need to be considered when designing interventions to improve infection control practices in a Cambodian medical setting.

  19. Participative Facility Planning for Obstetrical and Neonatal Care Processes: Beginning of Life Process

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    Jori Reijula

    2016-01-01

    Full Text Available Introduction. Old hospitals may promote inefficient patient care processes and safety. A new, functionally planned hospital presents a chance to create an environment that supports streamlined, patient-centered healthcare processes and adapts to users’ needs. This study depicts the phases of a facility planning project for pregnant women and newborn care processes (beginning of life process at Turku University Hospital. Materials and Methods. Project design reports and meeting documents were utilized to assess the beginning of life process as well as the work processes of the Women’s and Children’s Hospital. Results. The main elements of the facility design (FD project included rigorous preparation for the FD phase, functional planning throughout the FD process, and setting key values: (1 family-centered care, (2 Lean thinking and Lean tools as the framework for the FD process, (3 safety, and (4 cooperation. Conclusions. A well-prepared FD project with sufficient insight into functional planning, Lean thinking, and user-centricity seemed to facilitate the actual FD process. Although challenges occurred, the key values were not forgone and were successfully incorporated into the new hospital building.

  20. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

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    Alessandra N. Bazzano

    2016-12-01

    Full Text Available Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  1. Collaboration with behavioral health care facilities to implement systemwide tobacco control policies--California, 2012.

    Science.gov (United States)

    Gordon, Lauren; Modayil, Mary V; Pavlik, Jim; Morris, Chad D

    2015-02-05

    The California Tobacco Control Program (CTCP) administered 4 regional trainings in 2012 to staffers at CTCP-funded projects, tobacco control coalitions, several county departments of mental health and alcohol and drug, and administrators and providers from behavioral health care facilities. These trainings focused on the special tobacco use cessation needs and opportunities for cessation among persons with mental illness or substance abuse disorders, and they provided information about cessation and smoke-free policies. CTCP surveyed county and private behavioral health care programs to assess their readiness for adopting tobacco control strategies at treatment facilities. Between baseline and follow-up we found a decrease in the proportion of organizations at the precontemplation or contemplation stages of change and twice as many organizations at the action and maintenance stages of change. Significant obstacles remain to implementing policy: many agencies have concerns about going tobacco-free. But significant progress has been made, as evidenced by new policies and a growing number of tobacco-free coalitions consisting of public health agencies, behavioral health care agencies, and local hospitals.

  2. Collaboration With Behavioral Health Care Facilities to Implement Systemwide Tobacco Control Policies — California, 2012

    Science.gov (United States)

    Gordon, Lauren; Modayil, Mary V.; Pavlik, Jim

    2015-01-01

    The California Tobacco Control Program (CTCP) administered 4 regional trainings in 2012 to staffers at CTCP-funded projects, tobacco control coalitions, several county departments of mental health and alcohol and drug, and administrators and providers from behavioral health care facilities. These trainings focused on the special tobacco use cessation needs and opportunities for cessation among persons with mental illness or substance abuse disorders, and they provided information about cessation and smoke-free policies. CTCP surveyed county and private behavioral health care programs to assess their readiness for adopting tobacco control strategies at treatment facilities. Between baseline and follow-up we found a decrease in the proportion of organizations at the precontemplation or contemplation stages of change and twice as many organizations at the action and maintenance stages of change. Significant obstacles remain to implementing policy: many agencies have concerns about going tobacco-free. But significant progress has been made, as evidenced by new policies and a growing number of tobacco-free coalitions consisting of public health agencies, behavioral health care agencies, and local hospitals. PMID:25654218

  3. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia.

    Science.gov (United States)

    Bazzano, Alessandra N; Taub, Leah; Oberhelman, Richard A; Var, Chivorn

    2016-12-21

    Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  4. A lifesaving model: teaching advanced procedures on shelter animals in a tertiary care facility.

    Science.gov (United States)

    Spindel, Miranda E; MacPhail, Catriona M; Hackett, Timothy B; Egger, Erick L; Palmer, Ross H; Mama, Khursheed R; Lee, David E; Wilkerson, Nicole; Lappin, Michael R

    2008-01-01

    It is estimated that there are over 5 million homeless animals in the United States. While the veterinary profession continues to evolve in advanced specialty disciplines, animal shelters in every community lack resources for basic care. Concurrently, veterinary students, interns, and residents have less opportunity for practical primary and secondary veterinary care experiences in tertiary-care institutions that focus on specialty training. The two main goals of this project were (1) to provide practical medical and animal-welfare experiences to veterinary students, interns, and residents, under faculty supervision, and (2) to care for animals with medical problems beyond a typical shelter's technical capabilities and budget. Over a two-year period, 22 animals from one humane society were treated at Colorado State University Veterinary Medical Center. Initial funding for medical expenses was provided by PetSmart Charities. All 22 animals were successfully treated and subsequently adopted. The results suggest that collaboration between a tertiary-care facility and a humane shelter can be used successfully to teach advanced procedures and to save homeless animals. The project demonstrated that linking a veterinary teaching hospital's resources to a humane shelter's needs did not financially affect either institution. It is hoped that such a program might be used as a model and be perpetuated in other communities.

  5. Behavioral and clinical characteristics of people receiving medical care for HIV infection in an outpatient facility in Sicily, Italy

    Directory of Open Access Journals (Sweden)

    Di Carlo P

    2016-05-01

    Full Text Available Paola Di Carlo,1 Giuliana Guadagnino,1 Palmira Immordino,1 Giovanni Mazzola,2 Pietro Colletti,2 Ilenia Alongi,1 Lucia Adamoli,1 Francesco Vitale,1 Alessandra Casuccio1 1Department of Sciences for Health Promotion and Mother-Child Care “G D’Alessandro”, University of Palermo, 2Department of Medicinal Clinics and Emerging Diseases, “Paolo Giaccone” Polyclinic University Hospital, Palermo, Italy Aim: The authors examined a cohort of HIV-positive outpatients at the AIDS Center of Palermo University in Italy in order to identify factors related to the frequency of their visits to the outpatient facility for health care services.Methods: Two hundred and twenty-four HIV-infected subjects were enrolled in the study. Demographic and HIV disease characteristics were recorded and assessed with the number of days accessed to our outpatients unit in univariate and multivariate analyses. The potential relationship with immunological status was also analyzed stratifying the patients into groups according to their CD4+ T-cell counts (≥500 vs <500/mm3, and ≥200 vs <200/mm3.Results: Both univariate and multivariate analyses showed that duration of antiretroviral therapy <5 years and hypertension were significantly associated with a CD4+ T-cell count of <500/mm3, whereas geographic origin (Africa was associated with a CD4+ T-cell count of <200/mm3. Mean number of days the patients sought access to day-care services for laboratory tests was negatively associated with CD4+ T-cell count.Conclusion: Patients with low CD4+ T-cell counts showed higher use of health care services, demonstrating how early HIV diagnosis can help to reduce health care costs. The CD4+ T-cell cut-off of 200 cells emphasizes the importance of identifying and managing HIV infection among hard-to-reach groups like vulnerable migrants. In our sample, the illegal status of immigrants does not influence the management of their HIV/AIDS condition, but the lack of European health card

  6. Resilience and Its Contributing Factors in Adolescents in Long-Term Residential Care Facilities Affiliated to Tehran Welfare Organization

    Science.gov (United States)

    Nourian, Manijeh; Mohammadi Shahboulaghi, Farahnaz; Nourozi Tabrizi, Kian; Rassouli, Maryam; Biglarrian, Akbar

    2016-01-01

    ABSTRACT Background: Resilience is a quality that affects an individual’s ability to cope with tension. The present study was conducted to determine resilience and its contributing factors in high-risk adolescents living in residential care facilities affiliated to Tehran Welfare Organization in order to help develop effective preventive measures for them. Methods: The present descriptive study was conducted on 223 adolescents living in 15 different governmental residential care centers in 2014. Participants were selected through convenience sampling. The data required were collected via the Wagnild and Young Resilience Scale with content validity (S-CVI=0.92) and a reliability of α=0.77 and r=0.83 (Padolescents’ mean score of resilience was 84.41±11.01. The level of resilience was moderate in 46.2% of the participants and was significantly higher in the female than in the male adolescents (P=0.006); moreover, the score obtained was lower in primary school children as compared to middle school and high school students (Padolescents, particularly the male. It is important to provide a basis to prevent adolescents’ academic failure and place a stronger value on education than the past. PMID:27713901

  7. The Study on the Subjective Life Satisfaction That the Elderly Perceives in Long-term Care Facility and on the Influence Factors

    OpenAIRE

    Cho, Chu- yong; Jung, Yun-Tae

    2014-01-01

    The objectives of this study are to evaluate influences of environmental factors in elderly long-term care facility on life satisfaction of the elderly who live in the facility; to derive major determinants that affect level of life satisfaction; and thus to provide fundamental information for use in improving life satisfaction of the elderly in currently operating long-term care facilities as well as newly constructed elderly long-term care facilities. This study targeted at 252 of the elder...

  8. Infection Control in Acute Care Facilities: Evidence-Based Patient Safety

    Directory of Open Access Journals (Sweden)

    Lindsay E Nicolle

    2001-01-01

    Full Text Available Infection control in acute care facilities has a noble history. These programs were born of the nosocomial penicillin-resistant Staphylococcus aureus outbreaks in the post-World War II era. Over the past four decades, an impressive body of evidence has emerged that documents the effectiveness of infection control programs and systematically evaluates specific program components. Fumigation, tacky floor mats, shoe covers and 'reverse' isolation have disappeared. They are replaced by focused surveillance programs, prophylactic antimicrobial therapy, outbreak investigation and control, routine barrier practices and molecular typing of organisms for epidemiological analysis.

  9. Health Facilities

    Science.gov (United States)

    Health facilities are places that provide health care. They include hospitals, clinics, outpatient care centers, and specialized care centers, such as birthing centers and psychiatric care centers. When you ...

  10. Job Satisfactions of Nurses and Physicians Working in the Same Health Care Facility in Turkey

    Directory of Open Access Journals (Sweden)

    Züleyha Alper

    2011-01-01

    Full Text Available Background: Job satisfaction is defined as the degree to which employees like or enjoy their jobs and the degreeof satisfaction is based on the importance placed upon this reward and benefit.Objective: Aim of this study was to determine the job satisfaction levels of nurses and physicians working in thesame health care facility, analyze the factors that may affect job satisfaction levels. This study was conducted asa descriptive study and was carried out in one Medical Care Center Northwestern Region of Turkey, Bursa.Results:A job satisfaction scale developed by researchers according to literature review. The scale contained 36items related to measure job satisfaction levels of the participants. Data were collected from 65 nurses and 15physicians. Motivation of nurses is significantly higher than physicians. There is no affect of nurses’ educationlevels on general job satisfaction levels (p>0.05. No significant association was found between gender andmotivation (p>0.05. Payments and organization–related factors affect job satisfaction among nurses andphysicians.Conclusion:This scale yielded significant results in all subgroups except for satisfaction with patient treatment,care services and age. Seniority in the profession and age correlates with general job satisfaction level. Futurestudies need to focus on if job dissatisfaction affects health care workers to quit their jobs, differences amonggenders and profession.

  11. Do Internal Medicine Residents Know Enough About Skilled Nursing Facilities To Orchestrate a Good Care Transition?

    Science.gov (United States)

    Ward, Katherine T.; Eslami, Michelle S.; Garcia, Maristela B.; McCreath, Heather E.

    2015-01-01

    BACKGROUND Although many older adults require skilled nursing facility (SNF) care after acute hospitalization, it is unclear whether Internal Medicine (IM) residents have sufficient knowledge of the care that can be provided at this site. METHODS We developed a 10-item multiple choice pre-test that assessed knowledge of the definition of a SNF, SNF staffing requirements, and SNF services provided on-site. The test was administered to trainees on the first day of a mandatory SNF rotation that occurred during their first, second or third year of training. RESULTS 67 IM residents (41 PGY-1, 11 PGY-2, and 15 PGY-3) were assessed with the test. The mean number of questions answered correctly was 4.9, with a standard deviation of 1.6. Regardless of their level of training, residents had a poor baseline knowledge of SNF care (mean scores 4.2 for PGY-1, 5.3 for PGY-2, and 6.3 for PGY-3 (p<0.0001). Performance on some questions improved with increased level of training but others did not. CONCLUSIONS Medical residents have insufficient knowledge about the type of care that can be provided at a SNF and efforts to improve this knowledge are needed to assure proper triage of patients and safe transitions to the SNF. PMID:25282630

  12. The effect of user fee exemption on the utilization of maternal health care at mission health facilities in Malawi.

    Science.gov (United States)

    Manthalu, Gerald; Yi, Deokhee; Farrar, Shelley; Nkhoma, Dominic

    2016-11-01

    The Government of Malawi has signed contracts called service level agreements (SLAs) with mission health facilities in order to exempt their catchment populations from paying user fees. Government in turn reimburses the facilities for the services that they provide. SLAs started in 2006 with 28 out of 165 mission health facilities and increased to 74 in 2015. Most SLAs cover only maternal, neonatal and in some cases child health services due to limited resources. This study evaluated the effect of user fee exemption on the utilization of maternal health services. The difference-in-differences approach was combined with propensity score matching to evaluate the causal effect of user fee exemption. The gradual uptake of the policy provided a natural experiment with treated and control health facilities. A second control group, patients seeking non-maternal health care at CHAM health facilities with SLAs, was used to check the robustness of the results obtained using the primary control group. Health facility level panel data for 142 mission health facilities from 2003 to 2010 were used. User fee exemption led to a 15% (P facilities. No effects were found for the proportion of pregnant women who made the first ANC visit in the first trimester and the proportion of women who made postpartum care visits. We conclude that user fee exemption is an important policy for increasing maternal health care utilization. For certain maternal services, however, other determinants may be more important.

  13. Beyond Care Avoidance and Care Paralysis : Theorizing Public Mental Health Care

    NARCIS (Netherlands)

    Schout, Gert; de Jong, Gideon; Zeelen, Jacques

    2011-01-01

    Care avoidance refers to the condition wherein clients do not seek assistance and do not attend appointments although they are in need of help. Care avoidance is linked to another phenomenon, the inability to help clients with multiple and complex problems by social services and care facilities, in

  14. Utilisation of rheumatology care services in Germany: the case of physical therapy and self-help groups.

    Science.gov (United States)

    Thieme, Holm; Borgetto, Bernhard

    2012-01-01

    Physical Therapy (PT) and self-help groups (SHG) are important components of health care in rheumatic diseases. The utilisation of PT and SHG by patients with rheumatic diseases may be influenced by several factors. The aim of this study is to summarize the evidence on PT and SHG utilisation of patients with rheumatic diseases in Germany. We systematically searched the MEDLINE-database for studies that evaluated the utilisation and factors that possibly influence the utilisation of PT and SHG. Eight studies were found for PT-utilisation and one for SHG-utilisation. Between 25 and 59 percent of patients with rheumatic diseases received PT services. Several individual and contextual factors that may influence the utilisation could be identified. In conclusion, evidence exists for wide variations in the utilisation of PT services and an underuse of such services among patients with rheumatic diseases in Germany. By contrast, little evidence exists on the utilisation of SHG.

  15. Help Seeking and Access to Primary Care for People from “Hard-to-Reach” Groups with Common Mental Health Problems

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    K. Bristow

    2011-01-01

    Full Text Available Background. In the UK, most people with mental health problems are managed in primary care. However, many individuals in need of help are not able to access care, either because it is not available, or because the individual's interaction with care-givers deters or diverts help-seeking. Aims. To understand the experience of seeking care for distress from the perspective of potential patients from “hard-to-reach” groups. Methods. A qualitative study using semi-structured interviews, analysed using a thematic framework. Results. Access to primary care is problematic in four main areas: how distress is conceptualised by individuals, the decision to seek help, barriers to help-seeking, and navigating and negotiating services. Conclusion. There are complex reasons why people from “hard-to-reach” groups may not conceptualise their distress as a biomedical problem. In addition, there are particular barriers to accessing primary care when distress is recognised by the person and help-seeking is attempted. We suggest how primary care could be more accessible to people from “hard-to-reach” groups including the need to offer a flexible, non-biomedical response to distress.

  16. Determinants of life satisfaction among Japanese elderly women attending health care and welfare service facilities.

    Science.gov (United States)

    Onishi, Chiemi; Yuasa, Kyoko; Sei, Masako; Ewis, Ashraf A; Nakano, Takuro; Munakata, Hokuma; Nakahori, Yutaka

    2010-02-01

    Prolonged life expectancy must be recognized as an excellent achievement of modern medicine, but not all the elderly people are satisfied with their lives. Life satisfaction is a multi-dimensional issue that depends on many objective and subjective characteristics. In this study, we aimed at investigating the factors affecting life satisfaction of 314 elderly Japanese women attending in 28 elderly-care and welfare facilities at Tokushima Prefecture, Japan. Our results indicated that elderly subjects with depression tendencies always show significantly lower degrees of life satisfaction than others who are not depressed (pelderly women who shared decision for their living place and whose opinions were considered for daily life decisions reported significantly more life satisfaction levels than others. We conclude that elderly life satisfaction is affected by various determinants however, with different influencing weight. Life satisfaction of elderly people, with or without dementia, is greatly affected by their mood status and share in decision making. Avoiding elderly people depressive mood, sharing them in various daily decisions, considering their opinions, and allowing them to decide their elderly-care facility placement are crucial determinants for their life satisfaction and essential for their coping, adaptation, well-being and successful aging.

  17. Care for chronic illness in Australian general practice – focus groups of chronic disease self-help groups over 10 years: implications for chronic care systems reforms

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    Martin Carmel M

    2009-01-01

    Full Text Available Abstract Background Chronic disease is a major global challenge. However, chronic illness and its care, when intruding into everyday life, has received less attention in Asia Pacific countries, including Australia, who are in the process of transitioning to chronic disease orientated health systems. Aim The study aims to examine experiences of chronic illness before and after the introduction of Australian Medicare incentives for longer consultations and structured health assessments in general practice. Methods Self-help groups around the conditions of diabetes, epilepsy, asthma and cancer identified key informants to participate in 4 disease specific focus groups. Audio taped transcripts of the focus groups were coded using grounded theory methodology. Key themes and lesser themes identified using a process of saturation until the study questions on needs and experiences of care were addressed. Thematic comparisons were made across the 2002/3 and 1992/3 focus groups. Findings At times of chronic illness, there was need to find and then ensure access to 'the right GP'. The 'right GP or specialist' committed to an in-depth relationship of trust, personal rapport and understanding together with clinical and therapeutic competence. The 'right GP', the main specialist, the community nurse and the pharmacist were key providers, whose success depended on interprofessional communication. The need to trust and rely on care providers was balanced by the need for self-efficacy 'to be in control of disease and treatment' and 'to be your own case manager'. Changes in Medicare appeared to have little penetration into everyday perceptions of chronic illness burden or time and quality of GP care. Inequity of health system support for different disease groupings emerged. Diabetes, asthma and certain cancers, like breast cancer, had greater support, despite common experiences of disease burden, and a need for research and support programs. Conclusion Core

  18. Implementation of ‘Goals of Patient Care’ medical treatment orders in residential aged care facilities: protocol for a randomised controlled trial

    Science.gov (United States)

    Martin, Ruth S; Hayes, Barbara J; Hutchinson, Anastasia; Yates, Paul; Lim, Wen Kwang

    2017-01-01

    Introduction Systematic reviews demonstrate that advance care planning (ACP) has many positive effects for residents of aged care facilities, including decreased hospitalisation. The proposed Residential Aged Care Facility (RACF) ‘Goals of Patient Care’ (GOPC) form incorporates a resident's prior advance care plan into medical treatment orders. Where none exists, it captures residents' preferences. This documentation helps guide healthcare decisions made at times of acute clinical deterioration. Methods and analysis This is a mixed methods study. An unblinded cluster randomised controlled trial is proposed in three pairs of RACFs. In the intervention arm, GOPC forms will be completed by a doctor incorporating advance care plans or wishes. In the control arm, residents will have usual care which may include an advance care plan. The primary hypothesis is that the GOPC form is superior to standard ACP alone and will lead to decreased hospitalisation due to clearer documentation of residents' medical treatment plans. The primary outcome will be an analysis of the effect of the GOPC medical treatment orders on emergency department attendances and hospital admissions at 6 months. Secondary outcome measurements will include change in hospitalisation rates at 3 and 12 months, length of stay and external mortality rates among others. Qualitative interviews, 12 months post GOPC implementation, will be used for process evaluation of the GOPC and to evaluate staff perceptions of the form's usefulness for improving communication and medical decision-making at a time of deterioration. Dissemination The results will be disseminated in peer review journals and research conferences. This robust randomised controlled trial will provide high-quality data about the influence of medical treatment orders that incorporate ACP or preferences adding to the current gap in knowledge and evidence in this area. Trial registration number ACTRN12615000298516, Results. PMID:28283490

  19. Treating and preventing influenza in aged care facilities: a cluster randomised controlled trial.

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    Robert Booy

    Full Text Available BACKGROUND: Influenza is an important cause of morbidity and mortality for frail older people. Whilst the antiviral drug oseltamivir (a neuraminidase inhibitor is approved for treatment and prophylaxis of influenza during outbreaks, there have been no trials comparing treatment only (T versus treatment and prophylaxis (T&P in Aged Care Facilities (ACFs. Our objective was to compare a policy of T versus T&P for influenza outbreaks in ACFs. METHODS AND FINDINGS: We performed a cluster randomised controlled trial in 16 ACFs, that followed a policy of either "T"-oseltamivir treatment (75 mg twice a day for 5 days-or "T&P"-treatment and prophylaxis (75 mg once a day for 10 days for influenza outbreaks over three years, in addition to enhanced surveillance. The primary outcome measure was the attack rate of influenza. Secondary outcomes measures were deaths, hospitalisation, pneumonia and adverse events. Laboratory testing was performed to identify the viral cause of influenza-like illness (ILI outbreaks. The study period 30 June 2006 to 23 December 2008 included three southern hemisphere winters. During that time, influenza was confirmed as the cause of nine of the 23 ILI outbreaks that occurred amongst the 16 ACFs. The policy of T&P resulted in a significant reduction in the influenza attack rate amongst residents: 93/255 (36% in residents in T facilities versus 91/397 (23% in T&P facilities (p=0.002. We observed a non-significant reduction in staff: 46/216 (21% in T facilities versus 47/350 (13% in T&P facilities (p=0.5. There was a significant reduction in mean duration of outbreaks (T=24 days, T&P=11 days, p=0.04. Deaths, hospitalisations and pneumonia were non-significantly reduced in the T&P allocated facilities. Drug adverse events were common but tolerated. CONCLUSION: Our trial lacked power but these results provide some support for a policy of "treatment and prophylaxis" with oseltamivir in controlling influenza outbreaks in ACFs. TRIAL

  20. Sanitation in classroom and food preparation areas in child-care facilities in North Carolina and South Carolina.

    Science.gov (United States)

    Wohlgenent, Kelly C; Cates, Sheryl C; Fraser, Angela; Chapman, Benjamin; Jaykus, Lee-Ann; Chen, Xi

    2014-11-01

    Approximately 60% of U.S. children aged five and younger spend time in child-care settings. Such environments increase the risk of diarrheal disease, including diseases caused by enteric pathogens. To describe adherence to sanitation standards in classrooms and food preparation areas in child-care facilities, the authors conducted site visits in 40 North Carolina and South Carolina child-care facilities. Audits in up to two classrooms (rooms providing care for infants and toddlers) and the kitchen were performed using a form similar to a regulatory inspection form. Audit data were used to calculate indices to describe adherence to sanitation standards and were based on state environmental health regulations for child-care centers, the Food and Drug Administration's Food Code 2009, and guidance from food safety experts. Most facilities participating in the authors' study adhered to sanitation standards within the classroom; however, deficiencies with regard to sanitation in food preparation areas and refrigerator operating temperatures were noted. These results provide insight into possible risk factors for enteric disease transmission in child-care facilities.

  1. A record review of reported musculoskeletal pain in an Ontario long term care facility

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    Humphreys B Kim

    2006-03-01

    Full Text Available Abstract Background Musculoskeletal (MSK pain is one of the leading causes of chronic health problems in people over 65 years of age. Studies suggest that a high prevalence of older adults suffer from MSK pain (65% to 80% and back pain (36% to 40%. The objectives of this study were: 1. To investigate the period prevalence of MSK pain and associated subgroups in residents of a long-term care (LTC facility. 2. To describe clinical features associated with back pain in this population. 3. To identify associations between variables such as age, gender, cognitive status, ambulatory status, analgesic use, osteoporosis and osteoarthritis with back pain in a long-term care facility. Methods A retrospective chart review was conducted using a purposive sampling approach of residents' clinical charts from a LTC home in Toronto, Canada. All medical records for LTC residents from January 2003 until March 2005 were eligible for review. However, facility admissions of less than 6 months were excluded from the study to allow for an adequate time period for patient medical assessments and pain reporting/charting to have been completed. Clinical data was abstracted on a standardized form. Variables were chosen based on the literature and their suggested association with back pain and analyzed via multivariate logistic regression. Results 140 (56% charts were selected and reviewed. Sixty-nine percent of the selected residents were female with an average age of 83.7 years (51–101. Residents in the sample had a period pain prevalence of 64% (n = 89 with a 40% prevalence (n = 55 of MSK pain. Of those with a charted report of pain, 6% (n = 5 had head pain, 2% (n = 2 neck pain, 21% (n = 19 back pain, 33% (n = 29 extremity pain and 38% (n = 34 had non-descriptive/unidentified pain complaint. A multivariate logistic regression analysis revealed that osteoporosis was the only significant association with back pain from the variables studied (P = 0.001. Conclusion

  2. When doctors come to prison – a pilot project for better HIV care in correctional facilities

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    I Vaz Pinto

    2012-11-01

    Full Text Available Recent rearrangements in national policies regarding follow-up of HIV-infected inmates have determined that hospitals closest to the prison facility be responsible for their care. Our HIV Unit and the two prison facilities in the area have established a clinical protocol whereby a clinical team goes to the prisons for blood collecting and visits instead of having the inmates transported to the hospital. The purpose of the protocol, from a clinical point of view, was to: (i promote adherence to blood tests and clinical visits; (ii promote adherence to antiretroviral (ARV therapy; (iii facilitate ARV administration by promoting once-daily-dosing. This retrospective review looks back at the first year of protocol implementation between the HIV Unit of HPP Cascais Hospital and the prisons of Tires and Linhó. The purpose of this study is to characterize the demographics of our inmate population; assess the number of inmates on ARV and describe the regimens as PI- or NNRTI-based and as once- or twice-daily dosed; evaluate ARV efficacy by HIV viral load undetectability; and assess opportunity for ARV switch from twice- to once-daily dosing. From April 2011 until June 2012 a total of 53 inmates were included in this protocol. The majority of patients were female (55% as one of the prisons is mainly for female inmates. The median age is 36 years (from 23–59. The average time of follow-up was 11 months (15 months maximum. From the total of 53 patients under study, 40 are currently under care, the other 13 having been released or transferred to other prison facilities. The majority of these patients are on ARV therapy (83%. By the end of follow-up time 88% of patients were on a once-daily dosed regimen; these are PI-based in 69% and NNRTI-based in 31%. At their last evaluation, 32/33 patients on therapy had undetectable HIV viremia (97%. As a conclusion, we assess that this protocol implementation has benefitted all parts: patients assure regular

  3. [Consensus paper of the German Migraine and Headache Society on the structure of headache care facilities in Germany].

    Science.gov (United States)

    Marziniak, M; Malzacher, V; Förderreuther, S; Jürgens, T; Kropp, P; May, A; Straube, A

    2014-04-01

    This consensus paper introduces a classification of headache care facilities on behalf of the German Migraine and Headache Society. This classification is based on the recommendations of the International Association for the Study of Pain (IASP) and the European Headache Federation (EHF) and was adapted to reflect the specific situation of headache care in Germany. It defines three levels of headache care: headache practitioner (level 1), headache outpatient clinic (level 2) and headache centers (level 3). The objective of the publication is to define and establish reliable criteria in the field of headache care in Germany.

  4. The care of Filipino juvenile offenders in residential facilities evaluated using the risk-need-responsivity model.

    Science.gov (United States)

    Spruit, Anouk; Wissink, Inge B; Stams, Geert Jan J M

    2016-01-01

    According to the risk-need-responsivity model of offender, assessment and rehabilitation treatment should target specific factors that are related to re-offending. This study evaluates the residential care of Filipino juvenile offenders using the risk-need-responsivity model. Risk analyses and criminogenic needs assessments (parenting style, aggression, relationships with peers, empathy, and moral reasoning) have been conducted using data of 55 juvenile offenders in four residential facilities. The psychological care has been assessed using a checklist. Statistical analyses showed that juvenile offenders had a high risk of re-offending, high aggression, difficulties in making pro-social friends, and a delayed socio-moral development. The psychological programs in the residential facilities were evaluated to be poor. The availability of the psychological care in the facilities fitted poorly with the characteristics of the juvenile offenders and did not comply with the risk-need-responsivity model. Implications for research and practice are discussed.

  5. Examining physicians’ preparedness for tobacco cessation services in India: Findings from primary care public health facilities in two Indian states

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    Rajmohan Panda

    2013-03-01

    Full Text Available BackgroundA total of 275 million tobacco users live throughout India and are in need of tobacco cessation services. However, the preparation of physicians to deliver this service at primary care health facilities remains unknown.AimsThe study aimed to examine the primary care physicians’ preparedness to deliver tobacco cessation services in two Indian states.MethodResearchers surveyed physicians working in primary care public health facilities, primarily in rural areas using a semistructured interview schedule. Physicians’ preparedness was defined in the study as those possessing knowledge of tobacco cessation methods and exhibiting a positive attitude towards the benefits of tobacco cessation counselling as well as being willing to be part of tobacco prevention or cessation program.ResultsOverall only 17% of physicians demonstrated adequate preparation to provide tobacco cessation services at primary care health facilities in both the States. The findings revealed minimal tobacco cessation training during formal medical education (21.3% and on-the-job training (18.9%. Factors, like sex and age of service provider, type of health facility, location of health facility and number of patients attended by the service provider, failed to show significance during bivariate and regression analysis. Preparedness was significantly predicted by state health system.ConclusionThe study highlights a lack of preparedness of primary care physicians to deliver tobacco cessation services. Both the curriculum in medical school and on-the-job training require an addition of a learning component on tobacco cessation. The addition of this component will enable existing primary care facilities to deliver tobacco cessation services.

  6. CARE-JRA2* Activities on Photo-Injectors and CLIC Test Facility (CTF3)

    CERN Document Server

    Rinolfi, Louis

    2005-01-01

    In the frame of the CARE project, there is a Joint Research Activity (JRA2) called PHIN (PHoto-INjectors). The main objective of this JRA is to perform Research and Development on charge-production by interaction of a laser pulse with material within RF fields and improve or extend existing infrastructures. Another activity of PHIN is the coordination of the activities of various Institutes concerning photo-injectors. A brief review of the work of the eight European laboratories involved in PHIN is presented. One of these R&D topics is the construction of a photo-injector for the CLIC Test Facility (CTF3). In this context the status of CTF3 and its main goals - the demonstration of the feasibility of the key issues of the CLIC two-beam acceleration scheme - is also presented.

  7. Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities.

    Science.gov (United States)

    Genao, Liza; Buhr, Gwendolen T

    2012-04-01

    Urinary tract infections (UTIs) are commonly suspected in residents of long-term care (LTC) facilities, and it has been common practice to prescribe antibiotics to these patients, even when they are asymptomatic. This approach, however, often does more harm than good, leading to increased rates of adverse drug effects and more recurrent infections with drug-resistant bacteria. It also does not improve genitourinary symptoms (eg, polyuria or malodorous urine) or lead to improved mortality rates; thus, distinguishing UTIs from asymptomatic bacteriuria is imperative in the LTC setting. This article provides a comprehensive overview of UTI in the LTC setting, outlining the epidemiology, risk factors and pathophysiology, microbiology, diagnosis, laboratory assessment, and management of symptomatic UTI.

  8. Urinary Tract Infections in Older Adults Residing in Long-Term Care Facilities

    Science.gov (United States)

    Genao, Liza; Buhr, Gwendolen T.

    2013-01-01

    Urinary tract infections (UTIs) are commonly suspected in residents of long-term care (LTC) facilities, and it has been common practice to prescribe antibiotics to these patients, even when they are asymptomatic. This approach, however, often does more harm than good, leading to increased rates of adverse drug effects and more recurrent infections with drug-resistant bacteria. It also does not improve genitourinary symptoms (eg, polyuria or malodorous urine) or lead to improved mortality rates; thus, distinguishing UTIs from asymptomatic bacteriuria is imperative in the LTC setting. This article provides a comprehensive overview of UTI in the LTC setting, outlining the epidemiology, risk factors and pathophysiology, microbiology, diagnosis, laboratory assessment, and management of symptomatic UTI. PMID:23418402

  9. Caring for people with dementia disease (DD) and working in a private not-for-profit residential care facility for people with DD.

    Science.gov (United States)

    Ericson-Lidman, Eva; Larsson, Lise-Lotte Franklin; Norberg, Astrid

    2014-06-01

    Caring for people with dementia and working in dementia care is described as having both rewarding and unpleasant aspects and has been studied to a minor extent. This study aims to explore care providers' narrated experiences of caring for people with dementia disease (DD) and working in a private not-for-profit residential care facility for people with DD. Nine care providers were interviewed about their experiences, the interviews were recorded, transcribed and analysed using thematic analysis. The analysis revealed that participants were struggling to perform person-centred care, which meant trying to see the person behind the disease, dealing with troublesome situations in the daily care, a two-edged interaction with relatives, feelings of shortcomings and troubled conscience, and the need for improvements in dementia care. The analysis also revealed an ambiguous work situation, which meant a challenging value base, the differently judged work environment, feelings of job satisfaction and the need for a functional leadership and management. The results illuminate participants' positive as well as negative experiences and have identified areas requiring improvements. It seems of great importance to strive for a supportive and attendant leadership, a leadership which aims to empower care providers in their difficult work. Using conscience as a driving force together in the work group may benefit care providers' health.

  10. The state of emergency obstetric care services in Nairobi informal settlements and environs: Results from a maternity health facility survey

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    Saliku Teresa

    2009-03-01

    Full Text Available Abstract Background Maternal mortality in Sub-Saharan Africa remains a challenge with estimates exceeding 1,000 maternal deaths per 100,000 live births in some countries. Successful prevention of maternal deaths hinges on adequate and quality emergency obstetric care. In addition to skilled personnel, there is need for a supportive environment in terms of essential drugs and supplies, equipment, and a referral system. Many household surveys report a reasonably high proportion of women delivering in health facilities. However, the quality and adequacy of facilities and personnel are often not assessed. The three delay model; 1 delay in making the decision to seek care; 2 delay in reaching an appropriate obstetric facility; and 3 delay in receiving appropriate care once at the facility guided this project. This paper examines aspects of the third delay by assessing quality of emergency obstetric care in terms of staffing, skills equipment and supplies. Methods We used data from a survey of 25 maternity health facilities within or near two slums in Nairobi that were mentioned by women in a household survey as places that they delivered. Ethical clearance was obtained from the Kenya Medical Research Institute. Permission was also sought from the Ministry of Health and the Medical Officer of Health. Data collection included interviews with the staff in-charge of maternity wards using structured questionnaires. We collected information on staffing levels, obstetric procedures performed, availability of equipment and supplies, referral system and health management information system. Results Out of the 25 health facilities, only two met the criteria for comprehensive emergency obstetric care (both located outside the two slums while the others provided less than basic emergency obstetric care. Lack of obstetric skills, equipment, and supplies hamper many facilities from providing lifesaving emergency obstetric procedures. Accurate estimation of burden

  11. Minorities, men, and unmarried amyotrophic lateral sclerosis patients are more likely to die in an acute care facility.

    Science.gov (United States)

    Goutman, Stephen A; Nowacek, Dustin G; Burke, James F; Kerber, Kevin A; Skolarus, Lesli E; Callaghan, Brian C

    2014-09-01

    Studies suggest that dying at home is a more favorable experience. This study investigated where amyotrophic lateral sclerosis (ALS) patients die and the patient demographics associated with dying in an acute care facility or nursing home compared to home or hospice. Centers for Disease Control and Prevention Multiple Cause Mortality Files from 2005 to 2010 were used to identify ALS patients and to classify place of death. Multinomial logistic regression was used to determine the association between patient demographics and place of death. Between 2005 and 2010, 40,911 patients died of ALS in the United States. Place of death was as follows: home or hospice facility 20,231 (50%), acute care facility (25%), and nursing home (20%). African Americans (adjusted multinomial odds ratio (aMOR) 2.56, CI 2.32-2.83), Hispanics (aMOR 1.44, CI 1.30-1.62), and Asians (aMOR 1.87, CI 1.57-2.22) were more likely to die in an acute care facility, whereas females (aMOR 0.76, CI 0.72-0.80) and married individuals were less likely. Hispanics (aMOR 0.68, CI 0.58-0.79) and married individuals were less likely to die in a nursing home. In conclusion, minorities, men, and unmarried individuals are more likely to die in an acute care facility. Further studies are needed to better understand place of death preferences.

  12. Underreporting of influenza outbreaks in aged care facilities in South Western Sydney, Australia, 2014

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    Leng Boonwaat

    2016-03-01

    Full Text Available In 2014, influenza activity was high in New South Wales (NSW, Australia, and 21 443 people were hospitalized with a diagnosis of influenza-associated pneumonia. This translates to a rate of 252.4 cases per 100 000 population. More than 18 000 cases of laboratory-confirmed influenza were reported in NSW. The majority were influenza A, dominated by A/H3N2 subtype. There were also 111 influenza outbreaks in aged care facilities (ACFs reported in NSW in 2014, the highest number on record. Elderly residents in ACFs experience high rates of morbidity and mortality during influenza outbreaks. They are at increased risk of developing complications due to underlying diseases. These residents also have an increased risk of infection because of the institutional environment they share with many other residents and staff. Furthermore, impaired oral intake, limited dexterity and altered consciousness may limit treatment options when they are infected. The Australian Government’s Department of Health and Ageing (DHA has issued specific guidelines for prevention and control of influenza outbreaks in residential care facilities. While ACFs have primary responsibility for managing outbreaks, Public Health Units (PHUs are required to promote ACF compliance with these guidelines and facilitate delivery and administration of antivirals. However, effective influenza prophylaxis and other timely interventions can only occur if PHUs are notified in a timely manner. DHA guidelines indicate influenza outbreaks in ACFs are to be reported to PHUs. However, under NSW public health legislation, reporting of outbreaks in ACFs is not mandatory. In this report we investigated whether there were outbreaks that were not reported to the South Western Sydney Local Health Districts PHU during the 2014 influenza season.

  13. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities

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    Yamada Yukari

    2006-01-01

    Full Text Available Abstract Background The prevalence and risk factors of potentially inappropriate medication use among the elderly patients have been studied in various countries, but because of the difficulty of obtaining data on patient characteristics and medications they have not been studied in Japan. Methods We conducted a retrospective cross-sectional study in 17 Japanese long-term care (LTC facilities by collecting data from the comprehensive MDS assessment forms for 1669 patients aged 65 years and over who were assessed between January and July of 2002. Potentially inappropriate medications were identified on the basis of the 2003 Beers criteria. Results The patients in the sample were similar in terms of demographic characteristics to those in the national survey. Our study revealed that 356 (21.1% of the patients were treated with potentially inappropriate medication independent of disease or condition. The most commonly inappropriately prescribed medication was ticlopidine, which had been prescribed for 107 patients (6.3%. There were 300 (18.0% patients treated with at least 1 inappropriate medication dependent on the disease or condition. The highest prevalence of inappropriate medication use dependent on the disease or condition was found in patients with chronic constipation. Multiple logistic regression analysis revealed psychotropic drug use (OR = 1.511, medication cost of per day (OR = 1.173, number of medications (OR = 1.140, and age (OR = 0.981 as factors related to inappropriate medication use independent of disease or condition. Neither patient characteristics nor facility characteristics emerged as predictors of inappropriate prescription. Conclusion The prevalence and predictors of inappropriate medication use in Japanese LTC facilities were similar to those in other countries.

  14. Assessing pain as a fifth vital sign in long-term care facilities: Recommendations from the field.

    Science.gov (United States)

    Molony, Sheila L; Kobayashi, Mia; Holleran, Elizabeth A; Mezey, Mathy

    2005-03-01

    In long-term care facilities, pain management is complex because dementia, delirium, and other reasons for residents' altered communication ability are a significant barrier to pain assessment. The purpose of this study was to explore the status of implementation of pain as a fifth vital sign in a sample of long-term care facilities. A three-round Delphi survey was used to obtain consensus from personnel in 60 long-term care facilities in NY State. Findings are presented in terms of recommendations related to pain criteria, assessment methods, frequency of pain assessment, responsibility for pain assessment, monitoring strategies, education, documentation, and pain management education. The results of this study highlight many important considerations in the treatment of pain as a fifth vital sign in long-term care facilities. Evidence-based practice will be facilitated by further research related to underexplored aspects of pain assessment and management, and further attention to care delivery systems that support continued knowledge acquisition and the implementation of best practices.

  15. Old-age Care Modes and Facility Planning Based on the Concept of “Continuum of Care”

    Institute of Scientific and Technical Information of China (English)

    2012-01-01

    Through the comparative analysis on the theories and practical experience of the development of old-age care (OAC) in both China and other countries,and based on the interview and questionnaire survey in Zhejiang Province and Hangzhou City,this paper proposes the research and analysis framework for the old-age service system,i.e.,"OAC mode-OAC service system-OAC facility system." The paper argues that,oriented by OAC mode of "taking community-and home-based care as the main body and institution-based care as supplement," China should build an OAC facility system and planning thoughts that take "continuum of care" as concept and long-term care system as core.Taking Zhejiang Province and Hangzhou City as examples,the paper conducts the optimization research on current OAC facilities planning in terms of hierarchical system,scale,and differentiation,so as to formulate more systematic and operable planning standards for OAC facilities.

  16. Helping the decision maker effectively promote various experts’ views into various optimal solutions to China’s institutional problem of health care provider selection through the organization of a pilot health care provider research system

    OpenAIRE

    Tang, Liyang

    2013-01-01

    Background The main aim of China’s Health Care System Reform was to help the decision maker find the optimal solution to China’s institutional problem of health care provider selection. A pilot health care provider research system was recently organized in China’s health care system, and it could efficiently collect the data for determining the optimal solution to China’s institutional problem of health care provider selection from various experts, then the purpose of this study was to apply ...

  17. Predictors of Poor Pregnancy Outcomes Among Antenatal Care Attendees in Primary Health Care Facilities in Cross River State, Nigeria: A Multilevel Model.

    Science.gov (United States)

    Ameh, Soter; Adeleye, Omokhoa A; Kabiru, Caroline W; Agan, Thomas; Duke, Roseline; Mkpanam, Nkese; Nwoha, Doris

    2016-08-01

    Objectives Pregnancy carries a high risk for millions of women and varies by urban-rural location in Nigeria, a country with the second highest maternal deaths in the world. Addressing multilevel predictors of poor pregnancy outcomes among antenatal care (ANC) attendees in primary health care (PHC) facilities could reduce the high maternal mortality rate in Nigeria. This study utilised the "Risk Approach" strategy to (1) compare the risks of poor pregnancy outcomes among ANC attendees by urban-rural location; and (2) determine predictors of poor pregnancy outcomes among ANC attendees in urban-rural PHC facilities in Cross River State, Nigeria. Methods A cross-sectional survey was conducted in 2011 among 400 ANC attendees aged 15-49 years recruited through multistage sampling. Data on risk factors of poor pregnancy outcomes were collected using interviewer-administered questionnaires and clinic records. Respondents were categorised into low, medium or high risk of poor pregnancy outcomes, based on their overall risk scores. Predictors of poor pregnancy outcomes were determined by multilevel ordinal logistic regression. Results A greater proportion of the women in the rural areas were below the middle socio-economic quintile (75 vs. 4 %, p facilities had a low overall risk of poor pregnancy outcomes than those in the rural facilities (64 vs. 50 %, p = 0.034). Pregnant women in the urban areas had decreased odds of being at high risk of poor pregnancy outcomes versus the combined medium and low risks compared with those in the rural areas (OR 0.55, 95 % CI 0.09-0.65). Conclusions for Practice Pregnant women attending antenatal care in rural PHC facilities are more at risk of poor pregnancy outcomes than those receiving care in the urban facilities. Health programmes that promote safe pregnancy should target pregnant women in rural settings.

  18. Intention to Use Long-Term Care Facilities: Differences beween Korean Pre-elderly and Korean Baby-boomers.

    Science.gov (United States)

    Hong, Michin; Hong, Seunghye; Kim, Mee Hye; Yi, Eun Hye

    2016-12-01

    With the rapidly increasing number of older adults, dealing with long-term care (LTC) needs becomes an emerging issue in South Korea. This study aims to examine factors affecting the intention to use longtermcare facilities with two groups of young-old adults: (1) Korean pre-elderly (KPE) and (2) Korean babyboomers (KBB). Guided by Andersen's behavioral model of health service use and prior research, predisposing characters, enabling resources, need factors, availabilities of informal care and self-care activities were used as predictors. In the final analyses, 803 KPE and 966 KBB were included. The results of logistic regression analyses showed different findings in two groups. Age, education, spouse's physicalhealth, and self-care activities for relationship with family and friends are significantly associated with intention to use LTC facilities among KPE. However, income, physical health of respondents, and relationship satisfaction with children are significantly related to intention of use LTC facilities in the group of KBB. This study suggests different LTC needs between KPE and KBB. Health care professionals and policy makers need to consider such differences to provide quality LTC care for them.

  19. The impact of facility relocation on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care.

    Science.gov (United States)

    Alexiou, Eirini; Degl' Innocenti, Alessio; Kullgren, Anette; Wijk, Helle

    2016-08-01

    In recent years, large groups of forensic psychiatric patients have been relocated into new medium- and maximum-security forensic psychiatric facilities in Sweden, where a psychosocial care approach is embedded. From this perspective and on the assumption that physical structures affect the therapeutic environment, a prospective longitudinal study was designed to investigate the impact of the facility relocation of three forensic psychiatric hospitals on patients' perceptions of ward atmosphere and quality of received forensic psychiatric care. Participants were patients over 18 years of age sentenced to compulsory forensic psychiatric treatment. Data were obtained by validated questionnaires. Overall, 58 patients (78%) answered the questionnaires at baseline with a total of 25 patients (34%) completing follow-up 1 at six months and 11 patients (15%) completing follow-up 2, one year after relocation. Approximately two-thirds of the participants at all time-points were men and their age range varied from 18 to 69. The results of this study showed that poor physical environment features can have a severe impact on care quality and can reduce the possibilities for person-centered care. Furthermore, the study provides evidence that the patients' perceptions of person-centered care in forensic psychiatric clinics are highly susceptible to factors in the physical and psychosocial environment. Future work will explore the staff's perception of ward atmosphere and the possibilities to adapt a person-centered approach in forensic psychiatric care after facility relocation.

  20. Successful aging as an oxymoron: older people – with and without home-help care – talk about what aging well means to them

    Directory of Open Access Journals (Sweden)

    Sandra Torres

    2009-10-01

    Full Text Available Notions of what it means to age well or successfully are central to social gerontological research and practice. As such, one would expect that there would be consensus as to what the construct of successful aging means and/or how aging well is achieved. This is not, however, the case which is why this study explores the meanings that a group of older people (i.e. some with home-help care and some without attach to this construct. The empirical material is constituted of 16 semi-structured interviews. The findings bring to fore the different resources (such as physical, mental, psycho-social, spiritual, and financial ones that are associated with successful aging and the kind of outlook on life that is regarded as useful if one wants to age well. Differences between home-help care recipients and those that do not receive this type of care were found. Those that are managing without the help offered by home-help care services listed more resources and offered more nuanced descriptions of what successful aging means than those that receive home-help care. This suggests that receiving home-help care and/or not being able to manage primarily on one’s own might shape the manner in which older people think about what constitutes a good old age. The in-depth analysis of the notions of successful aging that were brought to the fore suggests also the paradoxical fact that the title of this article attests to; namely that some associate aging well with not aging at all and deem, in fact, the term successful aging to be an oxymoron.

  1. Laboratory testing improves diagnosis and treatment outcomes in primary health care facilities

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    Jane Y. Carter

    2011-12-01

    Full Text Available Objective: To determine if use of basic laboratory tests improves diagnosis and treatment outcomes in outpatients attending rural primary health care facilities.Setting: Six rural health centres in Kenya.Design: Cross-sectional study to observe change in diagnosis and treatment made by clinical officers after laboratory testing in outpatients attending six rural health centres in Kenya.Subject: The diagnosis and treatment of 1134 patients attending outpatient services in six rural health centres were compared before and after basic laboratory testing. Essential clinical diagnostic equipment and laboratory tests were established at each health centre. Clinical officers and laboratory technicians received on-site refresher training in good diagnostic practices and laboratory procedures before the study began.Results: Laboratory tests were ordered on 704 (62.1% patients. Diagnosis and treatment were changed in 45% of tested patients who returned with laboratory results (21% of all patients attending the clinics. 166 (23.5% patients did not return to the clinician for a final diagnosis and management decision after laboratory testing. Blood slide examination for malaria parasites, wet preparations, urine microscopy and stool microscopy resulted in most changes to diagnosis. There was no significant change in drug costs after laboratory testing. The greatest changes in numbers of recorded diseases following laboratory testing was for intestinal worms (53% and malaria (21%.Conclusion: Effective use of basic laboratory tests at primary health care level significantly improves diagnosis and patient treatment. Use of laboratory testing can be readily incorporated into routine clinical practice. On-site refresher training is an effective means of improving the quality of patient care and communication between clinical and laboratory staff.

  2. Medication incident reporting in residential aged care facilities: Limitations and risks to residents’ safety

    Directory of Open Access Journals (Sweden)

    Tariq Amina

    2012-11-01

    Full Text Available Abstract Background Medication incident reporting (MIR is a key safety critical care process in residential aged care facilities (RACFs. Retrospective studies of medication incident reports in aged care have identified the inability of existing MIR processes to generate information that can be used to enhance residents’ safety. However, there is little existing research that investigates the limitations of the existing information exchange process that underpins MIR, despite the considerable resources that RACFs’ devote to the MIR process. The aim of this study was to undertake an in-depth exploration of the information exchange process involved in MIR and identify factors that inhibit the collection of meaningful information in RACFs. Methods The study was undertaken in three RACFs (part of a large non-profit organisation in NSW, Australia. A total of 23 semi-structured interviews and 62 hours of observation sessions were conducted between May to July 2011. The qualitative data was iteratively analysed using a grounded theory approach. Results The findings highlight significant gaps in the design of the MIR artefacts as well as information exchange issues in MIR process execution. Study results emphasized the need to: a design MIR artefacts that facilitate identification of the root causes of medication incidents, b integrate the MIR process within existing information systems to overcome key gaps in information exchange execution, and c support exchange of information that can facilitate a multi-disciplinary approach to medication incident management in RACFs. Conclusions This study highlights the advantages of viewing MIR process holistically rather than as segregated tasks, as a means to identify gaps in information exchange that need to be addressed in practice to improve safety critical processes.

  3. Pathways to psychiatric care for children and adolescents at a tertiary facility in northern Nigeria

    Directory of Open Access Journals (Sweden)

    Jibril O. Abdulmalik

    2012-03-01

    Full Text Available There is limited availability of mental health services in Nigeria, and indeed most of Africa. Available services are also often under-utilized because of widespread ignorance and supernatural beliefs about the etiology of mental illnesses. The consequence, therefore, is a long and tedious pathway to care for the mentally ill, especially children and adolescents. This was a study of all new patients, aged 18 years and below, presenting over a 6 month period in 2009 (January – June at the outpatient clinic of a tertiary psychiatric facility in northern Nigeria. A socio-demographic questionnaire was utilized, along with a record of the clinician’s assessment of diagnosis for 242 patients. Subjects who had been withdrawn from school, or any previously engaged-in activity for longer than 4 weeks on account of the illness, were recorded as having disability from the illness. The children were aged 1-18 years (mean=12.3; SD=5.2 with males accounting for 51.7% (125 while 14.5% of the females (n=117 were married. Two thirds (64.5% of the patients had been ill for longer than 6 months prior to presentation. One hundred and forty four subjects (59.5% had received no care at all, while 36.4% had received treatment from traditional/religious healers prior to presentation. The most disabling conditions were ADHD (80%, mental retardation (77.8%, epilepsy (64.1% and psychotic disorders (50%. There is urgent need for extending mental health services into the community in order to improve access to care and increase awareness about effective and affordable treatments.

  4. Pathways to Psychiatric Care for Children and Adolescents at a Tertiary Facility in Northern Nigeria.

    Science.gov (United States)

    Abdulmalik, Jibril O; Sale, Shehu

    2012-03-07

    There is limited availability of mental health services in Nigeria, and indeed most of Africa. Available services are also often under-utilized because of widespread ignorance and supernatural beliefs about the etiology of mental illnesses. The consequence, therefore, is a long and tedious pathway to care for the mentally ill, especially children and adolescents. This was a study of all new patients, aged 18 years and below, presenting over a 6 month period in 2009 (January - June) at the outpatient clinic of a tertiary psychiatric facility in northern Nigeria. A socio-demographic questionnaire was utilized, along with a record of the clinician's assessment of diagnosis for 242 patients. Subjects who had been withdrawn from school, or any previously engaged-in activity for longer than 4 weeks on account of the illness, were recorded as having disability from the illness. The children were aged 1-18 years (mean=12.3; SD=5.2) with males accounting for 51.7% (125) while 14.5% of the females (n=117) were married. Two thirds (64.5%) of the patients had been ill for longer than 6 months prior to presentation. One hundred and forty four subjects (59.5%) had received no care at all, while 36.4% had received treatment from traditional/religious healers prior to presentation. The most disabling conditions were ADHD (80%), mental retardation (77.8%), epilepsy (64.1%) and psychotic disorders (50%). There is urgent need for extending mental health services into the community in order to improve access to care and increase awareness about effective and affordable treatments.

  5. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana.

    Science.gov (United States)

    Ahiabu, Mary-Anne; Tersbøl, Britt P; Biritwum, Richard; Bygbjerg, Ib C; Magnussen, Pascal

    2016-03-01

    Resistance to antibiotics is increasing globally and is a threat to public health. Research has demonstrated a correlation between antibiotic use and resistance development. Developing countries are the most affected by resistance because of high infectious disease burden, limited access to quality assured antibiotics and more optimal drugs and poor antibiotic use practices. The appropriate use of antibiotics to slow the pace of resistance development is crucial. The study retrospectively assessed antibiotic prescription practices in four public and private primary health-care facilities in Eastern Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis and logistic regression was used to explore for predictors of antibiotic prescription. Average number of medicines prescribed per encounter was 4.01, and 59.9% of prescriptions had antibiotics whilst 24.2% had injections. In total, 79.2% and 88.1% of prescribed medicines were generics and from the national essential medicine list, respectively. In the multivariate analysis, health facility type (odds ratio [OR] = 2.05; 95% confidence interval [CI]: 1.42, 2.95), patient age (OR = 0.97; 95% CI: 0.97, 0.98), number of medicines on a prescription (OR = 1.85; 95% CI: 1.63, 2.10) and 'no malaria drug' on prescription (OR = 5.05; 95% CI: 2.08, 12.25) were associated with an antibiotic prescription. A diagnosis of upper respiratory tract infection was positively associated with antibiotic use. The level of antibiotic use varied depending on the health facility type and was generally high compared with the national average estimated in 2008. Interventions that reduce diagnostic uncertainty in illness management should be considered. The National Health Insurance

  6. [Peers contribution to mental health work: considerations on the relationship between formal and informal help. A case study in a mental health facility in Buenos Aires].

    Science.gov (United States)

    Ardila Gómez, Sara; Agrest, Martín; Abadi, Daniel; Cáceres, Carmen

    2013-01-01

    Including peers to the mental health workforce has been part of a larger debate regarding specificity and incumbencies of peers' work, as well as their relationship with other workers. While some members of the workforce are proposing to train peers to have them help in different settings and interventions, others see them as unfair and underprepared competitors trying to replace them. Based on this debate, and from a Collective Health perspective on the concept of "care", this paper supports the idea that, since they put "care" as central to anything done by the mental health workforce, peers could be crucial to practices in Mental Health. An experience that took place in a Day Hospital in Buenos Aires City, conversed within a group dedicated to reflect on peers' support, is analyzed in order to unveil the relationship between peers and professionals, as well as peers' specificity. It is withstand that one of the main contributions of including peers is to help professionals think more about the relational dimension of their work and about the way they treat, call and refer to patients.

  7. Knowledge of Staff Members of Residential Care Facilities for Individuals with Intellectual Disability on Medication Administration via Enteral Feeding Tube

    Science.gov (United States)

    Joos, E.; Mehuys, E.; Van Bocxlaer, J.; Remon, J. P.; Van Winckel, M.; Boussery, K.

    2016-01-01

    Background: Guidelines for the safe administration of drugs through enteral feeding tube (EFT) are an important tool to minimise the risk of errors. This study aimed to investigate knowledge of these guidelines among staff of residential care facilities (RCF) for people with ID. Method: Knowledge was assessed using a 13-item self-administered…

  8. Epidemiology of Gram Negative Antimicrobial Resistance in a Multi-State Network of Long Term Care Facilities

    Science.gov (United States)

    Lautenbach, Ebbing; Marsicano, Roseann; Tolomeo, Pam; Heard, Michael; Serrano, Steve; Stieritz, Donald D.

    2009-01-01

    We identified 1,805 gram-negative organisms in urine cultures from residents of 63 long-term care facilities (LTCFs) over 10 months. Fluoroquinolone resistance was 51% among E. coli, while 26% and 6% of Klebsiella were resistant to ceftazidime and imipenem, respectively. Resistance varied significantly by type of LTCF, LTCF size, and geographic region. PMID:19566445

  9. Evaluation of the Color Me Healthy Program in Influencing Nutrition and Physical Activity in Mississippi Preschool Child Care Facilities

    Science.gov (United States)

    Huye, Holly F.; Bankston, Sarah; Speed, Donna; Molaison, Elaine F.

    2014-01-01

    Purpose/Objectives: The purpose of this research was to determine the level of implementation and perceived value in creating knowledge and behavior change from the Color Me Healthy (CMH) training program in child care centers, family day carehomes, or Head Start facilities throughout Mississippi. Methods: A two-phase survey was used to initially…

  10. Bacteremia in a Long-Term -Care Facility: a Five-Year Prospective Study of 163 Consecutive Episodes

    NARCIS (Netherlands)

    R.R. Muder; C. Brennen; M.M. Wagener (Marilyn); A.M. Geotz

    1992-01-01

    textabstractThe clinical features, microbiological characteristics, and outcomes of 163 episodes of bacteremia occurring at a long-term-care facility were evaluated. The rate of nosocomial bacteremia increased from 0.20 to 0.36 cases/1,000 patient-days from 1985 to 1989; there was a parallel increas

  11. Transmission of methicillin-resistant Staphylococcus aureus in long-term care facilities and their related healthcare networks

    OpenAIRE

    Harrison, Ewan M.; Ludden, Catherine; Brodrick, Hayley J.; Blane, Beth; Brennan, Gráinne; Morris, Dearbháile; Coll, Francesc; Reuter, Sandra; Brown, Nicholas M.; Holmes, Mark A.; O’Connell, Brian; Parkhill, Julian; Török, M.E.; Cormican, Martin; Sharon J Peacock

    2016-01-01

    Abstract Background Long-term care facilities (LTCF) are potential reservoirs for methicillin-resistant Staphylococcus aureus (MRSA), control of which may reduce MRSA transmission and infection elsewhere in the healthcare system. Whole-genome sequencing (WGS) has been used successfully to understand MRSA epidemiology and transmission in hospitals and has the potential to identify transmission between these and LTCF. ...

  12. The environmental design of residential care facilities: A sense of home through the eyes of nursing home residents.

    NARCIS (Netherlands)

    van Dijck-Heinen, C.J.M.L.; Wouters, E.J.M.; Janssen, B.M.; van Hoof, J.

    2014-01-01

    C.J.M.L. van Dijck-Heinen, E.J.M. Wouters, B.M. Janssen, J. van Hoof (2014) The environmental design of residential care facilities: A sense of home through the eyes of nursing home residents. International Journal for Innovative Research in Science & Technology 1(4): 57-69

  13. 78 FR 38594 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

    Science.gov (United States)

    2013-06-27

    ... requirements that an institution will have to meet in order to qualify to participate as a skilled nursing facility (SNF) in the Medicare program, or as a nursing facility (NF) in the Medicaid program. These... sections 1819(b)(2) and 1919(b)(2) of the Act, a skilled nursing facility (SNF) or nursing facility...

  14. Does Moral Case Deliberation Help Professionals in Care for the Homeless in Dealing with Their Dilemmas? A Mixed-Methods Responsive Study.

    Science.gov (United States)

    Spijkerboer, R P; van der Stel, J C; Widdershoven, G A M; Molewijk, A C

    2017-03-01

    Health care professionals often face moral dilemmas. Not dealing constructively with moral dilemmas can cause moral distress and can negatively affect the quality of care. Little research has been documented with methodologies meant to support professionals in care for the homeless in dealing with their dilemmas. Moral case deliberation (MCD) is a method for systematic reflection on moral dilemmas and is increasingly being used as ethics support for professionals in various health-care domains. This study deals with the question: What is the contribution of MCD in helping professionals in an institution for care for the homeless to deal with their moral dilemmas? A mixed-methods responsive evaluation design was used to answer the research question. Five teams of professionals from a Dutch care institution for the homeless participated in MCD three times. Professionals in care for the homeless value MCD positively. They report that MCD helped them to identify the moral dilemma/question, and that they learned from other people's perspectives while reflecting and deliberating on the values at stake in the dilemma or moral question. They became aware of the moral dimension of moral dilemmas, of related norms and values, of other perspectives, and learned to formulate a moral standpoint. Some experienced the influence of MCD in the way they dealt with moral dilemmas in daily practice. Half of the professionals expect MCD will influence the way they deal with moral dilemmas in the future. Most of them were in favour of further implementation of MCD in their organization.

  15. Integration of Chiropractic Services in Military and Veteran Health Care Facilities: A Systematic Review of the Literature.

    Science.gov (United States)

    Green, Bart N; Johnson, Claire D; Daniels, Clinton J; Napuli, Jason G; Gliedt, Jordan A; Paris, David J

    2016-04-01

    This literature review examined studies that described practice, utilization, and policy of chiropractic services within military and veteran health care environments. A systematic search of Medline, CINAHL, and Index to Chiropractic Literature was performed from inception through April 2015. Thirty articles met inclusion criteria. Studies reporting utilization and policy show that chiropractic services are successfully implemented in various military and veteran health care settings and that integration varies by facility. Doctors of chiropractic that are integrated within military and veteran health care facilities manage common neurological, musculoskeletal, and other conditions; severe injuries obtained in combat; complex cases; and cases that include psychosocial factors. Chiropractors collaboratively manage patients with other providers and focus on reducing morbidity for veterans and rehabilitating military service members to full duty status. Patient satisfaction with chiropractic services is high. Preliminary findings show that chiropractic management of common conditions shows significant improvement.

  16. Brucellosis is not a major cause of febrile illness in patients at public health care facilities in Binh Thuan Province, Vietnam

    NARCIS (Netherlands)

    T.T.T. Nga; P.J. de Vries; T.H. Abdoel; H.L. Smits

    2006-01-01

    Objective: To determine the presence of brucellosis among patients with acute febrile illness at health care facilities in Binh Thuan province, Vietnam. Method: A retrospective seroepidemiological study on serum samples collected at 13 not adjacent health care facilities using the Rose Bengal test a

  17. Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities

    Directory of Open Access Journals (Sweden)

    Scherer Samuel

    2009-08-01

    Full Text Available Abstract Background Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF staff and General Practitioners (GPs relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia education, perceived levels of current knowledge regarding dementia, perceived unmet educational needs, current barriers, facilitators and preferences for dementia education. Methods A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey and 202 GPs (19% of metropolitan GPs. Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically. Results Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern

  18. Physician strives to create lean, clean health care machine. Studies of manufacturing processes may one day help make your practice more efficient.

    Science.gov (United States)

    Hill, D

    2001-01-01

    Elisabeth Hager, MD, MMM, CPE, is teaming up with scientists and industrialists to teach physicians how to apply principles of lean, total-quality manufacturing to their practices. She believes innovation and efficiencies can help doctors resurrect their profession's image and their control over it--and perhaps even reinvent American health care.

  19. Evaluation of Antidiabetic Prescriptions from Medical Reimbursement Applications at Banaras Hindu University Health Care Facility

    Directory of Open Access Journals (Sweden)

    Dev Priya

    2015-10-01

    Full Text Available Background: Diabetes is on rapid increase in third world countries undergoing rapid transition in terms of development particularly in India, which is often being referred as Diabetic capital. It is a disease more prevalent at latter part of life of human beings when finances dwindle and social care gets neglected. The medication continues till the whole life on a regular basis. In present study, the objective has been to provide pharmacoeconomic medication to the diabetic pensioners in the backdrop as mentioned in above background.Methods: The data was collected at the medical reimbursement section of pensioners of the University. The data was examined to answer issues of therapeutic decisions in the light of the pharmacoeconomic considerations. In this paper essentially data on choice of prescriptions with the angle of pharmacoeconomic prudence were included. The dichotomy of specialist versus non specialist prescribers at the tertiary center (i.e. medical college hospital was compared. Effort was made to define merit of the prescription based on comprehensive considerations of patient profile, disease profile and therapeutic choice.Results: Total 72 prescriptions were analyzed for the study in which 475 drugs were prescribed to the patients.  Total antidiabetic drugs prescribed to the patients were 169. Out of 72 cases 39 were males and 33 were females with mean age 66.04 ± 5.80 (Mean ± SEM. The average number of drugs per prescription was 6.59 which was very high as per guidelines. Most commonly prescribed antidiabetic drug was Metformin (63.89% followed by Glimepiride (31.95%.Conclusion: This study reflects that there is need to make available the standard therapeutic optionat University Health Care Facility based upon pharmacoeconomic considerations.

  20. Reduction of femoral fractures in long-term care facilities: the Bavarian fracture prevention study.

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    Clemens Becker

    Full Text Available BACKGROUND: Hip fractures are a major public health burden. In industrialized countries about 20% of all femoral fractures occur in care dependent persons living in nursing care and assisted living facilities. Preventive strategies for these groups are needed as the access to medical services differs from independent home dwelling older persons at risk of osteoporotic fractures. It was the objective of the study to evaluate the effect of a fall and fracture prevention program on the incidence of femoral fracture in nursing homes in Bavaria, Germany. METHODS: In a translational intervention study a fall prevention program was introduced in 256 nursing homes with 13,653 residents. The control group consisted of 893 nursing homes with 31,668 residents. The intervention consisted of staff education on fall and fracture prevention strategies, progressive strength and balance training, and on institutional advice on environmental adaptations. Incident femoral fractures served as outcome measure. RESULTS: In the years before the intervention risk of a femoral fracture did not differ between the intervention group (IG and control group (CG. During the one-year intervention period femoral fracture rates were 33.6 (IG and 41.0/1000 person years (CG, respectively. The adjusted relative risk of a femoral fracture was 0.82 (95% CI 0.72-0.93 in residents exposed to the fall and fracture prevention program compared to residents from CG. CONCLUSIONS: The state-wide dissemination of a multi-factorial fall and fracture prevention program was able to reduce femoral fractures in residents of nursing homes.

  1. Prevalence of toenail onychomycosis among diabetics at a primary care facility in Malaysia.

    Science.gov (United States)

    Leelavathi, M; Azimah, M N; Kharuddin, N F; Tzar, M N

    2013-05-01

    Onychomycosis increases the risk of developing secondary bacterial infection and cellulitis if left untreated. The aim of this study was to determine the prevalence of onychomycosis among diabetics and its associated factors. A cross sectional study using universal sampling of all type 1 and 2 diabetic patients attending a primary care facility of the Universiti Kebangsaan Malaysia (UKM) from January to March 2011 was conducted. Samples were taken from clinically abnormal nails and from the first right toenail in the absence of nail abnormalities and cultured for fungal elements. A total of 151 diabetics participated in the study. The mean patient age was 60.7 +/- 9.1 years. A total of 123 nail samples (81.5%) were culture positive for fungal elements. A positive correlation was found between onychomycosis and increasing age (p = 0.011) and clinically abnormal nails (p < 0.05). There were no significant correlations with gender, ethnic group, duration of diabetes, types of diabetes or glycemic control. The prevalence of onychomycosis among diabetics in our study was high.

  2. The Association between Malnutrition and Pressure Ulcers in Elderly in Long-Term Care Facility

    Directory of Open Access Journals (Sweden)

    Lenche Neloska

    2016-08-01

    Full Text Available BACKGROUND: Malnutrition is common in elderly and is a risk factor for pressure ulcers. AIM: The aim of the present study was to determine the prevalence of malnutrition in geriatric and palliative patients hospitalised in long-term care facility, and to examine the influence of nutritional status on the prevalence of pressure ulcers (PU. MATERIAL AND METHODS: Descriptive, observational and cross-sectional study including 2099 patients admitted to the Hospital during a 24 month period (January 2013 to December 2014. We recorded: demographic data, body mass index (BMI, Braden score, laboratory parameters of interest (albumin, total protein, RBC count, haemoglobin and iron levels and presence or absence of malnutrition and pressure ulcers. RESULTS: The pressure ulcer prevalence was 12.9% (256 out of 2099. Based on the BMI classification, 61.7% of patients had a good nutritional status, 27.4% were undernourished, and 2.1% were considered malnourished. Nutritional status was statistically significantly different between patients with and without PU (p < 0.0001. This study also showed that hypoproteinemia, hypoalbuminemia, low RBC was positively associated with PU prevalence. CONCLUSION: The results highlight the impact of nutritional status on the prevalence of pressure ulcers in hospitalised geriatric and palliative population. It is of paramount importance to correctly evaluate the presence of malnutrition in patients at risk of pressure ulcers.

  3. Epidemiology and resistance patterns in urinary pathogens from long-term care facilities and GP populations.

    LENUS (Irish Health Repository)

    Brabazon, E D

    2012-06-01

    Urinary tract infections (UTIs) are a major source of antimicrobial prescribing in the clinical setting and a potential reservoir for the emergence of resistant organisms. Although studies have been published on resistance rates for urinary pathogens from both hospital and general practitioner (GP) settings, there is little information from Long-Term Care Facilities (LTCFs) in Ireland. This study aimed to document the epidemiology and resistance rates in urinary isolates, in the LTCF and GP setting, from samples submitted to a typical microbiology laboratory. In 2010, there were 963 urinary isolates from LTCFs and 1,169 urinary isolates from GPs, identified from patients 65 years and over, with cytology suggestive of infection. E. coil was the most common causative organism identified. There were significantly higher levels of resistance to ampicillin, co-amoxiclav, ciprofloxacin, nitrofurantoin, trimethoprim, and piperacillin\\/tazobactam in the LTCF population compared to the GP population (e.g. for E. coli, 86%-v-69%; 30%-v- 21%; 58%-v-26%, 10%-v-3%, 68%-v-48%, 10%-v- 4% respectively). Isolates with resistance mechanisms to beta-lactams, were identified in both populations. Results presented in this paper demonstrate significant differences between resistance rates in LTCF and GP populations which suggest that there are implications for empiric antimicrobial prescribing for UTIs in the LTCF setting.

  4. Study of Cyclospora cayetanensis in health care facilities, sewage water and green leafy vegetables in Nepal.

    Science.gov (United States)

    Sherchand, J B; Cross, J H; Jimba, M; Sherchand, S; Shrestha, M P

    1999-03-01

    Cyclospora cayetanensis, a newly emerging parasite, is endemic in Nepal. A total of 2,123 stool specimens were collected from 3 health care facilities based on clinical symptoms during the period between 1995 to October, 1998. Out of these specimens, cayetanensis oocysts were found in 632 (29.8%). To identify possible sources for Cyclospora infection, drinking water, sewage water, green-leafy vegetables including fecal samples of various animals were collected and examined. The vegetable leaves were washed in distilled water then the washings, sewage water and drinking water were centrifuged and the sediment were examined microscopically. As a result, oocyst of Cyclospora were identified in sewage water and vegetable washings on four different occasions in June, August, October and November. The positive results were also confirmed as C. cayetanensis by development of 2 sporocysts after 2 week incubation period in potassium dichromate. A survey of 196 domestic animals from the same areas demonstrated that two chickens were positive for Cyclospora-like organism and others were negative. Although further studies are needed to clarify the direct link between Cyclospora infection and these sources, the results suggest that sewage water, green leafy vegetables are possible sources of infection and chickens could be possible reservoir host of Cyclospora in Nepal.

  5. Treatment for osteoporosis in Australian residential aged care facilities: consensus recommendations for fracture prevention.

    Science.gov (United States)

    Duque, Gustavo; Close, Jacqueline J; de Jager, Julien P; Ebeling, Peter R; Inderjeeth, Charles; Lord, Stephen; McLachlan, Andrew J; Reid, Ian R; Troen, Bruce R; Sambrook, Philip N

    2010-08-02

    Older people living in residential aged care facilities (RACFs) are at considerably higher risk of suffering fractures than older people living in the community. When admitted to RACFs, patients should be assessed for fracture risk to ensure early implementation of effective fracture prevention measures. Routine or regular determination of calcium and phosphate serum levels in institutionalised older people is not indicated. Opinion is divided about the value of routine measurements of serum concentrations of 25-hydroxyvitamin D, parathyroid hormone and bone turnover markers. The non-pharmacological approach to fracture prevention includes multifactorial programs of falls prevention and the use of hip protectors. Vitamin D supplementation is recommended for all patients in RACFs. Dietary calcium intake should be optimised (1200-1500 mg per day is recommended) and supplementation offered to those with inadequate intake. The decision to prescribe calcium supplements should be guided by patients' tolerance, whether or not they have a history of kidney stones, and emerging data about its cardiovascular safety. Bisphosphonates are the first-choice pharmacological agents for fracture prevention in older persons at high risk. Intravenous administration is as efficient as oral and has the significant advantage of better adherence. Use of strontium ranelate has not been tested on people in RACFs, but evidence in the "old-old" (those aged 75 years and older) suggests it could be a therapeutic option for fracture prevention in this setting. In general, teriparatide should not be considered as a first-line treatment for fracture prevention, particularly for people in RACFs.

  6. Influence of a non-hospital medical care facility on antimicrobial resistance in wastewater.

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    Mathias Bäumlisberger

    Full Text Available The global widespread use of antimicrobials and accompanying increase in resistant bacterial strains is of major public health concern. Wastewater systems and wastewater treatment plants are considered a niche for antibiotic resistance genes (ARGs, with diverse microbial communities facilitating ARG transfer via mobile genetic element (MGE. In contrast to hospital sewage, wastewater from other health care facilities is still poorly investigated. At the instance of a nursing home located in south-west Germany, in the present study, shotgun metagenomics was used to investigate the impact on wastewater of samples collected up- and down-stream in different seasons. Microbial composition, ARGs and MGEs were analyzed using different annotation approaches with various databases, including Antibiotic Resistance Ontologies (ARO, integrons and plasmids. Our analysis identified seasonal differences in microbial communities and abundance of ARG and MGE between samples from different seasons. However, no obvious differences were detected between up- and downstream samples. The results suggest that, in contrast to hospitals, sewage from the nursing home does not have a major impact on ARG or MGE in wastewater, presumably due to much less intense antimicrobial usage. Possible limitations of metagenomic studies using high-throughput sequencing for detection of genes that seemingly confer antibiotic resistance are discussed.

  7. Association of antenatal care with facility delivery and perinatal survival – a population-based study in Bangladesh

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    Pervin Jesmin

    2012-10-01

    Full Text Available Abstract Background Antenatal Care (ANC during pregnancy can play an important role in the uptake of evidence-based services vital to the health of women and their infants. Studies report positive effects of ANC on use of facility-based delivery and perinatal mortality. However, most existing studies are limited to cross-sectional surveys with long recall periods, and generally do not include population-based samples. Methods This study was conducted within the Health and Demographic Surveillance System (HDSS of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b in Matlab, Bangladesh. The HDSS area is divided into an icddr,b service area (SA where women and children receive care from icddr,b health facilities, and a government SA where people receive care from government facilities. In 2007, a new Maternal, Neonatal, and Child Health (MNCH program was initiated in the icddr,b SA that strengthened the ongoing maternal and child health services including ANC. We estimated the association of ANC with facility delivery and perinatal mortality using prospectively collected data from 2005 to 2009. Using a before-after study design, we also determined the role of ANC services on reduction of perinatal mortality between the periods before (2005 – 2006 and after (2008–2009 implementation of the MNCH program. Results Antenatal care visits were associated with increased facility-based delivery in the icddr,b and government SAs. In the icddr,b SA, the adjusted odds of perinatal mortality was about 2-times higher (odds ratio (OR 1.91; 95% confidence intervals (CI: 1.50, 2.42 among women who received ≤1 ANC compared to women who received ≥3 ANC visits. No such association was observed in the government SA. Controlling for ANC visits substantially reduced the observed effect of the intervention on perinatal mortality (OR 0.64; 95% CI: 0.52, 0.78 to non-significance (OR 0.81; 95% CI: 0.65, 1.01, when comparing cohorts before

  8. Impact of free delivery care on health facility delivery and insurance coverage in Ghana's Brong Ahafo Region.

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    Susie Dzakpasu

    Full Text Available BACKGROUND: Many sub-Saharan countries, including Ghana, have introduced policies to provide free medical care to pregnant women. The impact of these policies, particularly on access to health services among the poor, has not been evaluated using rigorous methods, and so the empirical basis for defending these policies is weak. In Ghana, a recent report also cast doubt on the current mechanism of delivering free care--the National Health Insurance Scheme. Longitudinal surveillance data from two randomized controlled trials conducted in the Brong Ahafo Region provided a unique opportunity to assess the impact of Ghana's policies. METHODS: We used time-series methods to assess the impact of Ghana's 2005 policy on free delivery care and its 2008 policy on free national health insurance for pregnant women. We estimated their impacts on facility delivery and insurance coverage, and on socioeconomic differentials in these outcomes after controlling for temporal trends and seasonality. RESULTS: Facility delivery has been increasing significantly over time. The 2005 and 2008 policies were associated with significant jumps in coverage of 2.3% (p = 0.015 and 7.5% (p<0.001, respectively after the policies were introduced. Health insurance coverage also jumped significantly (17.5%, p<0.001 after the 2008 policy. The increases in facility delivery and insurance were greatest among the poorest, leading to a decline in socioeconomic inequality in both outcomes. CONCLUSION: Providing free care, particularly through free health insurance, has been effective in increasing facility delivery overall in the Brong Ahafo Region, and especially among the poor. This finding should be considered when evaluating the impact of the National Health Insurance Scheme and in supporting the continuation and expansion of free delivery care.

  9. A survey of Dutch GPs' attitudes towards help seeking and follow-up care for relatives bereaved by suicide

    NARCIS (Netherlands)

    de Groot, Marieke; van der Meer, Klaas; Burger, Huibert

    2009-01-01

    Methods. A cross-sectional survey among 488 GPs in the northern part of The Netherlands. Results. A 44% response was achieved (n = 214) during the last 3 years, 38 (18%) were exposed to suicide, 21 (10%) to help requests without being exposed to suicide and 52 (24%) to both suicide and help requests

  10. Health providers' perception of quality of care for neonates in health facilities in a municipality in Southern Ghana.

    Science.gov (United States)

    Elikplim Pomevor, Kokui; Adomah-Afari, Augustine

    2016-10-10

    Purpose The purpose of this paper is to assess available human resources for neonatal care and their skills, in order to explore health providers' perceptions of quality of neonatal care in health facilities in Ghana. Design/methodology/approach Data were gathered using qualitative interviews with health providers working in the maternity and paediatric wards and midwives; direct observation; and documentary review at a regional hospital, a municipal hospital and four health centres in a municipality in a region in Southern Ghana. Data were analysed using thematic framework through the process of coding in six phases to create and establish meaningful patterns. Findings The study revealed that health providers were concerned about the number of staff available, their competence and also equipment available for them to work more efficiently. Some essential equipment for neonatal care was either not available or was non-functional where it was available, while aseptic procedures were not adhered to. Moreover, personal protective equipment such as facemask, caps, aprons were not used except in the labour wards where staff had to change their footwear before entering. Research limitations/implications Limited number of health providers and facilities used, lack of exploration of parents of neonates' perspective of quality of neonatal care in this study and other settings, including the teaching hospitals. The authors did not examine issues related to the ineffective use of IV cannulation for neonates by nurses as well as referral of neonates. Additionally, the authors did not explore the perspectives of management of the municipal and regional health directorates or policy makers of the Ministry of Health and Ghana Health Service regarding the shortage of staff, inadequate provision of medical equipment and infrastructure. Practical implications This paper suggests the need for policy makers to redirect their attention to the issues that would improve the quality of

  11. Performance of the "house doctor". Effect of physician-to-patient ratio on follow up in long-term care facilities.

    OpenAIRE

    Sloan, J P; Buchanan, B.

    1993-01-01

    Do physicians with many patients in a long-term care facility provide more timely follow up of their drug orders than those with only a few? We reviewed 60 charts at random in three intermediate care facilities. Physician practices fell into two distinct groups. Those with more than 17 patients followed up sooner than those with fewer than six. We recommend a "house doctor" model of care for patients whose follow up is poor.

  12. The development, implementation, utilization and outcomes of a comprehensive dental program for older adults residing in long-term care facilities.

    Science.gov (United States)

    Wyatt, Chris C L; So, Frankie H C; Williams, P Michele; Mithani, Akber; Zed, Christopher M; Yen, Edwin H K

    2006-06-01

    This paper documents the experience of the University of British Columbia's Geriatric Dentistry Program (GDP) with emphasis on the dental treatment needs of patients during its first year of operation. The GDP provided access to dental care for residents of longterm care facilities, education for hospital staff concerning daily mouth care, education of dental students and an opportunity for research. The first year of clinical activity saw a small, yet significant, improvement in oral health for residents using the dental services. We hope that the outcomes of this new dental program for long-term care facilities will encourage dentists to provide care for this vulnerable population.

  13. The importance of leadership style and psychosocial work environment to staff-assessed quality of care: implications for home help services.

    Science.gov (United States)

    Westerberg, Kristina; Tafvelin, Susanne

    2014-09-01

    Work in home help services is typically conducted by an assistant nurse or nursing aide in the home of an elderly person, and working conditions have been described as solitary with a high workload, little influence and lack of peer and leader support. Relations between leadership styles, psychosocial work environment and a number of positive and negative employee outcomes have been established in research, but the outcome in terms of quality of care has been addressed to a lesser extent. In the present study, we aimed to focus on working conditions in terms of leadership and the employee psychosocial work environment, and how these conditions are related to the quality of care. The hypothesis was that the relation between a transformational leadership style and quality of care is mediated through organisational and peer support, job control and workload. A cross-sectional survey design was used and a total of 469 questionnaires were distributed (March-April 2012) to assistant nurses in nine Swedish home help organisations, including six municipalities and one private organisation, representing both rural and urban areas (302 questionnaires were returned, yielding a 65% response rate). The results showed that our hypothesis was supported and, when indirect effects were also taken into consideration, there was no direct effect of leadership style on quality of care. The mediated model explained 51% of the variance in quality of care. These results indicate that leadership style is important not only to employee outcomes in home help services but is also indirectly related to quality of care as assessed by staff members.

  14. Help is just a phone call away: after-hours support for palliative care patients wishing to die at home.

    Science.gov (United States)

    Baird-Bower, Debbie; Roach, Julie; Andrews, Morven; Onslow, Fiona; Curnin, Emma

    2016-06-01

    The 24-hour support for palliative patients is the gold standard of health care in Australia. However, in the state of Tasmania after-hours telephone support was spatially fragmented and inequitable. In 2014, hospice@HOME, a pilot programme introduced in Tasmania in that year, implemented a state-wide after-hours palliative care support service--1800HOSPICE--offering 24-hour support, 7 days a week for palliative patients, caregivers and the public. Six months of after-hours call logs in combination with additional patient data, were analysed to evaluate the use and wider implications of a state-wide after-hours palliative care support number. Family and caregivers mainly used the after-hours support to request changes to support services (25.1%), report changes in patients' overall condition (23.6%) and request acute medical assistance (16.2%). Through the use of the after-hours services by all individuals involved in the care, end-of-life patients were able to reduce ambulance contact and emergency department admission, and thereby increase their likelihood of dying at home (for patients whose preference was to die at home). Overall, 24-hour palliative care telephone support was found to be a valuable tool for all individuals involved in the care of end-of-life patients.

  15. Personal Digital Assistants as Point-of-Care Tools in Long-Term Care Facilities: A Pilot Study

    Science.gov (United States)

    Qadri, Syeda S.; Wang, Jia; Ruiz, Jorge G.; Roos, Bernard A.

    2009-01-01

    This study used both survey and interview questionnaires. It was designed to assess the feasibility, usability, and utility of two point-of-care tools especially prepared with information relevant for dementia care by staff nurses in a small, a medium-sized, and a large nursing home in Florida. Twenty-five LPN or RN nurses were recruited for the…

  16. Approaches towards a regional, shared electronic patient record for health care facilities of different health care organizations--IT-strategy and first results.

    Science.gov (United States)

    Schabetsberger, Thomas; Gross, Erich; Haux, Reinhold; Lechleitner, Georg; Pellizzari, Thomas; Schindelwig, Klaus; Stark, Christian; Vogl, Raimund; Wilhelmy, Immanuel

    2004-01-01

    Today, information processing in healthcare facilities is usually primarily directed towards the information needs of the respective institution. This stands in apparent contradiction to the fact that patients may not be solely treated in one general practice or hospital. More information processing towards patient-centered, shared care would better support high quality as well as efficient health care. We developed a stepwise approach transforming trans-institutional information system architectures (TISAs) from an inefficient state caused by redundancy and media cracks towards a state which better supports patient centered, shared care. In a total of three steps we want to establish electronic communication between existing information systems of different healthcare facilities for transmission of discharge summaries and diagnostic results. In further stages we plan to expand this communication solution to a regional comprehensive and consistent electronic patient record for multiple hospitals and general practices in Tyrol, Austria. In addition, two related approaches towards supporting shared care have been compared with our approach. The aim of this paper is to report on our approach and first experiences.

  17. The effect of exercise intervention on frail elderly in need of care: half-day program in a senior day-care service facility specializing in functional training

    Science.gov (United States)

    Sakamoto, Ryota; Miura, Yasushi

    2016-01-01

    [Purpose] This study investigated the long-term effect of a half-day exercise intervention program on health-related quality of life, life function, and physical function in frail elderly in need of care. The program was conducted at a senior day-care facility specializing in functional training. [Subjects and Methods] Subjects included 41 elderly in need of care who had visited the service facility for at least 1 year. Physical function and life function were evaluated at baseline, 6 months, and 12 months. Quality of life was evaluated with the Short Form-36 at baseline and 12 months. [Results] Improvements in balance, walking speed and endurance, complex performance abilities, self-efficacy during the activities, and the level and sphere of activity were observed at 6 months and maintained up to 12 months. Moreover, improvements in agility, activities of daily living, life function, and quality of life were also observed at 12 months. Improvements in muscle strength, walking ability, self-efficacy over an action, and activities of daily living were related to the improvement in quality of life. [Conclusion] The use of individualized exercise programs developed by physiotherapists led to improvements in activities of daily living and quality of life among elderly in need of care. PMID:27512243

  18. Perceived quality of care for common childhood illnesses: facility versus community based providers in Uganda.

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    Agnes Nanyonjo

    Full Text Available OBJECTIVE: To compare caretakers' perceived quality of care (PQC for under-fives treated for malaria, pneumonia and diarrhoea by community health workers (CHWs and primary health facility workers (PHFWs. METHODS: Caretaker rated PQC for children aged (2-59 months treated by either CHWs or PHFWs for a bought of malaria, pneumonia or diarrhoea was cross-sectionally compared in quality domains of accessibility, continuity, comprehensiveness, integration, clinical interaction, interpersonal treatment and trust. Child samples were randomly drawn from CHW (419 and clinic (399 records from eight Midwestern Uganda districts. An overall PQC score was predicted through factor analysis. PQC scores were compared for CHWs and PHFWs using Wilcoxon rank-sum test. Multinomial logistic regression models were used to specify the association between categorized PQC and service providers for each quality domain. Finally, overall PQC was dichotomized into "high" and "low" based on median score and relative risks (RR for PQC-service provider association were modeled in a "modified" Poisson regression model. RESULTS: Mean (SD overall PQC was significantly higher for CHWs 0.58 (0 .66 compared to PHFWs -0.58 (0.94, p<0.0001. In "modified" Poisson regression, the proportion of caretakers reporting high PQC was higher for CHWS compared to PHFWs, RR=3.1, 95%CI(2.5-3.8. In multinomial models PQC was significantly higher for CHWs compared to PHFWs in all domains except for continuity. CONCLUSION: PQC was significantly higher for CHWs compared to PHFWs in this resource constrained setting. CHWs should be tapped human resources for universal health coverage while scaling up basic child intervention as PQC might improve intervention utilization.

  19. Developing a plan for primary health care facilities in Soweto, South Africa. Part II: Applying locational criteria.

    Science.gov (United States)

    Doherty, J; Rispel, L; Webb, N

    1996-12-01

    This article is the second of a two-part series describing the development of a ten-year plan for primary health care facility development in Soweto. The first article concentrated on the political problems and general methodological approach of the project. This second article describes how the technical problem of planning in the context of scanty information was overcome. The reasoning behind the various assumptions and criteria which were used to assist the planning of the location of facilities is explained, as well as the process by which they were applied. The merits and limitations of this planning approach are discussed, and it is suggested that the approach may be useful to other facility planners, particularly in the developing world.

  20. The influences of Taiwan's National Health Insurance on women's choice of prenatal care facility: Investigation of differences between rural and non-rural areas

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    Chen Chi-Liang

    2008-03-01

    Full Text Available Abstract Background Taiwan's National Health Insurance (NHI, implemented in 1995, substantially increased the number of health care facilities that can deliver free prenatal care. Because of the increase in such facilities, it is usually assumed that women would have more choices regarding prenatal care facilities and thus experience reduction in travel cost. Nevertheless, there has been no research exploring these issues in the literature. This study compares how Taiwan's NHI program may have influenced choice of prenatal care facility and perception regarding convenience in transportation for obtaining such care for women in rural and non-rural areas in Taiwan. Methods Based on data collected by a national survey conducted by Taiwan's National Health Research Institutes (NHRI in 2000, we tried to compare how women chose prenatal care facility before and after Taiwan's National Health Insurance program was implemented. Basing our analysis on how women answered questionnaire items regarding "the type of major health care facility used and convenience of transportation to and from prenatal care facility," we investigated whether there were disparities in how women in rural and non-rural areas chose prenatal care facilities and felt about the transportation, and whether the NHI had different influences for the two groups of women. Results After NHI, women in rural areas were more likely than before to choose large hospitals for prenatal care services. For women in rural areas, the relative probability of choosing large hospitals to choosing non-hospital settings in 1998–1999 was about 6.54 times of that in 1990–1992. In contrast, no such change was found in women in non-rural areas. For a woman in a non-rural area, she was significantly more likely to perceive the transportation to and from prenatal care facilities to be very convenient between 1998 and 1999 than in the period between 1990 and 1992. No such improvement was found for women in

  1. Private, Social and Self-Insurance for Long-Term Care in the Presence of Family Help - A Political Economy Analysis

    OpenAIRE

    De Donder, Philippe; Pestieau, Pierre

    2013-01-01

    We study the political determination of the level of social long-term care insurance when voters also choose private insurance and saving amounts. Agents differ in income, probability of becoming dependent and of receiving family help. Social insurance redistributes across income and risk levels, while private insurance is actuarially fair. The income-to-risk ratio of agents determines whether they prefer social or private insurance. Family support crowds out the demand for both social and, e...

  2. Toward a Comprehensive Cure: Digital information and communication technology is helping to meet health care challenges in India.

    Science.gov (United States)

    Sheet, Debdoot

    2016-01-01

    How would you provide effective and affordable health care in a country of more than 1.25 billion where there are only 0.7 physicians for every 1,000 people [1]? The Revised National Tuberculosis Control Program (RNTCP) and the Karnataka Internet-Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) service are two notable efforts designed to deliver care across India, in both urban and rural areas and from the country?s flat plains to its rugged mountainous and desert regions.

  3. Self-help groups can improve utilization of post-natal care by HIV-positive mothers

    NARCIS (Netherlands)

    T.A. Nguyen; P. Oosterhoff; P.N. Yen; P. Wright; A. Hardon

    2009-01-01

    HIV prevention within maternal-child health services has increased in many developing countries, but many HIV-infected women in developing countries still receive insufficient postnatal care. This study explored the experience of 30 HIV-infected women in Vietnam in accessing HIV-related postnatal ca

  4. Medical Students and AIDS: A Few Avoid the Victims; Some Volunteer to Help, and All Are Very Careful.

    Science.gov (United States)

    Greene, Elizabeth

    1988-01-01

    Future physicians say they view acquired immune deficiency syndrome (AIDS) as an unfortunate reality that must be addressed, but with great care. The epidemic has not changed medical students' specialties. Fear of contagion, lack of a cure, unpleasant symptoms, and the youth of many victims are difficult realities for students. (MSE)

  5. Motivational Factors that Help in Coping with Barriers to Provision of Psychiatric Nursing Care: Perspective of Psychiatric Nurses in a Hospital Setting in Nigeria.

    Science.gov (United States)

    Gimba, Solomon Musa; Duma, Sinegugu

    2015-07-01

    This qualitative case study explored barriers to provision of psychiatric nursing care in a hospital in Plateau State, Nigeria, and revealed motivational factors that helped the nurses to cope with these barriers. Data collection methods included grand tour and in-depth interviews and participant observation. Motivational factors were related to the psychiatric nurse's individual intrinsic belief system, as well as to their intrinsic belief system as influenced by the environment. These motivational factors highlight how psychiatric nurses continue to cope with the barriers they face in provision of care. The findings indicate the need for hospital management to create and sustain an environment to complement the existing intrinsic motivation of psychiatric nurses to provide psychiatric nursing care, and to provide prompt and appropriate emotional and psychological support to psychiatric nurses worldwide.

  6. Client views, perception and satisfaction with immunisation services at Primary Health Care Facilities in Calabar, South-South Nigeria

    Institute of Scientific and Technical Information of China (English)

    Udonwa NE; Gyuse AN; Etokidem AJ; Ogaji DST

    2010-01-01

    Objective:To determine the degree of client satisfaction with immunisation services at Primary Health facilities in Calabar, Cross River State, Nigeria.Method: A semi-structured questionnaire was administered on 402 caregivers who were selected using systematic random sampling from four primary health centres. The four centres were randomly selected from the 19 health centres using the table of random numbers. Data obtained were analysed using Epi-Info software version 2002.Results: The majority of clients were dissatisfied with most aspects of care given at the Health Care Centres including long waiting time, accessibility of immunisation services, poor respect for clients' rights, especially to their dignity, health information and counseling on their medical needs.Conclusions:The study concludes that client satisfaction with immunization service in Calabar was low due to poor attitude of health care providers, long waiting time and lack of respect for clients' rights.

  7. Helping infants and toddlers in Foster family care : The evidence base of the Foster carer − Foster child Intervention

    NARCIS (Netherlands)

    van Andel, Hans

    2015-01-01

    The Foster carer- Foster child Intervention (FFI) helps very young foster children to feel safe in their new foster-environment. After placement young children often adapt to their new environment with avoidant behaviour. Evidence exist they do not feel safe, for example because they do not ask for

  8. Cross-sectional observational assessment of quality of newborn care immediately after birth in health facilities across six sub-Saharan African countries

    Science.gov (United States)

    de Graft-Johnson, Joseph; Vesel, Linda; Rosen, Heather E; Rawlins, Barbara; Abwao, Stella; Mazia, Goldy; Bozsa, Robert; Mwebesa, Winifrede; Khadka, Neena; Kamunya, Rosemary; Getachew, Ashebir; Tibaijuka, Gaudiosa; Rakotovao, Jean Pierre; Tekleberhan, Alemnesh

    2017-01-01

    Objective To present information on the quality of newborn care services and health facility readiness to provide newborn care in 6 African countries, and to advocate for the improvement of providers' essential newborn care knowledge and skills. Design Cross-sectional observational health facility assessment. Setting Ethiopia, Kenya, Madagascar, Mozambique, Rwanda and Tanzania. Participants Health workers in 643 facilities. 1016 health workers were interviewed, and 2377 babies were observed in the facilities surveyed. Main outcome measures Indicators of quality of newborn care included (1) provision of immediate essential newborn care: thermal care, hygienic cord care, and early and exclusive initiation of breast feeding; (2) actual and simulated resuscitation of asphyxiated newborn infants; and (3) knowledge of health workers on essential newborn care, including resuscitation. Results Sterile or clean cord cutting instruments, suction devices, and tables or firm surfaces for resuscitation were commonly available. 80% of newborns were immediately dried after birth and received clean cord care in most of the studied facilities. In all countries assessed, major deficiencies exist for essential newborn care supplies and equipment, as well as for health worker knowledge and performance of key routine newborn care practices, particularly for immediate skin-to-skin contact and breastfeeding initiation. Of newborns who did not cry at birth, 89% either recovered on their own or through active steps taken by the provider through resuscitation with initial stimulation and/or ventilation. 11% of newborns died. Assessment of simulated resuscitation using a NeoNatalie anatomic model showed that less than a third of providers were able to demonstrate ventilation skills correctly. Conclusions The findings shared in this paper call attention to the critical need to improve health facility readiness to provide quality newborn care services and to ensure that service providers have

  9. The Availability and Properness of The Health Care Facilities for Waste Handling Based on Indonesian Topography and Geo

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    Suci Wulansari

    2016-06-01

    Full Text Available Background: medical facilities research (Rifakes 2011 was performed to know a comprehensive image about thegovernment health care facilities as a plan in medical service development that fi ts with the society needs. Although healthcenter was already available, but the availability and the properness of the health care facilities were not spread evenly,such as waste handling facilities. The aim of this research is analyzing the availability and the properness of waste handlingin health center based on demography and geography in Indonesia. Methods: This research is a secondary data analysisof Rifakes 2011 about the availability and the properness of waste handling in health center. The data analysis was donein univariat and bivariat. The correlation between the properness of waste handling and the isolation of an area was testedwith spearmann correlation. The correlation between the properness of waste handling of health care in archipelago and ofthat in frontier area was tested with mann whitney test. Results: More than a half ( 66,8% of the waste handling of healthcenter is already available, yet with improper category ( 72,7% . There is a signifi cant correlation between the propernessof waste handling with a location topography ( isolation area, archipelago, and frontier area . The improper waste handlingis especially in rural area with 80, 6%, whereas in city with 5,7%. Conclusion: There is a signifi cant correlation between theproperness of waste handling in health center with topographical and geographical condition. Recommendation: Wastemanagement in health centers should be more serious attention and handling, availability WWTP, feasibility of handlingthe waste, and if possible waste minimalisali clinic.

  10. Depressive morbidity among elderly individuals who are hospitalized, reside at long-term care facilities, and are under outpatient care in Brazil: a meta-analysis

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    Luís Fernando S. Castro-de-Araújo

    2013-06-01

    Full Text Available Objectives: i To investigate studies published between 1991 and 2010 on the prevalence of depressive morbidity (major depressive disorder [MDD], dysthymia and clinically significant depressive symptoms [CSDS] among elderly Brazilians assisted at healthcare facilities; ii to establish the prevalence of depression and identify its related factors; and iii to conduct a meta-analysis to assess the prevalence of depressive syndrome among elderly individuals assisted or hospitalized at healthcare facilities. Methods: Studies were selected from articles dated between January 1991 and June 2010 and extracted from the MEDLINE, LILACS, and SciELO databases. Results: The final analysis consisted of 15 studies, distributed as follows: i four sampled hospitalized patients, totaling 299 individuals, and found a prevalence of CSDS varying between 20 and 56%; ii four sampled outpatients, totaling 1,454 individuals; the prevalence of CSDS varied between 11 and 65%, and the prevalence of MDD varied between 23 and 42%; and iii seven sampled elderly individuals residing in long-term care facilities (LTCF, totaling 839 individuals, and the prevalence of CSDS varied between 11 and 65%. Conclusion: The present review indicated a higher prevalence of both MDD and CSDS among elderly Brazilians assisted at healthcare facilities.

  11. Management of Diabetes in Long-term Care and Skilled Nursing Facilities: A Position Statement of the American Diabetes Association.

    Science.gov (United States)

    Munshi, Medha N; Florez, Hermes; Huang, Elbert S; Kalyani, Rita R; Mupanomunda, Maria; Pandya, Naushira; Swift, Carrie S; Taveira, Tracey H; Haas, Linda B

    2016-02-01

    Diabetes is more common in older adults, has a high prevalence in long-term care (LTC) facilities, and is associated with significant disease burden and higher cost. The heterogeneity of this population with regard to comorbidities and overall health status is critical to establishing personalized goals and treatments for diabetes. The risk of hypoglycemia is the most important factor in determining glycemic goals due to the catastrophic consequences in this population. Simplified treatment regimens are preferred, and the sole use of sliding scale insulin (SSI) should be avoided. This position statement provides a classification system for older adults in LTC settings, describes how diabetes goals and management should be tailored based on comorbidities, delineates key issues to consider when using glucose-lowering agents in this population, and provides recommendations on how to replace SSI in LTC facilities. As these patients transition from one setting to another, or from one provider to another, their risk for adverse events increases. Strategies are presented to reduce these risks and ensure safe transitions. This article addresses diabetes management at end of life and in those receiving palliative and hospice care. The integration of diabetes management into LTC facilities is important and requires an interprofessional team approach. To facilitate this approach, acceptance by administrative personnel is needed, as are protocols and possibly system changes. It is important for clinicians to understand the characteristics, challenges, and barriers related to the older population living in LTC facilities as well as the proper functioning of the facilities themselves. Once these challenges are identified, individualized approaches can be designed to improve diabetes management while lowering the risk of hypoglycemia and ultimately improving quality of life.

  12. Diversion of drugs within health care facilities, a multiple-victim crime: patterns of diversion, scope, consequences, detection, and prevention.

    Science.gov (United States)

    Berge, Keith H; Dillon, Kevin R; Sikkink, Karen M; Taylor, Timothy K; Lanier, William L

    2012-07-01

    Mayo Clinic has been involved in an ongoing effort to prevent the diversion of controlled substances from the workplace and to rapidly identify and respond when such diversion is detected. These efforts have found that diversion of controlled substances is not uncommon and can result in substantial risk not only to the individual who is diverting the drugs but also to patients, co-workers, and employers. We believe that all health care facilities should have systems in place to deter controlled substance diversion and to promptly identify diversion and intervene when it is occurring. Such systems are multifaceted and require close cooperation between multiple stakeholders including, but not limited to, departments of pharmacy, safety and security, anesthesiology, nursing, legal counsel, and human resources. Ideally, there should be a broad-based appreciation of the dangers that diversion creates not only for patients but also for all employees of health care facilities, because diversion can occur at any point along a long supply chain. All health care workers must be vigilant for signs of possible diversion and must be aware of how to engage a preexisting group with expertise in investigating possible diversions. In addition, clear policies and procedures should be in place for dealing with such investigations and for managing the many possible outcomes of a confirmed diversion. This article provides an overview of the multiple types of risk that result from drug diversion from health care facilities. Further, we describe a system developed at Mayo Clinic for evaluating episodes of potential drug diversion and for taking action once diversion is confirmed.

  13. A protocol for an individualised, facilitated and sustainable approach to implementing current evidence in preventing falls in residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Hill Keith

    2010-02-01

    Full Text Available Abstract Background Falls are common adverse events in residential care facilities. Commonly reported figures indicate that at least 50% of residents fall in a 12 month period, and that this figure is substantially higher for residents with dementia. This paper reports the protocol of a project which aims to implement evidence based falls prevention strategies in nine residential aged care facilities (RACFs in Australia. The facilities in the study include high and low care, small and large facilities, metropolitan and regional, facilities with a specific cultural focus, and target groups recognised as being more challenging to successful implementation of falls prevention practice (e.g. residents with dementia. Methods The project will be conducted from November 2007-November 2009. The project will involve baseline scoping of existing falls rates and falls prevention activities in each facility, an action research process, interactive falls prevention training, individual falls risk assessments, provision of equipment and modifications, organisation based steering committees, and an economic evaluation. In each RACF, staff will be invited to join an action research group that will lead the process of developing and implementing interventions designed to facilitate an evidence based approach to falls management in their facility. In all RACFs a pre/post design will be adopted with a range of standardised measures utilised to determine the impact of the interventions. Discussion The care gap in residential aged care that will be addressed through this project relates to the challenges in implementing best practice falls prevention actions despite the availability of best practice guidelines. There are numerous factors that may limit the uptake of best practice falls prevention guidelines in residential aged care facilities. A multi-factorial individualised (to the specific requirements of each facility approach will be used to develop and

  14. Computerized physician order entry with clinical decision support in long-term care facilities: costs and benefits to stakeholders.

    Science.gov (United States)

    Subramanian, Sujha; Hoover, Sonja; Gilman, Boyd; Field, Terry S; Mutter, Ryan; Gurwitz, Jerry H

    2007-09-01

    Nursing homes are the setting of care for growing numbers of our nation's older people, and adverse drug events are an increasingly recognized safety and quality concern in this population. Health information technology, including computerized physician/provider order entry (CPOE) with clinical decision support (CDS), has been proposed as an important systems-based approach for reducing medication errors and preventable drug-related injuries. This article describes the costs and benefits of CPOE with CDS for the various stakeholders involved in long-term care (LTC), including nurses, physicians, the pharmacy, the laboratory, the payer (e.g., the insurer), nursing home residents, and the LTC facility. Critical barriers to adoption of these systems are discussed, primarily from an economic perspective. The analysis suggests that multiple stakeholders will incur the costs related to implementation of CPOE with CDS in the LTC setting, but the costs incurred by each may not be aligned with the benefits, which may present a major barrier to broad adoption. Physicians and LTC facilities are likely to bear a large burden of the costs, whereas residents and payers will enjoy a large portion of the benefits. Consideration of these costs and benefits suggests that financial incentives to physicians and facilities may be necessary to encourage and accelerate widespread use of these systems in the LTC setting.

  15. Quality of labeling on dispensed medicines and associated factors among public health care facilities in Bahir dar city, Northwest Ethiopia

    Directory of Open Access Journals (Sweden)

    Wubante Demilew Nigussie

    2014-03-01

    Full Text Available Purpose: To determine the quality of labeling on dispensed medicines and identify the associated factors among public health facilities in Bahir Dar city. Methods: A cross sectional study was conducted from August 5 to 20, 2013 at selected health care facilities in Bahir Dar city. Simple random sampling and systematic random sampling techniques was used to select health facilities and dispensing encounters respectively. Data was collected from non participatory observations of the drug dispensing process using check list. Data was entered into EPI Info (version 3.5.2 and analyzed using SPSS version 16. Bivariate and multivariate regression analysis was computed to test the strength of association and level of significance. P-value <0.05 was considered as statistical significant. Results: A total of 400 dispensing encounters and 636 drugs dispensed were observed in eight (8 outpatient pharmacies. The percentage of drugs adequately labeled was 32.2%. Drugs adequate labeling score was higher in private health facilities (39.3% compared to government health facilities (25.83%. The name, strength and dosage form of the drugs were labeled in 95.6%, 90% and 85.8% respectively. Differences in dispenser work experiences (AOR = 2.99, CI: 1.67 – 5.37, average dispensing time (AOR = 6.22, CI: 3.08-12.57, average consultation time (AOR=3.42, CI: 1.64-7.13, level of health facility (AOR = 4.31, CI 1.94 – 9.59 and type of health facilities (AOR = 4.29, CI 1.72 – 10.66 were found to be independently associated factors for quality of labeling score. Conclusion: The quality of labeling on dispensed medicines was not adequate. Dispenser work experiences, average dispensing time, average consultation time, level of health facility and type of health facilities were found to be significant factors for quality of labeling score. Therefore, attention should be given to strong skill development, increasing manpower and implementation of regular monitoring for the

  16. Impact of an electronic clinical decision support system on workflow in antenatal care: the QUALMAT eCDSS in rural health care facilities in Ghana and Tanzania

    Directory of Open Access Journals (Sweden)

    Nathan Mensah

    2015-01-01

    Full Text Available Background: The implementation of new technology can interrupt established workflows in health care settings. The Quality of Maternal Care (QUALMAT project has introduced an (eCDSS for antenatal care (ANC and delivery in rural primary health care facilities in Africa. Objective: This study was carried out to investigate the influence of the QUALMAT eCDSS on the workflow of health care workers in rural primary health care facilities in Ghana and Tanzania. Design: A direct observation, time-and-motion study on ANC processes was conducted using a structured data sheet with predefined major task categories. The duration and sequence of tasks performed during ANC visits were observed, and changes after the implementation of the eCDSS were analyzed. Results: In 24 QUALMAT study sites, 214 observations of ANC visits (144 in Ghana, 70 in Tanzania were carried out at baseline and 148 observations (104 in Ghana, 44 in Tanzania after the software was implemented in 12 of those sites. The median time spent combined for all centers in both countries to provide ANC at baseline was 6.5 min [interquartile range (IQR =4.0–10.6]. Although the time spent on ANC increased in Tanzania and Ghana after the eCDSS implementation as compared to baseline, overall there was no significant increase in time used for ANC activities (0.51 min, p=0.06 in Ghana; and 0.54 min, p=0.26 in Tanzania as compared to the control sites without the eCDSS. The percentage of medical history taking in women who had subsequent examinations increased after eCDSS implementation from 58.2% (39/67 to 95.3% (61/64 p<0.001 in Ghana but not in Tanzania [from 65.4% (17/26 to 71.4% (15/21 p=0.70]. Conclusions: The QUALMAT eCDSS does not increase the time needed for ANC but partly streamlined workflow at sites in Ghana, showing the potential of such a system to influence quality of care positively.

  17. Key Considerations in Providing a Free Appropriate Public Education for Youth with Disabilities in Juvenile Justice Secure Care Facilities. Issue Brief

    Science.gov (United States)

    Gagnon, Joseph C.; Read, Nicholas W.; Gonsoulin, Simon

    2015-01-01

    Access to high-quality education for youth is critical to their long-term success as adults. Youth in juvenile justice secure care facilities, however, too often do not have access to the high-quality education and related supports and services that they need, particularly youth with disabilities residing in such facilities. This brief discusses…

  18. Implementation of mental health service has an impact on retention in HIV care: a nested case-control study in a japanese HIV care facility.

    Directory of Open Access Journals (Sweden)

    Shinjiro Tominari

    Full Text Available BACKGROUND: Poor retention in the care of patients with human immunodeficiency virus (HIV is associated with adverse patient outcomes such as antiretroviral therapy failure and death. Therefore, appropriate case management is required for better patient retention; however, which intervention in case management is important has not been fully investigated. Meanwhile, in Japan, each local government is required to organize mental health services for patients with HIV so that a case manager at an HIV care facility can utilize them, but little is known about the association between implementation of the services and loss to follow-up. Therefore, we investigated that by a nested case-control study. METHODS: The target population consisted of all patients with HIV who visited Osaka National Hospital, the largest HIV care facility in western Japan, between 2000 and 2010. Loss to follow-up was defined as not returning for follow-up care more than 1 year after the last visit. Independent variables included patient demographics, characteristics of the disease and treatment, and whether the patients have received mental health services. For each case, three controls were randomly selected and matched. RESULTS: Of the 1620 eligible patients, 88 loss to follow-up cases were identified and 264 controls were matched. Multivariate-adjusted conditional logistic regression revealed that loss to follow-up was less frequent among patients who had received mental health services implemented by their case managers (adjusted odds ratio [95% confidence interval] 0.35 [0.16-0.76]. Loss to follow-up also occurred more frequently in patients who did not receive antiretroviral therapy (adjusted odds ratio [95% confidence interval], 7.51 [3.34-16.9], who were under 30 years old (2.74 [1.36-5.50], or who were without jobs (3.38 [1.58-7.23]. CONCLUSION: Mental health service implementation by case managers has a significant impact on patient retention.

  19. Healthcare-associated infections and antimicrobial use in long-term care facilities: the Irish experience with the HALT surveys.

    Science.gov (United States)

    Burns, K; Roche, F; Donlon, S

    2015-04-01

    In the context of an ageing European population, point prevalence surveys (PPS) of healthcare-associated infection and antimicrobial use in long-term care facilities (HALT) in Europe were commissioned by the European Centre for Disease Prevention and Control. Sixty-nine Irish long-term care facilities (LTCFs) took part in the first survey in 2010. A series of interventions to raise the profile of infection prevention and control and antimicrobial stewardship in Irish LTCFs followed. HALT was repeated in Ireland in 2011, with 108 participating LTCFs, and again in 2013 as part of the second European HALT survey, with 190 participating LTCFs. The latest Irish HALT report incorporates data from the three PPSs to date, and discusses the findings and the national implementation priorities recommended by the Irish multi-disciplinary steering group. Ireland contributed ∼10% of the total resident population in both of the European HALT PPSs. This, and the growing number of participating LTCFs, shows that healthcare professionals in Irish LTCFs are committed to improving the quality and safety of resident care.

  20. Exploring the Demands on Nurses Working in Health Care Facilities During a Large-Scale Natural Disaster

    Directory of Open Access Journals (Sweden)

    Gillian C. Scrymgeour

    2016-06-01

    Full Text Available Nurses are pivotal to an effective societal response to a range of critical events, including disasters. This presents nurses with many significant and complex challenges that require them to function effectively under highly challenging and stressful circumstances and often for prolonged periods of time. The exponential growth in the number of disasters means that knowledge of disaster preparedness and how this knowledge can be implemented to facilitate the development of resilient and adaptive nurses and health care organizations represents an important adjunct to nurse education, policy development, and research considerations. Although this topic has and continues to attract attention in the literature, a lack of systematic understanding of the contingencies makes it difficult to clearly differentiate what is known and what gaps remain in this literature. Providing a sound footing for future research can be facilitated by first systematically reviewing the relevant literature. Focused themes were identified and analyzed using an ecological and interactive systems framework. Ten of the 12 retained studies included evacuation, revealing that evacuation is more likely to occur in an aged care facility than a hospital. The unpredictability of an event also highlighted organizational, functional, and competency issues in regard to the complexity of decision making and overall preparedness. The integrative review also identified that the unique roles, competencies, and demands on nurses working in hospitals and residential health care facilities during a natural disaster appear invisible within the highly visible event.

  1. Assisted Living Facilities, ElderCareFacilities-Elder care facilities in the State of Utah, Published in 2005, 1:24000 (1in=2000ft) scale, State of Utah Automated Geographic Reference Center.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Other information as of 2005. It is described as...

  2. A helping hand

    NARCIS (Netherlands)

    Mirjam de Klerk; Alice de Boer; Sjoerd Kooiker; Inger Plaisier; Peggy Schyns

    2014-01-01

    Original title: Hulp geboden   The help provided to people with a care need is about to undergo major changes in the Netherlands. People who need help will be expected to rely more on help from members of their network. What are the opportunities for informal carers and volunteers, and where do the

  3. Falls related to accidental deactivation of deep brain stimulators in patients with Parkinson's disease living in long term care facilities.

    Science.gov (United States)

    Tousi, Babak; Wilson, Kathy

    2013-01-01

    This case series highlights three patients with Parkinson's disease residing at nursing home facilities whose deep brain stimulators were accidentally deactivated for varying lengths of time, which was associated with an increase in falls. In all three cases, neither the patients nor the caregivers were aware of the random deactivations/reactivations. We propose a specific care plan for these patients that includes further education of caregivers regarding deep brain stimulators and regular checks of the review device, especially when there is concern about a patient's mobility or balance that is out of character.

  4. Influenza immunization coverage of residents and employees of long-term care facilities in New York State, 2000-2010.

    Science.gov (United States)

    Person, Cara J; Nadeau, Jessica A; Schaffzin, Joshua K; Pollock, Lynn; Wallace, Barbara J; McNutt, Louise Ann; Blog, Debra

    2013-08-01

    We describe influenza immunization coverage trends from the New York State (NYS) Department of Health long-term care facility (LTCF) reports. Overall median immunization coverage levels for NYS LTCF residents and employees were 84.0% (range: 81.6%-86.0%) and 37.7% (range: 32.7%-50.0%), respectively. LTCF resident immunization coverage levels in NYS have neared the Healthy People 2020 target of 90% but have not achieved high LTCF employee coverage, suggesting a need for more regulatory interventions.

  5. Quality of Longer Term Mental Health Facilities in Europe : Validation of the Quality Indicator for Rehabilitative Care against Service Users' Views

    NARCIS (Netherlands)

    Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L.; Turton, Penny; Kallert, Thomas; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Piotrowski, Patryk; Ploumpidis, Dimitris; Gonidakis, Fragiskos; Caldas-de-Almeida, Jose Miguel; Cardoso, Graca; King, Michael

    2012-01-01

    Background: The Quality Indicator for Rehabilitative Care (QuIRC) is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise wit

  6. Reforming Management of Behavior Symptoms and Psychiatric Conditions in Long-Term Care Facilities: A Different Perspective.

    Science.gov (United States)

    Levenson, Steven A; Desai, Abhilash K

    2017-02-24

    Despite much attention including national initiatives, concerns remain about the approaches to managing behavior symptoms and psychiatric conditions across all settings, including in long-term care settings such as nursing homes and assisted living facilities. One key reason why problems persist is because most efforts to "reform" and "correct" the situation have failed to explore or address root causes and instead have promoted inadequate piecemeal "solutions." Further improvement requires jumping off the bandwagon and rethinking the entire issue, including recognizing and applying key concepts of clinical reasoning and the care delivery process to every situation. The huge negative impact of cognitive biases and rote approaches on related clinical problem solving and decision making and patient outcomes also must be addressed.

  7. Gestational age at booking for antenatal care in a tertiary health facility in north-central, Nigeria

    Directory of Open Access Journals (Sweden)

    Dennis Isaac Ifenne

    2012-01-01

    Full Text Available Background: Early initiation of antenatal care is widely believed to improve maternal and fetal outcome. This study was designed to ascertain the gestational age at booking using World Health Organization recommendations for developing countries. Materials and Methods: This cross-sectional study was carried out using interviewer-administered questionnaire to 345 willing participants at a booking clinic in a tertiary health facility in North-Central, Nigeria. Results: A total of 345 women were interviewed. The average age of the clients was 27.1±5.1 years. Almost (45.8% had at least secondary level of education. One-third of the women were not working women. The average gestational age at booking was 19.1±7.8. Late booking (≥17 weeks was significantly influenced by the client′s level of education ( P=0.017. Reasons for booking late were given as follows: Not being sick (26.1%, Lack of knowledge of booking time (22.8%, having booked elsewhere (14.1%, financial constraints (9.2%, fear of too many follow-up visits (4.9%, spouse′s un co-operative attitude (3.9%, lack of transport to the health care facility (2.2%, and other minor reasons (16.8%. Conclusion: Most women booked for antenatal care (ANC late. Efforts toward maternal education, public health enlightenment campaigns, poverty reduction, and use of focused antenatal care model should be sustained as measures to encourage early initiation of ANC.

  8. Vaccination coverage of health care personnel working in health care facilities in France: results of a national survey, 2009.

    Science.gov (United States)

    Guthmann, Jean-Paul; Fonteneau, Laure; Ciotti, Céline; Bouvet, Elisabeth; Pellissier, Gérard; Lévy-Bruhl, Daniel; Abiteboul, Dominique

    2012-06-29

    We conducted a national cross-sectional survey to investigate vaccination coverage (VC) in health care personnel (HCP) working in clinics and hospitals in France. We used a two-stage stratified random sampling design to select 1127 persons from 35 health care settings. Data were collected by face-to-face interviews and completed using information gathered from the occupational health doctor. A total of 183 physicians, 110 nurses, 58 nurse-assistants and 101 midwives were included. VC for compulsory vaccinations was 91.7% for hepatitis B, 95.5% for the booster dose of diphtheria-tetanus-polio (DTP), 94.9% for BCG. For non-compulsory vaccinations, coverage was 11.4% for the 10 year booster of the DTP pertussis containing vaccine, 49.7% for at least one dose of measles, 29.9% for varicella and 25.6% for influenza. Hepatitis B VC did not differ neither between HCP working in surgery and HCP in other sectors, nor in surgeons and anaesthesiologists compared to physicians working in medicine. Young HCP were better vaccinated for pertussis and measles (pvaccinated for influenza and pertussis (pcompulsory vaccinations, whereas VC for non-compulsory vaccinations is very insufficient. The vaccination policy regarding these latter vaccinations should be reinforced in France.

  9. [Preventive measures of food poisoning at care facilities for the elderly--current status and problems in food poisoning by noroviruses].

    Science.gov (United States)

    Ezoe, Kumiko; Nagatomi, Hideki; Imaizumi, Iwao

    2012-08-01

    Food poisoning at care facilities for the elderly has been breaking out approximately ten cases per year nationwide from 2001 to 2010. Especially, it reflected the characteristics of food poisoning caused by noroviruses at a high rate. Usually we have been preventing from food poisoning by noroviruses working on existing measures such as temperature control of food materials, sanitary handlings of cooking tools and table wares, and so on. Additionally, the most effective measures to avoid secondary pollution at care facilities for the elderly is that all members at these facilities have to have a sense of crisis about food poisoning by noroviruses and managers at these facilities must take care of health control for all staff.

  10. Positive and negative emotional responses to workrelated trauma of intensive care nurses in private health care facilities

    Directory of Open Access Journals (Sweden)

    Lizelle Van der Vyver

    2011-02-01

    Full Text Available Intensive care nursing is a stressful occupation and nurses are continually subjected to both primary and secondary trauma. Responses may be positive in the form of compassion satisfaction, or negative in the form of compassion fatigue. However, nurses tend to deny the negative impact of secondary trauma which leads to the silencing response and subsequent burnout. This article explores and describes the presence of these emotions and the relationships between them. A quantitative approach with a non-probability sampling method was used. The sample consisted of 30 registered nurses working in private health care intensive care units in East London, Eastern Cape. Data were gathered via the Professional Quality of Life Scale: Compassion Satisfaction and Fatigue Subscales – Revision IV (ProQOL – R-IV and the Silencing Response Scale and were analysed according to descriptive statistics and correlation coefficients. Findings suggest a high risk for compassion fatigue, a moderate risk for burnout and the silencing response and moderate potential for compassion satisfaction. A marked negative relationship was found between compassion satisfaction and burnout and a substantial positive relationship between compassion fatigue and burnout, as well as compassion fatigue and the silencing response.

    Opsomming

    Intensiewesorgverpleging is ‘n stresvolle beroep en verpleegsters word gedurig aan beide primêre en sekondêre trauma blootgestel. Reaksie hierop kan óf positief wees, in die vorm van empatie-tevredenheid, óf negatief, in die vorm van empatie-uitputting. Verpleegsters is egter geneig om die negatiewe impak van sekondêre trauma te ontken,wat gevolglik tot stilswye en uitbranding kan lei. Hierdie artikel ondersoek en beskryf die teenwoordigheid en verwantskap tussen hierdie emosies. ‘n Kwantitatiewe benadering met ‘n nie-waarskynlikheidsteekproefmetode is gebruik. Die steekproef het bestaan uit 30 geregistreerde

  11. 45 CFR 234.130 - Assistance in the form of institutional services in intermediate care facilities.

    Science.gov (United States)

    2010-10-01

    ... nutritionally adequate diet, are served in one or more dining areas separate from sleeping quarters, and tray... facility's health services, guidance, and assistance for each resident in carrying out his personal health... properly carried out and recorded; (d) Arrangements for services of a physician in the event of...

  12. Consumer Satisfaction in Long-Term Care: State Initiatives in Nursing Homes and Assisted Living Facilities

    Science.gov (United States)

    Lowe, Timothy J.; Lucas, Judith A.; Castle, Nicholas G.; Robinson, Joanne P.; Crystal, Stephen

    2003-01-01

    Purpose: We report the results of a survey of state initiatives that measure resident satisfaction in nursing homes and assisted living facilities, and we describe several model programs for legislators and public administrators contemplating the initiation of their own state programs. Design and Methods: Data on state initiatives and programs…

  13. A retrospective audit of antibiotic prescriptions in primary health-care facilities in Eastern Region, Ghana

    DEFF Research Database (Denmark)

    Ahiabu, Mary-Anne; Tersbøl, Britt Pinkowski; Biritwum, Richard;

    2016-01-01

    Region, Ghana using the WHO/International Network for the Rational Use of Drugs rational drug use indicators. Using a systematic sampling procedure, 400 prescriptions were selected per facility for the period April 2010 to March 2011. Rational drug use indicators were assessed in the descriptive analysis...

  14. 75 FR 65282 - Medicare and Medicaid Programs; Requirements for Long Term Care Facilities; Hospice Services

    Science.gov (United States)

    2010-10-22

    ... a resident's right to a dignified existence, self- determination, and communication with, and access... change.'' The article further stated that, while most non- hospice healthcare providers do not follow... for transfer. Thus, an LTC facility may accept a written or verbal request for transfer. We...

  15. Opinions on building design for old-aged caring facility%关于养老设施建筑设计的几点看法

    Institute of Scientific and Technical Information of China (English)

    董越秀

    2016-01-01

    根据养老设施的建筑设计理念,介绍了养老设施的建筑内容,从整体规划、居住单元、绿色设计等方面,阐述了养老设施建筑设计的要点,使养老建筑的设计实现全面化、通达化、庭院化、舒适化。%According to building design concept of old-age caring facility,the paper introduces the old-age caring facility building contents. Start-ing from aspects of integral planning,housing unit and green design,it describes the building design points of old-age caring facility,so as to make old-age caring building design comprehensive,smooth,comfortable and garden-like yards.

  16. Implementing a Help Desk at a Small Liberal Arts College.

    Science.gov (United States)

    Actis, Bev

    1993-01-01

    Planning for a computer use "help desk" at Kenyon College (Ohio) was constrained by very limited resources. However, careful and thorough planning resulted in a low-budget, homegrown, but highly effective facility. Staffing, training, staff communication, and marketing the service were essential elements in its success. (MSE)

  17. Type of soap and the incidence of skin tears among residents of a long-term care facility.

    Science.gov (United States)

    Mason, S R

    1997-09-01

    Skin tears are common among residents of long-term care facilities. This study evaluated the effectiveness of emollient antibacterial soap compared to non-emollient antibacterial soap in improving skin quality and reducing skin tears among residents of a long-term care facility. Skin tears were monitored over 4 months: non-emollient soap in the first and third months, and emollient soap in the second and fourth months were used. Rate of skin tears per resident per month were calculated. Incident reports were monitored the first month to establish skin tear rates using non-emollient soap. Skin tears decreased with the use of emollient soap (37% and 33% decrease in months two and four, respectively) and increased with the reintroduction of non-emollient soap (43% increase in month three). Overall incidence of skin tears with the use of emollient soap was 34.8 percent lower than that of the non-emollient soap. Analysis of variance did not show statistical significance [F(1,84) = 3.108, p = .0821], but clinical significance was demonstrated by the reduced number of skin tears with the use of emollient soap. While the etiology of skin tears seems to be a problem of aging, the decrease in skin tears in this study supports the continued use of emollient soap.

  18. Design of the study: How can health care help female breast cancer patients reduce their stress symptoms? A randomized intervention study with stepped-care

    Directory of Open Access Journals (Sweden)

    Nordin Karin

    2012-05-01

    Full Text Available Abstract Background A life threatening illness such as breast cancer can lead to a secondary diagnosis of PTSD (post traumatic stress disorder with intrusive thoughts and avoidance as major symptoms. In a former study by the research group, 80% of the patients with breast cancer reported a high level of stress symptoms close to the diagnosis, such as intrusive thoughts and avoidance behavior. These symptoms remained high throughout the study. The present paper presents the design of a randomized study evaluating the effectiveness and cost-effectiveness of a stress management intervention using a stepped-care design. Method Female patients over the age of 18, with a recent diagnosis of breast cancer and scheduled for adjuvant treatment in the form of chemotherapy, radiation therapy and/or hormonal therapy are eligible and will consecutively be included in the study. The study is a prospective longitudinal intervention study with a stepped-care approach, where patients will be randomised to one of two interventions in the final stage of treatment. The first step is a low intensity stress-management intervention that is given to all patients. Patients who do not respond to this level are thereafter given more intensive treatment at later steps in the program and will be randomized to more intensive stress-management intervention in a group setting or individually. The primary out-come is subjective distress (intrusion and avoidance assessed by the Impact of Event Scale (IES. According to the power-analyses, 300 patients are planned to be included in the study and will be followed for one year. Other outcomes are anxiety, depression, quality of life, fatigue, stress in daily living and utilization of hospital services. This will be assessed with well-known psychometric tested questionnaires. Also, the cost-effectiveness of the intervention given in group or individually will be evaluated. Discussion This randomized clinical trial will provide

  19. Does the Janani Suraksha Yojana cash transfer programme to promote facility births in India ensure skilled birth attendance? A qualitative study of intrapartum care in Madhya Pradesh

    Directory of Open Access Journals (Sweden)

    Sarika Chaturvedi

    2015-07-01

    Full Text Available Background: Access to facility delivery in India has significantly increased with the Janani Suraksha Yojana (JSY cash transfer programme to promote facility births. However, a decline in maternal mortality has only followed secular trends as seen from the beginning of the decade well before the programme began. We, therefore, examined the quality of intrapartum care provided in facilities under the JSY programme to study whether it ensures skilled attendance at birth. Design: 1 Non-participant observations (n=18 of intrapartum care during vaginal deliveries at a representative sample of 11 facilities in Madhya Pradesh to document what happens during intrapartum care. 2 Interviews (n=10 with providers to explore reasons for this care. Thematic framework analysis was used. Results: Three themes emerged from the data: 1 delivery environment is chaotic: delivery rooms were not conducive to safe, women-friendly care provision, and coordination between providers was poor. 2 Staff do not provide skilled care routinely: this emerged from observations that monitoring was limited to assessment of cervical dilatation, lack of readiness to provide key elements of care, and the execution of harmful/unnecessary practices coupled with poor techniques. 3 Dominant staff, passive recipients: staff sometimes threatened, abused, or ignored women during delivery; women were passive and accepted dominance and disrespect. Attendants served as ‘go-betweens’ patients and providers. The interviews with providers revealed their awareness of the compromised quality of care, but they were constrained by structural problems. Positive practices were also observed, including companionship during childbirth and women mobilising in the early stages of labour. Conclusions: Our observational study did not suggest an adequate level of skilled birth attendance (SBA. The findings reveal insufficiencies in the health system and organisational structures to provide an

  20. Dental Treatment in a State-Funded Primary Dental Care Facility: Contextual and Individual Predictors of Treatment Need?

    Science.gov (United States)

    Radford, David R.; Gallagher, Jennifer E.

    2017-01-01

    Objective This study examined individual and contextual factors which predict the dental care received by patients in a state-funded primary dental care training facility in England. Methods Routine clinical and demographic data were extracted from a live dental patient management system in a state-funded facility using novel methods. The data, spanning a four-year period [2008–2012] were cleaned, validated, linked by means of postcode to deprivation status, and analysed to identify factors which predict dental treatment need. The predictive relationship between patients’ individual characteristics (demography, smoking, payment status) and contextual experience (deprivation based on area of residence), with common dental treatments received was examined using unadjusted analysis and adjusted logistic regression. Additionally, multilevel modelling was used to establish the isolated influence of area of residence on treatments. Results Data on 6,351 dental patients extracted comprised of 147,417 treatment procedures delivered across 10,371 courses of care. Individual level factors associated with the treatments were age, sex, payment exemption and smoking status and deprivation associated with area of residence was a contextual predictor of treatment. More than 50% of children (tooth extraction’ (3%; p = 0.001), and ‘instruction and advice’ (3%; p = 0.001). Smokers had a higher likelihood of receiving all treatments; and were notably over four times more likely to receive ‘instruction and advice’ than non-smokers (OR 4.124; 95% CI: 3.088–5.508; p = 0.01). A further new finding from the multilevel models was a significant difference in treatment related to area of residence; adults from the most deprived quintile were more likely to receive ‘tooth extraction’ when compared with least deprived, and less likely to receive preventive ‘instruction and advice’ (p = 0.01). Conclusion This is the first study to model patient management data from a

  1. Rural-Urban Differences in End-of-Life Nursing Home Care: Facility and Environmental Factors

    Science.gov (United States)

    Temkin-Greener, Helena; Zheng, Nan Tracy; Mukamel, Dana B.

    2012-01-01

    Purpose of the study: This study examines urban-rural differences in end-of-life (EOL) quality of care provided to nursing home (NH) residents. Data and Methods: We constructed 3 risk-adjusted EOL quality measures (QMs) for long-term decedent residents: in-hospital death, hospice referral before death, and presence of severe pain. We used…

  2. Menu Planning, Food Consumption, and Sanitation Practices in Day Care Facilities.

    Science.gov (United States)

    Kuratko, Connye N.; Martin, Ruth E.; Lan, William Y.; Chappell, James A.; Ahmad, Mahassen

    2000-01-01

    In 102 day care centers, data were collected on nutritional content of menus, compliance with guidelines, children's food consumption, and safety/sanitation. Although menus exceeded recommended daily allowances, quantities of food were below recommendations. No menu components were consumed by more than 65% of children. Sanitation problems were…

  3. Assessing post-abortion care in health facilities in Afghanistan : a cross-sectional study

    NARCIS (Netherlands)

    Ansari, Nasratullah; Zainullah, Partamin; Kim, Young Mi; Tappis, Hannah; Kols, Adrienne; Currie, Sheena; Haver, Jaime; van Roosmalen, Jos; Broerse, Jacqueline E. W.; Stekelenburg, Jelle

    2015-01-01

    Background: Complications of abortion are one of the leading causes of maternal mortality worldwide, along with hemorrhage, sepsis, and hypertensive diseases of pregnancy. In Afghanistan little data exist on the capacity of the health system to provide post-abortion care (PAC). This paper presents f

  4. Reaction Reading: A Tool for Providing Fantasy Imagery for Long-Term Care Facility Residents.

    Science.gov (United States)

    Asmuth, M. Violet

    1995-01-01

    Describes a project utilizing reaction reading, the choral reading of poetry in small groups. Mentally alert long-term care residents are provided with an opportunity to react to the poetry, and the activity can be led by a nonprofessional. Residents are encouraged to share their memories and fantasies as inspired by poetic images. (JPS)

  5. A Recovery-Oriented Care Approach: Weighing the Pros and Cons of a Newly Built Mental Health Facility.

    Science.gov (United States)

    Ahern, Catherine Clark; Bieling, Peter; McKinnon, Margaret C; McNeely, Heather E; Langstaff, Karen

    2016-02-01

    The current study adopted a recovery-oriented care approach by emphasizing patients' perspectives and experiences regarding changes to a newly built mental health facility. The inpatient entrance, or "portal," intended to balance the aims of recovery-oriented care with minimizing risk. A mixed-methods study of the portal's pros and cons was conducted, according to four themes: (a) autonomy versus inconvenience; (b) safety and security versus stigma; (c) unit door versus portal operating costs; and (d) privacy versus community integration. Focus groups engaging with patients (N = 39) indicated that the design effectively supported recovery-oriented care. Patients did not find the portal to be stigmatizing or triggering and valued the safety and privacy it created, and visitors also generally had a positive experience. Survey responses (N = 101) from portal users were also positive about the new design. The study findings suggest that the pros outweighed the cons of the new design. [Journal of Psychosocial Nursing and Mental Health Services, 54(2), 39-48.].

  6. The role of context and the interpersonal experience of loneliness among older people in a residential care facility

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    Vera Roos

    2012-10-01

    Full Text Available Older people are more prone to experience loneliness when living in residential care facilities. The purpose of this study was to explore older people's experiences of loneliness in the context of institutionalized care. A voluntary and convenience-based sample of 10 white South African older people (age range 62 to 82 years; three men and seven women was drawn. Data on the subjective experience of loneliness were then gathered through the Mmogo-method®, whereby drawings were employed to explore matters and issues of importance in the lives of older people that could be used to deal with loneliness. Data were analyzed thematically and visually as well as through the use of keywords in context. The results showed that older people experienced loneliness in terms of having unavailable interactions due to loss, and an absence of meaningful interpersonal interactions. Meaningful interpersonal interactions were described as when the older people had regular contact and a variety of interactions. Ineffective interpersonal styles (e.g. taking a controlling position in relationships and being rigid elicited rejection and isolation, and were associated with a lack of confirmatory interpersonal relationships. It is recommended that greater emphasis should be placed on creating awareness of unhealthy group dynamics as well as on psychosocial interventions to develop group support. Interpersonal styles, either effective or ineffective, take place in a social context, which, in this research, was observed to be unsafe, lacking in care, and a non-stimulating environment.

  7. Comorbidity-polypharmacy score predicts in-hospital complications and the need for discharge to extended care facility in older burn patients.

    Science.gov (United States)

    Justiniano, Carla F; Coffey, Rebecca A; Evans, David C; Jones, Larry M; Jones, Christian D; Bailey, J Kevin; Miller, Sidney F; Stawicki, Stanislaw P

    2015-01-01

    Advancing age is associated with increased mortality despite smaller burn size. Chronic conditions are common in the elderly with resulting polypharmacy. The Comorbidity-Polypharmacy Score (CPS) facilitates quantitative assessment of the severity of comorbid conditions, or physiologic age. Burn injury in older patients is associated with increasing morbidity and mortality and the CPS may be predictive of outcomes such as mortality, ICU and hospital LOS, complications, and final hospital disposition. Our goal was to evaluate the predictive value of CPS for outcomes in the elderly burn population. A retrospective study was undertaken of 920 burn patients with age ≥45 admitted with acute burn injuries (January 1, 2006 to December 31, 2012). CPS was calculated by adding preinjury comorbidities and medications. Subjects were stratified into three groups according to CPS severity. Data collected included demographics, total body surface area burned (TBSA), presence of inhalation injury, ICU/hospital length of stay, complications, discharge disposition, and mortality. Univariate and multivariate analyses were performed. The mean age was 55.7; 72.9% were males; the mean initial TBSA was 6.93%; and mean CPS was 8.01. The risk of in-hospital complications is independently associated with CPS (OR 1.35). CPS (OR 1.81) was an independent predictor of discharge to a facility CPS but not of mortality. While increasing CPS was associated with lower TBSA, mortality remained unchanged. CPS is an independent predictor of in-hospital complications and need for transfer to extended care facilities in older burn patients, which can be determined at the stage of admission to help direct patient management.

  8. Two Case Studies Using Mock-Ups for Planning Adult and Neonatal Intensive Care Facilities

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    Sue Hignett

    2010-01-01

    Full Text Available This paper describes two case studies using a 5-step protocol to determine functional space requirements for cardiac and neonatal intensive care clinical activities. Functional space experiments were conducted to determine the spatial requirements (defined as the minimumsized rectangle to encompass the Link Analysis. The data were collected with multi-directional filming and analysed frame-by-frame to plot the movements between the nurses and other components in the space. The average clinical functional space for the adult critical care unit was 22.83m2 (excluding family and hygiene space and in-room storage. The average functional clinical space for neonatal intensive care unit was 13.5m2 (excluding circulation and storage. The use of the 5-step protocol is reviewed, with limitations in case study 1 addressed in case study 2. The findings from both case studies have been incorporated into government guidance and achieved knowledge transfer by being implemented in building design.

  9. Surveillance for outbreaks of gastroenteritis in elderly long-term care facilities in France, November 2010 to May 2012.

    Science.gov (United States)

    Barret, A S; Jourdan-da Silva, N; Ambert-Balay, K; Delmas, G; Bone, A; Thiolet, J M; Vaillant, V

    2014-07-24

    This article describes outbreaks of gastroenteritis in elderly long-term care facilities (LTCF) in France from November 2010 to May 2012 reported through the surveillance system for gastroenteritis outbreaks in LTCF. A total of 1,072 outbreaks were reported, causing 26,551 episodes of illness and 60 deaths. The median attack rate (AR) among residents was 32%. Norovirus and person-to-person transmission were the most frequently reported aetiology and mode of transmission. Control measures were implemented in 1,054 (98%) outbreaks and for 928 outbreaks, the timing of such measures could be inferred. Of these, 799 (86%) had put control measures into effect within three days of the occurrence of the first case. Outbreaks of gastroenteritis in LTCF cause substantial morbidity and mortality among elderly people in France. LTCF are encouraged to develop infection prevention and control plans and to notify any gastroenteritis outbreak to health authorities to ensure rapid control.

  10. An Assessment of the Electric Power Quality and Electrical Installation Impacts on Medical Electrical Equipment Operations at Health Care Facilities

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    Mário C.G. Ramos

    2009-01-01

    Full Text Available Problem statement: Medical electrical equipments at health care facilities presented malfunction and wrong medical information due to poor electric power quality and to inadequate electrical Installations. Some equipment such as X-ray, computerized axial tomography and magnetic resonance imaging are considered as polluting ones due to their high amount of harmonics and voltage transients produced on the electrical power supply when in operation, while other equipments, connected to the same power supply, are considered sensitive or victim ones, presenting failure or producing wrong. Approach: The effects on some sensitive medical electrical equipment were verified in a controlled environment at energy quality technological center of the technical school of the University of Sao Paulo. A heart monitor, pulmonary ventilator and pulse oxymeter equipment types were submitted to a controlled voltage supply with high harmonic content and voltage sags. The test methodology used simulated conditions based on Brazilian NBR standards, ANSI/IEEE Std. 519, IEC 60601 and IEC 61000-4-11 standards. Results: The results of the polluting equipment current consumption measurements as well as the three sensitive equipments tested were presented and discussed. The pulmonary ventilator presented problems that range from stoppage to expiratory valve blockage and alarm system failures. The pulse oxymeter presented display malfunctions and it was extremely sensitive to voltage sags. The heart monitor maintained steady operation in all test cases. Conclusion/Recommendations: In spite of several existing recommendations and standards for testing medical electrical equipments, there is a lack of standard related to test cases considering the effects of high harmonic and voltage sags. The quality of electrical installation in health care facilities needs to be improved to reduce risks to the patients and to provide better health treatment.

  11. Inducing Herd Immunity against Seasonal Influenza in Long-Term Care Facilities through Employee Vaccination Coverage: A Transmission Dynamics Model

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    Aaron M. Wendelboe

    2015-01-01

    Full Text Available Introduction. Vaccinating healthcare workers (HCWs in long-term care facilities (LTCFs may effectively induce herd immunity and protect residents against influenza-related morbidity and mortality. We used influenza surveillance data from all LTCFs in New Mexico to validate a transmission dynamics model developed to investigate herd immunity induction. Material and Methods. We adjusted a previously published transmission dynamics model and used surveillance data from an active system among 76 LTCFs in New Mexico during 2006-2007 for model validation. We used a deterministic compartmental model with a stochastic component for transmission between residents and HCWs in each facility in order to simulate the random variation expected in such populations. Results. When outbreaks were defined as a dichotomous variable, our model predicted that herd immunity could be induced. When defined as an attack rate, the model demonstrated a curvilinear trend, but insufficiently strong to induce herd immunity. The model was sensitive to changes in the contact parameter β but was robust to changes in the visitor contact probability. Conclusions. These results further elucidate previous studies’ findings that herd immunity may not be induced by vaccinating HCWs in LTCFs; however, increased influenza vaccination coverage among HCWs reduces the probability of influenza infection among residents.

  12. A Novel Hierarchical Model to Locate Health Care Facilities with Fuzzy Demand Solved by Harmony Search Algorithm

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    Mehdi Alinaghian

    2014-08-01

    Full Text Available In the field of health losses resulting from failure to establish the facilities in a suitable location and the required number, beyond the cost and quality of service will result in an increase in mortality and the spread of diseases. So the facility location models have special importance in this area. In this paper, a successively inclusive hierarchical model for location of health centers in term of the transfer of patients from a lower level to a higher level of health centers has been developed. Since determination the exact number of demand for health care in the future is difficult and in order to make the model close to the real conditions of demand uncertainty, a fuzzy programming model based on credibility theory is considered. To evaluate the proposed model, several numerical examples are solved in small size. In order to solve large scale problems, a meta-heuristic algorithm based on harmony search algorithm was developed in conjunction with the GAMS software which indicants the performance of the proposed algorithm.

  13. Design and methods of the Hospital Elder Life Program (HELP), a multicomponent targeted intervention to prevent delirium in hospitalized older patients: efficacy and cost-effectiveness in Dutch health care

    NARCIS (Netherlands)

    Strijbos, Marije; Steunenberg, Bas; Mast, Roos van der; Inouye, Sharon; Schuurmans, Marieke

    2013-01-01

    The Hospital Elder Life Program (HELP) has been shown to be highly efficient and (cost-)effective in reducing delirium incidence in the USA. HELP provides multicomponent protocols targeted at specific risk factors for delirium and introduces a different view on care organization, with trained volunt

  14. Health facility environment as humanization strategy care in the pediatric unit: systematic review

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    Juliane Portella Ribeiro

    2014-06-01

    Full Text Available Objective: To identify and analyze the production of knowledge about the strategies that health care institutions have implemented to humanize care of hospitalized children. Method: This is a systematic review conducted in the Virtual Health Library - Nursing and SciELO, using the seven steps proposed by the Cochrane Handbook. Results: 15 studies were selected, and strategies that involved relationship exchanges were used between the health professional, the hospitalized child and their families, which may be mediated by leisure activities, music and by reading fairy tales. We also include the use of the architecture itself as a way of providing welfare to the child and his/her family, as well as facilitating the development of the work process of health professionals. Conclusion: Investments in research and publications about the topic are necessary, so that, the National Humanization Policy does not disappear and that the identified strategies in this study do not configure as isolated and disjointed actions of health policy.

  15. Equity of inpatient health care in rural Tanzania: a population- and facility-based survey

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    Ferry Grace A

    2012-02-01

    Full Text Available Abstract Objective To explore the equity of utilization of inpatient health care at rural Tanzanian health centers through the use of a short wealth questionnaire. Methods Patients admitted to four rural health centers in the Kigoma Region of Tanzania from May 2008 to May 2009 were surveyed about their illness, asset ownership and demographics. Principal component analysis was used to compare the wealth of the inpatients to the wealth of the region's general population, using data from a previous population-based survey. Results Among inpatients, 15.3% were characterized as the most poor, 19.6% were characterized as very poor, 16.5% were characterized as poor, 18.9% were characterized as less poor, and 29.7% were characterized as the least poor. The wealth distribution of all inpatients (p Conclusion The findings indicated that while current Tanzanian health financing policies may have improved access to health care for children under five, additional policies are needed to further close the equity gap, especially for obstetric inpatients.

  16. Quality of longer term mental health facilities in Europe: validation of the quality indicator for rehabilitative care against service users' views.

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    Helen Killaspy

    Full Text Available BACKGROUND: The Quality Indicator for Rehabilitative Care (QuIRC is a staff rated, international toolkit that assesses care in longer term hospital and community based mental health facilities. The QuIRC was developed from review of the international literature, an international Delphi exercise with over 400 service users, practitioners, carers and advocates from ten European countries at different stages of deinstitutionalisation, and review of the care standards in these countries. It can be completed in under an hour by the facility manager and has robust content validity, acceptability and inter-rater reliability. In this study, we investigated the internal validity of the QuIRC. Our aim was to identify the QuIRC domains of care that independently predicted better service user experiences of care. METHOD: At least 20 units providing longer term care for adults with severe mental illness were recruited in each of ten European countries. Service users completed standardised measures of their experiences of care, quality of life, autonomy and the unit's therapeutic milieu. Unit managers completed the QuIRC. Multilevel modelling allowed analysis of associations between service user ratings as dependent variables with unit QuIRC domain ratings as independent variables. RESULTS: 1750/2495 (70% users and the managers of 213 units from across ten European countries participated. QuIRC ratings were positively associated with service users' autonomy and experiences of care. Associations between QuIRC ratings and service users' ratings of their quality of life and the unit's therapeutic milieu were explained by service user characteristics (age, diagnosis and functioning. A hypothetical 10% increase in QuIRC rating resulted in a clinically meaningful improvement in autonomy. CONCLUSIONS: Ratings of the quality of longer term mental health facilities made by service managers were positively associated with service users' autonomy and experiences of care

  17. A Description of the Practice Pattern Characteristics of Anesthesia Care in Small, Medium and Large Teaching and Non-Teaching Medical Treatment Facilities in the Air Force

    Science.gov (United States)

    1999-05-20

    percentages of cesarean sections ; however, small facilities do twice as many intrathecal narcotic procedures as labor * epidurals. The majority of medium...military health care delivery systems as well. Virtually all health care providers will feel the effects of change be it in technological updates or...data obtained will be presented in relation to the major research questions outlined in Chapter 1. The first section provides demographic and

  18. Which health care facilities do adult malawian antiretroviral therapy patients utilize during intercurrent illness? a cross sectional study

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    Masangalawe Caroline

    2011-12-01

    Full Text Available Abstract Background Antiretroviral therapy (ART clinic populations have expanded enormously in the successful Malawi ART scale-up programme. Overcrowding, long waiting times and living far away from the clinic may affect the extent to which patients use their ART clinic for intercurrent illnesses. Methods We interviewed patients of a large urban ART clinic in Blantyre, Malawi, during routine visits about the choice of health care facility during recent illness episodes. Results Out of 346 enrolled adults, mean age 39.8 (range 18-70 years, 54.3% female, 202 (58% reported one or more illness in the past 6 months, during which 85 (42.1%; 95%-confidence interval: 36.9-47.3% did not utilize their own clinic. Long distance to the clinic was the main subjective reason, while low education attainment, rural residence, perceived mild illness and dissatisfaction with the ART service were associated with not using their own clinic in multivariate analyses. Of all participants, 83.6% were satisfied with the service provided; only 6.1% were aware of the full service package of the ART clinic. Conclusions ART patients often seek health care outside their own clinic, which may have detrimental effects, and has consequences for ART counseling content and reporting of ART information in health passports.

  19. Hysterectomy at a Canadian tertiary care facility: results of a one year retrospective review

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    Gorwill R Hugh

    2004-11-01

    Full Text Available Abstract Background The purpose of this study was to investigate the indications for and approach to hysterectomy at Kingston General Hospital (KGH, a teaching hospital affiliated with Queen's University at Kingston, Ontario. In particular, in light of current literature and government standards suggesting the superiority of vaginal versus abdominal approaches and a high number of concurrent oophorectomies, the aim was to examine the circumstances in which concurrent oophorectomies were performed and to compare abdominal and vaginal hysterectomy outcomes. Methods A retrospective chart audit of 372 consecutive hysterectomies performed in 2001 was completed. Data regarding patient characteristics, process of care and outcomes were collected. Data were analyzed using descriptive statistics, t-tests and linear and logistic regression. Results Average age was 48.5 years, mean body mass index (BMI was 28.6, the mean length of stay (LOS was 5.2 days using an abdominal approach and 3.0 days using a vaginal approach without laparoscopy. 14% of hysterectomies were performed vaginally, 5.9% were laparoscopically assisted vaginal hysterectomies and the rest were abdominal hysterectomies. The most common indication was dysfunctional or abnormal uterine bleeding (37%. The average age of those that had an oophorectomy (removal of both ovaries was 50.8 years versus 44.3 years for those that did not (p Conclusions A significant reduction in LOS was found using the vaginal approach. Both the patient and the health care system may benefit from the tendency towards an increased use of vaginal hysterectomies. The audit process demonstrated the usefulness of an on-going review mechanism to examine trends associated with common surgical procedures.

  20. The influence of social environment on the smoking status of women employed in health care facilities

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    Dragana Nikšić

    2013-04-01

    Full Text Available Introduction: Bosnia and Herzegovina has a high prevalence of smoking among women, especially among health care professionals. The goal of this study is to investigate the influence of the social environment of women employed in health institutions in relation to the cigarettes smoking habits.Methods: The study included 477 women employed in hospitals, outpatient and public health institutions in Sarajevo Canton Bosnia and Herzegovina. We used a modifi ed questionnaire assessing smoking habits of medical staff in European hospitalsResults: The results showed that 50% of women are smokers, with the highest incidence among nurses (58.1% and administrative staff (55.6%. The social environment is characterized by a high incidence of colleagues (60.1% and friends who are smokers (54.0% at the workplace and in the family (p<0.005. One third of women (27.8%, mainly non-smokers, states that the work environment supports employees smoking (p=0.003.Conclusion: Workplace and social environment support smoking as an acceptable cultural habit and is contributing to increasing rates of smoking among women.

  1. Advanced yellow fever virus genome detection in point-of-care facilities and reference laboratories.

    Science.gov (United States)

    Domingo, Cristina; Patel, Pranav; Yillah, Jasmin; Weidmann, Manfred; Méndez, Jairo A; Nakouné, Emmanuel Rivalyn; Niedrig, Matthias

    2012-12-01

    Reported methods for the detection of the yellow fever viral genome are beset by limitations in sensitivity, specificity, strain detection spectra, and suitability to laboratories with simple infrastructure in areas of endemicity. We describe the development of two different approaches affording sensitive and specific detection of the yellow fever genome: a real-time reverse transcription-quantitative PCR (RT-qPCR) and an isothermal protocol employing the same primer-probe set but based on helicase-dependent amplification technology (RT-tHDA). Both assays were evaluated using yellow fever cell culture supernatants as well as spiked and clinical samples. We demonstrate reliable detection by both assays of different strains of yellow fever virus with improved sensitivity and specificity. The RT-qPCR assay is a powerful tool for reference or diagnostic laboratories with real-time PCR capability, while the isothermal RT-tHDA assay represents a useful alternative to earlier amplification techniques for the molecular diagnosis of yellow fever by field or point-of-care laboratories.

  2. Presence of selected priority and personal care substances in an onsite bathroom greywater treatment facility.

    Science.gov (United States)

    Eriksson, E; Donner, E; Ledin, A

    2010-01-01

    In recent years, concerns about climate change and the inefficient use and ongoing pollution of water resources have increased the political motivation to encourage water recycling. This has led to the widespread introduction of water saving measures and to advances in the decentralised treatment and reuse of wastewater. In particular, the treatment and reuse of greywater has received attention, although important information such as greywater substance loadings is still only rarely available. With the implementation of the European Water Framework Directive the focus on controlling and phasing-out Priority/Priority Hazardous Substances (PS/PHS) is growing, and it is vital to know their sources and flows in order to generate sustainable emission control strategies. The main objective of this study was to quantify the concentrations and loads of PS/PHS and personal care substances in bathroom greywater, and to thereby assess the contribution of household activities to municipal wastewater loads for these substances. Nickel and mercury may be sourced substantially from household activities as it shown in the paper that bathroom greywater contributed a significant proportion of the overall load of these substances at the municipal wastewater treatment plant. Organic matter in the influent greywater was found to be principally associated with large particles (>8 µm), however it was the dissolved and small sized particles that were predominantly removed in the treatment.

  3. How to change organisational culture: Action research in a South African public sector primary care facility

    Science.gov (United States)

    De Sa, Angela; Christodoulou, Maria

    2016-01-01

    Background Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim To explore how to transform the organisational culture in line with the desired values. Setting Retreat Community Health Centre, Cape Town, South Africa. Methods Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA) survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA) and had 6 months of coaching. Results Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group. PMID:27608671

  4. The development of the Quality Indicator for Rehabilitative Care (QuIRC) : a measure of best practice for facilities for people with longer term mental health problems

    NARCIS (Netherlands)

    Killaspy, Helen; White, Sarah; Wright, Christine; Taylor, Tatiana L.; Turton, Penny; Schuetzwohl, Matthias; Schuster, Mirjam; Cervilla, Jorge A.; Brangier, Paulette; Raboch, Jiri; Kalisova, Lucie; Onchev, Georgi; Alexiev, Spiridon; Mezzina, Roberto; Ridente, Pina; Wiersma, Durk; Visser, Ellen; Kiejna, Andrzej; Adamowski, Tomasz; Ploumpidis, Dimitri; Gonidakis, Fragiskos; Caldas-de-Almeida, Jose; Cardoso, Graca; King, Michael B.

    2011-01-01

    Background: Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at

  5. Treatment of binge eating disorder in racially and ethnically diverse obese patients in primary care: randomized placebo-controlled clinical trial of self-help and medication.

    Science.gov (United States)

    Grilo, Carlos M; Masheb, Robin M; White, Marney A; Gueorguieva, Ralitza; Barnes, Rachel D; Walsh, B Timothy; McKenzie, Katherine C; Genao, Inginia; Garcia, Rina

    2014-07-01

    The objective was to determine whether treatments with demonstrated efficacy for binge eating disorder (BED) in specialist treatment centers can be delivered effectively in primary care settings to racially/ethnically diverse obese patients with BED. This study compared the effectiveness of self-help cognitive-behavioral therapy (shCBT) and an anti-obesity medication (sibutramine), alone and in combination, and it is only the second placebo-controlled trial of any medication for BED to evaluate longer-term effects after treatment discontinuation. 104 obese patients with BED (73% female, 55% non-white) were randomly assigned to one of four 16-week treatments (balanced 2-by-2 factorial design): sibutramine (N = 26), placebo (N = 27), shCBT + sibutramine (N = 26), or shCBT + placebo (N = 25). Medications were administered in double-blind fashion. Independent assessments were performed monthly throughout treatment, post-treatment, and at 6- and 12-month follow-ups (16 months after randomization). Mixed-models analyses revealed significant time and medication-by-time interaction effects for percent weight loss, with sibutramine but not placebo associated with significant change over time. Percent weight loss differed significantly between sibutramine and placebo by the third month of treatment and at post-treatment. After the medication was discontinued at post-treatment, weight re-gain occurred in sibutramine groups and percent weight loss no longer differed among the four treatments at 6- and 12-month follow-ups. For binge-eating, mixed-models revealed significant time and shCBT-by-time interaction effects: shCBT had significantly lower binge-eating frequency at 6-month follow-up but the treatments did not differ significantly at any other time point. Demographic factors did not significantly predict or moderate clinical outcomes. Our findings suggest that pure self-help CBT and sibutramine did not show long-term effectiveness relative to placebo for treating BED in

  6. Helping people make well-informed decisions about health care: old and new challenges to achieving the aim of the Cochrane Collaboration.

    Science.gov (United States)

    Oxman, Andrew D

    2013-09-20

    The aim of the Cochrane Collaboration is to help people make well-informed decisions about health care by preparing, maintaining and promoting the accessibility of systematic reviews of the effects of health care interventions. This aim is as relevant now as it was 20 years ago, when the Cochrane Collaboration was established. Substantial progress has been made toward addressing challenges to achieving the Collaboration's aim. At the same time, a huge amount of work remains to be done. Current challenges include improving the quality of reviews, methodological challenges, meeting the needs of contributors and users and taking on new challenges while staying focused on the Collaboration's aim. Radical thinking and substantial change may be needed to identify and implement pragmatic strategies to ensure that reviews are up-to-date and informative. Methodological challenges include the development and application of better methods for addressing explanatory factors, incorporating non-randomized evidence and making comparisons across multiple interventions. Innovations in editorial processes and strategies to meet the needs of low- and middle-income countries and diverse users of Cochrane reviews are needed. Finally, although it is important to consider broadening the aims of the Collaboration to include types of questions other than the effects of interventions and types of products other than the Cochrane Library, we should not lose sight of the aim of the Cochrane Collaboration. Addressing that aim is still a major challenge that requires the collaboration of thousands of people around the world and continuing improvements in the methods used to achieve that aim.

  7. How to change organisational culture: Action research in a South African public sector primary care facility

    Directory of Open Access Journals (Sweden)

    Robert Mash

    2016-03-01

    Full Text Available Background: Organisational culture is a key factor in both patient and staff experience of the healthcare services. Patient satisfaction, staff engagement and performance are related to this experience. The department of health in the Western Cape espouses a values-based culture characterised by caring, competence, accountability, integrity, responsiveness and respect. However, transformation of the existing culture is required to achieve this vision. Aim: To explore how to transform the organisational culture in line with the desired values. Setting: Retreat Community Health Centre, Cape Town, South Africa. Methods: Participatory action research with the leadership engaged with action and reflection over a period of 18 months. Change in the organisational culture was measured at baseline and after 18 months by means of a cultural values assessment (CVA survey. The three key leaders at the health centre also completed a 360-degree leadership values assessment (LVA and had 6 months of coaching. Results: Cultural entropy was reduced from 33 to 13% indicating significant transformation of organisational culture. The key driver of this transformation was change in the leadership style and functioning. Retreat health centre shifted from a culture that emphasised hierarchy, authority, command and control to one that established a greater sense of cohesion, shared vision, open communication, appreciation, respect, fairness and accountability. Conclusion: Transformation of organisational culture was possible through a participatory process that focused on the leadership style, communication and building relationships by means of CVA and feedback, 360-degree LVA, feedback and coaching and action learning in a co-operative inquiry group.

  8. The impact of social networks on knowledge transfer in long-term care facilities: Protocol for a study

    Directory of Open Access Journals (Sweden)

    Valente Thomas W

    2010-06-01

    Full Text Available Abstract Background Social networks are theorized as significant influences in the innovation adoption and behavior change processes. Our understanding of how social networks operate within healthcare settings is limited. As a result, our ability to design optimal interventions that employ social networks as a method of fostering planned behavior change is also limited. Through this proposed project, we expect to contribute new knowledge about factors influencing uptake of knowledge translation interventions. Objectives Our specific aims include: To collect social network data among staff in two long-term care (LTC facilities; to characterize social networks in these units; and to describe how social networks influence uptake and use of feedback reports. Methods and design In this prospective study, we will collect data on social networks in nursing units in two LTC facilities, and use social network analysis techniques to characterize and describe the networks. These data will be combined with data from a funded project to explore the impact of social networks on uptake and use of feedback reports. In this parent study, feedback reports using standardized resident assessment data are distributed on a monthly basis. Surveys are administered to assess report uptake. In the proposed project, we will collect data on social networks, analyzing the data using graphical and quantitative techniques. We will combine the social network data with survey data to assess the influence of social networks on uptake of feedback reports. Discussion This study will contribute to understanding mechanisms for knowledge sharing among staff on units to permit more efficient and effective intervention design. A growing number of studies in the social network literature suggest that social networks can be studied not only as influences on knowledge translation, but also as possible mechanisms for fostering knowledge translation. This study will contribute to building

  9. Communities, birth attendants and health facilities: a continuum of emergency maternal and newborn care (the global network's EmONC trial

    Directory of Open Access Journals (Sweden)

    Liechty Edward A

    2010-12-01

    Full Text Available Abstract Background Maternal and newborn mortality rates remain unacceptably high, especially where the majority of births occur in home settings or in facilities with inadequate resources. The introduction of emergency obstetric and newborn care services has been proposed by several organizations in order to improve pregnancy outcomes. However, the effectiveness of emergency obstetric and neonatal care services has never been proven. Also unproven is the effectiveness of community mobilization and community birth attendant training to improve pregnancy outcomes. Methods/Design We have developed a cluster-randomized controlled trial to evaluate the impact of a comprehensive intervention of community mobilization, birth attendant training and improvement of quality of care in health facilities on perinatal mortality in low and middle-income countries where the majority of births take place in homes or first level care facilities. This trial will take place in 106 clusters (300-500 deliveries per year each across 7 sites of the Global Network for Women's and Children's Health Research in Argentina, Guatemala, India, Kenya, Pakistan and Zambia. The trial intervention has three key elements, community mobilization, home-based life saving skills for communities and birth attendants, and training of providers at obstetric facilities to improve quality of care. The primary outcome of the trial is perinatal mortality. Secondary outcomes include rates of stillbirth, 7-day neonatal mortality, maternal death or severe morbidity (including obstetric fistula, eclampsia and obstetrical sepsis and 28-day neonatal mortality. Discussion In this trial, we are evaluating a combination of interventions including community mobilization and facility training in an attempt to improve pregnancy outcomes. If successful, the results of this trial will provide important information for policy makers and clinicians as they attempt to improve delivery services for pregnant

  10. Critical Care

    Science.gov (United States)

    Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications ... a team of specially-trained health care providers. Critical care usually takes place in an intensive care ...

  11. Impact, meaning and need for help and support: The experience of parents caring for children with disabilities, life-limiting/life-threatening illness or technology dependence.

    Science.gov (United States)

    Whiting, Mark

    2013-03-01

    Parenting a child with complex needs or disabilities is a challenging proposition. This study, which drew upon of the experiences of the parents of 34 children (in 33 families), set out to explore the themes of impact, need for help and support and meaning/sense-making as they were related by parents. Data were collected using semi-structured interviews, and an emerging theoretical framework was validated through the use of a series of mind-maps(®) which were presented to individual parents as the basis for a second round (verificational) interview. Parents were nominated into the study by health care professions who were asked to identify the subject children to one of three separate sub-groups: children with a disability; children with a life-limiting/life-threatening illness or children with a technology dependence. Comparisons were made between the three study sub-groups in order to identify areas of consistency and of inconsistency. A fourth study theme - 'battleground' emerged from entirely within the data set. Sense-making occupied a central position within the overall theoretical framework for the study and parental perception of 'battleground' presented as significant element of parental sense-making, particularly in the context of their relationships with professional staff.

  12. Prescribing behavior of diabetes treating physicians in selected health care facilities of the Diabetic Association of Bangladesh

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    Bilkis Banu

    2014-01-01

    Full Text Available Background: Practicing behavior of the physicians varies from population to population due to diverse socioeconomic, cultural, and professional factors. Evidence on these issues is almost nonexistent in the developing countries. Objective: The prescribing behavior of diabetes treating physicians working in selected hospitals of the Diabetic Association of Bangladesh was studied along with the factors affecting those behaviors. Materials and Methods: This was an observational study on 818 prescriptions given by 49 physicians working in 16 health care facilities, which were photocopied by a portable photocopier. The various components of the prescription were scrutinized for presence and absence, and evaluated independently by two expert Diabetologists for their qualitative aspects. Results: The mean ± standard deviation of the total prescribing score (expressed as percentage was 60 ± 11. Physicians scoring around or below 60% belonged more to lower age (<40 years, less experienced (<7 years and mid-position (Senior Medical Officers groups. Most of them also had public medical college background. Physicians with Certificate Course on Diabetology (CCD had significantly higher score compared with the Non-CCD group (P < 0.001. Direction and duration of drug use were absent in majority of prescriptions (72.0% and 61.6%, respectively. Symptoms were not written in 78.0% and the family histories were not recorded in 98.5% prescriptions. Diet (49.4% and exercise (51.0% related advices were not mentioned in a large number of prescriptions. Appropriate change of drug (78.2% and proper use of drug (99.1% and brand (93.8% were found rational, but still, 22.4% of the prescriptions found illegible. Conclusion: A large proportion of prescriptions in Bangladesh related to diabetes care still lack standardization and acceptable quality. Nondrug related issues (such as history, symptoms, and dietary/exercise-related advices are the most neglected ones in a

  13. Effect of Talbinah food consumption on depressive symptoms among elderly individuals in long term care facilities, randomized clinical trial

    Directory of Open Access Journals (Sweden)

    Badrasawi MM

    2013-03-01

    Full Text Available Manal M Badrasawi, Suzana Shahar, Zahara Abd Manaf, Hasnah HaronDietetics program, School of Health Care Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, MalaysiaAbstract: Talbinah is a barley syrup cooked with milk and sweetened by honey. In his famous Hadith on Talbinah, the Prophet Mohammad (SAW recommended it when sad events happen for its effect on soothing hearts and relieving sadness. This 3-week crossover designed, randomized clinical trial was conducted to determine the effect of Talbinah on mood and depression among institutionalized elderly people in Seremban. A sample of 30 depressed elderly subjects (21 men and 9 women was selected from the long term care facility. Three different interview-based validated scales (Geriatric Depression Scale, Depression Anxiety Stress Scales, and Profile of Mood States were used to determine mood, depression, stress, and anxiety at week 0, 3, 4, and 7. The nutritional value of Talbinah was examined using proximate food analysis, minerals content analysis, and differential amino acid analysis. The results indicated that Talbinah is a high carbohydrate food (86.4% and has a high tryptophan: branch chain amino acids ratio (1:2. A Wilcoxon nonparametric test showed that there was a statistically significant decrease on depression, stress, and mood disturbances scores among the intervention group (P < 0.05 for all parameters. In conclusion, Talbinah has the potential to reduce depression and enhance mood among the subjects. Ingestion of functional foods such as Talbinah may provide a mental health benefit to elderly people.Keywords: Talbinah, food and depression, cross over study, elderly

  14. Help LEP

    CERN Multimedia

    Carreras,R; Lehmann,P

    1988-01-01

    première partie: Help LEP ou le tunnel de l'infini- pièce radiophonique intéréssant sur l'origine de la matière deuxième partie: Help LEP débat; suite à cette pièce interview avec 3 physiciens du Cern sur le projet LEP et le but du Cern qui est la recherche fondamentale

  15. Investigating the current methods of assessing behavioral and psychological symptoms in residential aged care facilities in a metropolitan city.

    Science.gov (United States)

    Loi, Samantha M; Lautenschlager, Nicola T

    2017-05-01

    Up to 90% of people with dementia living in residential aged care facilities (RACFs) display behavioral and psychological symptoms of dementia (BPSD), and these are associated with poorer quality of life and increased morbidity and mortality. In order to implement appropriate interventions, it is important to understand the symptoms in more detail. Despite the availability of BPSD assessment tools, it is unknown what the current practice of monitoring of BPSD in RACFs. We sought to investigate the current BPSD assessment tools being used in RACFs and explore different stakeholders' views on current practices. A cross-sectional convenience sample of 21 clinicians were identified and administered a questionnaire. Old age psychiatrists, aged psychiatry clinicians, behavior management teams and RACF staff completed the questionnaires. Clinicians reported that objective consistent information about BPSD were important for recommending and implementing pharmacological and non-pharmacological strategies for BPSD; however, the use of validated BPSD assessments in RACFs was not a usual part of clinical practice. RACF staff stated the major barrier to assessment of BPSD was lack of time. Alternate methods of assessing BPSD which consider preferences from clinicians and RACF staff should be further investigated. Modern technology which can allow "real time" assessment may be a solution.

  16. Insights into the impact and use of research results in a residential long-term care facility: a case study

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    Cranley Lisa A

    2012-09-01

    Full Text Available Abstract Background Engaging end-users of research in the process of disseminating findings may increase the relevance of findings and their impact for users. We report findings from a case study that explored how involvement with the Translating Research in Elder Care (TREC study influenced management and staff at one of 36 TREC facilities. We conducted the study at ‘Restwood’ (pseudonym nursing home because the Director of Care engaged actively in the study and TREC data showed that this site differed on some areas from other nursing homes in the province. The aims of the case study were two-fold: to gain a better understanding of how frontline staff engage with the research process, and to gain a better understanding of how to share more detailed research results with management. Methods We developed an Expanded Feedback Report for use during this study. In it, we presented survey results that compared Restwood to the best performing site on all variables and participating sites in the province. Data were collected regarding the Expanded Feedback Report through interviews with management. Data from staff were collected through interviews and observation. We used content analysis to derive themes to describe key aspects related to the study aims. Results We observed the importance of understanding organizational routines and the impact of key events in the facility’s environment. We gleaned additional information that validated findings from prior feedback mechanisms within TREC. Another predominant theme was the sense that the opportunity to engage in a research process was reaffirming for staff (particularly healthcare aides—what they did and said mattered, and TREC provided a means of having one’s voice heard. We gained valuable insight from the Director of Care about how to structure and format more detailed findings to assist with interpretation and use of results. Conclusions Four themes emerged regarding staff engagement with

  17. [Factors influencing continuation of home life after returning home from geriatric intermediate care facilities in a metropolitan suburb].

    Science.gov (United States)

    Miyata, K

    2000-11-01

    A follow-up study was conducted to elucidate the factors influencing continuation of home life after returning home from geriatric intermediate care facilities (GICFs). The subjects were 237 elderly persons (56 men, 181 women, average age of 84 years) who were admitted to three GICFs located in the suburbs of Osaka, and their family caregivers. A follow-up study was performed from 1997 to 1998. Seventy percent of the elderly were bedridden persons with grade B or C of activities of daily living (ADL) according to the criteria of disabled elderly of the Japanese government. Dementia was observed in 82.3% of them. Family caregivers were sons (30.7%), daughters (27.4%), daughters-in-law (27.8%) and spouses (9.7%). The percentage of families spending all day long with the elderly person was 57.5%. Although the rate of having their own detached house was high, that of a private room for the elderly individuals was only about 60%. Most of the families cared for the elderly before admission to the GICFs. The families desired them to stay in the GICFs for as long as possible. Therefore, the families did not want to take the elderly into their home after discharge and only 45% of the families desired home care after the discharge. Concerning the flow of the 237 elderly subjects, the rate of admission from hospitals was high (60.8%), and that of discharge to hospitals was also high (44.3%). The place of residence at the end of follow-up was the GICF (35.4%), the elderly subject's home (19.0%), and hospital (16.0%). Of the 96 elderly who had returned home from GICFs, 40.6% were re-admitted to GICFs. According to multiple logistic analysis, the factors related to continuation of home life were "the elderly with family caregivers who can always supervise him/her", and "the elderly without problem behavior". From the results obtained, it is important that in order for disabled elderly individuals to continue their home life, the GICFs must be the function as the center of a

  18. Layout Improvement Study to Reduce Staff Walking Distance in a Large Health Care Facility: How to Not Walk an Extra 4740 Miles.

    Science.gov (United States)

    Ley-Chavez, Adriana; Hmar-Lagroun, Tatiana; Douglas-Ntagha, Pamela; Cumbo, Charlotte L

    2016-01-01

    Inefficient facility layouts have been found to be a challenge in health care, with excessive walking adding to the demands of staff and creating delays, which can impact the quality of care. Minimizing unnecessary transportation during care delivery improves efficiency, reduces delays, and frees up resources for use on value-added activities. This article presents a methodology and application of facility design to improve responsiveness and efficiency at a large hospital. The approach described provides the opportunity to improve existing layouts in facilities in which the floor plan is already defined, but there is some flexibility to relocate key areas. The existing physical constraints and work flows are studied and taken into consideration, and the volume of traffic flow throughout the facility guides the decision of where to relocate areas for maximum efficiency. Details on the steps followed and general recommendations to perform the necessary process and data analyses are provided. We achieved a 34.8% reduction in distance walked (4740 miles saved per year) and a 30% reduction in floors traveled in elevators (344 931 floors, which translate to 842 hours spent using elevators) by relocating 4 areas in which frequently used resources are housed.

  19. Acceptability and use of portable drinking water and hand washing stations in health care facilities and their impact on patient hygiene practices, Western kenya.

    Directory of Open Access Journals (Sweden)

    Sarah D Bennett

    Full Text Available Many health care facilities (HCF in developing countries lack access to reliable hand washing stations and safe drinking water. To address this problem, we installed portable, low-cost hand washing stations (HWS and drinking water stations (DWS, and trained healthcare workers (HCW on hand hygiene, safe drinking water, and patient education techniques at 200 rural HCFs lacking a reliable water supply in western Kenya. We performed a survey at baseline and a follow-up evaluation at 15 months to assess the impact of the intervention at a random sample of 40 HCFs and 391 households nearest to these HCFs. From baseline to follow-up, there was a statistically significant increase in the percentage of dispensaries with access to HWSs with soap (42% vs. 77%, p<0.01 and access to safe drinking water (6% vs. 55%, p<0.01. Female heads of household in the HCF catchment area exhibited statistically significant increases from baseline to follow-up in the ability to state target times for hand washing (10% vs. 35%, p<0.01, perform all four hand washing steps correctly (32% vs. 43%, p = 0.01, and report treatment of stored drinking water using any method (73% vs. 92%, p<0.01; the percentage of households with detectable free residual chlorine in stored drinking water did not change (6%, vs. 8%, p = 0.14. The installation of low-cost, low-maintenance, locally-available, portable hand washing and drinking water stations in rural HCFs without access to 24-hour piped water helped assure that health workers had a place to wash their hands and provide safe drinking water. This HCF intervention may have also contributed to the improvement of hand hygiene and reported safe drinking water behaviors among households nearest to HCFs.

  20. Implementation of patient charges at primary care facilities in Kenya: implications of low adherence to user fee policy for users and facility revenue.

    Science.gov (United States)

    Opwora, Antony; Waweru, Evelyn; Toda, Mitsuru; Noor, Abdisalan; Edwards, Tansy; Fegan, Greg; Molyneux, Sassy; Goodman, Catherine

    2015-05-01

    With user fees now seen as a major hindrance to universal health coverage, many countries have introduced fee reduction or elimination policies, but there is growing evidence that adherence to reduced fees is often highly imperfect. In 2004, Kenya adopted a reduced and uniform user fee policy providing fee exemptions to many groups. We present data on user fee implementation, revenue and expenditure from a nationally representative survey of Kenyan primary health facilities. Data were collected from 248 randomly selected public health centres and dispensaries in 2010, comprising an interview with the health worker in charge, exit interviews with curative outpatients, and a financial record review. Adherence to user fee policy was assessed for eight tracer conditions based on health worker reports, and patients were asked about actual amounts paid. No facilities adhered fully to the user fee policy across all eight tracers, with adherence ranging from 62.2% for an adult with tuberculosis to 4.2% for an adult with malaria. Three quarters of exit interviewees had paid some fees, with a median payment of US dollars (USD) 0.39, and a quarter of interviewees were required to purchase additional medical supplies at a later stage from a private drug retailer. No consistent pattern of association was identified between facility characteristics and policy adherence. User fee revenues accounted for almost all facility cash income, with average revenue of USD 683 per facility per year. Fee revenue was mainly used to cover support staff, non-drug supplies and travel allowances. Adherence to user fee policy was very low, leading to concerns about the impact on access and the financial burden on households. However, the potential to ensure adherence was constrained by the facilities' need for revenue to cover basic operating costs, highlighting the need for alternative funding strategies for peripheral health facilities.

  1. Decision-making factors affecting different family members regarding the placement of relatives in long-term care facilities

    OpenAIRE

    Huang, Ying-Chia; Chu, Chiao-Lee; Ho, Ching-Sung; Lan, Shou-Jen; Hsieh, Chen-Hsi; Hsieh, Yen-Ping

    2014-01-01

    Background The aim of this research was to investigate factors affecting different family members’ decisions regarding the placement of relatives in long-term car (LTC) facilities in Taiwan. The objective was to investigate the correlations between family members’ personal traits, the living conditions of residents in the LTC facilities, and family members’ experiences with LTC facilities. Methods This study selected family members visiting residents in LTC facilities as research subjects and...

  2. Why some women fail to give birth at health facilities: a qualitative study of women’s perceptions of perinatal care from rural Southern Malawi

    Directory of Open Access Journals (Sweden)

    Kumbani Lily

    2013-02-01

    Full Text Available Abstract Background Despite Malawi government’s policy to support women to deliver in health facilities with the assistance of skilled attendants, some women do not access this care. Objective The study explores the reasons why women delivered at home without skilled attendance despite receiving antenatal care at a health centre and their perceptions of perinatal care. Methods A descriptive study design with qualitative data collection and analysis methods. Data were collected through face-to-face in-depth interviews using a semi- structured interview guide that collected information on women’s perception on perinatal care. A total of 12 in- depth interviews were conducted with women that had delivered at home in the period December 2010 to March 2011. The women were asked how they perceived the care they received from health workers before, during, and after delivery. Data were manually analyzed using thematic analysis. Results Onset of labor at night, rainy season, rapid labor, socio-cultural factors and health workers’ attitudes were related to the women delivering at home. The participants were assisted in the delivery by traditional birth attendants, relatives or neighbors. Two women delivered alone. Most women went to the health facility the same day after delivery. Conclusions This study reveals beliefs about labor and delivery that need to be addressed through provision of appropriate perinatal information to raise community awareness. Even though, it is not easy to change cultural beliefs to convince women to use health facilities for deliveries. There is a need for further exploration of barriers that prevent women from accessing health care for better understanding and subsequently identification of optimal solutions with involvement of the communities themselves.

  3. Use of RDTs to improve malaria diagnosis and fever case management at primary health care facilities in Uganda

    Directory of Open Access Journals (Sweden)

    Nabakooza Jane

    2010-07-01

    Full Text Available Abstract Background Early and accurate diagnosis of malaria followed by prompt treatment reduces the risk of severe disease in malaria endemic regions. Presumptive treatment of malaria is widely practised where microscopy or rapid diagnostic tests (RDTs are not readily available. With the introduction of artemisinin-based combination therapy (ACT for treatment of malaria in many low-resource settings, there is need to target treatment to patients with parasitologically confirmed malaria in order to improve quality of care, reduce over consumption of anti-malarials, reduce drug pressure and in turn delay development and spread of drug resistance. This study evaluated the effect of malaria RDTs on health workers' anti-malarial drug (AMD prescriptions among outpatients at low level health care facilities (LLHCF within different malaria epidemiological settings in Uganda. Methods All health workers (HWs in 21 selected intervention (where RDTs were deployed LLHF were invited for training on the use RDTs. All HWs were trained to use RDTs for parasitological diagnosis of all suspected malaria cases irrespective of age. Five LLHCFs with clinical diagnosis (CD only were included for comparison. Subsequently AMD prescriptions were compared using both a 'pre - post' and 'intervention - control' analysis designs. In-depth interviews of the HWs were conducted to explore any factors that influence AMD prescription practices. Results A total of 166,131 out-patient attendances (OPD were evaluated at 21 intervention LLHCFs. Overall use of RDTs resulted in a 38% point reduction in AMD prescriptions. There was a two-fold reduction (RR 0.62, 95% CI 0.55-0.70 in AMD prescription with the greatest reduction in the hypo-endemic setting (RR 0.46 95% CI 0.51-0.53 but no significant change in the urban setting (RR1.01, p-value = 0.820. Over 90% of all eligible OPD patients were offered a test. An average of 30% (range 25%-35% of the RDT-negative fever patients received

  4. An evaluation of Snoezelen(®) compared to 'common best practice' for allaying the symptoms of wandering and restlessness among residents with dementia in aged care facilities.

    Science.gov (United States)

    Bauer, Michael; Rayner, Jo-Anne; Tang, Judy; Koch, Susan; While, Christine; O'Keefe, Fleur

    2015-01-01

    Snoezelen has become an increasingly popular therapy in residential aged care facilities in Australia and elsewhere, despite no conclusive evidence of its clinical efficacy. This paper reports on an evaluation of the use of Snoezelen compared to 'common best practice' for allaying the dementia related behaviors of wandering and restlessness in two residential aged care facilities in Victoria, Australia. Sixteen residents had their behavior and responses to Snoezelen or 'common best practice' observed and recorded over three time periods. The Wilcoxon signed-rank test showed there was a significant improvement in behaviors immediately after the intervention and after 60 min. However, no significant differences were found between residents receiving Snoezelen and 'common best practice' interventions for the reduction of the dementia related behaviors.

  5. Applying of Decision Tree Analysis to Risk Factors Associated with Pressure Ulcers in Long-Term Care Facilities

    Science.gov (United States)

    Moon, Mikyung

    2017-01-01

    Objectives The purpose of this study was to use decision tree analysis to explore the factors associated with pressure ulcers (PUs) among elderly people admitted to Korean long-term care facilities. Methods The data were extracted from the 2014 National Inpatient Sample (NIS)—data of Health Insurance Review and Assessment Service (HIRA). A MapReduce-based program was implemented to join and filter 5 tables of the NIS. The outcome predicted by the decision tree model was the prevalence of PUs as defined by the Korean Standard Classification of Disease-7 (KCD-7; code L89*). Using R 3.3.1, a decision tree was generated with the finalized 15,856 cases and 830 variables. Results The decision tree displayed 15 subgroups with 8 variables showing 0.804 accuracy, 0.820 sensitivity, and 0.787 specificity. The most significant primary predictor of PUs was length of stay less than 0.5 day. Other predictors were the presence of an infectious wound dressing, followed by having diagnoses numbering less than 3.5 and the presence of a simple dressing. Among diagnoses, “injuries to the hip and thigh” was the top predictor ranking 5th overall. Total hospital cost exceeding 2,200,000 Korean won (US $2,000) rounded out the top 7. Conclusions These results support previous studies that showed length of stay, comorbidity, and total hospital cost were associated with PUs. Moreover, wound dressings were commonly used to treat PUs. They also show that machine learning, such as a decision tree, could effectively predict PUs using big data. PMID:28261530

  6. Cross-sectional relationship between physical fitness components and functional performance in older persons living in long-term care facilities

    Directory of Open Access Journals (Sweden)

    van Mechelen Willem

    2006-02-01

    Full Text Available Abstract Background The age-related deterioration of physiological capacities such as muscle strength and balance is associated with increased dependence. Understanding the contribution of physical fitness components to functional performance facilitates the development of adequate exercise interventions aiming at preservation of function and independence of older people. The aim of the study was to investigate the relationship between physical fitness components and functional performance in older people living in long-term care facilities. Methods Design cross-sectional study Subjects 226 persons living in long-term care facilities (mean age: 81.6 ± 5.6. Outcome measures Physical fitness and functional performance were measured by performance-based tests. Results Knee and elbow extension strength were significantly higher in men (difference = 44.5 and 50.0 N, respectively, whereas women were more flexible (difference sit & reach test = 7.2 cm. Functional performance was not significantly different between the genders. In men, motor coordination (eye-hand coordination and measures of strength were the main contributors to functional performance, whereas in women flexibility (sit and reach test and motor coordination (tandem stance and eye-hand coordination played a major role. Conclusion The results of this study show that besides muscle strength, fitness components such as coordination and flexibility are associated with functional performance of older people living in long-term care facilities. This suggests that men and women living in long-term care facilities, differ considerably concerning the fitness factors contributing to functional performance. Women and men may, therefore, need exercise programs emphasizing different fitness aspects in order to improve functional performance.

  7. Help Others,Help Me

    Institute of Scientific and Technical Information of China (English)

    1997-01-01

    WHEN they first came to Xingcheng, Huang Jing and her husband Ma Shiyu didn’t come to help others. They came to seek their own fortune in this small, ancient coastal town where they saw prospects of prosperity. So when the couple decided to move to Xingcheng, they didn’t know their coming would be a turning point for many locals. too.

  8. Help Us to Help Ourselves

    Science.gov (United States)

    Stanistreet, Paul

    2010-01-01

    Local authorities have a strong tradition of supporting communities to help themselves, and this is nowhere better illustrated than in the learning they commission and deliver through the Adult Safeguarded Learning budget. The budget was set up to protect at least a minimum of provision for adult liberal education, family learning and learning for…

  9. When Ideals Get in the Way of Self-Care: Perfectionism and Self-Stigma for Seeking Psychological Help among High School Students

    Science.gov (United States)

    Zeifman, Richard J.; Atkey, Sarah K.; Young, Rebecca E.; Flett, Gordon L.; Hewitt, Paul L.; Goldberg, Joel O.

    2015-01-01

    In the current study, we investigated whether adolescents high in perfectionism are prone to experiencing self-stigma for seeking psychological help. This work is based on the premise that the need to seek help for psychological difficulties is not consistent with idealistic personal goals of perfectionistic young people and their desire to retain…

  10. Contributing influences of work environment on sleep quantity and quality of nursing assistants in long-term care facilities: A cross-sectional study.

    Science.gov (United States)

    Zhang, Yuan; Punnett, Laura; McEnany, Geoffry Phillips; Gore, Rebecca

    2016-01-01

    The effect of shift work on nurses' sleep is well-studied, but there are other challenging aspects of health care work that might also affect the sleep of direct caregivers. This study examined the influence of the long-term care work environment on sleep quantity and quality of nursing assistants. A cross-sectional survey collected data from 650 nursing assistants in 15 long-term care facilities; 46% reported short sleep duration and 23% reported poor sleep quality. A simple additive index of the number of beneficial work features (up to 7) was constructed for analysis with Poisson regression. With each unit increase of beneficial work features, nursing assistants were 7% less likely to report short sleep duration and 17% less likely to report poor sleep quality. These results suggest that effective workplace interventions should address a variety of work stressors, not only work schedule arrangements, in order to improve nursing assistants' sleep health.

  11. The Optimizing Patient Transfers, Impacting Medical Quality, andImproving Symptoms:Transforming Institutional Care approach: preliminary data from the implementation of a Centers for Medicare and Medicaid Services nursing facility demonstration project.

    Science.gov (United States)

    Unroe, Kathleen T; Nazir, Arif; Holtz, Laura R; Maurer, Helen; Miller, Ellen; Hickman, Susan E; La Mantia, Michael A; Bennett, Merih; Arling, Greg; Sachs, Greg A

    2015-01-01

    The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project aims to reduce avoidable hospitalizations of long-stay residents enrolled in 19 central Indiana nursing facilities. This clinical demonstration project, funded by the Centers for Medicare and Medicaid Services Innovations Center, places a registered nurse in each nursing facility to implement an evidence-based quality improvement program with clinical support from nurse practitioners. A description of the model is presented, and early implementation experiences during the first year of the project are reported. Important elements include better medical care through implementation of Interventions to Reduce Acute Care Transfers tools and chronic care management, enhanced transitional care, and better palliative care with a focus on systematic advance care planning. There were 4,035 long-stay residents in 19 facilities enrolled in OPTIMISTIC between February 2013 and January 2014. Root-cause analyses were performed for all 910 acute transfers of these long stay residents. Of these transfers, the project RN evaluated 29% as avoidable (57% were not avoidable and 15% were missing), and opportunities for quality improvement were identified in 54% of transfers. Lessons learned in early implementation included defining new clinical roles, integrating into nursing facility culture, managing competing facility priorities, communicating with multiple stakeholders, and developing a system for collecting and managing data. The success of the overall initiative will be measured primarily according to reduction in avoidable hospitalizations of long-stay nursing facility residents.

  12. [Genetic analysis of multidrug-resistant Streptococcus pneumoniae including meropenem resistance that was isolated from elderly residents with pneumonia in nursing-care facilities].

    Science.gov (United States)

    Ota, Kazuko; Chiba, Naoko; Sato, Kentaro; Nara, Syoetu; Kato, Satoko; Kanazawa, Hisao; Ikejima, Shin; Takahashi, Yoshihiro; Iwata, Satoshi; Ubukata, Kimiko

    2014-07-01

    From February to December 20XX, penicillin-resistant Streptococcus pneumoniae (PRSP) showing MICs of 16-32 microg/mL to cefotaxime (CTX) and 4-8 microg/mL to meropenem (MEPM) were isolated from 6 patients hospitalized at the general hospital S (2 cases) and hospital A (4 cases), close to the hospital S. Five elderly patients among these six cases came from nursing care facilities or nursing care-related medical facilities. All elderly persons (mean age: 81.7 years) were diagnosed as having pneumonia at the time of admission and the problematic PRSP was isolated from sputum samples collected on admission. Notably, all of these PRSP isolates simultaneously showed high resistance to macrolide agents mediated by an erm (B) gene and to fluoroquinolone agents via mutations in the gyrA and parC genes. Eventually, they were identified as multidrug-resistant S. pneumoniae (MDRSP) with high resistance to many agents. The capsule type of all strains was serotype 19F and multilocus sequence typing (MLST) revealed that they belonged to clonal complex (CC) 7993, which has not been reported before. It was thus concluded that the MDRSP that had spread within the nursing facilities was transmitted to the general hospitals via the elderly inpatients with pneumonia caused by these agents. Although one case finally had a poor outcome, the pneumococcal infection was not the direct trigger of the event. The current ratio of MDRSP is concluded to be very low. However, general hospitals that accept patients for therapeutic purposes from nursing-care facilities have to share epidemiological information in a timely manner with the nursing homes to prevent nosocomial infections.

  13. Skilled nursing or rehabilitation facilities

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000435.htm Skilled nursing or rehabilitation facilities To use the sharing features ... facility. Who Needs to go to a Skilled Nursing or Rehabilitation Facility? Your health care provider may ...

  14. Silent and suffering: a pilot study exploring gaps between theory and practice in pain management for people with severe dementia in residential aged care facilities

    Directory of Open Access Journals (Sweden)

    Peisah C

    2014-10-01

    Full Text Available Carmelle Peisah,1–3 Judith Weaver,1 Lisa Wong,1 Julie-Anne Strukovski1 1Behaviour Assessment Management Service, Specialist Mental Health Services for Older People, Mental Health Drug and Alcohol, Northern Sydney Local Health District, 2University of Sydney, 3University of NSW, Sydney, NSW, Australia Background: Pain is common in older people, particularly those in residential aged care facilities (RACF and those with dementia. However, despite 20 years of discourse on pain and dementia, pain is still undetected or misinterpreted in people with dementia in residential aged care facilities, particularly those with communication difficulties. Methods: A topical survey typology with semistructured interviews was used to gather attitudes and experiences of staff from 15 RACF across Northern Sydney Local Health District. Results: While pain is proactively assessed and pain charts are used in RACF, this is more often regulatory-driven than patient-driven (eg, prior to accreditation. Identification of pain and need for pain relief was ill defined and poorly understood. Both pharmacological and nonpharmacological regimes were used, but in an ad hoc, variable and unsystematic manner, with patient, staff, and attitudinal obstacles between the experience of pain and its relief.Conclusion: A laborious “pain communication chain” exists between the experience of pain and its relief for people with severe dementia within RACF. Given the salience of pain for older people with dementia, we recommend early, proactive consideration and management of pain in the approach to behaviors of concern. Individualized pain measures for such residents; empowerment of nursing staff as “needs interpreters”; collaborative partnerships with common care goals between patients where possible; RACF staff, doctors, and family carers; and more meaningful use of pain charts to map response to stepped pain protocols may be useful strategies to explore in clinical settings

  15. Guided self-help concreteness training as an intervention for major depression in primary care: a Phase II randomized controlled trial

    DEFF Research Database (Denmark)

    Watkins, E R; Taylor, R S; Baeyens, C

    2012-01-01

    and twenty-one consecutively recruited participants meeting criteria for current major depression were randomly allocated to treatment as usual (TAU) or to TAU plus concreteness training (CNT) guided self-help or to TAU plus relaxation training (RT) guided self-help. CNT involved repeated practice at mental...... exercises designed to switch patients from an unhelpful abstract thinking habit to a helpful concrete thinking habit, thereby targeting depressogenic cognitive processes (rumination, overgeneralization). Results The addition of CNT to TAU significantly improved depressive symptoms at post-treatment [mean......Background The development of widely accessible, effective psychological interventions for depression is a priority. This randomized trial provides the first controlled data on an innovative cognitive bias modification (CBM) training guided self-help intervention for depression. Method One hundred...

  16. Preschool Facilities, Day_care_preschool_providers, Published in 2008, 1:600 (1in=50ft) scale, Buffalo County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Preschool Facilities dataset, published at 1:600 (1in=50ft) scale, was produced all or in part from Orthoimagery information as of 2008. It is described as...

  17. Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province

    Directory of Open Access Journals (Sweden)

    Rhulani C. Shihundla

    2016-02-01

    Full Text Available Background: Recording of information on multiple documents increases professional nurses’ responsibilities and workload during working hours. There are multiple registers and books at Primary Health Care (PHC facilities in which a patient’s information is to be recorded for different services during a visit to a health professional. Antenatal patients coming for the first visit must be recorded in the following documents: tick register; Prevention of Mother-ToChild Transmission (PMTCT register; consent form for HIV and AIDS testing; HIV Counselling and Testing (HCT register (if tested positive for HIV and AIDS then this must be recorded in the Antiretroviral Therapy (ART wellness register; ART file with an accompanying single file, completion of which is time-consuming; tuberculosis (TB suspects register; blood specimen register; maternity case record book and Basic Antenatal Care (BANC checklist. Nurses forget to record information in some documents which leads to the omission of important data. Omitting information might lead to mismanagement of patients. Some of the documents have incomplete and inaccurate information. As PHC facilities in Vhembe District render twenty four hour services through a call system, the same nurses are expected to resume duty at 07:00 the following morning. They are expected to work effectively and when tired a nurse may record illegible information which may cause problems when the document is retrieved by the next person for continuity of care.Objectives: The objective of this study was to investigate and describe the effects of increased nurses’ workload on quality documentation of patient information at PHC facilities in Vhembe District, Limpopo Province.Methods: The study was conducted in Vhembe District, Limpopo Province, where the effects of increased nurses’ workload on quality documentation of information is currently experienced. The research design was explorative, descriptive and contextual in

  18. Provider adherence to first antenatal care guidelines and risk of pregnancy complications in public sector facilities : a Ghanaian cohort study

    NARCIS (Netherlands)

    Amoakoh-Coleman, Mary; Klipstein-Grobusch, Kerstin; Agyepong, Irene Akua; Kayode, Gbenga A; Grobbee, Diederick E; Ansah, Evelyn K

    2016-01-01

    BACKGROUND: Guideline utilization aims at improvement in quality of care and better health outcomes. The objective of the current study was to determine the effect of provider complete adherence to the first antenatal care guidelines on the risk of maternal and neonatal complications in a low resour

  19. Effect of antiviral prophylaxis on influenza outbreaks om aged care facilities in three local health districts in New South Wales, Australia, 2014

    Directory of Open Access Journals (Sweden)

    Tony Merritt

    2016-02-01

    Full Text Available Background: There was a record number (n = 111 of influenza outbreaks in aged care facilities in New South Wales, Australia during 2014. To determine the impact of antiviral prophylaxis recommendations in practice, influenza outbreak data were compared for facilities in which antiviral prophylaxis and treatment were recommended and for those in which antivirals were recommended for treatment only. Methods: Routinely collected outbreak data were extracted from the Notifiable Conditions Information Management System for two Local Health Districts where antiviral prophylaxis was routinely recommended and one Local Health District where antivirals were recommended for treatment but not routinely for prophylaxis. Data collected on residents included counts of influenza-like illness, confirmed influenza, hospitalizations and related deaths. Dates of onset, notification, influenza confirmation and antiviral recommendations were also collected for analysis. The Mann–Whitney U test was used to assess the significance of differences between group medians for key parameters. Results: A total of 41 outbreaks (12 in the prophylaxis group and 29 in the treatment-only group were included in the analysis. There was no significant difference in overall outbreak duration; outbreak duration after notification; or attack, hospitalization or case fatality rates between the two groups. The prophylaxis group had significantly higher cases with influenza-like illness (P = 0.03 and cases recommended antiviral treatment per facility (P = 0.01. Discussion: This study found no significant difference in key outbreak parameters between the two groups. However, further high quality evidence is needed to guide the use of antivirals in responding to influenza outbreaks in aged care facilities.

  20. Integrating the hospital information system (HIS) into the Austrian electronic health record ("ELGA") using the example of the health care facility "Breitenstein".

    Science.gov (United States)

    Bonstingl, Martina

    2014-01-01

    The health care facility "Breitenstein" makes use of a hospital information system to coordinate clinical processes and document medical health data. So as to comply with novel Austrian legislation and fit the "ELGA" architecture, the system has to be adapted. This paper is based on a literature research and gives answers to technical and legal aspects of "ELGA". The introduction of an IHE connector and a CDA manager are the main changes to the current hospital information system. The implementation of interfaces that allow an integration of further "ELGA" features possible are the next step of the project.

  1. Determinants of delays in travelling to an emergency obstetric care facility in Herat, Afghanistan: an analysis of cross-sectional survey data and spatial modelling

    OpenAIRE

    Hirose, A; Borchert, M; Cox, J. (Jürgen); Alkozai, AS; Filippi, V.

    2015-01-01

    Background Women’s delays in reaching emergency obstetric care (EmOC) facilities contribute to high maternal and perinatal mortality and morbidity in low-income countries, yet few studies have quantified travel times to EmOC and examined delays systematically. We defined a delay as the difference between a woman’s travel time to EmOC and the optimal travel time under the best case scenario. The objectives were to model travel times to EmOC and identify factors explaining delays. i.e., the dif...

  2. Common presentations of elder abuse in health care settings.

    Science.gov (United States)

    Powers, James S

    2014-11-01

    Health care professionals encounter elder abuse in the community and in medical offices, emergency rooms, hospitals, and long-term care facilities. Keen awareness of risk factors for elder abuse and the variety of presentations in different health settings helps promote detection, treatment, and prevention of elder abuse.

  3. Women at risk: why increasing numbers of women are failing to get the health care they need and how the Affordable Care Act will help. Findings from the Commonwealth Fund Biennial Health Insurance Survey of 2010.

    Science.gov (United States)

    Robertson, Ruth; Collins, Sara R

    2011-05-01

    Women have greater health care needs than men, and generally play larger roles in the health care of family members. Rising health care costs combined with sluggish income growth has contributed to losses in health insurance among women and rising rates of problems gaining necessary health care and paying medical bills. Women who seek coverage in the individual insurance market face additional hurdles--few plans offer maternity coverage and, in most states, insurance carriers charge higher premium rates to young women than men of the same age. The Affordable Care Act is bringing change for women through required free coverage of preventive care services, small business tax credits, new affordable coverage options, and insurance market reforms, including bans on gender rating. When the law is fully implemented in 2014, nearly all the 27 million working-age women who went without health insurance in 2010 will gain affordable and comprehensive benefits.

  4. Analysis of First Level Health Care Facility (FKTP Readiness as ‘Gatekeeper’ on The JKN Implementation in East Kalimantan and Central Java Year 2014

    Directory of Open Access Journals (Sweden)

    Wasis Budiarto

    2016-06-01

    Full Text Available Background: FKTP as a gatekeeperhas four function such us: the fi rst contact, sustainability, comprehensive healthcare and coordination. Readiness from input aspects on health care involves health care facilities, fi nance, humanresources, medicines and medical devices. This research is to identify the FKTP readiness as a gatekeeper in the inthe implementationof JKN in East Kalimantan and Central Java. Methods: Data collection wasby conducting interviews,observation and documents’ review. The data analysis techniques were descriptive statistics for quantitative and Miles,Huberman and Spradley concept qualitative. There were 6 health centers, 2 primary clinics, 6 doctors and 3 private dentistryclinics for each province. Results: The numbers of FKTP availability were 23.7 health centers and 3.2 primary clinics perdistrict/city. The average was 51.7 FKTP per district/city. Not all of primary clinics facilited by inpatient care. There were44% primary clinics facilitated by laboratory and 56% in collaboration with privatelaboratory. The highest ratio of numberof members by the population was Surakarta i. e. 1 member by 1.98 population. While, the lowest was East Kutai with 1member by 4.65 population. All health centres had been implementing gatekeeper functions. Most of primary clinics had beendone the functions while less of them had not already implemented excellent service yet. Phycisians had implemented theirfunctions as the fi rst contact and coordination very well. Moreover, dentist did the same as the fi rst contact. Conclusion:Availability of health centers as FKTP was adequate. Health centers were also ready to function as a gatekeeper for JKNimplementation. Primary clinics were ready for the fi rst contact and coordination; and dentist as the fi rst contact were allready. Recomendation: The numbers of health facilities need to be build and improved according to district/city’s capability.Moreover, health workers’ distribution should

  5. Impact of supervised drug consumption services on access to and engagement with care at a palliative and supportive care facility for people living with HIV/AIDS: a qualitative study

    Directory of Open Access Journals (Sweden)

    Ryan McNeil

    2014-03-01

    Full Text Available Introduction: Improvements in the availability and effectiveness of highly active antiretroviral therapy (HAART have prolonged the lives of people living with HIV/AIDS. However, mortality rates have remained high among populations that encounter barriers to accessing and adhering to HAART, notably people who use drugs. This population consequently has a high burden of illness and complex palliative and supportive care needs, but is often unable to access these services due to anti-drug policies and discrimination. In Vancouver, Canada, the Dr. Peter Centre (DPC, which operates a 24-bed residential HIV/AIDS care facility, has sought to improve access to palliative and supportive care services by adopting a comprehensive harm reduction strategy, including supervised injection services. We undertook this study to explore how the integration of comprehensive harm reduction services into this setting shapes access to and engagement with care. Methods: Qualitative interviews were conducted with 13 DPC residents between November 2010 and August 2011. Interviews made use of a semistructured interview guide which facilitated discussion regarding how the DPC Residence's model of care (a shaped healthcare access, (b influenced healthcare interactions and (c impacted drug use practices and overall health. Interview transcripts were analysed thematically. Results: Participant accounts highlight how the harm reduction policy altered the structural-environmental context of healthcare services and thus mediated access to palliative and supportive care services. Furthermore, this approach fostered an atmosphere in which drug use could be discussed without the risk of punitive action, and thus increased openness between residents and staff. Finally, participants reported that the environmental supports provided by the DPC Residence decreased drug-related risks and improved health outcomes, including HAART adherence and survival. Conclusions: This study highlights

  6. "If you don't take a stand for your life, who will help you?": Men's engagement in HIV care in KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Zissette, Seth; Watt, Melissa H; Prose, Neil S; Mntambo, Ntokozo; Moshabela, Mosa

    2016-07-01

    The needs of South African men with HIV may often be overlooked in the provision of HIV services, leading to care programs that do not adequately serve the unique needs of male patients. Additionally, norms of masculinity guide men's behaviors as they navigate health decision-making and the healthcare systems. The aim of this study is to examine how masculinity influences healthcare access and utilization in South Africa, and to identify opportunities for interventions. The qualitative study took place at one primary health care clinic in a peri-urban township in KwaZulu-Natal, South Africa. In-depth individual interviews were conducted with 21 HIV-infected men recruited from the study clinic. Direct observations of the clinic waiting area were conducted to provide context. Data were analyzed using a grounded theory-informed approach involving memo writing and thematic exploration with data coding. On average, participants were 42 years old and had been on ART for 3.6 years. Participants expressed a range of ways in which masculine ideals and identity both promoted and inhibited their willingness and ability to engage in HIV care. Notions of masculinity and social identity were often directly tied to behaviors influencing care engagement. Such engagement fostered the reshaping of identity around a novel sense of clinic advocacy in the face of HIV. Our findings suggested that masculinities are complex, and are subject to changes and reprioritization in the context of HIV. Interventions focusing on reframing hegemonic masculinities and initiating treatment early may have success in bringing more men to the clinic.

  7. The development of the Quality Indicator for Rehabilitative Care (QuIRC: a measure of best practice for facilities for people with longer term mental health problems

    Directory of Open Access Journals (Sweden)

    Visser Ellen

    2011-03-01

    Full Text Available Abstract Background Despite the progress over recent decades in developing community mental health services internationally, many people still receive treatment and care in institutional settings. Those most likely to reside longest in these facilities have the most complex mental health problems and are at most risk of potential abuses of care and exploitation. This study aimed to develop an international, standardised toolkit to assess the quality of care in longer term hospital and community based mental health units, including the degree to which human rights, social inclusion and autonomy are promoted. Method The domains of care included in the toolkit were identified from a systematic literature review, international expert Delphi exercise, and review of care standards in ten European countries. The draft toolkit comprised 154 questions for unit managers. Inter-rater reliability was tested in 202 units across ten countries at different stages of deinstitutionalisation and development of community mental health services. Exploratory factor analysis was used to corroborate the allocation of items to domains. Feedback from those using the toolkit was collected about its usefulness and ease of completion. Results The toolkit had excellent inter-rater reliability and few items with narrow spread of response. Unit managers found the content highly relevant and were able to complete it in around 90 minutes. Minimal refinement was required and the final version comprised 145 questions assessing seven domains of care. Conclusions Triangulation of qualitative and quantitative evidence directed the development of a robust and comprehensive international quality assessment toolkit for units in highly variable socioeconomic and political contexts.

  8. Assessment of the risk status of pregnant women presenting for antenatal care in a rural health facility in Ebonyi State, South Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Patrick Gold Oyibo

    2011-01-01

    Full Text Available Background: Nigeria has one of the worst maternal and child health indices globally. Aims: The objective of this study was to assess the risk status of pregnant women presenting for antenatal care in a rural health facility in Ebonyi State, South East Nigeria. Subjects and Method: This was a cross-sectional descriptive study of pregnant women selected by systematic random sampling. The study instrument was a pre-tested semi-structured interviewer-administered questionnaire. Result: The age range of the women in the study was 16-43 years. The mean age was 25.3 ± 1.3 years. According to the scoring system used, about one-fourth of the women (26% had a high risk pregnancy while about a tenth (9.1% had very high risk pregnancy. The vast majority of the women with at-risk pregnancies registered for antenatal care late: 58.9 % registered for antenatal care in the second trimester and 37.0 % registered for antenatal care in the third trimester of pregnancy. Of the women with an at-risk pregnancy, 79.5% had their last delivery at home and 67.1 % of them preferred to deliver at home in their current pregnancies. Conclusion: This study revealed that a substantial proportion of rural women with at-risk pregnancies go through their pregnancy period without significant modern antenatal care. The local government health department should intensify efforts through health enlightenment campaigns to educate rural pregnant women of the benefits of utilizing modern antenatal care services.

  9. Impact of Free Delivery Care on Health Facility Delivery and Insurance Coverage in Ghana's Brong Ahafo Region.

    OpenAIRE

    Dzakpasu, S; Soremekun, S; Manu, A; ten Asbroek, G.; Tawiah, C.; Hurt, L.; Fenty, J; Owusu-Agyei, S; Hill, Z; Campbell, OM; Kirkwood, BR

    2012-01-01

    BACKGROUND: Many sub-Saharan countries, including Ghana, have introduced policies to provide free medical care to pregnant women. The impact of these policies, particularly on access to health services among the poor, has not been evaluated using rigorous methods, and so the empirical basis for defending these policies is weak. In Ghana, a recent report also cast doubt on the current mechanism of delivering free care--the National Health Insurance Scheme. Longitudinal surveillance data from t...

  10. 'There's only one enabler; come up, help us': staff perspectives of barriers and enablers to continuous quality improvement in Aboriginal primary health-care settings in South Australia.

    Science.gov (United States)

    Newham, Jo; Schierhout, Gill; Bailie, Ross; Ward, Paul R

    2016-01-01

    This paper presents the findings from a qualitative study, which sought to investigate the barriers and enablers to implementation of a continuous quality improvement (CQI) program by health-care professionals in Aboriginal primary health-care services in South Australia. Eighteen semi-structured interviews across 11 participating services were conducted alongside CQI implementation activities. Multiple barriers exist, from staff perspectives, which can be categorised according to different levels of the primary health-care system. At the macro level, barriers related to resource constraints (workforce issues) and access to project support (CQI coordinator). At the meso level, barriers related to senior level management and leadership for quality improvement and the level of organisational readiness. At the micro level, knowledge and attitudes of staff (such as resistance to change; lack of awareness of CQI) and lack of team tenure were cited as the main barriers to implementation. Staff identified that successful and sustained implementation of CQI requires both organisational systems and individual behaviour change. Improvements through continuing regional level collaborations and using a systems approach to develop an integrated regional level CQI framework, which includes building organisational and clinic team CQI capacity at the health centre level, are recommended. Ideally, this should be supported at the broader national level with dedicated funding.

  11. Gerontechnology: Providing a Helping Hand When Caring for Cognitively Impaired Older Adults—Intermediate Results from a Controlled Study on the Satisfaction and Acceptance of Informal Caregivers

    Directory of Open Access Journals (Sweden)

    Anelia Mitseva

    2012-01-01

    Full Text Available The incidence of cognitive impairment in older age is increasing, as is the number of cognitively impaired older adults living in their own homes. Due to lack of social care resources for these adults and their desires to remain in their own homes and live as independently as possible, research shows that the current standard care provisions are inadequate. Promising opportunities exist in using home assistive technology services to foster healthy aging and to realize the unmet needs of these groups of citizens in a user-centered manner. ISISEMD project has designed, implemented, verified, and assessed an assistive technology platform of personalized home care (telecare for the elderly with cognitive impairments and their caregivers by offering intelligent home support services. Regions from four European countries have carried out long-term pilot-controlled study in real-life conditions. This paper presents the outcomes from intermediate evaluations pertaining to user satisfaction with the system, acceptance of the technology and the services, and quality of life outcomes as a result of utilizing the services.

  12. Supplemental Environmental Assessment of the Ambulatory Care Center at Joint Base Andrews-Naval Air Facility Washington, Maryland

    Science.gov (United States)

    2011-06-01

    to the south of the new proposed ACC building rather than surface parking, 2) the proposed ACC building with a “ green ” roof , and 3) staff parking...wing mission changes than the construction of a parking facility. 2) A green roof was considered as part of LEED. However, the client and project

  13. Determinants of anemia among pregnant mothers attending antenatal care in Dessie town health facilities, northern central Ethiopia, unmatched case -control study

    Science.gov (United States)

    Seid, Omer; G/Mariam, Yemane; Fekadu, Abel; Wasihun, Yitbarek; Endris, Kedir; Bitew, Abebayehu

    2017-01-01

    Introduction Anemia affects around 38.2% and 22% of pregnant women at a global and national level respectively. In developing countries, women start pregnancy with already depleted body stores of iron and other vitamins with significant variation of anemia within and between regions. Objective To identify the determinants of anemia among pregnant mothers attending antenatal care in Dessie town health facilities, northern central Ethiopia. Methods A health facility based unmatched case control study was conducted among 112 cases and 336 controls from January to March 2016 G.C. The sample size was determined by using Epi Info version 7.1.5.2. Study subjects were selected using consecutive sampling technique. Data were collected using a structured questionnaire, entered using Epi Data version 3.1 and analyzed using SPSS version 20. Bivariable and multivariable logistic regression model was used to see the determinants of anemia. Adjusted odds ratio (AOR) with 95% confidence interval (CI) and p-valueanemia. Conclusions Inadequate intake of dark green leafy vegetables, inadequate consumption of chicken, trimester of the current pregnancy, HIV infection and medication were the determinants of anemia among pregnant women. Therefore, anemia prevention strategy should include promotion of adequate intake of dark green leafy vegetables and chicken, increase meal pattern during the entire pregnancy and strengthen the prevention of mother to child HIV transmission/antenatal care programs. PMID:28288159

  14. Current trends in use of intracanal medications in dental care facilities: questionnaire-based survey on training dental hygienists at educational institutions.

    Science.gov (United States)

    Furusawa, Masahiro; Yoshida, Takashi; Hosokawa, Souhei; Ariizumi, Yuugo

    2013-01-01

    The success of root canal therapy is dependent not only on removal of infected pulp (pulpectomy) followed by root canal enlargement, but also on the pharmacological effects of intracanal medications. Various intracanal medications are used. Formaldehyde preparations such as formocresol were common in the past, but these are no longer used in Europe or the US due to the biological toxicity of formaldehyde. In this study, a questionnaire was used to determine current trends in the use of intracanal medications at dental care facilities where dental hygiene students undergo practical training. The questionnaire comprised questions regarding the types of frequently used intracanal medications and their methods of application at dental care facilities in Saitama and Shizuoka prefectures. The results indicated that calcium hydroxide preparations were more commonly used in Europe or the US. However, these results also revealed that formaldehyde preparations were frequently used, which slightly differs from the scenario in Europe and the US. This study revealed that multiple intracanal medications were used for root canal therapy. Furthermore, it was also observed that cotton plugs were generally used as applicator tips for intracanal medications, whereas the use of absorbent paper points was relatively uncommon. The results suggest that the cost of absorbent paper points needs to be reduced.

  15. Environmental surveillance and molecular epidemiology of waterborne pathogen Legionella pneumophila in health-care facilities of Northeastern Greece: a 4-year survey.

    Science.gov (United States)

    Alexandropoulou, Ioanna G; Ntougias, Spyridon; Konstantinidis, Theocharis G; Parasidis, Theodoros A; Panopoulou, Maria; Constantinidis, Theodoros C

    2015-05-01

    A 4-year proactive environmental surveillance of Legionella spp. in the water distribution and cooling systems of five health-care facilities was carried out as part of the strategy for the prevention of hospital-acquired Legionnaires' disease in Northeastern Greece. Legionella spp. were detected in 71 out of 458 collected samples. The majority of strains belonged to Legionella pneumophila serogroups 2-15 (75.0%), while all L. pneumophila serogroup 1 strains (23.6%) were isolated from a single hospital. The highest percentage of positive samples was found in distal sites (19.4%), while no Legionella strains were detected in cooling systems. Each hospital was colonized at least once with L. pneumophila, while remedial actions resulted in significant reduction of Legionella concentration. The molecular epidemiology of environmental L. pneumophila strains was also investigated using random amplified polymorphic DNA (RAPD) and multi-gene sequence-based analysis. Based on RAPD patterns, L. pneumophila serogroups 2-15 and serogroup 1 strains were classified into 24 and 9 operational taxonomic units (OTUs), respectively. Sequencing of housekeeping and diversifying pressure-related genes recommended by European Working Group for Legionella Infections (EWGLI) revealed not only a high intraspecies variability but also the circulation and persistence of one specific genotyping profile in the majority of hospitals. This study highlights the necessity for diachronic surveillance of Legionella in health-care facilities by adopting both cultural and molecular methods.

  16. Is a change in functional capacity or dependency in activities of daily living associated with a change in mental health among older people living in residential care facilities?

    Directory of Open Access Journals (Sweden)

    Conradsson M

    2013-11-01

    Full Text Available Mia Conradsson,1 Håkan Littbrand,1,2 Gustaf Boström,1 Nina Lindelöf,1 Yngve Gustafson,1 Erik Rosendahl1,2 1Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden; 2Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden Aim: Functional capacity and dependency in activities of daily living (ADL could be important mediators for an association between physical exercise and mental health. The aim of this study was to investigate whether a change in functional capacity or dependency in ADL is associated with a change in depressive symptoms and psychological well-being among older people living in residential care facilities, and whether dementia can be a moderating factor for this association. Methods: A prospective cohort study was undertaken. Participants were 206 older people, dependent in ADL, living in residential care facilities, 115 (56% of whom had diagnosed dementia. Multivariate linear regression, with comprehensive adjustment for potential confounders, was used to investigate associations between differences over 3 months in Berg Balance Scale (BBS and Geriatric Depression Scale (GDS-15 scores, and in BBS and Philadelphia Geriatric Center Morale Scale (PGCMS scores. Associations were also investigated between differences in Barthel ADL Index and GDS-15 scores, and in Barthel ADL Index and PGCMS scores. Results: There were no significant associations between changes in scores over 3 months; the unstandardized β for associations between BBS and GDS-15 was 0.026 (P=0.31, BBS and PGCMS 0.045 (P=0.14, Barthel ADL Index and GDS-15 0.123 (P=0.06, and Barthel ADL Index and PGCMS -0.013 (P=0.86. There were no interaction effects for dementia. Conclusion: A change in functional capacity or dependency in ADL does not appear to be associated with a change in depressive symptoms or psychological well-being among older people living in residential care

  17. Obstetric hemorrhage and shock management: using the low technology Non-pneumatic Anti-Shock Garment in Nigerian and Egyptian tertiary care facilities

    Directory of Open Access Journals (Sweden)

    al Hussaini Tarek

    2010-10-01

    Full Text Available Abstract Background Obstetric hemorrhage is the leading cause of maternal mortality globally. The Non-pneumatic Anti-Shock Garment (NASG is a low-technology, first-aid compression device which, when added to standard hypovolemic shock protocols, may improve outcomes for women with hypovolemic shock secondary to obstetric hemorrhage in tertiary facilities in low-resource settings. Methods This study employed a pre-intervention/intervention design in four facilities in Nigeria and two in Egypt. Primary outcomes were measured mean and median blood loss, severe end-organ failure morbidity (renal failure, pulmonary failure, cardiac failure, or CNS dysfunctions, mortality, and emergency hysterectomy for 1442 women with ≥750 mL blood loss and at least one sign of hemodynamic instability. Comparisons of outcomes by study phase were assessed with rank sum tests, relative risks (RR, number needed to treat for benefit (NNTb, and multiple logistic regression. Results Women in the NASG phase (n = 835 were in worse condition on study entry, 38.5% with mean arterial pressure Conclusion Adding the NASG to standard shock and hemorrhage management may significantly improve maternal outcomes from hypovolemic shock secondary to obstetric hemorrhage at tertiary care facilities in low-resource settings.

  18. Knowledge about childhood autism and opinion among healthcare workers on availability of facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders in Nigeria

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    Igwe Monday N

    2009-02-01

    associated with age group distribution of the healthcare workers, with those age group of fourth decades and above more likely to have higher mean score (p = 0.004 and previous experience of managing children with autism spectrum disorders (ASD (p = 0.000. KCA showed near significant association with area of specialty, with those healthcare workers in psychiatry compared to pediatrics having higher mean score (p = 0.071 and also with years of working experience of the healthcare workers (p = 0.056. More than half of the healthcare workers subscribed to the opinion that facilities and law caring for the needs and rights of children with childhood autism and other developmental disorders are lacking in Nigeria. Conclusion The correlates of KCA may help in selection of those tertiary healthcare workers that would best fit the role of trainers. It is important to update the knowledge gaps of those healthcare workers who scored low in different domains of KCAHW questionnaire. It is imperative for policy makers in Nigeria to advocate and implement multidisciplinary healthcare service system that would ensure early diagnosis and interventions. Nationally representative baseline epidemiological data that would guide policy and planning are also desirable.

  19. Prospective encounter study of the degree of adherence to patient care indicators related to drug dispensing in Health Care facilities: A Sri Lankan perspective

    OpenAIRE

    Lukshmy Menik Hettihewa; Amarasinghe Isuru; Jayarathna Kalana

    2011-01-01

    The World Health Organization-recommended patient care indicators in Government Hospitals were assessed in 422 patients attending the Outpatient Department in selected hospitals of the Galle district in Southern Province. The average dispensing time (ADT), percentage of drugs actually dispensed (PDAD), percentage of drugs adequately labeled (PDAL) and patient′s knowledge on correct dosage (PKCD) were compared in these selected teaching hospitals (TH), general hospitals (GHs) and district hosp...

  20. Chasm in primary care provision in a universal health system: Findings from a nationally representative survey of health facilities in Malaysia

    Science.gov (United States)

    Sivasampu, Sheamini; Khoo, Ee Ming; Mohamad Noh, Kamaliah

    2017-01-01

    Background Malaysia has achieved universal health coverage since 1980s through the expansion of direct public provision, particularly in rural areas. However, no systematic examination of the rural-urban distribution of primary care services and resources has been conducted to date for policy impact evaluation. Methods We conducted a national cross-sectional survey of 316 public and 597 private primary care clinics, selected through proportionate stratified random sampling, from June 2011 through February 2012. Using a questionnaire developed based on the World Health Organization toolkits on monitoring health systems strengthening, we examined the availability of primary care services/resources and the associations between service/resource availability and clinic ownership, locality, and patient load. Data were weighted for all analyses to account for the complex survey design and produce unbiased national estimates. Results Private primary care clinics and doctors outnumbered their public counterparts by factors of 5.6 and 3.9, respectively, but the private clinics were significantly less well-equipped with basic facilities and provided a more limited range of services. Per capita densities of primary care clinics and workforce were higher in urban areas (2.2 clinics and 15.1 providers per 10,000 population in urban areas versus 1.1 clinics and 11.7 providers per 10,000 population in rural areas). Within the public sector, the distribution of health services and resources was unequal and strongly favored the urban clinics. Regression analysis revealed that rural clinics had lower availability of services and resources after adjusting for ownership and patient load, but the associations were not significant except for workforce availability (adjusted odds ratio [OR]: 0.82; 95% confidence interval [CI]: 0.71–0.96). Conclusions Targeted primary care expansion in rural areas could be an effective first step towards achieving universal health coverage, especially in

  1. Assessment and documentation of non-healing, chronic wounds in inpatient health care facilities in the Czech Republic: an evaluation study.

    Science.gov (United States)

    Pokorná, Andrea; Leaper, David

    2015-04-01

    The foundation of health care management of patients with non-healing, chronic wounds needs accurate evaluation followed by the selection of an appropriate therapeutic strategy. Assessment of non-healing, chronic wounds in clinical practice in the Czech Republic is not standardised. The aim of this study was to analyse the methods being used to assess non-healing, chronic wounds in inpatient facilities in the Czech Republic. The research was carried out at 77 inpatient medical facilities (8 university/faculty hospitals, 63 hospitals and 6 long- term hospitals) across all regions of the Czech Republic. A mixed model was used for the research (participatory observation including creation of field notes and content analysis of documents for documentation and analysis of qualitative and quantitative data). The results of this research have corroborated the suspicion of inconsistencies in procedures used by general nurses for assessment of non-healing, chronic wounds. However, the situation was found to be more positive with regard to evaluation of basic/fundamental parameters of a wound (e.g. size, depth and location of a wound) compared with the evaluation of more specific parameters (e.g. exudate or signs of infection). This included not only the number of observed variables, but also the action taken. Both were significantly improved when a consultant for wound healing was present (P = 0·047). The same applied to facilities possessing a certificate of quality issued by the Czech Wound Management Association (P = 0·010). In conclusion, an effective strategy for wound management depends on the method and scope of the assessment of non-healing, chronic wounds in place in clinical practice in observed facilities; improvement may be expected following the general introduction of a 'non-healing, chronic wound assessment' algorithm.

  2. An Intervention to Improve the Oral Health of Residents in an Aged Care Facility Led by Nurses

    Science.gov (United States)

    Blinkhorn, F. A.; Weingarten, L.; Boivin, L.; Plain, J.; Kay, M.

    2012-01-01

    Introduction: The growing population of elderly people is impacting on overstretched dental services in many countries, as many individuals are retaining natural teeth and may have dentures or implants, all of which influence the way in which the oral cavity must be cared for. A major difficulty for older residents is their decreasing level of…

  3. Effects of Physical Environment on Health and Behaviors of Residents With Dementia in Long-Term Care Facilities: A Longitudinal Study.

    Science.gov (United States)

    Lee, Sook Young; Chaudhury, Habib; Hung, Lillian

    2016-01-01

    The challenges in investigating the effects of the physical environment on residents with dementia include having a sample of comparable study groups and a lack of long-term follow-up evaluation. The current study attempted to address these two challenges by carefully matching residents and analyzing long-term measurement data. The aim of the study was to examine whether residents with dementia (N = 12) living in a traditional large-scale setting or a small-scale, home-like setting exhibit any difference in health and behaviors over time. Physical environmental assessment of the two care facilities was conducted using the Therapeutic Environment Screening Survey for Nursing Homes. Residents' behavioral assessments were performed using three tools at three assessments over a period of 1 year: (a) Multidimensional Observation Scale for Elderly Subjects, (b) Minimum Data Set, and (c) Dementia Care Mapping. The results suggest that older adults with dementia can have increased social interaction and engagement with the support of an optimal physical environment.

  4. Critérios de escolha de postos de saúde para acompanhamento pré-natal em Pelotas, RS Criteria for choosing primary health care facilities for prenatal care, Brazil

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    Iná S Santos

    2000-12-01

    Full Text Available OBJETIVO: Caracterizar o cuidado pré-natal em uma amostra representativa de mães, identificando o serviço de saúde onde estas realizaram o acompanhamento da gestação e os motivos que as levaram a escolher este local. MÉTODOS: Estudo transversal, realizado nos meses de março e abril de 1997, nas quatro principais maternidades de Pelotas, RS, através de entrevista a 401 mães no pós-parto imediato. RESULTADOS: Fizeram acompanhamento pré-natal, em um posto de saúde 51% das mães, sendo a proximidade geográfica o critério mais freqüentemente referido para tal escolha (46,8%. Para 85% das mães, o serviço de saúde mais próximo de casa era um posto de saúde. No entanto, 52,2% dessas não utilizaram esse local para as consultas pré-natais alegando a má qualidade do atendimento (37,4%. Conforme referido pelas mães, entre os procedimentos de rotina do pré-natal recomendados pelo programa de saúde da rede pública, incluindo a promoção do aleitamento materno, apenas a imunização anti-tetânica foi realizada mais freqüentemente nos postos do que nos demais locais. CONCLUSÕES: Tendo em vista a expressiva utilização da rede pública para o acompanhamento pré-natal, necessitam ser implementados investimentos em educação continuada dos profissionais, com ênfase no cumprimento de normas técnicas pré-estabelecidas.OBJECTIVE: To describe the prenatal care delivered to a representative sample of mothers, identifying the health care facility they attended and to explore the reasons that led them to choose that specific health facility. METHOD: A cross-sectional study was conducted at four maternity hospitals in Pelotas, in Southern Brazil, from March to April 1997. A total of 401 mothers were interviewed at the hospital, immediately after delivery. RESULTS: The majority of mothers (51% were followed up at a primary health care facility (PHCF. The main reported reason for choosing a PHCF was its geographic accessibility (46

  5. Programme level implementation of malaria rapid diagnostic tests (RDTs use: outcomes and cost of training health workers at lower level health care facilities in Uganda

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    Kyabayinze Daniel J

    2012-04-01

    Full Text Available Abstract Background The training of health workers in the use of malaria rapid diagnostic tests (RDTs is an important component of a wider strategy to improve parasite-based malaria diagnosis at lower level health care facilities (LLHFs where microscopy is not readily available for all patients with suspected malaria. This study describes the process and cost of training to attain competence of lower level health workers to perform malaria RDTs in a public health system setting in eastern Uganda. Methods Health workers from 21 health facilities in Uganda were given a one-day central training on the use of RDTs in malaria case management, including practical skills on how to perform read and interpret the test results. Successful trainees subsequently integrated the use of RDTs into their routine care for febrile patients at their LLHFs and transferred their acquired skills to colleagues (cascade training model. A cross-sectional evaluation of the health workers’ competence in performing RDTs was conducted six weeks following the training, incorporating observation, in-depth interviews with health workers and the review of health facility records relating to tests offered and antimalarial drug (AMD prescriptions pre and post training. The direct costs relating to the training processes were also documented. Results Overall, 135 health workers were trained including 63 (47% nursing assistants, a group of care providers without formal medical training. All trainees passed the post-training concordance test with ≥ 80% except 12 that required re-training. Six weeks after the one-day training, 51/64 (80% of the health workers accurately performed the critical steps in performing the RDT. The performance was similar among the 10 (16% participants who were peer-trained by their trained colleagues. Only 9 (14% did not draw the appropriate amount of blood using pipette. The average cost of the one-day training was US$ 101 (range $92-$112, with the

  6. Evaluation of an intervention for staff in a long-term care facility using a retrospective pretest design.

    Science.gov (United States)

    Hyman, R B

    1993-06-01

    It has been previously established that human service workers often suffer from emotional exhaustion, which has been conceptualized by Maslach and Jackson as burnout. Burnout may be a particularly great risk in workers providing long-term geriatric care. The current study evaluated the effects of a series of three 3-hour sessions designed to address team building, communication skills, self-esteem, and stress management on a random sample of 51 of the 188 long-term care staff who participated. Using a retrospective pretest design, a statistically significant improvement from "then" to "today" was found for the three components of burnout: Depersonalization, Emotional Exhaustion, and Personal Accomplishment. Responses to an open-ended question about workshop effects corroborated the quantitative data, and effects noted were highly related to the defined objectives of the workshops.

  7. The Combination of SAT and SBT Protocols May Help Reduce the Incidence of Ventilator-Associated Pneumonia in the Burn Intensive Care Unit.

    Science.gov (United States)

    Lee, Yann-Leei Larry; Sims, Kaci D; Butts, Charles C; Frotan, M Amin; Kahn, Steven; Brevard, Sidney B; Simmons, Jon D

    There are few published reports on the unique nature of burn patients using a paired spontaneous awakening and spontaneous breathing protocol. A combined protocol was implemented in our burn intensive care unit (ICU) on January 1, 2012. This study evaluates the impact of this protocol on patient outcomes in a burn ICU. We performed a retrospective review of our burn registry over 4 years, including all patients placed on mechanical ventilation. In the latter 2 years, patients meeting criteria underwent daily spontaneous awakening trial; if successful, spontaneous breathing trial was performed. Patient data included age, burn size, percent full-thickness burn, tracheostomy, and inhalation injury. Outcome measures included ventilator days, ICU and hospital lengths of stay, pneumonia, and disposition. Data were analyzed using Graphpad Prism and IBM SPSS software, with statistical significance defined as P < .05. There were 171 admissions in the preprotocol period and 136 after protocol implementation. Protocol patients had greater percent full-thickness burns, but did not differ in other characteristics. The protocol group had significantly shorter ICU length of stay, fewer ventilator days, and lower pneumonia incidence. Hospital length of stay, disposition, and mortality were not significantly different. Among patients with inhalation injuries, the protocol group exhibited fewer ventilator and ICU days. Protocol implementation in a burn ICU was accompanied by decreased ventilator days and a reduced incidence of pneumonia. A combined spontaneous awakening and breathing protocol is safe and may improve clinical practice in the burn ICU.

  8. Paper-Based Survivorship Care Plans May be Less Helpful for Cancer Patients Who Search for Disease-Related Information on the Internet: Results of the Registrationsystem Oncological Gynecology (ROGY) Care Randomized Trial

    NARCIS (Netherlands)

    Nicolaije, K.A.; Ezendam, N.P.; Pijnenborg, J.M.A.; Boll, D.; Vos, M.C.; Kruitwagen, R.F.; Poll-Franse, L.V. van de

    2016-01-01

    BACKGROUND: The Institute of Medicine recommends Survivorship Care Plans (SCPs) for all cancer survivors. However, it is unclear whether certain patient groups may or may not benefit from SCPs. OBJECTIVE: The aim was to assess whether the effects of an automatically generated paper SCP on patients'

  9. "Let us help them to raise their children into good citizens": the Lone-Parent Families Act and the wages of care-giving in Israel.

    Science.gov (United States)

    Helman, Sara

    2011-01-01

    Based on the assumption that the construction of meaning in the process of policy-making is crucial if we wish to understand the gender outcomes of social policy, this article analyzes the parliamentary debates that preceded and accompanied the legislation of the Israeli Mono-Parental Families Act, 1992. It focuses on the enunciation of gender roles and relations in the discourses that framed and justified the Act as well as on how the capacity to establish and maintain autonomous households was constructed and legitimized. Two sets of discourses emerged during the deliberations over the Act, each of which endeavored to interpret the needs, identities, and capacities for action among lone-parent families. The article shows how a specific version of the capacity to establish and maintain autonomous households—that of caregivers who happen to be workers—was privileged in the policy paradigm underlying the Act. The alternative vision—that of workers with caregiving responsibilities—was marginalized and eventually disregarded in the final wording and implementation of the Act. The article concludes with an analysis of the socio-political processes that underlie the prioritization of the version, which was ultimately expressed in the implementation of the Act. It is suggested that a state-level collective identity project shaped by demographic concerns and geo-political factors and changes in the political economy combined to define the needs, identities, and capacities for action of lone-parent families in terms of a model of motherhood in which care-giving trumped paid work.

  10. What are the factors that interplay from normal pregnancy to near miss maternal morbidity in a Nigerian tertiary health care facility?

    Science.gov (United States)

    Adeoye, Ikeola A; Ijarotimi, Omotade O; Fatusi, Adesegun O

    2015-01-01

    Researchers in Nigeria examined the epidemiological characteristics and factors associated with maternal outcomes using a mixed method approach: a prospective case control study design involving 375 pregnant women who received maternal care from a tertiary facility and in-depth interviews reporting the experience of near-miss survivors. A generalized ordered logit model was used to generate the estimates of partial proportional odds ratios (and 95% confidence intervals) across categories of the outcome variable. Factors strongly associated with maternal morbidity were late referral of women, presence of complications at booking antenatal visits, low birth weight, and severe birth asphyxia. The nearmiss women were further characterized, and a low proportion (25%) had organ dysfunction or failure. The challenge of such diagnoses in resource-constrained settings raises questions about the appropriateness of using organ dysfunction criteria in developing countries.

  11. [A guide to good practice for information security in the handling of personal health data by health personnel in ambulatory care facilities].

    Science.gov (United States)

    Sánchez-Henarejos, Ana; Fernández-Alemán, José Luis; Toval, Ambrosio; Hernández-Hernández, Isabel; Sánchez-García, Ana Belén; Carrillo de Gea, Juan Manuel

    2014-04-01

    The appearance of electronic health records has led to the need to strengthen the security of personal health data in order to ensure privacy. Despite the large number of technical security measures and recommendations that exist to protect the security of health data, there is an increase in violations of the privacy of patients' personal data in healthcare organizations, which is in many cases caused by the mistakes or oversights of healthcare professionals. In this paper, we present a guide to good practice for information security in the handling of personal health data by health personnel, drawn from recommendations, regulations and national and international standards. The material presented in this paper can be used in the security audit of health professionals, or as a part of continuing education programs in ambulatory care facilities.

  12. Spread of CTX-M-type ESßLs in isolates of E. coli from long-term care and rehabilitation facilities in Northern Italy

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    Elisabetta Nucleo

    2008-09-01

    Full Text Available During the period March 2003 – May 2004 at the Laboratory of Clinical Microbiology “Redaelli” LTCRF in Milan, Italy, a total of 529 E. coli, obtained from inpatients of 3 different Long Term Care Rehabilitation Facilities (LTCRFs in Northern Italy, were processed and 77 ESßLs producers (14.5% were identified by Vitek System. The results were confirmed by double-disk synergy test with tazobactam (TZP. 61/77 isolates were characterized by higher levels of resistance to cefotaxime (CTX than to ceftazidime (CAZ. (ß-lactamase production was investigated by analytical isoelectric focusing (IEF coupled with a bioassay and showed multiple (ß-lactamase bands including one enzyme with pI 8.4 that, in a bioassay, was more active on CTX,ATM than on CAZ. The presence of (ß-lactamase genes was investigated by colony blot hybridization and by PCR amplification of blaTEM, blaSHV and blaCTX-M alleles. 43/61 isolates produced both TEM-1 and CTX-M-type enzymes, 14/61 expressed only CTX-M-type while in 4 cases were found blaCTX-M, blaTEM and blaSHV genes.The remainders (16/77, characterized by high levels of resistance to both CTX and CAZ, produced TEM-1 and SHV-5 enzymes (1/16 and TEM type ESßLs (15/16. Conjugation experiments, performed in liquid medium, confermed that the ESßLs determinants were transferable. Pulsed-field gel electrophoresis profiles of genomic DNA, digested with NotI, were analysed and revealed clonal heterogeneity. Our work confirms the emergence of CTX-M-type enzymes and their spread in Northern Italy also in longterm care and rehabilitation facilities that may be an important reservoir of ES?L producing E. coli.

  13. Epidemiology and characteristics of Escherichia coli sequence type 131 (ST131) from long-term care facility residents colonized intestinally with fluoroquinolone-resistant Escherichia coli.

    Science.gov (United States)

    Han, Jennifer H; Garrigan, Charles; Johnston, Brian; Nachamkin, Irving; Clabots, Connie; Bilker, Warren B; Santana, Evelyn; Tolomeo, Pam; Maslow, Joel; Myers, Janice; Carson, Lesley; Lautenbach, Ebbing; Johnson, James R

    2017-03-01

    The objective of this study was to evaluate molecular and epidemiologic factors associated with Escherichia coli sequence type 131 (ST131) among long-term care facility (LTCF) residents who acquired gastrointestinal tract colonization with fluoroquinolone-resistant E. coli (FQREC). Colonizing isolates from 37 residents who newly developed FQREC colonization at three LTCFs from 2006 to 2008 were evaluated. Twenty-nine (78%) of 37 total FQREC colonizing isolates were ST131. Most ST131 isolates had a distinctive combination of gyrA and parC replacement mutations. The ST131 and non-ST131 isolates differed significantly for the prevalence of many individual virulence factors but not for the proportion that qualified molecularly as extraintestinal pathogenic E. coli (ExPEC) or aggregate virulence factor scores. E. coli ST131 was highly prevalent among LTCF residents with FQREC colonization. Future studies should determine the risk factors for infection among ST131-colonized residents, and assess the potential for increased transmissibility of ST131 in the long-term care setting.

  14. Effectiveness of a Staff Promoted Wellness Program to Improve Health in Residents of a Mental Health Long-Term Care Facility.

    Science.gov (United States)

    Hutchison, Shari L; Terhorst, Lauren; Murtaugh, Stephanie; Gross, Sarah; Kogan, Jane N; Shaffer, Sherry L

    2016-01-01

    The current study describes physical and mental health outcomes during a health promotion program for individuals with serious mental illness (SMI). A sample of 43 adults in a long-term residential facility volunteered for an individualized, healthy lifestyle program designed to promote physical activity and combat premature mortality among individuals with SMI. Nurses and residential counselors were trained in the program and encouraged to work collaboratively with the program's personal trainers. Weekly nutrition and activity logs were obtained over the year-long evaluation. Assessments of physical and psychological health indicators were collected quarterly. Qualitative data through focus groups described staff experience. Self-report of moderate and vigorous physical activity improved over time as did fitness level as measured through a walking challenge (p = .001). Significant decreases in weight (p < .001), BMI (p = .001), and total cholesterol (p < .001) were observed from baseline through 12 months. Mean recovery scores (RMQ) were significantly higher between baseline and all time points (p < .001). Participants reported decreasing levels of depression (PHQ-9) by the 12-month time point (p < .001). Staff encouraged participation in physical activity and observed improved motivation and socialization among participants. A health promotion program with participation encouraged by health care staff is effective for increasing physical activity and improving physical and mental health outcomes in individuals with SMI in long-term residential care.

  15. Constipation and Laxative Use among Nursing Home Patients: Prevalence and Associations Derived from the Residents Assessment Instrument for Long-Term Care Facilities (interRAI LTCF

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    Lene Elisabeth Blekken

    2016-01-01

    Full Text Available Introduction. Constipation is a common, bothersome, and potentially dangerous condition among nursing home (NH patients. Between 50 and 74% of NH patients use laxatives. Objective. To study prevalence and associations of laxative use and constipation using the comprehensive Norwegian version of the Resident Assessment Instrument for Long-Term Care Facilities. Methods. Cross-sectional study. Patients from 20 NH units were included. Logistic regression was used to analyze the results. Data collected in NHs might be clustered. Consequently, the multivariable models were tested against a mixed effects regression model to investigate variance both on the level of patients and on the level of NH units. Results. In all, 261 patients were included. The prevalence of constipation was 23.4%, and 67.1% used laxatives regularly. Balance problems, urinary incontinence, hypothyroidism, and Parkinson’s disease were associated with constipation. Reduced ability to communicate and number of drugs were associated with laxative use. Antidementia-drugs and being involved in activities 1/3 to 2/3 of daytime were protective factors for laxative use. Mixed effects analyses identified variance on the level of NH units as nonsignificant. Conclusion. Constipation and laxative use are common. Variance is mainly explained by different patient characteristics/health deficiencies. Hence, patients might benefit from individualized care to compensate for deficiencies.

  16. Constipation and Laxative Use among Nursing Home Patients: Prevalence and Associations Derived from the Residents Assessment Instrument for Long-Term Care Facilities (interRAI LTCF)

    Science.gov (United States)

    Blekken, Lene Elisabeth; Nakrem, Sigrid; Vinsnes, Anne Guttormsen; Mørkved, Siv; Gjeilo, Kari Hanne

    2016-01-01

    Introduction. Constipation is a common, bothersome, and potentially dangerous condition among nursing home (NH) patients. Between 50 and 74% of NH patients use laxatives. Objective. To study prevalence and associations of laxative use and constipation using the comprehensive Norwegian version of the Resident Assessment Instrument for Long-Term Care Facilities. Methods. Cross-sectional study. Patients from 20 NH units were included. Logistic regression was used to analyze the results. Data collected in NHs might be clustered. Consequently, the multivariable models were tested against a mixed effects regression model to investigate variance both on the level of patients and on the level of NH units. Results. In all, 261 patients were included. The prevalence of constipation was 23.4%, and 67.1% used laxatives regularly. Balance problems, urinary incontinence, hypothyroidism, and Parkinson's disease were associated with constipation. Reduced ability to communicate and number of drugs were associated with laxative use. Antidementia-drugs and being involved in activities 1/3 to 2/3 of daytime were protective factors for laxative use. Mixed effects analyses identified variance on the level of NH units as nonsignificant. Conclusion. Constipation and laxative use are common. Variance is mainly explained by different patient characteristics/health deficiencies. Hence, patients might benefit from individualized care to compensate for deficiencies. PMID:26884751

  17. MANAGING CUSTOMER RELATIONSHIPS IN PRIVATE HEALTH CARE FACILITIES - A STUDY WITH REFERENCE TO GREATER NOIDA CITY OF UTTAR PRADESH

    Directory of Open Access Journals (Sweden)

    Arun Kumar Panda

    2011-03-01

    Full Text Available Customer relationship management (CRM which has overriding significance for any business isno less significant for hospital services. Hospitals are most important elements in any health caredelivery system. A hospital plays a major role in maintaining and restoring the health of the people.Care of the sick and injured, preventive health care, health research, and training of medical andparamedical staff are general broad functions of a hospital. It involves to the outpatient and inpatienthospital services and on many occasions emergency medical services. An important resource in ahospital is a human resource. This should be particularly emphasized. This should be particularlyemphasized in the content of a hospital since relationship of medical staff plays important role intreating patients - the hospital customers. In health care, CRM practices are essentially patient -focused strategies that involve effective management of hospital interface and interaction withpatients. Effective CRM practices in a hospital may mean providing services related information toa patient very quickly. Responding to the patent appointment and an admission requests promptly,dealing with patient queries and complaints expeditiously, exercising all kinds of flexibilities inserving patients to the patients. This research paper made an attempt to analyze the factorsinfluencing the customers to select the hospital and to suggest better ways and means to retain thecustomers. For the study, the researcher has collected data from 200 respondents of 10 privatehospitals located in Greater Noida city. For this purpose stratified random sampling method was usedto select the samples. The present study highlights the extent of utilization of the hospital services bythe selected sample respondents. It also shed light on the common problems faced by therespondents. The major features of the service sectors especially on hospital performance is projectedin order to utilize the

  18. Prospective encounter study of the degree of adherence to patient care indicators related to drug dispensing in Health Care facilities: A Sri Lankan perspective.

    Science.gov (United States)

    Hettihewa, Lukshmy Menik; Isuru, Amarasinghe; Kalana, Jayarathna

    2011-04-01

    The World Health Organization-recommended patient care indicators in Government Hospitals were assessed in 422 patients attending the Outpatient Department in selected hospitals of the Galle district in Southern Province. The average dispensing time (ADT), percentage of drugs actually dispensed (PDAD), percentage of drugs adequately labeled (PDAL) and patient's knowledge on correct dosage (PKCD) were compared in these selected teaching hospitals (TH), general hospitals (GHs) and district hospitals (DHs) in Galle. ADT in DH (1.16 min) and GH (1.07 min) were high when compared with ADT in TH (0.81 min). PDAD was 100% in DH, 97.79% in GH and lowest in TH (94.64%). PDAL was highest (22.66%) in TH, 17.57% in GH and lowest in DH (1.57%). PKCD was 100% in GH and lowest in DH (0%) and only 50% in TH in Galle district. We noted that there was a significant difference in ADT in all three categories (P PKCD was 0% due to negligence in dispensing practices. We also noted a 100% PKCD only in GH due to the practice of a well-prepared correct labeling system in GH. We noticed that these patients were provided drugs with inadequate labeling and that patients had only a poor knowledge about the drug administration schedule. We conclude that there was a low dispenser-patient ratio in all three hospitals and that there was a need for an implementation plan for proper dispensing techniques by introducing a well-prepared drug labeling system in a printed format.

  19. Prospective encounter study of the degree of adherence to patient care indicators related to drug dispensing in Health Care facilities: A Sri Lankan perspective

    Directory of Open Access Journals (Sweden)

    Lukshmy Menik Hettihewa

    2011-01-01

    Full Text Available The World Health Organization-recommended patient care indicators in Government Hospitals were assessed in 422 patients attending the Outpatient Department in selected hospitals of the Galle district in Southern Province. The average dispensing time (ADT, percentage of drugs actually dispensed (PDAD, percentage of drugs adequately labeled (PDAL and patient′s knowledge on correct dosage (PKCD were compared in these selected teaching hospitals (TH, general hospitals (GHs and district hospitals (DHs in Galle. ADT in DH (1.16 min and GH (1.07 min were high when compared with ADT in TH (0.81 min. PDAD was 100% in DH, 97.79% in GH and lowest in TH (94.64%. PDAL was highest (22.66% in TH, 17.57% in GH and lowest in DH (1.57%. PKCD was 100% in GH and lowest in DH (0% and only 50% in TH in Galle district. We noted that there was a significant difference in ADT in all three categories (P < 0.05. We noted that dispensers spend only a short dispensing time and showed a tendency for dispensing errors. We found that PDAL was very low in all hospitals but PDAD was significantly high. Even though the ADT was high in DH, PKCD was 0% due to negligence in dispensing practices. We also noted a 100% PKCD only in GH due to the practice of a well-prepared correct labeling system in GH. We noticed that these patients were provided drugs with inadequate labeling and that patients had only a poor knowledge about the drug administration schedule. We conclude that there was a low dispenser-patient ratio in all three hospitals and that there was a need for an implementation plan for proper dispensing techniques by introducing a well-prepared drug labeling system in a printed format.

  20. Midwives' knowledge and utilization of non-pneumatic anti shock garment in reducing complication of postpartum haemorrhage in selected health care facilities in Bayelsa state Nigeria

    Directory of Open Access Journals (Sweden)

    Olayinka A. Onasoga

    2015-08-01

    Full Text Available Background: Non-pneumatic anti-shock garment (NASG is a first-aid lower-body pressure device that reverses hypovolaemic shock and decreases obstetric hemorrhage thereby decreasing maternal morbidity and mortality due to post-partum haemorrhage (PPH.This study assessed the knowledge and utilization of non-pneumatic anti shock garment in the management of postpartum hemorrhage among midwives in selected health care facilities in Bayelsa state. Methods: This is a descriptive cross-sectional study in which a sample size of 112 nurses were selected using purposive sampling technique. The instrument for data collection was questionnaire and data collected were analyzed using descriptive and inferential statistics. Results: The study revealed that majority of the respondents regardless of their educational level had good knowledge of the description, mechanism of action, and uses of NASG. It was also revealed that majority of the respondents do not use NASG in their centers and its application in management of post-partum hemorrhage was not part of the protocols in these centers, which was a clear indication of underutilization of the NASG in the primary health care centers. There was no significant association found between years of working experience of respondents and their utilization of NASG with (X2 = 8.577, df = 2, P = 0.114 as well as between the level of knowledge of midwives and their utilization of the NASG with (X2 = 0.387, df = 1, P = 0.534. Conclusions: It was recommended that non-pneumonic antishock garment should be made available by government and its utilization should be included in all health care centers policy as a management protocol for post-partum hemorrhage. [Int J Reprod Contracept Obstet Gynecol 2015; 4(4.000: 977-981

  1. Domestic violence against nurses by their marital partners: A facility-based study at a tertiary care hospital

    Directory of Open Access Journals (Sweden)

    Kamlesh Kumari Sharma

    2011-01-01

    Full Text Available Background: In recent times, domestic violence against women by marital partners has emerged as an important public health problem. Objectives: 1. To determine the prevalence, characteristics and impact of domestic violence against nurses by their marital partners, in Delhi, India. 2. To identify nurses′ perceptions regarding acceptable behavior for men and women. Materials and Methods: A facility-based pilot study was conducted at All India Institute of Medical Sciences (AIIMS, New Delhi. Data were collected using self-administered standardized questionnaire, among 60 ever married female nurses working at AIIMS hospital, selected by convenience sampling. The principal outcome variables were controlling behavior, emotional, physical and sexual violence by marital partners. Data were analyzed using SPSS 12 software. The test applied was Fisher′s exact test and 1-sided Fisher′s exact test. Results: Sixty percent of nurses reported marital partner perpetrated controlling behavior, 65% reported emotional violence, 43.3% reported physical violence and 30% reported sexual violence. About 3/5 th of nurses (58% opined that no reason justified violence, except wife infidelity (31.67%. Of the physically or sexually abused respondents, 40% were ever injured, and 56.7% reported that violence affected their physical and mental health. Conclusion: There is a high magnitude of domestic violence against nurses and this is reported to have affected their physical and mental health.

  2. Geographic access to care is not a determinant of child mortality in a rural Kenyan setting with high health facility density

    Directory of Open Access Journals (Sweden)

    Williams Thomas N

    2010-03-01

    Full Text Available Abstract Background Policy-makers evaluating country progress towards the Millennium Development Goals also examine trends in health inequities. Distance to health facilities is a known determinant of health care utilization and may drive inequalities in health outcomes; we aimed to investigate its effects on childhood mortality. Methods The Epidemiological and Demographic Surveillance System in Kilifi District, Kenya, collects data on vital events and migrations in a population of 220,000 people. We used Geographic Information Systems to estimate pedestrian and vehicular travel times to hospitals and vaccine clinics and developed proportional-hazards models to evaluate the effects of travel time on mortality hazard in children less than 5 years of age, accounting for sex, ethnic group, maternal education, migrant status, rainfall and calendar time. Results In 2004-6, under-5 and under-1 mortality ratios were 65 and 46 per 1,000 live-births, respectively. Median pedestrian and vehicular travel times to hospital were 193 min (inter-quartile range: 125-267 and 49 min (32-72; analogous values for vaccine clinics were 47 (25-73 and 26 min (13-40. Infant and under-5 mortality varied two-fold across geographic locations, ranging from 34.5 to 61.9 per 1000 child-years and 8.8 to 18.1 per 1000, respectively. However, distance to health facilities was not associated with mortality. Hazard Ratios (HR were 0.99 (95% CI 0.95-1.04 per hour and 1.01 (95% CI 0.95-1.08 per half-hour of pedestrian and vehicular travel to hospital, respectively, and 1.00 (95% CI 0.99-1.04 and 0.97 (95% CI 0.92-1.05 per quarter-hour of pedestrian and vehicular travel to vaccine clinics in children Conclusions Significant spatial variations in mortality were observed across the area, but were not correlated with distance to health facilities. We conclude that given the present density of health facilities in Kenya, geographic access to curative services does not influence

  3. Home Care Services

    Science.gov (United States)

    Home care is care that allows a person with special needs stay in their home. It might be for people who are getting ... chronically ill, recovering from surgery, or disabled. Home care services include Personal care, such as help with ...

  4. What is palliative care?

    Science.gov (United States)

    Comfort care; End of life - palliative care; Hospice - palliative care ... The goal of palliative care is to help people with serious illnesses feel better. It prevents or treats symptoms and side effects of disease and ...

  5. Skilled nursing and rehabilitation facilities - choosing

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/patientinstructions/000436.htm Skilled nursing and rehabilitation facilities - choosing To use the sharing ... you may need to go to a skilled nursing or rehabilitation facility . Skilled nursing facilities provide care ...

  6. Managing Disruptive Behavior by Patients and Physicians: A Responsibility of the Dialysis Facility Medical Director.

    Science.gov (United States)

    Jones, Edward R; Goldman, Richard S

    2015-08-07

    The Centers for Medicare & Medicaid Services' Conditions for Coverage make the medical director of an ESRD facility responsible for all aspects of care, including high-quality health care delivery (e.g., safe, effective, timely, efficient, and patient centered). Because of the high-pressure environment of the dialysis facility, conflicts are common. Conflict frequently occurs when aberrant behaviors disrupt the dialysis facility. Patients, family members, friends, and, less commonly appreciated, nephrology clinicians (i.e., nephrologists and advanced care practitioners) may manifest disruptive behavior. Disruptive behavior in the dialysis facility impairs the ability to deliver high-quality care. Furthermore, disruptive behavior is the leading cause for involuntary discharge (IVD) or involuntary transfer (IVT) of a patient from a facility. IVD usually results in loss of continuity of care, increased emergency department visits, and increased unscheduled, acute dialysis treatments. A sufficient number of IVDs and IVTs also trigger an extensive review of the facility by the regional ESRD Networks, exposing the facility to possible Medicare-imposed sanctions. Medical directors must be equipped to recognize and correct disruptive behavior. Nephrology-based literature and tools exist to help dialysis facility medical directors successfully address and resolve disruptive behavior before medical directors must involuntarily discharge a patient or terminate an attending clinician.

  7. Help Me Remember My Meds.

    Science.gov (United States)

    Lines, Rachel M; Panther, Shannon G

    2016-01-01

    Nonadherence has led to increased health consequences and higher health care costs. A study surveyed subjects using either blister pack or a Philips Medication Dispenser machine to determine medication adherence. Although there is still a research gap associated with medication packaging, it has great potential to help patients who have difficulty managing their multiple medications.

  8. Appropriate criteria for identification of near-miss maternal morbidity in tertiary care facilities: A cross sectional study

    Directory of Open Access Journals (Sweden)

    Serruya SJ

    2007-09-01

    Full Text Available Abstract Background The study of severe maternal morbidity survivors (near miss may be an alternative or a complement to the study of maternal death events as a health care indicator. However, there is still controversy regarding the criteria for identification of near-miss maternal morbidity. This study aimed to characterize the near miss maternal morbidity according to different sets of criteria. Methods A descriptive study in a tertiary center including 2,929 women who delivered there between July 2003 and June 2004. Possible cases of near miss were daily screened by checking different sets of criteria proposed elsewhere. The main outcome measures were: rate of near miss and its primary determinant factors, criteria for its identification, total hospital stay, ICU stay, and number and kind of special procedures performed. Results There were two maternal deaths and 124 cases of near miss were identified, with 102 of them admitted to the ICU (80.9%. Among the 126 special procedures performed, the most frequent were central venous access, echocardiography and invasive mechanical ventilation. The mean hospital stay was 10.3 (± 13.24 days. Hospital stay and the number of special procedures performed were significantly higher when the organ dysfunction based criteria were applied. Conclusion The adoption of a two level screening strategy may lead to the development of a consistent severe maternal morbidity surveillance system but further research is needed before worldwide near miss criteria can be assumed.

  9. Santa Monica Children's Centers, Santa Monica, California: Low-Cost Day Care Facilities for Children of Working Mothers Made Available Through the Cooperation of the California State Government and Local School District. Model Programs--Childhood Education.

    Science.gov (United States)

    American Institutes for Research in the Behavioral Sciences, Palo Alto, CA.

    Two of the four Santa Monica Children's Centers are nursery schools for children aged 3 to 5; the other two centers serve as extended care facilities for children of school age. All centers are concerned with meeting the physical, intellectual, and emotional needs of children on a long-term basis and stress a program offering a variety of play…

  10. Facility-based care for delivery and management of complications related to pregnancy and childbirth in Mexico

    Directory of Open Access Journals (Sweden)

    Bernardo Hernández

    2012-10-01

    Full Text Available OBJECTIVE: To describe the incidence and management of severe maternal and newborn complications in selected health facilities in Mexico. MATERIALS AND METHODS: As part of the WHO Multicountry Survey on Maternal and Newborn health, information was collected from medical records of women with deliveries and/or severe maternal complications during pregnancy or puerperium in 14 hospitals in Mexico City and the state of Guanajuato, Mexico. RESULTS: Of 13 311 women, 157 (12 per 1 000 live births had severe maternal complications including 4 maternal deaths. The most frequent complications were preeclampsia, postpartum hemorrhage, and chronic hypertension. Adverse perinatal outcomes were more frequent among women with severe maternal complications. A high use of uterotonics and parenteral antibiotics was found. A small proportion of women with eclampsia received magnesium sulfate. CONCLUSION: This study provides indicators on the incidence and management of maternal and neonatal complications in Mexico, which may be useful in studying and evaluating the performance of obstetric services.OBJETIVO: Describir la incidencia y manejo de complicaciones maternas y neonatales severas en hospitales seleccionados de México. MATERIAL Y MÉTODOS: En el marco de la Encuesta Multipaís de la OMS sobre Salud Materna y Neonatal, se recolectó información de los expedientes médicos de las mujeres que tuvieron su parto o experimentaron complicaciones maternas severas durante el embarazo o puerperio en 14 hospitales de la Ciudad de México y el estado de Guanajuato, México. RESULTADOS: De 13 311 mujeres, 157 (12/1 000 nacidos vivos tuvieron complicaciones maternas severas, incluyendo 4 muertes maternas. Las complicaciones más frecuentes fueron preeclampsia, hemorragia postparto e hipertensión crónica. Los resultados perinatales adversos fueron más frecuentes en las mujeres con complicaciones severas. Hubo un uso amplio de uterotónicos y antibi

  11. Relationship between adolescents’ family function with socio-demographic characteristics and behaviour risk factors in a primary care facility

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    Abu S. Muyibi

    2010-03-01

    Full Text Available Background: The family as a unit of care has great effect in tackling adolescent problems and this could be influenced by family functioning.Objective: This study assesses the relationship between adolescents’ family functioning with socio-demographic characteristics and behavioural risk factors.Method: The research was a cross-sectional, hospital-based study carried out at the General Outpatients Department, University College Hospital (GOPD,UCH, Ibadan, over a period of three months. Four hundred subjects were recruited using a modified Guideline for Adolescent Preventive Services (GAPS questionnaire, with an incorporated family APGAR (Adaptation,Partnership, Growth, Affection, Resolve score table. The results were analysed using the Statistical Package for Social Sciences (SPSS, version 11 and the findings on the family assessment and behavioural risk factors were relayed to the respondents.Results: The ages of the adolescents ranged from 10 to 19 years. Of the subjects, 8% were sexually active. Mean age for first coitus among the respondents was 15 ± 2.4 years. The rate of ingestion of alcohol and cigarette smoking was very low. The family APGAR scores obtained revealed that 84.5% subjects were rated as having a functional family (7–10 points and 15.5% of the subjects were rated as having a dysfunctional family (0–6 points. There was a significant association between perceived family function and subjects’ occupation (p = 0.01, parent social class (p = 0.00 and subjects’ sexual activities (p = 0.00.Conclusion: The majority of the adolescents were rated as having functional families. Dysfunctional families had significantly sexually active respondents.

  12. Efficacy of Hospital Germicides against Adenovirus 8, a Common Cause of Epidemic Keratoconjunctivitis in Health Care Facilities

    Science.gov (United States)

    Rutala, William A.; Peacock, Jeffrey E.; Gergen, Maria F.; Sobsey, Mark D.; Weber, David J.

    2006-01-01

    The inactivation of virus-contaminated nonporous inanimate surfaces was investigated using adenovirus type 8, a common cause of epidemic keratoconjunctivitis. A 10-μl inoculum of adenovirus was placed onto each stainless steel disk (1-cm diameter), and the inoculum was allowed to air dry for 40 min. Twenty-one different germicides (including disinfectants and antiseptics) were selected for this study based on their current uses in health care. After a 1- or 5-minute exposure to 50 μl of the germicide, the virus-germicide test mixture was neutralized and assayed for infectivity. Using an efficacy criterion of a 3-log10 reduction in the titer of virus infectivity and regardless of the virus suspending medium (i.e., hard water, sterile water, and hard water with 5% fetal calf serum), only five disinfectants proved to be effective against the test virus at 1 min: 0.55% ortho-phthalaldehyde, 2.4% glutaraldehyde, 2.65% glutaraldehyde, ∼6,000 ppm chlorine, and ∼1,900 ppm chlorine. Four other disinfectants showed effectiveness under four of the five testing conditions: 70% ethanol, 65% ethanol with 0.63% quaternary ammonium compound, 79.6% ethanol with 0.1% quaternary ammonium compound, and 0.2% peracetic acid. Of the germicides suitable for use as an antiseptic, 70% ethanol achieved a 3-log10 reduction under four of the five test conditions. These results emphasize the need for proper selection of germicides for use in disinfecting noncritical surfaces and semicritical medical devices, such as applanation tonometers, in order to prevent outbreaks of epidemic keratoconjunctivitis. PMID:16569860

  13. Bed leasing program helps hospitals discharge hard-to-place patients.

    Science.gov (United States)

    2015-12-01

    UCLA Health's program that pays a negotiated daily rate to skilled nursing facilities to hold beds for patients who otherwise would stay in an acute care bed saved a total of 2,516 acute care days from June 2014 to July 2015. UCLA Health pays a negotiated daily rate if the beds are occupied or not. The rate covers boarding, nursing care, medications, and physical therapy and occupational therapy Nurse practitioners are embedded in the participating nursing homes and provide care for UCLA Health's patients every day, often treating problems that might cause a readmission. The program helps with emergency department throughput and frees up acute care beds for patients who need them.

  14. CSIR helps prevent spontaneous combustion

    Energy Technology Data Exchange (ETDEWEB)

    Vuuren, M. van (CSIR Energy Technology (South Africa))

    1992-03-01

    Heaps of stockpiled coal could present a fire hazard due to the risk of spontaneous combustion. Regular monitoring of stockpiles and bunker testing of coals help to prevent stockpile fires. This brief article describes the recent upgrading of the CSIR's bunker test facility that enables coal producers, users and exporters to test their products under simulated conditions that duplicate the actual conditions under which coal is stored. 2 photos.

  15. Conditions, components and outcomes of Integrative Validation Therapy in a long-term care facility for people with dementia. A qualitative evaluation study.

    Science.gov (United States)

    Erdmann, Anke; Schnepp, Wilfried

    2016-09-01

    In this study, the practical application of Integrative Validation Therapy (IVA) in a nursing home for people with dementia was investigated and evaluated from the perspectives of professionals and relatives by using Fourth Generation Evaluation. IVA, a complex intervention frequently applied in Germany's long-term care settings, is a modification of Feil's Validation Therapy and contains a specific attitude and several components of action. The findings demonstrate that professionals as well as relatives of nursing home residents gave the intervention a positive rating. From the perspective of the participating professionals, the application of IVA results in less agitated residents which also has an influence on the consumption of benzodiazepine and neuroleptics. The authors conclude that IVA is a beneficial nursing intervention helping to facilitate the illness-related transition process of people with dementia. IVA is able to support them to cope with emotional distress during transition (e.g. irritability, anxiety, depression, changes in self-esteem). Another conclusion is that IVA supports person-centred care because, with IVA, professionals react to typical needs people with dementia have: comfort, inclusion, attachment and identity (Kitwood, 2012).

  16. Key determinants of induced abortion in women seeking postabortion care in hospital facilities in Ouagadougou, Burkina Faso

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    Ilboudo PGC

    2014-05-01

    Full Text Available Patrick GC Ilboudo,1–3 Serge MA Somda,4 Johanne Sundby3 1Département de Santé Publique, Unité de Recherche sur les Politiques et Systèmes de Santé, Centre Muraz, Bobo-Dioulasso, Burkina Faso; 2Agence de Formation, de Recherche et d'Expertise en Santé pour l'Afrique (AFRICSanté, Bobo-Dioulasso, Burkina Faso; 3Department of Community Medicine, University of Oslo, Oslo, Norway; 4Département des Maladies Non Transmissibles, Unité de Formation et d'Appui Méthodologique, Centre Muraz, Bobo-Dioulasso, Burkina Faso Introduction: Despite the universal recognition of unsafe abortion as a major public health problem, very little research has been conducted to document its precipitating factors in Burkina Faso. Our aim was to investigate the key determinants of induced abortion in a sample of women who sought postabortion care. Materials and methods: A cross-sectional household survey was carried out from February to September 2012 in Ouagadougou, Burkina Faso. Data of 37 women who had had an induced abortion and 267 women who had had a spontaneous abortion were prospectively collected on sociodemographic characteristics, pregnancy and birth history, abortion experience, including previous abortion experience, and selected clinical information, including the type of abortion. A two-step regression analysis consisting of a univariate and a multivariate logistic regression was run on Stata version 11.2 in order to identify the key determinants of induced abortion. Results: The findings indicated that 12% of all abortions were certainly induced. Three key factors were significantly and positively associated with the probability of having an induced abortion: whether the woman reported that her pregnancy was unwanted (odds ratio [OR] 10.45, 95% confidence interval [CI] 3.59–30.41; whether the woman reported was living in a household headed by her parents (OR 6.83, 95% CI 2.42–19.24; and if the woman reported was divorced or widowed (OR 3.47, 95

  17. MRIs Might Help Guide Preemies' Neurological Care

    Science.gov (United States)

    ... which premature infants will suffer from future motor, thinking and language problems by using MRI scans to identify specific ... babies at 18 months of age, performing motor, thinking and language assessments to determine how their development had proceeded. ...

  18. Helping You Choose Quality Behavioral Health Care

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    ... would like a printed copy, please call the Customer Service Center at (630) 792-5800. To report information or concerns about accredited organizations: ▪ Call or e-mail our Office of Quality Monitoring (800) 994-6610 or complaint@ jointcommission. org.

  19. Client Satisfaction with Delivery Care Service and Associated Factors in the Public Health Facilities of Gamo Gofa Zone, Southwest Ethiopia: In a Resource Limited Setting

    Directory of Open Access Journals (Sweden)

    Rahel Tesfaye

    2016-01-01

    Full Text Available Background. Ensuring patient satisfaction is an important means of secondary prevention of maternal mortality. This study presents findings from a multidimensional study of client satisfaction from the Gamo Gofa Zone in Southwest Ethiopia. Methods. A facility based cross-sectional study using exit interviews was conducted from 2014. Client satisfaction was measured using a survey adopted from the Donabedian quality assessment framework. Thirteen health institutions were randomly sampled of 66 institutions in Gamo Gofa Zone. Logistic regression was used to determine predictors of client satisfaction. Results. The overall satisfaction level of the clients in this study was 79.1% with (95% CI; 75–82. Women attending health centres were more likely satisfied than women attending hospitals (χ2=83.7, df=12, P<0.001. The proportion of women who complained about an unfriendly attitude or unresentful care from health workers was higher in the hospitals (χ2=27.4, df=1, P<0.001. The presence of support persons during child birth improved client satisfaction (AOR = 6.23 95% CI; 2.75–14.1 and women who delivered with caesarean section are four times more likely satisfied than those who deliver vaginally (AOR 3.6 95% CI; 1.44–9.06. Client satisfaction was reduced if the women had to pay for the services (AOR = 0.27 95% CI; 0.09–81. Conclusions. The study shows that overall satisfaction level is good. More emphasis should be put on giving women friendly care, particularly at the hospitals.

  20. Client Satisfaction with Delivery Care Service and Associated Factors in the Public Health Facilities of Gamo Gofa Zone, Southwest Ethiopia: In a Resource Limited Setting.

    Science.gov (United States)

    Tesfaye, Rahel; Worku, Amare; Godana, Wanzahun; Lindtjorn, Bernt

    2016-01-01

    Background. Ensuring patient satisfaction is an important means of secondary prevention of maternal mortality. This study presents findings from a multidimensional study of client satisfaction from the Gamo Gofa Zone in Southwest Ethiopia. Methods. A facility based cross-sectional study using exit interviews was conducted from 2014. Client satisfaction was measured using a survey adopted from the Donabedian quality assessment framework. Thirteen health institutions were randomly sampled of 66 institutions in Gamo Gofa Zone. Logistic regression was used to determine predictors of client satisfaction. Results. The overall satisfaction level of the clients in this study was 79.1% with (95% CI; 75-82). Women attending health centres were more likely satisfied than women attending hospitals (χ (2) = 83.7, df = 12, P < 0.001). The proportion of women who complained about an unfriendly attitude or unresentful care from health workers was higher in the hospitals (χ (2) = 27.4, df = 1, P < 0.001). The presence of support persons during child birth improved client satisfaction (AOR = 6.23 95% CI; 2.75-14.1) and women who delivered with caesarean section are four times more likely satisfied than those who deliver vaginally (AOR 3.6 95% CI; 1.44-9.06). Client satisfaction was reduced if the women had to pay for the services (AOR = 0.27 95% CI; 0.09-81). Conclusions. The study shows that overall satisfaction level is good. More emphasis should be put on giving women friendly care, particularly at the hospitals.

  1. “Silent” Dissemination of Klebsiella pneumoniae Isolates Bearing K. pneumoniae Carbapenemase in a Long-term Care Facility for Children and Young Adults in Northeast Ohio

    Science.gov (United States)

    Viau, Roberto A.; Hujer, Andrea M.; Marshall, Steven H.; Perez, Federico; Hujer, Kristine M.; Briceño, David F.; Dul, Michael; Jacobs, Michael R.; Grossberg, Richard; Toltzis, Philip

    2012-01-01

    Background. Klebsiella pneumoniae isolates harboring the K. pneumoniae carbapenemase gene (blaKPC) are creating a significant healthcare threat in both acute and long-term care facilities (LTCFs). As part of a study conducted in 2004 to determine the risk of stool colonization with extended-spectrum cephalosporin-resistant gram-negative bacteria, 12 isolates of K. pneumoniae that exhibited nonsusceptibility to extended-spectrum cephalosporins were detected. All were gastrointestinal carriage isolates that were not associated with infection. Methods. Reassessment of the carbapenem minimum inhibitory concentrations using revised 2011 Clinical Laboratory Standards Institute breakpoints uncovered carbapenem resistance. To further investigate, a DNA microarray assay, PCR-sequencing of bla genes, immunoblotting, repetitive-sequence-based PCR (rep-PCR) and multilocus sequence typing (MLST) were performed. Results. The DNA microarray detected blaKPC in all 12 isolates, and blaKPC-3 was identified by PCR amplification and sequencing of the amplicon. In addition, a blaSHV-11 gene was detected in all isolates. Immunoblotting revealed “low-level” production of the K. pneumoniae carbapenemase, and rep-PCR indicated that all blaKPC-3-positive K. pneumoniae strains were genetically related (≥98% similar). According to MLST, all isolates belonged to sequence type 36. This sequence type has not been previously linked with blaKPC carriage. Plasmids from 3 representative isolates readily transferred the blaKPC-3 to Escherichia coli J-53 recipients. Conclusions. Our findings reveal the “silent” dissemination of blaKPC-3 as part of Tn4401b on a mobile plasmid in Northeast Ohio nearly a decade ago and establish the first report, to our knowledge, of K. pneumoniae containing blaKPC-3 in an LTCF caring for neurologically impaired children and young adults. PMID:22492318

  2. Do loss to follow-up and death rates from ART care vary across primary health care facilities and hospitals in south Ethiopia? A retrospective follow-up study

    Directory of Open Access Journals (Sweden)

    Teshome W

    2015-05-01

    , age, facility type, and educational status were independently associated with LTFU. Moreover, baseline tuberculous disease, poor functional status, and follow-up at a health center were associated with an elevated probability of death. Conclusion: We observed a higher death rate and a lower LTFU rate in health centers than in hospitals. Most of the associated variables were also previously documented. Higher LTFU was noticed for patients with a smaller gap between testing and initiation of treatment. Keywords: antiretroviral therapy, primary care, loss to follow-up, death rates, Ethiopia

  3. Charity Bazaar Helps the Aged

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    Hundreds of people on September 24 participated in a charitybazaar held in Beijing International Club to help the aged Chinese in Beijing.The event demonstrated China's tradition of"respecting and caring for the aged,"and helped enhance relations be-tween the association of Former Diplomats of China,spouses of diplo-mats to China,and female diplomats. More than 40 embassies,international agencies and companies soldand/or donated goods.Dozens of domestic enterprises and institutions

  4. Biologic activities of molecular chaperones and pharmacologic chaperone imidazole-containing dipeptide-based compounds: natural skin care help and the ultimate challenge: implication for adaptive responses in the skin.

    Science.gov (United States)

    Babizhayev, Mark A; Nikolayev, Gennady M; Nikolayeva, Juliana G; Yegorov, Yegor E

    2012-03-01

    Accumulation of molecular damage and increased molecular heterogeneity are hallmarks of photoaged skin and pathogenesis of human cutaneous disease. Growing evidence demonstrates the ability of molecular chaperone proteins and of pharmacologic chaperones to decrease the environmental stress and ameliorate the oxidation stress-related and glycation disease phenotypes, suggesting that the field of chaperone therapy might hold novel treatments for skin diseases and aging. In this review, we examine the evidence suggesting a role for molecular chaperone proteins in the skin and their inducer and protecting agents: pharmacologic chaperone imidazole dipeptide-based agents (carcinine and related compounds) in cosmetics and dermatology. Furthermore, we discuss the use of chaperone therapy for the treatment of skin photoaging diseases and other skin pathologies that have a component of increased glycation and/or free radical-induced oxidation in their genesis. We examine biologic activities of molecular and pharmacologic chaperones, including strategies for identifying potential chaperone compounds and for experimentally demonstrating chaperone activity in in vitro and in vivo models of human skin disease. This allows the protein to function and traffic to the appropriate location in the skin, thereby increasing protein activity and cellular function and reducing stress on skin cells. The benefits of imidazole dipeptide antioxidants with transglycating activity (such as carcinine) in skin care are that they help protect and repair cell membrane damage and help retain youthful, younger-looking skin. All skin types will benefit from daily, topical application of pharmacologic chaperone antioxidants, anti-irritants, in combination with water-binding protein agents that work to mimic the structure and function of healthy skin. General strategies are presented addressing ground techniques to improve absorption of usually active chaperone proteins and dipeptide compounds, include

  5. Review on colonization of residents and staff in Italian long-term care facilities by multidrug-resistant bacteria compared with other European countries

    Directory of Open Access Journals (Sweden)

    Richard Aschbacher

    2016-10-01

    Full Text Available Abstract Background Rates of colonization and infection with multidrug-resistant (MDR bacteria are increasing worldwide, in both acute care hospitals and long-term care facilities (LTCFs. Italy has one of the highest prevalence of MDR bacteria in European countries, especially with regard to methicillin-resistant Staphylococcus aureus (MRSA and extended-spectrum β-lactamase (ESBL or carbapenemase producing Enterobacteriaceae (CPE. Method Review of studies on colonization by MDR bacteria from Italian LTCFs, risk factors for colonization and molecular characteristics of surveillance and clinical isolates, compared with other European countries. Results High variability of MDR colonization has been reported within and especially between European countries. Only a few surveillance studies have been performed in Italian LTCFs; these show MRSA colonization prevalence of 7.8–38.7 % for residents and 5.2–7.0 % for staff members, ESBL prevalence of 49.0–64.0 % for residents and 5.2–14.5 % for staff and prevalence of CPE of 1.0–6.3 % for residents and 0.0–1.5 % for staff. In Italian LTCFs, as well as in other European countries, the most prevalent ESBLs from surveillance or clinical Escherichia coli isolates were found to be CTX-M-type enzymes, particularly CTX-M-15, expressed by the pandemic ST131 clonal group; this lineage also expresses carbapenemase genes of the bla VIM and bla KPC types. Various risk factors for colonization of residents by MDR bacteria were identified. Conclusions The limited data from Italian LTCFs confirms these settings as important reservoirs for MDR organisms, allowing important considerations regarding the infection risk by these organisms. Nevertheless, more extended and countrywide screening studies for MDR colonization in Italian LTCFs are required. To promote further studies of various microbiological aspects related to LTCFs, the Association of Italian Clinical Microbiologists (Associazione Microbiologi

  6. Depression: FDA-Approved Medications May Help

    Science.gov (United States)

    ... Products For Consumers Home For Consumers Consumer Updates Depression: FDA-Approved Medications May Help Share Tweet Linkedin ... symptoms in some people. back to top Diagnosing Depression Diagnosis—which should be from a health care ...

  7. VA Health Care Facilities Locator

    Science.gov (United States)

    ... Inside the Media Room Public Affairs News Releases Speeches Videos Publications National Observances Veterans Day Memorial Day Celebrating America's Freedoms Special Events Adaptive Sports Program Creative Arts Festival ...

  8. Molecular epidemiology of extended-spectrum beta-lactamases among Escherichia coli isolates collected in a Swedish hospital and its associated health care facilities from 2001 to 2006.

    Science.gov (United States)

    Fang, Hong; Ataker, Ferda; Hedin, Göran; Dornbusch, Kathrine

    2008-02-01

    The genetic characteristics and molecular epidemiology of extended-spectrum beta-lactamases (ESBLs) among Escherichia coli isolates were investigated at a general hospital and its associated health care facilities in Stockholm, Sweden, during the period from 2001 to 2006. Of 87 consecutive nonduplicate ESBL-positive isolates, 80 isolates encoded CTX-M-type ESBLs, 64 of which were group 1 enzymes. TEM-type and OXA-type beta-lactamases were encoded in 63 and 59% of the ESBL isolates, respectively. Pulsed-field gel electrophoresis (PFGE) analysis revealed 40 different pulsotypes, consisting of 11 clones accounting for 66% of all isolates, and 29 unique patterns. Moreover, of the 11 clones, clones 1 and 4 comprised half of the clonally related isolates (28 of 57). Clone 1 was a persistent endemic clone in the area throughout the years, and clone 4 emerged in 2003. However, in recent years, clone 1 isolates were no longer predominant and were gradually replaced by new emerging strains. Concerning beta-lactamase gene profiles in relation to PFGE pulsotypes, clone-related bla profiles were observed in certain clones, while in most cases different bla profiles could be observed in the same clone, and the same bla profile could be present in different clones. The molecular epidemiology of ESBL-positive E. coli in the area shows shifts in predominant strains and increased clonal diversity over time. The study also indicated that both clonal spread of epidemic strains and transfer of transposable genetic elements might contribute to the proliferation of ESBLs.

  9. A novel influenza A (H1N1 outbreak experience among residents of a long term-care facility in Saudi Arabia during 2010 seasonal flu circulation

    Directory of Open Access Journals (Sweden)

    Raouf M. Afifi

    2012-03-01

    Full Text Available The aim of this work was to describe and analyze an outbreak of novel 2009 influenza A (H1N1 among residents of a long-term care facility (LTCF in Prince Mansour Military Hospital (PMMH, Taif, Saudi Arabia. These patients had been admitted to the LTCF months or years before the outbreak for several reasons, e.g. cerebral palsy, neurological deficits due to road traffic accidents with resultant handicap, chronic diseases associated with old age. An observational study was carried out to demonstrate and analyze the epidemiological characteristics (demographic factors, risk factors, and outcomes associated with the outbreak in order to clarify which prevention and control measures had been taken and which recommendations were followed. During the period October 28 to November 11 2010, 21 LTCF residents were suspected to be clinically involved: fever ≥38ºC with influenza-like illness (ILI. Age ranged from 9-91 years (mean 46±24.13; 62% were males. Among them, 12 (57% were influenza A (H1N1 positive by reverse transcription polymerase chain reaction (RTPCR. Mortality involved 2 (17% of the A (H1N1 laboratory confirmed individuals. Implementation of the recommended infection control measures mitigated the transmission of infection to new individuals. The fulfillment of strict infection control measures could limit H1N1 infection among LTCFPMMH patients. Routine influenza, including specific H1N1 immunization of all LTCF residents together with their healthcare staff, should be mandatory in those settings serving immunocompromised patients.

  10. Knowledge and practices of supervisors on the performance management and development system at rural primary health care facilities in the Limpopo Province

    Directory of Open Access Journals (Sweden)

    Rosemary H. Mashego

    2016-03-01

    Full Text Available Background: The South African government has introduced Performance Management and Development System (PMDS as a tool to monitor and manage the performances of health institutions, in order to improve service delivery within primary health care settings. The aim of the study was to determine the knowledge and practices of supervisors regarding PMDS in primary health institutions of the Limpopo Province.Materials and Methods: A cross-sectional, descriptive, quantitative study was used. A total of 117 participants were sampled using stratified random sampling technique and a questionnaire was used to collect data. Statistical Package for Social Sciences (SPSS version 22.0 was used to analyse both descriptive and inferential statistics.Results: Generally all the respondents had an average (65.8% understanding of the PMDS processes including the purpose and their roles as supervisors. However, a gap exists between the theoretical knowledge and the actual ability to practise PMDS which was found to be at 52%. There are areas of weakness that still need attention, such as unavailability of PMDS guidelines and lack of training of both supervisors and employees on PMDS.Conclusion: This study highlights the problem of lack of knowledge and skills, unavailability of PMDS policy and poor induction into PMDS. To improve the knowledge and ability to supervise PMDS, proper induction of all PMDS supervisors and periodic in-service training should be done; reference materials, the PMDS policy manuals, are to be made available in the facility and all supervisors be orientated on how to use these manuals.

  11. Your cancer care team

    Science.gov (United States)

    ... gov/ency/patientinstructions/000929.htm Your cancer care team To use the sharing features on this page, ... help your body heal. Working with Your Care Team Each member of your care team plays an ...

  12. Effects of resistance and all-round, functional training on quality of life, vitality and depression of older adults living in long-term care facilities: a 'randomized' controlled trial [ISRCTN87177281

    Directory of Open Access Journals (Sweden)

    van Mechelen Willem

    2004-07-01

    Full Text Available Abstract Background Regular physical activity may improve different aspects of wellbeing in older people, such as quality of life, vitality and depression. However, there is little experimental evidence to support this assumption. Therefore, we examined the effect of different training protocols on quality of life, vitality and depression of older adults living in long-term care facilities. Methods Subjects (n = 173, aged 64 to 94 years, living in long-term care facilities, were randomized to six months of three different moderate-intensity group exercise training protocols, or to an 'educational' control condition. Exercise consisted of two 45–60-minute training sessions per week of 1 resistance training; 2 all-round, functional training; or 3 a combination of both. Perceived health, the Geriatric Depression Scale (GDS, the Vitality Plus Scale (VPS and the Dementia Quality of Life questionnaire (DQoL were administered at baseline and after six months. Results In the combined training group a small but significant decline was seen in perceived health, DQoL and VPS score compared to the control group. Conclusions We conclude that neither strength training nor all-round, functional training of moderate intensity is effective in improving quality of life, vitality or depression of older people living in long-term care facilities.

  13. Assisted Living Facilities, Licensed Long Term Care Facilities, Published in 2007, 1:24000 (1in=2000ft) scale, State of California - Office of the State Chief Information Officer.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, published at 1:24000 (1in=2000ft) scale, was produced all or in part from Published Reports/Deeds information as of 2007. It...

  14. Dysarthria - care

    Science.gov (United States)

    Speech and language disorder - dysarthria care; Slurred speech - dysarthria; Articulation disorder - dysarthria ... Dysarthria is a condition that occurs when there are problems with the muscles that help you talk. ...

  15. Facilities & Leadership

    Data.gov (United States)

    Department of Veterans Affairs — The facilities web service provides VA facility information. The VA facilities locator is a feature that is available across the enterprise, on any webpage, for the...

  16. National Health Care Survey

    Science.gov (United States)

    This survey encompasses a family of health care provider surveys, including information about the facilities that supply health care, the services rendered, and the characteristics of the patients served.

  17. The Impact of the Medicare-Eligible Retiree Health Care Fund on Navy Military Treatment Facilities’ Demand-to-Capacity Solution

    Science.gov (United States)

    2012-03-01

    Dental Intern, Dental Fellow, Dental Resident, Veterinarian 2—Direct Care Professional Physician Assistant, Nurse Practitioner, Nurse Midwife...Specialty Care that includes Obstetrics/Gynecology, General Surgery, Orthopedics , Podiatry, Mental Health, Substance Abuse Rehabilitation Program (SARP...2) Specialty Care that includes Obstetrics/Gynecology, General Surgery, Orthopedics , Mental Health, a Substance Abuse Rehabilitation Program (SARP

  18. Serving Youth Who Are Serving Time: A Study of the Special Education Services for Incarcerated Youth in a Short-Term Care Facility

    Science.gov (United States)

    Hoshide, Sachiko

    2013-01-01

    This study examined the communication between sending court and community schools of a County Office of Education's (COE) Alternative Education program and the receiving juvenile detention facility of a county in a Western state and how the communication between the two facilities affected the level of special education services provided to…

  19. Biochemistry Facility

    Data.gov (United States)

    Federal Laboratory Consortium — The Biochemistry Facility provides expert services and consultation in biochemical enzyme assays and protein purification. The facility currently features 1) Liquid...

  20. Molecular characterization of methicillin-resistant Staphylococcus aureus in nosocomial infections in a tertiary-care facility: emergence of new clonal complexes in Saudi Arabia.

    Science.gov (United States)

    Senok, A; Ehricht, R; Monecke, S; Al-Saedan, R; Somily, A

    2016-11-01

    Changes in the molecular epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) continue to be reported. This study was carried out to characterize MRSA isolates in Saudi Arabia. MRSA isolates causing nosocomial infections (n = 117) obtained from 2009-2015 at a tertiary-care facility in Riyadh, Saudi Arabia, were studied. Molecular characterization of isolates was carried out using the StaphyType DNA microarray (Alere Technologies, Jena, Germany). Fourteen clonal complexes (CC) were identified, with the most common being CC80 (n = 35), CC6 (n = 15), CC5 (n = 13) and CC22 (n = 12). With the exception of nine ST239 MRSA-III isolates, all others were of community-associated MRSA lineages. The following strains are identified for the first time in Saudi Arabia: ST8-MRSA-IV [PVL(+)/ACME(+)], USA300 (n = 1); ST72-MRSA-IV USA700 (n = 1); CC5-MRSA-IV, [PVL(+)/edinA(+)], WA MRSA-121 (n = 1); CC5-MRSA-V+SCCfus, WA MRSA-14/109 (n = 2), CC97-MRSA-IV, WA MRSA-54/63; CC2250/2277-MRSA-IV and WA MRSA-114. CC15-MRSA (n = 3) was identified for the first time in clinical infection in Saudi Arabia. None of the isolates harboured vancomycin resistance genes, while genes for resistance to mupirocin and quaternary ammonium compounds were found in one and nine isolates respectively. Fifty-seven isolates (48.7%) were positive for Panton-Valentine leukocidin genes. While the staphylokinase (sak) and staphylococcal complement inhibitor (scn) genes were present in over 95% of the isolates, only 37.6% had the chemotaxis-inhibiting protein (chp) gene. Increasing occurrence of community-acquired MRSA lineages plus emergence of pandemic and rare MRSA strains is occurring in our setting. Strict infection control practices are important to limit the dissemination of these MRSA strains.

  1. Symptom Clusters in People Living with HIV Attending Five Palliative Care Facilities in Two Sub-Saharan African Countries: A Hierarchical Cluster Analysis.

    Directory of Open Access Journals (Sweden)

    Katrien Moens

    Full Text Available Symptom research across conditions has historically focused on single symptoms, and the burden of multiple symptoms and their interactions has been relatively neglected especially in people living with HIV. Symptom cluster studies are required to set priorities in treatment planning, and to lessen the total symptom burden. This study aimed to identify and compare symptom clusters among people living with HIV attending five palliative care facilities in two sub-Saharan African countries.Data from cross-sectional self-report of seven-day symptom prevalence on the 32-item Memorial Symptom Assessment Scale-Short Form were used. A hierarchical cluster analysis was conducted using Ward's method applying squared Euclidean Distance as the similarity measure to determine the clusters. Contingency tables, X2 tests and ANOVA were used to compare the clusters by patient specific characteristics and distress scores.Among the sample (N=217 the mean age was 36.5 (SD 9.0, 73.2% were female, and 49.1% were on antiretroviral therapy (ART. The cluster analysis produced five symptom clusters identified as: 1 dermatological; 2 generalised anxiety and elimination; 3 social and image; 4 persistently present; and 5 a gastrointestinal-related symptom cluster. The patients in the first three symptom clusters reported the highest physical and psychological distress scores. Patient characteristics varied significantly across the five clusters by functional status (worst functional physical status in cluster one, p<0.001; being on ART (highest proportions for clusters two and three, p=0.012; global distress (F=26.8, p<0.001, physical distress (F=36.3, p<0.001 and psychological distress subscale (F=21.8, p<0.001 (all subscales worst for cluster one, best for cluster four.The greatest burden is associated with cluster one, and should be prioritised in clinical management. Further symptom cluster research in people living with HIV with longitudinally collected symptom data to

  2. Unlocking community capabilities for improving maternal and newborn health: participatory action research to improve birth preparedness, health facility access, and newborn care in rural Uganda

    Directory of Open Access Journals (Sweden)

    Elizabeth Ekirapa-Kiracho

    2016-11-01

    Full Text Available Abstract Background Community capacities and resources must be harnessed to complement supply side initiatives addressing high maternal and neonatal mortality rates in Uganda. This paper reflects on gains, challenges and lessons learnt from working with communities to improve maternal and newborn health in rural Uganda. Methods A participatory action research project was supported from 2012 to 2015 in three eastern districts. This project involved working with households, saving groups, sub county and district leaders, transporters and village health teams in diagnosing causes of maternal and neonatal mortality and morbidity, developing action plans to address these issues, taking action and learning from action in a cyclical manner. This paper draws from project experience and documentation, as well as thematic analysis of 20 interviews with community and district stakeholders and 12 focus group discussions with women who had recently delivered and men whose wives had recently delivered. Results Women and men reported increased awareness about birth preparedness, improved newborn care practices and more male involvement in maternal and newborn health. However, additional direct communication strategies were required to reach more men beyond the minority who attended community dialogues and home visits. Saving groups and other saving modalities were strengthened, with money saved used to meet transport costs, purchase other items needed for birth and other routine household needs. However saving groups required significant support to improve income generation, management and trust among members. Linkages between savings groups and transport providers improved women’s access to health facilities at reduced cost. Although village health teams were a key resource for providing information, their efforts were constrained by low levels of education, inadequate financial compensation and transportation challenges. Ensuring that the village health

  3. Not Everybody Needs Help to Seek Help: Surprising Effects of Metacognitive Instructions to Foster Help-Seeking in an Online-Learning Environment

    Science.gov (United States)

    Stahl, Elmar; Bromme, Rainer

    2009-01-01

    Offering help functions is a standard feature of computer-based interactive learning environments (ILE). Nevertheless, a number of recent studies indicate that learners are not using such help facilities effectively. We compared the effects of different metacognitive supports to foster learners' help-seeking behavior in an ILE for plant…

  4. Online Help Systems

    Science.gov (United States)

    1989-09-07

    delivery allows Greater availability -- With networks and portable computers becoming more prevalent, we anticipate that it will become increasingly... networking in which software is centrally stored and distributed around a facility and even to facilities across the country will make it difficult if not...WordStar .15 .31 .23 "VordPerfect 5.0 .23 .31 .27 Macintosh Hyperscan 1.0 .60 Xpplelink 4.0 .87 IBM PC ixcel .62 DBase 111 .54 -)ystat .30 ,oxBase

  5. Skilled nursing facilities after joint replacement

    Science.gov (United States)

    ... may need to be transferred to a skilled nursing facility. You should talk about this issue with ... Medicare and Medicaid Services. Medicare coverage of skilled nursing facility care. Revised January 2015. www.caretelinns.com/ ...

  6. Morbidity profile of elderly outpatients attending selected sub-district Siddha health facilities in Tamil Nadu, India

    Directory of Open Access Journals (Sweden)

    Kalaiselvi Selvaraj

    2016-01-01

    Conclusion: Elderly constitute more than one fourth of outpatients load from siddha health facilities. Degenerative diseases like arthritis and non-communicable diseases were the common morbidities in this age group. Geriatric clinics and mobile clinics under siddha system may help in improving health care services.

  7. Assisted Living Facilities, Burke County Family Care Homes, Published in 2005, 1:63360 (1in=1mile) scale, City of Morganton.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Assisted Living Facilities dataset, published at 1:63360 (1in=1mile) scale, was produced all or in part from Published Reports/Deeds information as of 2005. It...

  8. Preschool Facilities, Pre-school point layer, combined with day care center points., Published in 2005, 1:4800 (1in=400ft) scale, Reno County.

    Data.gov (United States)

    NSGIC GIS Inventory (aka Ramona) — This Preschool Facilities dataset, published at 1:4800 (1in=400ft) scale, was produced all or in part from Published Reports/Deeds information as of 2005. It is...

  9. Managed care demands flexibility, creativity.

    Science.gov (United States)

    1996-05-01

    The definition of hospice care is changing as home care providers come under managed care regulations. Hospice care for AIDS patients is demanding, requiring extra time from home care providers. The managed care cost-cutting measures require creativitity and patience. The Visiting Nurses and Hospice of San Francisco (VNH) has held seminars to help providers adapt to managed care.

  10. Finding Health Care Services

    Science.gov (United States)

    If you have been diagnosed with cancer, finding a doctor and treatment facility for your cancer care is an important step to getting the best treatment possible. Learn tips for choosing a doctor and treatment facility to manage your cancer care.

  11. A Robot to Help Make the Rounds

    Science.gov (United States)

    2003-01-01

    This paper presents a discussion on the Pyxis HelpMate SecurePak (SP) trackless robotic courier designed by Transitions Research Corporation, to navigate autonomously throughout medical facilities, transporting pharmaceuticals, laboratory specimens, equipment, supplies, meals, medical records, and radiology films between support departments and nursing floors.

  12. CERN helps Grid cmputing into the mainstream

    CERN Multimedia

    Moran, Nuala

    2006-01-01

    CERN, the European Laboratory for Particle Physics, has launched the seocnd phase of Openlab, its partnership with IT companies for the development of advanced computing facilities. The industrial partners in this phase, Hewlett Packard, Intel and Oracle, will help build on the experience from the last three years when Openlab worked on cluster and Grid computing (1 page)

  13. Contributions of Physical Therapists to Primary Preventive Health Care.

    Science.gov (United States)

    Nomura, Takuo

    2016-01-01

    The limitations of what physical therapists can differ from country to country. In Japan, physical therapists are national licensed health care professionals who can help patients improve or restore their mobility. Most Japanese physical therapists provide care for people in health care facilities, medical-welfare transitional facilities, and welfare facilities for the elderly. Currently, physical therapists are unable to sufficiently contribute to primary preventive health care in Japan. However, there are many health problems that physical therapists could help alleviate. For example, low back pain (LBP) more likely than any other condition prevents people from working; thus, making the establishment of effective measures to prevent and reduce LBP vital. An estimated 20,500,000 Japanese individuals have diabetes mellitus (DM) or are at a high risk of developing the disease. DM commonly accompanies stroke and/or heart disease, and is characterized by complications that result from chronic hyperglycemia. Evidence-based physical therapy is effective for the prevention and treatment of LBP and DM. The Japanese Physical Therapy Association established the Japanese Society of Physical Therapy (JSPT) in June 2013. The JSPT has 12 departmental societies and 10 sections. We believe that the JSPT will advance the study of the potential role of physical therapists in primary preventive health care. In the future, it is expected that Japanese physical therapists will contribute to primary preventive health care.

  14. Catastrophic Health Expenditure amongst People Living with HIV/AIDS Availing Antiretroviral Treatment Services at Two Tertiary Care Health Facilities in District of Northern India

    Directory of Open Access Journals (Sweden)

    Mukesh Shukla, Monika Agarwal, Jai Vir Singh, Anil Kumar Tripathi, Anand Kumar Srivastava, Vijay Kumar Singh

    2015-01-01

    Conclusions: Decentralisation of ART programme up to grass root level, integration of HIV/AIDS-related services into primary health care services and bridging of the loop holes like effective convening of various government benefit schemes to patients during their visit to ART centre and there by promoting utilisation could reduce their financial burden for care and treatment."

  15. Quality of life of residents with dementia in long-term care settings in the Netherlands and Belgium: design of a longitudinal comparative study in traditional nursing homes and small-scale living facilities

    Directory of Open Access Journals (Sweden)

    Luijkx Katrien G

    2011-05-01

    Full Text Available Abstract Background The increase in the number of people with dementia will lead to greater demand for residential care. Currently, large nursing homes are trying to transform their traditional care for residents with dementia to a more home-like approach, by developing small-scale living facilities. It is often assumed that small-scale living will improve the quality of life of residents with dementia. However, little scientific evidence is currently available to test this. The following research question is addressed in this study: Which (combination of changes in elements affects (different dimensions of the quality of life of elderly residents with dementia in long-term care settings over the course of one year? Methods/design A longitudinal comparative study in traditional and small-scale long-term care settings, which follows a quasi-experimental design, will be carried out in Belgium and the Netherlands. To answer the research question, a model has been developed which incorporates relevant elements influencing quality of life in long-term care settings. Validated instruments will be used to evaluate the role of these elements, divided into environmental characteristics (country, type of ward, group size and nursing staff; basic personal characteristics (age, sex, cognitive decline, weight and activities of daily living; behavioural characteristics (behavioural problems and depression; behavioural interventions (use of restraints and use of psychotropic medication; and social interaction (social engagement and visiting frequency of relatives. The main outcome measure for residents in the model is quality of life. Data are collected at baseline, after six and twelve months, from residents living in either small-scale or traditional care settings. Discussion The results of this study will provide an insight into the determinants of quality of life for people with dementia living in traditional and small-scale long-term care settings in

  16. Handi Helps, 1985

    Science.gov (United States)

    Handi Helps, 1985

    1985-01-01

    The six issues of Handi Helps presented here focus on specific issues of concern to the disabled, parents, and those working with the disabled. The two-page handi help fact sheets focus on the following topics: child sexual abuse prevention, asthma, scoliosis, the role of the occupational therapist, kidnapping, and muscular dystrophy. Each handi…

  17. Helping Friends and Family

    Science.gov (United States)

    ... chapter Join our online community Helping Friends and Family Part of living well with Alzheimer’s is adjusting to your “new normal” and helping family and friends do the same. Knowing what to ...

  18. Helping Children Understand Divorce.

    Science.gov (United States)

    Allers, Robert D.

    1980-01-01

    Children of divorced parents may bring many problems along when they come to school. Teachers can recognize these troubles and help children learn to handle them. They may be able to help children better understand their feelings about their parents' divorce. (CJ)

  19. Help! It's Hair Loss!

    Science.gov (United States)

    ... los dientes Video: Getting an X-ray Help! It's Hair Loss! KidsHealth > For Kids > Help! It's Hair Loss! Print A A A What's in ... part above the skin, is dead. (That's why it doesn't hurt to get a haircut!) This ...

  20. Controlled Archaeological Test Site (CATS) Facility

    Data.gov (United States)

    Federal Laboratory Consortium — CATS facility is at the Construction Engineering Research Laboratory (CERL), Champaign, IL. This 1-acre test site includes a variety of subsurface features carefully...

  1. Ayudando a los Ninos a Amarse a Si Mismos y a Otros: Una guia profesional para el cuidado infantil en el hogar (Helping Children Love Themselves and Others: A Professional Handbook for Family Day Care).

    Science.gov (United States)

    Gellert, Sandra; And Others

    This Spanish-language guide presents an anti-bias, multicultural approach to family day care. Part A provides a rationale for such an approach. Subsections of this part concern: (1) family day care as a site for the transmission of bias; (2) characteristics of an anti-bias, multicultural approach; (3) language and stereotypes; (4) developmental…

  2. Comorbidities of HIV infection and health care seeking behavior among HIV infected patients attending public sector healthcare facilities in KwaZulu-Natal: A cross sectional study

    Science.gov (United States)

    Nlooto, Manimbulu

    2017-01-01

    Background HIV-infected people may present with co-infections, comorbidities, and side effects associated with antiretroviral therapy. This study explored the prevalence of comorbid health problems and determined the extent of the use of traditional medicine for treatment of co-infections, comorbidities of HIV infection and side effects. Methods A cross sectional study, using researcher-administered questionnaires, was carried out among HIV-infected patients in eight public sector healthcare facilities in KwaZulu-Natal between April and October 1024. Self-reports of comorbidities, co-infections and side effects were analyzed with respect to factors such as age, gender, race, and health care seeking behavior including the use of traditional medicine. Cross-tabulations were conducted to test the association between factors and the use of traditional medicine, using Pearson chi-squared (χ2) test. Simple and multiple logistic regression models tested the association of the use of traditional medicine with age, gender, race, side effects and comorbidities. Odds ratios with 95% confidence intervals were estimated. Missing values were handled, defined and treated as missing values in the final analysis. Results Overall, 29.5% (n = 516) of the survey participants reported having other comorbidities and or co-infections besides their HIV condition. Same participants reported two or more comorbidities. Almost forty percent of participants (208/531, 39.17%) reported having hypertension as the most noninfectious comorbidity while 21.65% of participants (115/531) had tuberculosis accounting for the most infectious comorbidity. Almost eight percent of participants (142/1748, 8.12%) reported using traditional medicine after starting with cART. Sixty out of 142 participants (60/142, 42.25%) on cART resorted to the use of traditional medicine for the management of comorbidities and or co-infections of their HIV infection. Overall, 311 out of 1748 participants (17.80%) complained

  3. Respite Care

    Science.gov (United States)

    ... provided in a home, an adult day-care program or over a weekend in a nursing home or an assisted living facility. For more information on the NFCSP visit the Administration on Aging website at http://www.aoa.gov/ ...

  4. Achieving Excellence in Palliative Care: Perspectives of Health Care Professionals

    Directory of Open Access Journals (Sweden)

    Margaret I Fitch

    2016-01-01

    Full Text Available Caring for individuals at the end of life in the hospital environment is a challenging proposition. Understanding the challenges to provide quality end of life care is an important first step in order to develop appropriate approaches to support and educate staff members and facilitate their capacity remaining "caring." Four studies were undertaken at our facility to increase our understanding about the challenges health professionals experience in caring for patients at end of life and how staff members could be supported in providing care to patients and families: (1 In-depth interviews were used with cancer nurses (n = 30 to explore the challenges talking about death and dying with patients and families; (2 Surveys were used with nurses (n = 27 and radiation therapists (n = 30 to measure quality of work life; (3 and interprofessional focus groups were used to explore what it means "to care" (five groups held; and (4 interprofessional focus groups were held to understand what "support strategies for staff" ought to look like (six groups held. In all cases, staff members confirmed that interactions concerning death and dying are challenging. Lack of preparation (knowledge and skill in palliative care and lack of support from managers and colleagues are significant barriers. Key strategies staff members thought would be helpful included: (1 Ensuring all team members were communicating and following the same plan of care, (2 providing skill-based education on palliative care, and (3 facilitating "debriefing" opportunities (either one-on-one or in a group. For staff to be able to continue caring for patients at the end of life with compassion and sensitivity, they need to be adequately prepared and supported appropriately.

  5. Fabrication Facilities

    Data.gov (United States)

    Federal Laboratory Consortium — The Fabrication Facilities are a direct result of years of testing support. Through years of experience, the three fabrication facilities (Fort Hood, Fort Lewis, and...

  6. Helping at the bedside: spouses' preferences for helping critically ill patients.

    Science.gov (United States)

    Eldredge, Deborah

    2004-10-01

    Spouses of patients in intensive care units (ICU) need to be close and helpful to ill partners. According to adult attachment theory, emotional responses may be related to preferences for closeness and helpfulness, and according to control theory optimism also may influence spouses' emotional responses. Spouses' goals and helping behaviors were assessed in 88 spouses of ICU patients. Using a repeated-measures design, the relationships of closeness, helpfulness, and optimism to emotional outcomes were assessed. Preferences for closeness and helpfulness were strongly related, and together with optimism, predicted spouses' mood at some point of the illness trajectory. Spouses who were over-involved with partners' care requirements were at greater risk for emotional distress. Results suggest that closeness and helpfulness are integrated concepts, and that attachment dimensions of a relationship and optimism are useful for understanding spouses' emotional responses to critical illness.

  7. Facility Microgrids

    Energy Technology Data Exchange (ETDEWEB)

    Ye, Z.; Walling, R.; Miller, N.; Du, P.; Nelson, K.

    2005-05-01

    Microgrids are receiving a considerable interest from the power industry, partly because their business and technical structure shows promise as a means of taking full advantage of distributed generation. This report investigates three issues associated with facility microgrids: (1) Multiple-distributed generation facility microgrids' unintentional islanding protection, (2) Facility microgrids' response to bulk grid disturbances, and (3) Facility microgrids' intentional islanding.

  8. Helping Kids Handle Worry

    Science.gov (United States)

    ... Parents MORE ON THIS TOPIC Connecting With Your Preteen Why Is My Child Anxious About Going to School? Helping Kids Cope With Stress Teens Talk About Stress (Video) Anxiety, Fears, and Phobias Childhood Stress How Can ...

  9. Can Reading Help?

    Science.gov (United States)

    Crowe, Chris

    2003-01-01

    Ponders the effect of September 11th on teenagers. Proposes that reading books can help teenagers sort out complicated issues. Recommends young adult novels that offer hope for overcoming tragedy. Lists 50 short story collections worth reading. (PM)

  10. Helping Parents Say No.

    Science.gov (United States)

    Duel, Debra K.

    1988-01-01

    Provides some activities that are designed to help students understand some of the reasons why parents sometimes refuse to let their children have pets. Includes mathematics and writing lessons, a student checklist, and a set of tips for parents. (TW)

  11. Fixing the broken image of care homes, could a 'care home innovation centre' be the answer?

    Science.gov (United States)

    Hockley, Jo; Harrison, Jennifer Kirsty; Watson, Julie; Randall, Marion; Murray, Scott

    2016-09-08

    The UK has many excellent care homes that provide high-quality care for their residents; however, across the care home sector, there is a significant need for improvement. Even though the majority of care homes receive a rating of 'good' from regulators, still significant numbers are identified as requiring 'improvement' or are 'inadequate'. Such findings resonate with the public perceptions of long-term care as a negative choice, to be avoided wherever possible-as well as impacting on the career choices of health and social care students. Projections of current demographics highlight that, within 10 years, the part of our population that will be growing the fastest will be those people older than 80 years old with the suggestion that spending on long-term care provision needs to rise from 0.6% of our Gross Domestic Product in 2002 to 0.96% by 2031. Teaching/research-based care homes have been developed in the USA, Canada, Norway, the Netherlands and Australia in response to scandals about care, and the shortage of trained geriatric healthcare staff. There is increasing evidence that such facilities help to reduce inappropriate hospital admissions, increase staff competency and bring increased enthusiasm about working in care homes and improve the quality of care. Is this something that the UK should think of developing? This commentary details the core goals of a Care Home Innovation Centre for training and research as a radical vision to change the culture and image of care homes, and help address this huge public health issue we face.

  12. Cost analysis helps evaluate contract profitability.

    Science.gov (United States)

    Sides, R W

    2000-02-01

    A cost-accounting analysis can help group practices assess their costs of doing business and determine the profitability of managed care contracts. Group practices also can use cost accounting to develop budgets and financial benchmarks. To begin a cost analysis, group practices need to determine their revenue and cost centers. Then they can allocate their costs to each center, using an appropriate allocation basis. The next step is to calculate costs per procedure. The results can be used to evaluate operational cost efficiency as well as help negotiate managed care contracts.

  13. Utility of conventional transbronchial needle aspiration with rapid on-site evaluation (c-TBNA-ROSE at a tertiary care center with endobronchial ultrasound (EBUS facility

    Directory of Open Access Journals (Sweden)

    Neha Kawatra Madan

    2016-01-01

    Conclusion: c-TBNA with ROSE is a safe, efficacious, and cost-effective bronchoscopic modality. When it was performed by operators routinely performing EBUS-TBNA, diagnostic yields similar to that of EBUS-TBNA can be obtained. Even at the centers where EBUS facilities are available, c-TBNA should be routinely performed.

  14. Study of obstetric and fetal outcome of twin pregnancy in a tertiary care centre

    Directory of Open Access Journals (Sweden)

    Gurpreet Kaur Nandmer

    2015-12-01

    Conclusions: Twin pregnancies are high risk pregnancies with more maternal and fetal complications. The use of antenatal care services, identification and anticipation of complications, intrapartum management and good NICU facilities will help to improve maternal and neonatal outcome in twin pregnancies. [Int J Reprod Contracept Obstet Gynecol 2015; 4(6.000: 1789-1792

  15. Nosocomial infection in long-term care facilities. A survey in a Brazilian psychiatric hospital Infecção hospitalar em instituições de longa permanência. Pesquisa em hospital psiquiátrico brasileiro

    Directory of Open Access Journals (Sweden)

    Regina Capanema de ALMEIDA

    1999-11-01

    Full Text Available Nosocomial infection among male patients in a public psychiatric hospital was studied and the definitions for use in long-term care facilities were employed for diagnosis. The overall nosocomial infection rate was 6.7 per 1,000 day inpatients; 55.6% of these infections were identified in the respiratory tract, 50% of them being respiratory viral diseases; 38.9% of the nosocomial infections involved the eyes, ears, nose, throat and mouth, and 5.6% involved the skin and soft tissues. The epidemiological characteristics and the main clinical alterations of these inpatients were also identified.Foi estudada a Infecção Hospitalar (IH em pacientes masculinos internados em hospital psiquiátrico público e as definições sugeridas para uso em instituições de longa permanência (ILPs/Long-Term Care Facilities-LTCFs foram utilizadas para diagnóstico das IH. A taxa global de IH foi de 6,7 por 1000 pacientes-dia, 55,6% das infecções foram identificadas no trato respiratório, sendo que 50% dessas eram viroses respiratórias; 38,9% das IH relacionavam-se aos olhos, ouvidos, nariz, garganta e boca e 5,6% a pele e partes moles. As características epidemiológicas e as principais alterações clínicas desses pacientes também foram identificadas.

  16. Acceptability and efficacy of intra-rectal quinine alkaloids as a pre-transfer treatment of non-per os malaria in peripheral health care facilities in Mopti, Mali

    Directory of Open Access Journals (Sweden)

    Sacko Massambou

    2007-05-01

    Full Text Available Abstract Background The acceptability and efficacy of a new kit with a new formulation of quinine alkaloids designed for the intra-rectal administration in the treatment of non-per os malaria was assessed in the peripheral health care system of Mopti, Mali. Methods A single-arm trial was conducted from August 2003 to January 2004. An initial dose of diluted quinine alkaloids (20 mg/kg Quinimax® was administered by the intra-rectal route to children with presumptive non per-os malaria at six peripheral heath care centres. The children were then referred to two referral hospitals where standard inpatient care including intravenous route were routinely provided. A malaria thick smear was done at inclusion and a second malaria thick smear after arrival at the referral facility, where a more complete clinical examination and laboratory testing was done to confirm diagnosis. Confirmed cases of severe malaria or others diseases were treated according to national treatment guidelines. Cases of non per-os malaria received a second dose of intra rectal quinine alkaloids. Primary outcome was acceptability of the intra rectal route by children and their parents as well as the ease to handle the kit by health care workers. Results The study included 134 children with a median age of 33 months and 53.7% were male. Most of the children (67% and 92% of parents or guardians readily accepted the intra-rectal route; 84% of health care workers found the kit easy to use. At the peripheral health care centres, 32% of children had a coma score ≤ 3 and this was reduced to 10% at the referral hospital, following one dose of intra-rectal quinine alkaloids (IRQA. The mean time to availability of oral route treatment was 1.8 ± 1.1 days. Overall, 73% of cases were confirmed severe malaria and for those the case fatality rate was 7.2%. Conclusion IRQA was well accepted by children, their parents/guardians and by the health workers at peripheral health facilities in Mopti

  17. 探索养老服务设施规划的“浦东模式”%The Research on the New-type for Aged Care Facilities Planning in Shanghai Pudong

    Institute of Scientific and Technical Information of China (English)

    罗翔; 严己

    2013-01-01

      人口老龄化趋势对城市规划工作提出挑战。以浦东新区养老服务设施规划为例,探讨大都市发展养老设施的新模式:在借鉴国内外经验和调查老年日常行为和需求分析基础上,探索符合浦东实际的养老设施体系和规划指标,以及空间布局方案和实施策略;并对浦东模式的内涵进行解析,提出进一步完善养老设施规划的若干思考。%Urban planning is now facing the chal enge of trend of population aging. In the case of aged care facilities planning in Shanghai Pudong, the paper explores a new model of development facilities for the elderly by studying the experiences from home and abroad, and surveying behavioral ways of the elderly&needs analysis based, proposes the actual pension systems and facilities planning targets for Pudong, also as spatial layout and implementation strategies;furthermore parses the meanings of Pudong model and improves the next thinkings.

  18. Putting the 'care' back into aged care.

    Science.gov (United States)

    Beadnell, Cathy

    2006-04-01

    Aged care is well and truly back on the political agenda in Australia. While the mainstream media has recently exposed a number of horrific cases of alleged abuse in aged care facilities it has done little to highlight the failings of social policy over time or to foster debate on how to improve the care of older Australians. What are the barriers to providing safe and quality aged care to a growing number of our citizens and how do we overcome them? If you relied on the recent media coverage for your impression of aged care you could be forgiven for thinking it is all bad news. But there are facilities providing high quality care and stories of nurses working wonders in the face of adversity. Cathy Beadnell considers some of the broader cultural and workforce issues in aged care.

  19. Stretching: Does It Help?

    Science.gov (United States)

    Vardiman, Phillip; Carrand, David; Gallagher, Philip M.

    2010-01-01

    Stretching prior to activity is universally accepted as an important way to improve performance and help prevent injury. Likewise, limited flexibility has been shown to decrease functional ability and predispose a person to injuries. Although this is commonly accepted, appropriate stretching for children and adolescents involved with sports and…

  20. Profile: parents help themselves.

    Science.gov (United States)

    Woods, G E

    1981-01-01

    A short account is given of a voluntary organization, PACE, formed by parents of young handicapped children in Leeds. PACE provides friendship and help to other parents, arranges the toy library, riding for the disabled and other activities for the children. It also raises money that is needed for special projects.

  1. Self-Help Experiences

    Science.gov (United States)

    Woody, Robert H.

    1973-01-01

    The author believes that there is a distinct need for professionals to become competent in providing materials for self-help lay efforts. Colleges and universities must provide for the facilitation of personal growth through self administered procedures by either a clinical approach (in counseling centers) or a didactic one (in classes as, for…

  2. You Can Help, Too

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Beijing starts recruiting volunteers for the 2008 Olympic Games A recruitment drive for 100,000 Olympic volunteers aimed at helping Chinese people and foreigners get involved in the 2008 Games was officially launched on August 28 in Beijing. Organizers say that applications are expected to start flooding in from around the city, while mainland applicants from outside Beijing can apply for positions start-

  3. Help for Stressed Students

    Science.gov (United States)

    Pope, Denise Clarke; Simon, Richard

    2005-01-01

    The authors argue that increased focus and pressure for high academic achievement, particularly among more highly-motivated and successful students, may have serious negative consequences. They present a number of strategies designed to help reduce both causes and consequences associated with academic stress and improve students' mental and…

  4. Ecological risks of home and personal care products in the riverine environment of a rural region in south China without domestic wastewater treatment facilities

    NARCIS (Netherlands)

    Zhang, N.; Liu, Y.; Brink, van den P.J.; Price, O.R.; Ying, G.G.

    2015-01-01

    Home and personal care products (HPCPs) including biocides, benzotriazoles (BTs) and ultraviolet (UV) filters are widely used in our daily life. After use, they are discharged with domestic wastewater into the receiving environment. This study investigated the occurrence of 29 representative HPCPs,

  5. Dying and Death: Helping Children Cope.

    Science.gov (United States)

    Ledezma, Melissa L.

    This paper suggests strategies for helping children understand death. The early experiences of childhood build the foundation on which the child establishes a healthy orientation towards life and living. Grieving parents are often so upset by their own loss that they do not carefully explain death to their children. Parents may feel that the child…

  6. A guide to help children understand cancer

    Science.gov (United States)

    ... what you tell your child will help your child face cancer. Explaining things honestly at the right level for ... Other ways to talk to your child about cancer: Practice what you ... your child. Ask your child's health care provider for advice ...

  7. Three Approaches to Helping Students at Risk.

    Science.gov (United States)

    Harper, Doris; And Others

    1993-01-01

    Describes three approaches to helping students at risk: (1) a 30-week program to provide adults with basic proficiency in written and spoken English, problem-solving techniques, computer software, and teamwork skills; (2) motivating students by caring about them and creating a positive classroom environment; and (3) communicating effectively with…

  8. Perceptions of users and providers on barriers to utilizing skilled birth care in mid- and far-western Nepal: a qualitative study

    Directory of Open Access Journals (Sweden)

    Sharad Onta

    2014-08-01

    Full Text Available Background: Although skilled birth care contributes significantly to the prevention of maternal and newborn morbidity and mortality, utilization of such care is poor in mid- and far-western Nepal. This study explored the perceptions of service users and providers regarding barriers to skilled birth care. Design: We conducted 24 focus group discussions, 12 each with service users and service providers from different health institutions in mid- and far-western Nepal. All discussions examined the perceptions and experiences of service users and providers regarding barriers to skilled birth care and explored possible solutions to overcoming such barriers. Results: Our results determined that major barriers to skilled birth care include inadequate knowledge of the importance of services offered by skilled birth attendants (SBAs, distance to health facilities, unavailability of transport services, and poor availability of SBAs. Other barriers included poor infrastructure, meager services, inadequate information about services/facilities, cultural practices and beliefs, and low prioritization of birth care. Moreover, the tradition of isolating women during and after childbirth decreased the likelihood that women would utilize delivery care services at health facilities. Conclusions: Service users and providers perceived inadequate availability and accessibility of skilled birth care in remote areas of Nepal, and overall utilization of these services was poor. Therefore, training and recruiting locally available health workers, helping community groups establish transport mechanisms, upgrading physical facilities and services at health institutions, and increasing community awareness of the importance of skilled birth care will help bridge these gaps.

  9. American Academy of Pediatrics: Health care for children and adolescents in the juvenile correctional care system.

    Science.gov (United States)

    2001-04-01

    Over the past decade, there has been a dramatic increase in the population of juvenile offenders in the United States. Juveniles detained or confined in correctional care facilities have been shown to have numerous health problems. Such conditions may have existed before incarceration; may be closely associated with legal problems; may have resulted from parental neglect, mental health disorders, or physical, drug, or sexual abuse; or may develop within the institutional environment. Delinquent youths are often disenfranchised from traditional health care services in the community. For these adolescents, health care provided through correctional services may be their major source of health services. Pediatricians and correctional health care systems have an opportunity and responsibility to help improve the health of this underserved and vulnerable group of adolescents.

  10. Hinder, More Than Help

    Institute of Scientific and Technical Information of China (English)

    余习榜

    2008-01-01

    @@ Ladies and gentlemen, I'm honored to stand here on behalf of my school to share my experiences and opinions with you. Some people say that our mother ton-gue is of great help to our learning English. However, for my point of view, too much use of Chinese will definitely exert nega-tive effects and tend to hinder the learning progress.

  11. A Little Help

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    More government changes needed to clarify role of NGOs in China As China's first NGOs to receive state funding embark on a pilot program to help poverty-stricken villages, experts say the work of aid groups in a country trying to ease a significant rich-poor divide remains hamstrung by regulations and bureaucracy. In February, the China Foundation for Poverty Alleviation (CFPA) announced that

  12. Understanding the information dynamics of medication administration in residential aged care facilities (RACFs): a prerequisite for design of effective ICT systems.

    Science.gov (United States)

    Tariq, Amina; Georgiou, Andrew; Westbrook, Johanna

    2013-01-01

    Medication information is a critical part of the information required to ensure residents' safety in the highly collaborative care context of RACFs. Studies report poor medication information as a barrier to improve medication management in RACFs. Research exploring medication work practices in aged care settings remains limited. This study aimed to identify contextual and work practice factors contributing to breakdowns in medication information exchange in RACFs in relation to the medication administration process. We employed non-participant observations and semi-structured interviews to explore information practices in three Australian RACFs. Findings identified inefficiencies due to lack of information timeliness, manual stock management, multiple data transcriptions, inadequate design of essential documents such as administration sheets and a reliance on manual auditing procedures. Technological solutions such as electronic medication administration records offer opportunities to overcome some of the identified problems. However these interventions need to be designed to align with the collaborative team based processes they intend to support.

  13. Perioperative Care of Prisoners: Providing Safe Care.

    Science.gov (United States)

    Smith, Francis Duval

    2016-03-01

    Correctional nurses are trained to care for prisoners in a controlled security environment; however, when a convict is transferred to a noncorrectional health care facility, the nurses there are often unfamiliar with custody requirements or how to safely care for these patients. The care of prisoners outside of prison has not been adequately investigated, and a gap exists between research and nursing education and practice. Nurses rarely have to consider how providing care for a prisoner in custody affects their practice, the potential dissonance between routine nursing care and the requirements to maintain security, or that care of prisoners in unsecured clinical areas places the nurse and other personnel at risk for physical assault or prisoner escape. Educating perioperative nurses in the care of prisoners in a public hospital environment is important for the provision of safe care and prevention of physical and emotional repercussions to personnel.

  14. Availability, utilisation and quality of maternal and neonatal health care services in Karamoja region, Uganda: a health facility-based survey

    OpenAIRE

    Wilunda, Calistus; Oyerinde, Koyejo; Putoto, Giovanni; Lochoro, Peter; Dall’Oglio, Giovanni; Manenti, Fabio; Segafredo, Giulia; Atzori, Andrea; Criel, Bart; Panza, Alessio; Quaglio, Gianluca

    2015-01-01

    Background Maternal mortality is persistently high in Uganda. Access to quality emergency obstetrics care (EmOC) is fundamental to reducing maternal and newborn deaths and is a possible way of achieving the target of the fifth millennium development goal. Karamoja region in north-eastern Uganda has consistently demonstrated the nation’s lowest scores on key development and health indicators and presents a substantial challenge to Uganda’s stability and poverty eradication ambitions. The objec...

  15. Acceptance of screening for Intimate Partner Violence, actual screening and satisfaction with care amongst female clients visiting a health facility in Kano, Nigeria

    Science.gov (United States)

    Lawoko, Stephen; Oluwatosin, Abimbola

    2011-01-01

    Abstract Background Healthcare providers have advocated for the screening and management of Intimate Partner Violence (IPV) against women and its consequences. Unfortunately, data from high income countries suggest that women may have varied preferences for being screened for IPV in healthcare. Although women's preference for screening in sub-Saharan countries has not been well researched, IPV remains an accepted societal norm in many of these countries, including Nigeria. Objective The objective of the study was to assess women's acceptance of screening for IPV in healthcare, the extent to which inquiry about IPV was carried out in healthcare and whether such inquiry impacted on satisfaction with care. Method Data on these variables were gathered through structured interviews from a sample of 507 women at a regional hospital in Kano, Nigeria. The study design was cross-sectional. Results The results found acceptance for screening in the sample to be high (76%), but few women (7%) had actually been probed about violence in their contact with care providers. Acceptance for screening was associated with being married and being employed. Actual screening was associated with ethnicity and religion, where ethnic and religious majorities were more likely to be screened. Finally, being screened for IPV seemed to improve satisfaction with care. Conclusion The findings demonstrate the need for adaptation of a screening protocol that is also sensitive to detect IPV amongst all ethnic and religious groups. The findings also have implications for further education of socio-economically disadvantaged women on the benefits of screening.

  16. Assessing the efficacy of the healthy eating and lifestyle programme (HELP compared with enhanced standard care of the obese adolescent in the community: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Christie Deborah

    2011-11-01

    Full Text Available Abstract Background The childhood obesity epidemic is one of the foremost UK health priorities. Childhood obesity tracks into adult life and places individuals at considerable risk for diabetes, cardiovascular disease, liver disease and other morbidities. There is widespread need for paediatric lifestyle programmes as change may be easier to accomplish in childhood than later in life. Study Design/Method The study will evaluate the management of adolescent obesity by conducting a Medical Research Council complex intervention phase III efficacy randomised clinical trial of the Healthy Eating Lifestyle Programme within primary care. The study tests a community delivered multi-component intervention designed for adolescents developed from best practice as identified by National Institute for Health and Clinical Excellence. The hospital based pilot reduced body mass index and improved health-related quality of life. Subjects will be individually randomised to receiving either the Healthy Eating Lifestyle Programme (12 fortnightly family sessions or enhanced standard care. Baseline and follow up assessments will be undertaken blind to allocation status. A health economic evaluation is also being conducted. 200 obese young people (13-17 years, body mass index > 98th centile for age and sex will be recruited from primary care within the greater London area. The primary hypothesis is that a motivational and solution-focused family-based weight management programme delivered over 6 months is more efficacious in reducing body mass index in obese adolescents identified in the community than enhanced standard care. The primary outcome will be body mass index at the end of the intervention, adjusted for baseline body mass index, age and sex. The secondary hypothesis is that the Healthy Eating Lifestyle Programme is more efficacious in improving quality of life and psychological function and reducing waist circumference and cardiovascular risk factors in

  17. Performance assessment through pre- and post-training evaluation of continuing medical education courses in prevention and management of cardio-vascular diseases in primary health care facilities of Armenia.

    Science.gov (United States)

    Khachatryan, Lilit; Balalian, Arin

    2013-12-01

    To assess the difference of pre- and post-training performance evaluation of continuing medical education (CME) courses in cardio-vascular diseases (CVD) management among physicians at primary health care facilities of Armenian regions we conducted an evaluation survey. 212 medical records were surveyed on assessment of performance before and after the training courses through a self-employed structured questionnaire. Analysis of survey revealed statistically significant differences (p evaluation of performance assessment may be explained by improved and interactive training modes, more advanced methods of demonstration of modeling. Current findings may serve a basis for future planning of CME courses for physicians of remote areas facing challenges in upgrading their knowledge, as well as expand the experience of performance assessment along with evaluation of knowledge scores.

  18. 42 CFR 483.25 - Quality of care.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Quality of care. 483.25 Section 483.25 Public...) STANDARDS AND CERTIFICATION REQUIREMENTS FOR STATES AND LONG TERM CARE FACILITIES Requirements for Long Term Care Facilities § 483.25 Quality of care. Each resident must receive and the facility must provide...

  19. Corona helps curb losses

    Energy Technology Data Exchange (ETDEWEB)

    Laasonen, M.; Lahtinen, M.; Lustre, L.

    1996-11-01

    The greatest power losses in electricity transmission arise through a phenomenon called load losses. Corona losses caused by the surface discharge of electricity also constitute a considerable cost item. IVS, the nationwide network company, is investigating corona- induced losses, and has also commissioned similar research from IVO International, the Technical Research Centre of Finland (VTT) and from Tampere University of Technology. The research work strives to gain more in-depth knowledge on the phenomenon of frosting and its impact on corona losses. The correct prediction of frost helps reduce corona losses, while also cutting costs considerably. (orig.)

  20. Acceptance of screening for Intimate Partner Violence, actual screening and satisfaction with care amongst female clients visiting a health facility in Kano, Nigeria

    Directory of Open Access Journals (Sweden)

    Ime A. John

    2011-02-01

    Full Text Available Background: Healthcare providers have advocated for the screening and management of Intimate Partner Violence (IPV against women and its consequences. Unfortunately, data from high income countries suggest that women may have varied preferences for being screened for IPV in healthcare. Although women’s preference for screening in sub-Saharan countries has not been well researched, IPV remains an accepted societal norm in many of these countries, including Nigeria.Objective: The objective of the study was to assess women’s acceptance of screening for IPV in healthcare, the extent to which inquiry about IPV was carried out in healthcare and whether such inquiry impacted on satisfaction with care.Method: Data on these variables were gathered through structured interviews from a sample of 507 women at a regional hospital in Kano, Nigeria. The study design was cross-sectional.Results: The results found acceptance for screening in the sample to be high (76%, but few women (7% had actually been probed about violence in their contact with care providers. Acceptance for screening was associated with being married and being employed. Actual screening was associated with ethnicity and religion, where ethnic and religious majorities were more likely to be screened. Finally, being screened for IPV seemed to improve satisfaction with care.Conclusion: The findings demonstrate the need for adaptation of a screening protocol that is also sensitive to detect IPV amongst all ethnic and religious groups. The findings also have implications for further education of socio-economically disadvantaged women on the benefits of screening.