WorldWideScience

Sample records for case management home

  1. Case management considerations of progressive dementia in a home setting.

    Science.gov (United States)

    Pierce, Mary Ellen

    2010-01-01

    Nursing theory, research, and best practice guidelines contribute substantially to the field of dementia care. Interventional plans are challenged most by those dementias considered progressive and deteriorative in nature, requiring ongoing reassessment and modification of care practices as the clinical course changes. The purpose of this article is to provide guidelines for case managers in the development of effective, individualized care plans for clients with progressive dementia residing in a home setting. The application of these guidelines is illustrated through the presentation of an actual case. The practice setting is a private home in the Pacific Northwest. Geriatric case management is provided by an RN case manager. Progressive dementia presents challenges to home care. Professional case management using comprehensive, holistic assessment, collaborative approaches, and best practice fundamentals serve to create an effective, individualized plan of care. The increasing geriatric population presents great opportunities for case managers in strategic management for creating successful home care models in clients with progressive dementia. Use of nursing diagnoses, dementia research, and collaborative approaches with families and other medical providers creates a viable alternative for clients with progressive dementia.

  2. Case management approaches to home support for people with dementia.

    Science.gov (United States)

    Reilly, Siobhan; Miranda-Castillo, Claudia; Malouf, Reem; Hoe, Juanita; Toot, Sandeep; Challis, David; Orrell, Martin

    2015-01-05

    Over 35 million people are estimated to be living with dementia in the world and the societal costs are very high. Case management is a widely used and strongly promoted complex intervention for organising and co-ordinating care at the level of the individual, with the aim of providing long-term care for people with dementia in the community as an alternative to early admission to a care home or hospital. To evaluate the effectiveness of case management approaches to home support for people with dementia, from the perspective of the different people involved (patients, carers, and staff) compared with other forms of treatment, including 'treatment as usual', standard community treatment and other non-case management interventions. We searched the following databases up to 31 December 2013: ALOIS, the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group,The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS, Web of Science (including Science Citation Index Expanded (SCI-EXPANDED) and Social Science Citation Index), Campbell Collaboration/SORO database and the Specialised Register of the Cochrane Effective Practice and Organisation of Care Group. We updated this search in March 2014 but results have not yet been incorporated. We include randomised controlled trials (RCTs) of case management interventions for people with dementia living in the community and their carers. We screened interventions to ensure that they focused on planning and co-ordination of care. We used standard methodological procedures as required by The Cochrane Collaboration. Two review authors independently extracted data and made 'Risk of bias' assessments using Cochrane criteria. For continuous outcomes, we used the mean difference (MD) or standardised mean difference (SMD) between groups along with its confidence interval (95% CI). We applied a fixed- or random-effects model as appropriate. For binary or dichotomous data, we generated the corresponding odds

  3. Managing radical innovation: The case of the Home Communication Concept

    DEFF Research Database (Denmark)

    Madsen, Arne Stjernholm; Ulhøi, John Parm

    2002-01-01

    This case addresses the Home Communication Concept (HCC) and represents the response of a major ICT manufacturer to the reshaping of the telecom market, paved by Internet technology. The project is described from its start in summer 1997 to the end of 2001. This is a unique case study in more than...... one respect. The first author followed the project very closely during his employment in a new Business Development Department (BDD) at Ericsson Denmark. Secondly, the study covers all phases and aspects, from inception to field trials. Thirdly, it represents a radical innovation, based...... on a disruptive technology (Internet technology), which transcends the traditional business of the company in question. The paper describes the entire project and tries to present it within a framework capable of analysing the actual events. In this respect, it not only demonstrates the classical dilemma...

  4. Vesper Home Care Alzheimer Case Management and In-Home Respite Program, September 1, 1985-August 30, 1986.

    Science.gov (United States)

    Rosenheimer, Lilia

    This document describes the Alzheimer Case Management and In-Home Respite Program begun in 1985 in California. Training provided to nurses and selected homemakers in the program is discussed and sources of referrals are identified. Initial nursing visits which involved physical and behavioral assessment of the patient and discussions with stressed…

  5. The political economy of a public health case management program's transition into medical homes.

    Science.gov (United States)

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.

  6. Managing menopause at home

    Science.gov (United States)

    ... or supplements. Eat high calcium foods, such as cheese, leafy green vegetables, low-fat milk and other ... unable to manage your symptoms of menopause with home care only. Also call if you have any ...

  7. Community referral in home management of malaria in western Uganda: A case series study

    Directory of Open Access Journals (Sweden)

    Nsungwa-Sabiiti Jesca

    2006-03-01

    Full Text Available Abstract Background Home Based Management of fever (HBM was introduced as a national policy in Uganda to increase access to prompt presumptive treatment of malaria. Pre-packed Chloroquine/Fansidar combination is distributed free of charge to febrile children Methods A case-series study was performed during 20 weeks in a West-Ugandan sub-county with an under-five population of 3,600. Community drug distributors (DDs were visited fortnightly and recording forms collected. Referred children were located and primary caretaker interviewed in the household. Referral health facility records were studied for those stating having completed referral. Results Overall referral rate was 8% (117/1454. Fever was the main reason for mothers to seek DD care and for DDs to refer. Twenty-six of the 28 (93% "urgent referrals" accessed referral care but 8 (31% delayed >24 hours. Waiting for antimalarial drugs to finish caused most delays. Of 32 possible pneumonias only 16 (50% were urgently referred; most delayed ≥ 2 days before accessing referral care. Conclusion The HBM has high referral compliance and extends primary health care to the communities by maintaining linkages with formal health services. Referral non-completion was not a major issue but failure to recognise pneumonia symptoms and delays in referral care access for respiratory illnesses may pose hazards for children with acute respiratory infections. Extending HBM to also include pneumonia may increase prompt and effective care of the sick child in sub-Saharan Africa.

  8. The Lifestyle Engagement Activity Program (LEAP): Implementing Social and Recreational Activity into Case-Managed Home Care.

    Science.gov (United States)

    Low, Lee-Fay; Baker, Jessica Rose; Harrison, Fleur; Jeon, Yun-Hee; Haertsch, Maggie; Camp, Cameron; Skropeta, Margaret

    2015-12-01

    The Lifestyle Engagement Activity Program (LEAP) incorporates social support and recreational activities into case-managed home care. This study's aim was to evaluate the effect of LEAP on engagement, mood, and behavior of home care clients, and on case managers and care workers. Quasi-experimental. Five Australian aged home care providers, including 2 specializing in care for ethnic minorities. Clients (n = 189) from 5 home care providers participated. The 12-month program had 3 components: (1) engaging support of management and staff; (2) a champion to drive practice change; (3) staff training. Case managers were trained to set meaningful social and/or recreational goals during care planning. Care workers were trained in good communication, to promote client independence and choice, and in techniques such as Montessori activities, reminiscence, music, physical activity, and humor. Data were collected 6 months before program commencement, at baseline, and 6 and 12 months. The Homecare Measure of Engagement Staff report and Client-Family interview were primary outcomes. Secondary outcomes were the Cohen-Mansfield Agitation Inventory; apathy, dysphoria, and agitation subscales of the Neuropsychiatric Inventory-Clinician Rating; the geriatric depression scale; UCLA loneliness scale; and home care satisfaction scale. Staff provided information on confidence in engaging clients and the Utrecht Work Engagement Scale. Twelve months after program commencement, clients showed a significant increase in self- or family-reported client engagement (b = 5.39, t[113.09] = 3.93, P .05). Client and family self-rated apathy increased over 12 months (b = 0.04, t(43.36) = 3.06, P = .004; b = 3.63, t(34.70) = 2.20, P = .035) CONCLUSIONS: LEAP demonstrated that home care providers can incorporate social and recreational care into usual practice for older clients, and that this benefits clients' engagement, dysphoria, and agitation. Copyright © 2015 AMDA – The Society for Post

  9. Design and application of a theory-based case/care management model for home care: advanced practice for nurses as care managers.

    Science.gov (United States)

    Sears, Nancy A

    2002-01-01

    Case management has developed in a variety of health care, social service, and insurance industries. Its historical pattern of development has resulted in practices that are generally administrative and technical in nature as well as being relatively generic and often undifferentiated between being a role and process. Research over the last decade has resulted in the opportunity to move case management practice for home care into a structured theory-based model and practice. Design and implementation of a specialized advanced practice care management model reflective of care management research and theory design by British researchers is beginning to show clinical and systemic results that should be replicable in other regions.

  10. Case management.

    Science.gov (United States)

    Woodward, Judy; Rice, Eve

    2015-03-01

    Health care in the United States is changing rapidly under pressure from both political and professional stakeholders, and one area on the front line of required change is the discipline of case management. Historically, case management has worked to defragment the health care delivery system for clients and increase access to health care. Case management will have an expanded role resulting from Affordable Care Act initiatives to improve health care. This article includes definitions of case management, current issues related to case management, case management standards of practice, and a case study of the management of pediatric chronic disease. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. [Management of Uninhabitable Homes - Investigation of 186 Cases of Hoarding, Domestic Neglect and Squalor in Dortmund (Germany)].

    Science.gov (United States)

    Lenders, T; Kuster, J; Bispinck, R

    2015-12-01

    To develop an intervention concept for the management of uninhabitable homes. Retrospective analysis of 186 cases of the community mental health service in Dortmund (Germany) presenting with a destitute situation of the domestic environment as core problem. All patients suffered from psychiatric illnesses, mainly from addiction (F1: 41 %), psychosis (F2: 17 %), depression (F3: 17 %), and hoarding disorder (F63.8: 12 %). Main socio-demographic characteristics of our sample are: middle age (45-65 years, 48 %), male gender (73 %), isolated situation (only 7 % married, 84 % living alone), normal schooling (only 4 % without completion of schooling, 7 % attended a school for special needs), after initial integration into employment nearly all patients suffered vocational disintegration (5 % employed, 44 % unemployment benefit, 7 % welfare, 39 % pension or invalidity benefit).Psychosocial interventions differed between the 4 main diagnostic groups: F1: treatment of dependence (rehab) and treatment of concomitant somatic diseases; F2: admission to a psychiatric hospital and implementation of guardianship; F3: mediation of conflicts with neighbours/landlords and implementation of guardianship; F63.8: direct practical help by members of the community mental health team and organisation of home help/waste disposal. In all diagnostic groups, acceptance of help was impaired due to social withdrawal, resistance and psychiatric symptoms. At 13 %, compliance with help and interventions was lowest in the hoarder group (F1: 27 %, F2: 26 %, F3: 38 %). Consequently, in this group the poor outcome categories "nothing accomplished" and "lost flat/eviction" were more frequent (44 %, F1: 27 %, F2: 26 %, F3: 38 %). Concurrent to the deterioration of the domestic situation, patients suffer vocational disintegration as well as family and social isolation. Uninhabitable homes occur in the course of various severe and chronic psychiatric diseases

  12. Home audit program: management manual

    Energy Technology Data Exchange (ETDEWEB)

    1980-09-01

    Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)

  13. The process of decision-making in home-care case management: implications for the introduction of universal assessment and information technology.

    Science.gov (United States)

    Egan, Mary; Wells, Jennie; Byrne, Kerry; Jaglal, Susan; Stolee, Paul; Chesworth, Bert M; Hillier, Loretta M

    2009-07-01

    Increasingly, jurisdictions are adopting universal assessment procedures and information technology to aid in healthcare data collection and care planning. Before their potential can be realised, a better understanding is needed of how these systems can best be used to support clinical practice. We investigated the decision-making process and information needs of home-care case managers in Ontario, Canada, prior to the widespread use of universal assessment, with a view of determining how universal assessment and information technology could best support this work. Three focus groups and two individual interviews were conducted; questioning focused on decision-making in the post-acute care of individuals recovering from a hip fracture. We found that case managers' decisional process was one of a clinician-broker, combining clinical expertise and information about local services to support patient goals within the context of limited resources. This process represented expert decision-making, and the case managers valued their ability to carry out non-standardised interviews and override system directives when they noted that data may be misleading. Clear information needs were found in four areas: services available outside of their regions, patient medical information, patient pre-morbid functional status and partner/spouse health and functional status. Implications for the use of universal assessment are discussed. Recommendations are made for further research to determine the impact of universal assessment and information technology on the process and outcome of home-care case manager decision-making.

  14. Alert management for home healthcare based on home automation analysis.

    Science.gov (United States)

    Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

    2010-01-01

    Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.

  15. Case Study of Home-School Visits

    Science.gov (United States)

    Aguerrebere, Yolanda

    2009-01-01

    This case study evaluated one site of a California teacher home visit program. Home visits have been an important means of connecting families and schooling. In 1999, California inaugurated a statewide home visit program to promote effective partnership between home and school for low-achieving schools. At this site, families in 3 kindergarten…

  16. Development and Evaluation of Self-Management and Task-Oriented Approach to Rehabilitation Training (START) in the Home: Case Report.

    Science.gov (United States)

    Richardson, Julie; DePaul, Vincent; Officer, Alexis; Wilkins, Seanne; Letts, Lori; Bosch, Jackie; Wishart, Laurie

    2015-06-01

    The incidence of stroke and subsequent level of disability will increase, as age is the greatest risk factor for stroke and the world's population is aging. Hospital admissions are too brief for patients to regain necessary function. Research to examine therapy delivered within the home environment has the potential to expedite relearning of function and reduce health care expenditures. This case report describes the use of the knowledge-to-action cycle (KTA) to develop and evaluate an evidence-based approach for rehabilitation in the home that incorporates self-management and task-oriented functional training (TOFT) for people with stroke. The KTA cycle was used to guide adaptation of evidence from self-management and TOFT into an approach titled START (Self-Management and Task-Oriented Approach to Rehabilitation Training). Three stakeholder symposiums identified barriers and supports to implementation. Clinical practice leaders were engaged as partners in the development of the intervention. An online learning management system housed the resources to support therapist training. Therapist focus groups were conducted and stroke outcomes were used to assess patient response. Eight therapists completed 4 workshops and applied the home intervention in 12 people with stroke. A mentoring process for therapists included feedback from peers and experts after viewing treatment videos. Therapist response was determined from the focus groups; patient response was measured by standardized assessments. The therapists noted that the intervention was easier to implement with patients who were motivated and had minimal cognitive impairment. The KTA cycle provided a structure for the development of this evidence-based rehabilitation intervention, which was feasible to implement in the home. Further evaluation needs to be undertaken to assess the effectiveness of START. © 2015 American Physical Therapy Association.

  17. Smart Home Energy Management Based on Zigbee

    OpenAIRE

    E.Mallikarjuna

    2015-01-01

    Today organizations use IEEE 802.15&Zigbee to effectively deliver solutions for a variety of areas including consumer electronic device control, energy management and efficiency home and commercial building automation as well as industrial plant management. The smart home energy network has gained widespread attentions due to its flexible integrati- ion into everyday life. This next generation green home system transparently unifies various home appliances smart sensors &wireless communicati...

  18. An ethical analysis of a home visit case study.

    Science.gov (United States)

    Pibernat, Artur Dalfó; Vidal, Jessica Rosell; Pibernat, Enric Dalfó; Rodríguez, Francisco Javier Pelegrina; Colomer, Gerard; Cid, Maria Feijoo

    2017-12-01

    This article will explore a clinical case study of a home visit carried out by the case manager nurse. In this case, we will discuss the dilemma of finding the balance between autonomy and beneficence from the perspective of principlist ethics, virtue ethics and the 'ethics of care'. The main conflict in this case study deals with all proposals are unsuitable and it is not necessary for a nurse to pay him a home visit, whereas for the healthcare system it is considered necessary. We could conclude that, during the home visit, the case manager aspires to achieve excellence, and throughout his clinical relationship with Francesc, searches for a series of virtues, respecting certain fundamental principles. In this way, the case managers ensure that Jaume's care is more humanised. The case has been anonymised and confidentiality maintained.

  19. Effects on leisure activities and social participation of a case management intervention for frail older people living at home: a randomised controlled trial.

    Science.gov (United States)

    Granbom, Marianne; Kristensson, Jimmie; Sandberg, Magnus

    2017-07-01

    Frailty causes disability and restrictions on older people's ability to engage in leisure activities and for social participation. The objective of this study was to evaluate the effects of a 1-year case management intervention for frail older people living at home in Sweden in terms of social participation and leisure activities. The study was a randomised controlled trial with repeated follow-ups. The sample (n = 153) was consecutively and randomly assigned to intervention (n = 80) or control groups (n = 73). The intervention group received monthly home visits over the course of a year by nurses and physiotherapists working as case managers, using a multifactorial preventive approach. Data collections on social participation, leisure activities and rating of important leisure activities were performed at baseline, 3, 6, 9 and 12 months, with recruitment between October 2006 and April 2011. The results did not show any differences in favour of the intervention on social participation. However, the intervention group performed leisure activities in general, and important physical leisure activities, to a greater extent than the control group at the 3-month follow-up (median 13 vs. 11, P = 0.034 and median 3 vs. 3, P = 0.031 respectively). A statistically significantly greater proportion of participants from the intervention group had an increased or unchanged number of important social leisure activities that they performed for the periods from baseline to 3 months (93.2% vs. 75.4%, OR = 4.48, 95% CI: 1.37-14.58). Even though statistically significant findings in favour of the intervention were found, more research on activity-focused case management interventions is needed to achieve clear effects on social participation and leisure activities. © 2017 John Wiley & Sons Ltd.

  20. [Useful wound management at home].

    Science.gov (United States)

    Mizuhara, Akihiro; Taguchi, Akemi; Sato, Mikako; Shindo, Kazuko

    2014-12-01

    In wound care, close observation of the quantity and nature of exudate from a wound, and selection of appropriate dressing and/or medication are crucial. Care should be taken to prevent wounds with excessive exudate from becoming too moist. Furthermore, wound care at home must be easy, which is achievable through the use of readily available materials and medications. 1 ) A wound with little to moderate exudate should be treated using wrap therapy with perforated polyethylene sheets. This therapy can be used to treat pressure ulcers, wounds, wounds with slough, and burns. 2 ) An 18-gauge needle can be used to perforate wounds with little exudate, such as mild pressure ulcers or wounds with slough, and polyurethane film can then be applied. 3 ) Polyurethane film should be applied to blisters, pressure ulcers, or similar skin injuries with little exudate. 4 ) A hydrocolloid dressing should be used on wounds with light exudate. 5 ) An ointment containing steroids should be applied to critically colonized wounds. 6 ) Melolin dressings, Moiskin Pads, or a disposable diaper should be used to manage wounds with heavy exudate.

  1. A Novel Home Energy Management System Architecture

    DEFF Research Database (Denmark)

    Rossello Busquet, Ana; Soler, José; Dittmann, Lars

    2011-01-01

    The number of electronic devices found in home environments is increasing, leading to an increase in the energy consumption in users’ premises. Introducing a Home Energy Management System (HEMS) into user residences might provide the necessary tools to reduce and optimize the energy consumption...... in home environments. However, this is not an easy task as devices can use different communication technologies and be manufactured by different producers which can lead to interoperability issues. This paper presents a home gateway designed for a HEMS system that offers interoperability between...... the different devices at the service level and provides the necessary tools to apply energy management strategies....

  2. [Management of infectious diarrhea in nursing homes].

    Science.gov (United States)

    Ferahta, Nabila; Héquet, Delphine; Bizzozzero, Tosca; Major, Kristof; Petignat, Christiane

    2018-04-11

    Infectious diarrheas are of great concern in nursing homes and can engender outbreaks. Their importance in terms of morbidity, mortality and health economics justify the implementation of prevention and control measures. Although past studies emphasize the importance of infectious diarrheas occurring during hospitalization, data on nursing homes epidemiology remain scarce. This article is founded on recent data of the literature, on recommendations for the management of infectious diarrheas and for prevention and control of outbreaks in nursing homes.

  3. Managing Food Allergies at Home

    Science.gov (United States)

    ... to Give Special Events FARE Store Food Allergy Heroes Walk Hometown Heroes Community Walk Team FARE Ways to Connect Food ... And Don'ts See All Resources Talking to Children About Their Food Allergy Creating a safe home ...

  4. Managing performance based building of smart homes

    NARCIS (Netherlands)

    Vlies, R.D. van der; Maas, G.J.

    2010-01-01

    Smart homes are considered a vital technology in an aging society as they compensate for a shortage in care workers. However, often smart homes do not perform well. Performance management is well known in the manufacturing industry but not common in the building industry. The performance approach is

  5. Home Care Nursing Improves Cancer Symptom Management

    Science.gov (United States)

    Home care nursing (HCN) improves the management of symptoms in breast and colorectal cancer patients who take the oral chemotherapy drug capecitabine, according to a study published online November 16 in the Journal of Clinical Oncology.

  6. [Reducing the Care-Related Burdens of a Family Caregiver of a Person With Mild Cognitive Impairment: A Home-Based Case Management Program].

    Science.gov (United States)

    Chen, Min-Chia; Chiu, Yi-Chen; Wei, Pi-Mei; Hsu, Wen-Chuin

    2017-06-01

    The long-term care of cognitively impaired patients with concomitant behavioral problems brings great stress and burdens to family caregivers. The present article describes a family caregiver with multiple chronic diseases who concurrently shouldered primary care responsibilities for her husband, a patient with mild cognitive impairment, problematic behaviors, and medication non-adherence issues. The period of care was between September 23rd and December 29th, 2015. Data on physiological, psychological, and social burdens were collected based on a stress process model for family caregiving. We then applied a home-based, individually tailored intervention, which included nursing education, skills training, listening/counseling, and resource connecting, that effectively helped the family caregiver reduce her burdens. Our assessment identified nursing-care-related problems as the primary source of caregiver burden in this case, with identified stressors including a lack of knowledge regarding patient care, medication management problems, sleep disorders, and inadequate social resources. Using continuous care interactions, we established a trust relationship with the family caregiver, prioritized her needs, and provided dementia care knowledge and skills, which gradually improved her caregiving competence. Our instruction included increasing caregiver understanding of the disease course of dementia, related problematic behaviors, and medication management. Our intervention enhanced the disease awareness of the caregiver and helped her become more positive about her caregiving tasks. Therefore, the negative impacts on her family were reduced. Social support and long-term care resources further reduced her burden and improved her quality of life.

  7. Leadership philosophy of care home managers.

    Science.gov (United States)

    Rippon, Daniel; James, Ian Andrew

    Care home managers have a significant influence on staff morale and care delivery. Training methods underpinned by transformational leadership theory (TLT) have been used successfully to develop leaders in healthcare services. The aim of this preliminary study was to establish which aspects of TLT were apparent in care home managers' philosophies of leadership. A qualitative research design was used and 25 care home managers in the north-east of England took part. Participants were asked to provide their philosophies of leadership by completing a questionnaire; a thematic analysis of the responses was then conducted. Development of philosophy, enablement and interpersonal impact emerged as key themes. The findings suggested that elements of TLT were apparent in the participants' philosophies of leadership. However, the importance of gaining the support of senior management when attempting to apply a philosophy of eadership in practice was lacking. Aspects of TLT, such as supporting frontline employees to engage in education and establishing trust, were embedded in care home managers' philosophies. To develop leadership skills, managers may benefit from training programmes that involve both structured teaching and guided learning through experience.

  8. Sms-Based Home Management System

    Directory of Open Access Journals (Sweden)

    Paing Soe Oo

    2015-08-01

    Full Text Available Mobile phones are widely used nowadays for different application such as wireless control and monitoring due to its availability and ease of use. The implemented system is based on global system mobile GSM network by using short message service SMS. The design mainly contains a GSM modem and Arduino Uno. In this work the system will be described how to manage and control home appliances using mobile phone people can use this system to do things in their home from a far place before they reach home. For instance user may controlmanage hisher home lighting door or water pump which needed in daily life in different area House Office or factory etc. when they are away from home. The user can check the condition in the home that light is on or off door is locked or unlocked water pump is on or off and so on. If the time taken for this appliances to perform a task is known that can also be set so that if the time elapsed the appliance will automatically switch off itself. The control is done by sending a specific SMS messages from smart phone to a SIM900 and Arduino Uno which is connected to the appliance once the message is received the SIM 900 will send the command to a microcontroller in Arduino for controlling the appliance appropriately. Also feedback status of three devices can be requested in designed system.

  9. A Business Case for Home Performance Contracting

    Energy Technology Data Exchange (ETDEWEB)

    Baechler, Michael C.; Antonopoulos, Chrissi A.; Sevigny, Maureen; Gilbride, Theresa L.; Hefty, Marye G.

    2012-10-01

    This report was prepared by PNNL for the DOE Building America program. The report provides information for businesses considering entering the home performance contracting industry. Metrics discussed include industry trends and drivers, specific points of entry, business models, startup costs, and marketing strategies. The report includes detailed analysis of eight businesses around the country that have successfully entered the home performance contracting industry. Data is provided on their financial structures, program participation, marketing efforts, and staff training. This report will be distributed via the DOE Building America website, www.buildingamerica.gov. Individual case studies will also be cleared separately.

  10. Home Environment Service Knowledge Management System

    DEFF Research Database (Denmark)

    Zhang, Jiang; Rossello Busquet, Ana; Soler, José

    2011-01-01

    This paper makes three contributions to assist households to control their home devices in an easy way and to simplify the software installation and configuration processes across multi-vendor environments. First, a Home Environment Service Knowledge Management System is proposed, which is based...... on the knowledge implemented by ontology and uses the inference function of reasoner to find out available software services according to household requests. Second, this paper provides a concrete methodology to exploit and acquire conflict-free information from ontology knowledge by using a reasoner. At last...

  11. Securing a Home Energy Managing Platform

    DEFF Research Database (Denmark)

    Mikkelsen, Søren Aagaard; Jacobsen, Rune Hylsberg

    2016-01-01

    for balancing the electrical grid and a surveillance unit in private homes, security and privacy become essential to address. In this chapter, we identify and address potential threats Home Energy Management Platform (HEMP) developers should consider in the progress of designing architecture, selecting hardware...... and building software. Our approach starts with a general view of the involved stakeholders and the HEMS. Given the system overview, a threat model is constructed from the HEMP developer's point of view. Based on the threats that have been detected, possible mitigation strategies are proposed taking...

  12. Project management case studies

    CERN Document Server

    Kerzner, Harold R

    2013-01-01

    A new edition of the most popular book of project management case studies, expanded to include more than 100 cases plus a ""super case"" on the Iridium Project Case studies are an important part of project management education and training. This Fourth Edition of Harold Kerzner''s Project Management Case Studies features a number of new cases covering value measurement in project management. Also included is the well-received ""super case,"" which covers all aspects of project management and may be used as a capstone for a course. This new edition:Contains 100-plus case studies drawn from re

  13. Dementia Home Care Resources: How Are We Managing?

    Directory of Open Access Journals (Sweden)

    Catherine Ward-Griffin

    2012-01-01

    Full Text Available With the number of people living with dementia expected to more than double within the next 25 years, the demand for dementia home care services will increase. In this critical ethnographic study, we drew upon interview and participant data with persons with dementia, family caregivers, in-home providers, and case managers in nine dementia care networks to examine the management of dementia home care resources. Three interrelated, dialectical themes were identified: (1 finite formal care-inexhaustible familial care, (2 accessible resources rhetoric-Iinaccessible resources reality, and (3 diminishing care resources-increasing care needs. The development of policies and practices that provide available, accessible, and appropriate resources, ensuring equitable, not necessarily equal, distribution of dementia care resources is required if we are to meet the goal of aging in place now and in the future.

  14. Putting Home Data Management into Perspective

    Science.gov (United States)

    2009-12-01

    An Anthropological Study of Television Usage Behaviors. Human Factors and Ergonomics Society 39th Annual Meet- ing, pages 326–330, 1995. 10 [38...advanced networking setups in the home, exploring the management of the physical networks (e.g., wireless routers) installed by the owners themselves...their usage. Pre-study file sharing methods: Before installation of the system, household members primarily used email and physical media to move data

  15. Home management of malaria by care givers of under-five children ...

    African Journals Online (AJOL)

    Background: One of the key interventions proposed under the Roll back malaria initiative is improvement of case management of malaria at the home and community levels to reduce malaria burden. This study was conducted to determine the practice and determinants of Home Management of Malaria (HMM) among care ...

  16. Remote Patient Management for Home Dialysis Patients

    Directory of Open Access Journals (Sweden)

    Eric L. Wallace

    2017-11-01

    Full Text Available Remote patient management (RPM offers renal health care providers and patients with end-stage kidney disease opportunities to embrace home dialysis therapies with greater confidence and the potential to obtain better clinical outcomes. Barriers and evidence required to increase adoption of RPM by the nephrology community need to be clearly defined. Ten health care providers from specialties including nephrology, cardiology, pediatrics, epidemiology, nursing, and health informatics with experience in home dialysis and the use of RPM systems gathered in Vienna, Austria to discuss opportunities for, barriers to, and system requirements of RPM as it applies to the home dialysis patient. Although improved outcomes and cost-effectiveness of RPM have been demonstrated in patients with diabetes mellitus and heart disease, only observational data on RPM have been gathered in patients on dialysis. The current review focused on RPM systems currently in use, on how RPM should be integrated into future care, and on the evidence needed for optimized implementation to improve clinical and economic outcomes. Randomized controlled trials and/or large observational studies could inform the most effective and economical use of RPM in home dialysis. These studies are needed to establish the value of existing and/or future RPM models among patients, policy makers, and health care providers.

  17. Management of Pulmonary Tuberculosis- A Family Case Study ...

    African Journals Online (AJOL)

    Family medicine tools including the Family circle, Family life cycle, Home visits and Family counseling were used in the management of this case. This case emphasizes the need for a thorough contact tracing, family involvement in care, home visits and individualization in the management of pulmonary tuberculosis.

  18. Role for a Labor-Management Partnership in Nursing Home Person-Centered Care

    Science.gov (United States)

    Leutz, Walter; Bishop, Christine E.; Dodson, Lisa

    2010-01-01

    Purpose: To investigate how a partnership between labor and management works to change the organization and focus of nursing home frontline work, supporting a transition toward person-centered care (PCC) in participating nursing homes. Design and Methods: Using a participatory research approach, we conducted case studies of 2 nursing homes…

  19. COMMUNITY BASED HOME ENERGY MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    Muhammad Adnan Aziz

    2017-05-01

    Full Text Available In a Smart Grid (SG scenario, domestic consumers can gain cost reduction benefit by scheduling their Appliance Activation Time (AAT towards the slots of low charge. Minimization in cost is essential in Home Energy Management Systems (HEMS to induce consumers acceptance for power scheduling to accommodate for a Demand Response (DR at peak hours. Despite the fact that many algorithms address the power scheduling for HEMS, community based optimization has not been the focus. This paper presents an algorithm that targets the minimization of energy costs of whole community while keeping a low Peak to Average Ratio (PAR and smooth Power Usage Pattern (PUP. Objective of cost reduction is accomplished by finding most favorable AAT by Particle Swarm Optimization (PSO in conjunction with Inclined Block Rate (IBR approach and Circular Price Shift (CPS. Simulated numerical results demonstrate the effectiveness of CPS to assist the merger of PSO & IBR to enhance the reduction/stability of PAR and cost reduction.

  20. A Novel Web Service Based Home Energy Management System

    DEFF Research Database (Denmark)

    Rossello Busquet, Ana; Soler, José

    2011-01-01

    In the last years energy consumption in the home environments has increased considerably. There is an interest to provide users with means to reduce their energy consumption. Introducing a Home Energy Management System (HEMS) into user residences might provide the necessary tools to reduce...... and optimize the energy consumption in home environments. The main element of HEMS is the home gateway. In this paper, a home gateway suitable for HEMS is presented. The home gateway proposed uses rules to implement the home energy management system. The rules can be downloaded though web services from a rule...... server. Furthermore, web services are used to provide modularity to the home gateway by enabling the deployment of the different logical components into different devices, if necessary....

  1. Designing a Portable and Low Cost Home Energy Management Toolkit

    NARCIS (Netherlands)

    Keyson, D.V.; Al Mahmud, A.; De Hoogh, M.; Luxen, R.

    2013-01-01

    In this paper we describe the design of a home energy and comfort management system. The system has three components such as a smart plug with a wireless module, a residential gateway and a mobile app. The combined system is called a home energy management and comfort toolkit. The design is inspired

  2. Home management of malaria in an academic community ...

    African Journals Online (AJOL)

    Malaria remains one of the world\\'s most devastating diseases, killing millions of people yearly. Home management is an important strategy adopted for the reduction of its fatality. This survey to evaluate home management practices towards malaria among heads of households was undertaken at the residential quarters of ...

  3. Development of home power management system | Apeh | Nigerian ...

    African Journals Online (AJOL)

    This study aimed at the design and development of a prototype Power Management System for home which will enhance energy user behavior for achieving energy consumption efficiency. It allows the user to transfer management of supply to appliances at home to a real time monitoring, switching and control device with ...

  4. A Database Design and Development Case: Home Theater Video

    Science.gov (United States)

    Ballenger, Robert; Pratt, Renee

    2012-01-01

    This case consists of a business scenario of a small video rental store, Home Theater Video, which provides background information, a description of the functional business requirements, and sample data. The case provides sufficient information to design and develop a moderately complex database to assist Home Theater Video in solving their…

  5. BTS Case Study: Prairie Crossing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Brandegee.

    1999-03-08

    More than three hundred homes are being built in a northwest Chicago suburb that demonstrate the whole house design concept. The homes cost approximately the same as competitive houses of the same size but use approximately 50% less energy for heating and cooling.

  6. BTS Case Study: Prairie Crossing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Brandegee

    1999-03-08

    More than three hundred homes are being built in a northwest Chicago suburb that demonstrate the ''whole house'' design concept. The homes cost approximately the same as competitive houses of the same size but use approximately 50% less energy for heating and cooling.

  7. Quality Assurance Strategy for Existing Homes. Final Quality Management Primer for High Performing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Del Bianco, M. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Taggart, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Sikora, J. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States); Wood, A. [NAHB Research Center Industry Partnership, Upper Marlboro, MD (United States)

    2012-12-01

    This guide is designed to help Building America (BA) teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

  8. Quality Assurance Strategy for Existing Homes: Final Quality Management Primer for High Performing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Del Bianco, M.; Taggart, J.; Sikora, J.; Wood, A.

    2012-12-01

    This guide is designed to help Building America (BA) Teams understand quality management and its role in transitioning from conventional to high performance home building and remodeling. It explains what quality means, the value of quality management systems, the unique need for QMS when building high performing homes, and the first steps to a implementing a comprehensive QMS. This document provides a framework and context for BA teams when they encounter builders and remodelers.

  9. Adapters, strugglers, and case managers: a typology of spouse caregivers.

    Science.gov (United States)

    Davis, Linda Lindsey; Chestnutt, Deborah; Molloy, Margory; Deshefy-Longhi, Tess; Shim, Bomin; Gilliss, Catherine L

    2014-11-01

    Although family home care problems are frequently described in the health care literature, the ways in which families and other informal caregivers manage those problems are not often addressed. We conducted a descriptive analysis of interviews in which spouses caring for a partner with Alzheimer's or Parkinson's disease were asked to describe difficult home care problems and how they managed those problems. Analysis of these interviews indicated three recurring management styles. Adapters told stories about applying pre-existing skills to manage home care problems. Strugglers told stories of reoccurring home care problems for which they had few or no management strategies. Case managers' interview stories focused on the challenges of finding and coordinating home care services. These findings suggest that caregiving burden might be influenced more by the caregiver's management style than the demands of the care situation. Suggestions for tailoring support programs for the three types of caregivers are proposed. © The Author(s) 2014.

  10. Myths, experiences and home management of childhood diarrhea ...

    African Journals Online (AJOL)

    Background: Diarrhea is a major threat to child survival due to its devastating complication of dehydration. Several home remedies inclusive of oral rehydration therapy have benefited many people. This study assessed nursing mothers' knowledge and experiences of home management of childhood diarrhea. Methodology: ...

  11. Assessment of Home Management of Malaria by Caregivers in a ...

    African Journals Online (AJOL)

    Saharan Africa. Home-based management of malaria (HMM) is promoted as a major strategy of reducing malaria mortality and severe morbidity, in line with the Millennium Development Goal 6. This study assessed the treatment of malaria at home in ...

  12. Smart grid business case for private homes

    DEFF Research Database (Denmark)

    Villefrance, Rasmus; Brandt, Jonas; Eriksen, Poul Svante

    2013-01-01

    We describe and consider how the potential of energy savings may drive the penetration of smart grid technology into private homes. We assess the sociological processes which lead to energy savings when the residents have access to smart grid technology. We propose a way to establish a cash flow...... from consumers via electrical distribution companies to smart grid technology providers on the Danish market. Finally, we assess the impact of such a business development on the society, as well as relating the penetration of smart grid technology in private homes to the societal goal of 100% renewable...

  13. Novel pervasive scenarios for home management: the Butlers architecture.

    Science.gov (United States)

    Denti, Enrico

    2014-01-01

    Many efforts today aim to energy saving, promoting the user's awareness and virtuous behavior in a sustainability perspective. Our houses, appliances, energy meters and devices are becoming smarter and connected, domotics is increasing possibilities in house automation and control, and ambient intelligence and assisted living are bringing attention onto people's needs from different viewpoints. Our assumption is that considering these aspects together allows for novel intriguing possibilities. To this end, in this paper we combine home energy management with domotics, coordination technologies, intelligent agents, ambient intelligence, ubiquitous technologies and gamification to devise novel scenarios, where energy monitoring and management is just the basic brick of a much wider and comprehensive home management system. The aim is to control home appliances well beyond energy consumption, combining home comfort, appliance scheduling, safety constraints, etc. with dynamically-changeable users' preferences, goals and priorities. At the same time, usability and attractiveness are seen as key success factors: so, the intriguing technologies available in most houses and smart devices are exploited to make the system configuration and use simpler, entertaining and attractive for users. These aspects are also integrated with ubiquitous and pervasive technologies, geo-localization, social networks and communities to provide enhanced functionalities and support smarter application scenarios, hereby further strengthening technology acceptation and diffusion. Accordingly, we first analyse the system requirements and define a reference multi-layer architectural model - the Butlers architecture - that specifies seven layers of functionalities, correlating the requirements, the corresponding technologies and the consequent value-added for users in each layer. Then, we outline a set of notable scenarios of increasing functionalities and complexity, discuss the structure of the

  14. Autonomous energy management system in next generation homes

    OpenAIRE

    Charro Laiño, Raúl

    2012-01-01

    [ANGLÈS] The energy management system in next generation home has been developed in web semantic technology. This technology is used in smart homes. And for the monitoring of the power level and consumption of appliances, groups and rooms. Inside the autonomous energy system. The semantic web will give us the necessary interrelated to use autonomous. For good management of energy consumption, we must create communication methods to interact with the user. We can refer to the possibilities off...

  15. Fuzzy-Logic Subsumption Controller for Home Energy Management Systems

    Energy Technology Data Exchange (ETDEWEB)

    Ainsworth, Nathan; Johnson, Brian; Lundstrom, Blake

    2015-10-06

    Home Energy Management Systems (HEMS) are controllers that manage and coordinate the generation, storage, and loads in a home. These controllers are increasingly necessary to ensure that increasing penetrations of distributed energy resources are used effectively and do not disrupt the operation of the grid. In this paper, we propose a novel approach to HEMS design based on behavioral control methods, which do not require accurate models or predictions and are very responsive to changing conditions. We develop a proof-of-concept behavioral HEMS controller and show by simulation on an example home energy system that it capable of making context-dependent tradeoffs between goals under challenging conditions.

  16. Time Slot Management in Attended Home Delivery

    NARCIS (Netherlands)

    N.A.H. Agatz (Niels); A.M. Campbell (Ann Melissa); M. Fleischmann (Moritz); M.W.P. Savelsbergh (Martin)

    2008-01-01

    textabstractMany e-tailers providing attended home delivery, especially e-grocers, offer narrow delivery time slots to ensure satisfactory customer service. The choice of delivery time slots has to balance marketing and operational considerations, which results in a complex planning problem. We

  17. Communicating Caregivers' Challenges With Cancer Pain Management: An Analysis of Home Hospice Visits.

    Science.gov (United States)

    Han, Claire J; Chi, Nai-Ching; Han, Soojeong; Demiris, George; Parker-Oliver, Debra; Washington, Karla; Clayton, Margaret F; Reblin, Maija; Ellington, Lee

    2018-05-01

    Family caregivers (FCGs) of hospice cancer patients face significant challenges related to pain management. Addressing many of these challenges requires effective communication between FCGs and hospice nurses, yet little empirical evidence exists on the nature of communication about pain management between hospice nurses and FCGs. We identified ways in which FCGs of hospice cancer patients communicated their pain management challenges to nurses during home visits and explored nurses' responses when pain management concerns were raised. Using secondary data from audio recordings of hospice nurses' home visits, a deductive content analysis was conducted. We coded caregivers' pain management challenges and immediate nurses' responses to these challenges. From 63 hospice nurse visits, 101 statements describing caregivers' pain management challenges were identified. Thirty percent of these statements pertained to communication and teamwork issues. Twenty-seven percent concerned caregivers' medication skills and knowledge. In 52% of the cases, nurses responded to caregivers' pain management challenges with a validating statement. They provided information in 42% of the cases. Nurses did not address 14% of the statements made by caregivers reflecting pain management challenges. To optimize hospice patients' comfort and reduce caregivers' anxiety and burden related to pain management, hospice nurses need to assess and address caregivers' pain management challenges during home visits. Communication and educational tools designed to reduce caregivers' barriers to pain management would likely improve clinical practice and both patient- and caregiver-related outcomes. Copyright © 2018 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  18. Consumer Acceptance Analysis of the Home Energy Management System

    Directory of Open Access Journals (Sweden)

    Eung-Suk Park

    2017-12-01

    Full Text Available The purpose of this paper is to study consumer acceptance of the Home Energy Management System, which is the next generation electronic management system that the Korean government plans to implement in households. The Home Energy Management System is a critical device in maximizing the efficiency of electric energy consumption for each household by using a smart grid. Because it can visualize real-time price information on the electricity, households can easily monitor and control the amount of electricity consumption. With this feature, the Home Energy Management System can contribute to consumers’ total energy savings. This is a major reason why the Korean government wishes to implement it nationwide. Since the Home Energy Management System is a product that applies new technology that has not yet been directly encountered by consumers, there may be a difference in the level of public perception of the Home Energy Management System. Therefore, the impact of consumers’ awareness of the Home Energy Management System on their intention to use is important. To do this, the Technology Acceptance Model is utilized in this study. Traditional research on the Technology Acceptance Model includes awareness of usefulness and ease of use as well as intention to use. In contrast, in this research, an extended Technology Acceptance Model with four additional factors—economic benefit, social contribution, environmental responsibility, and innovativeness—that may affect the consumer’s awareness of usefulness and ease of use, is proposed. To collect the data, the survey was conducted with 287 respondents. As a result, the proposed model proved to be suitable in explaining the intention to use with a 70.3% explanation power. It is found that economic benefit (0.231 and innovativeness (0.259 impact on usefulness of the Home Energy Management System. Moreover, usefulness (0.551 has a bigger effect on intention to use than ease of use (0.338 does. Based

  19. Home Management Of Diarrhea Among Underfives In A Rural ...

    African Journals Online (AJOL)

    Introduction: Diarrheal disease is a major cause of morbidity and mortality among under-fives especially in rural and peri-urban communities in developing countries. Home management of diarrhea is one of the key household practices targeted for enhancement in the Community Integrated Management of Childhood ...

  20. Management of Giant Sequoia on Mountain Home Demonstration State Forest

    Science.gov (United States)

    Norman J. Benson

    1986-01-01

    Established in 1946, the Mountain Home Demonstration State Forest, Tulare County, California, is managed by the California Department of Forestry. It is a multiple-use forest with recreation as its primary focus, although timber management has always played an important role. Giant sequoia (Sequoiadendron giganteum [Lindl. ] Buchholz) occurs in...

  1. Home Management of Febrile Convulsion in Under-fives: an ...

    African Journals Online (AJOL)

    Home Management of Febrile Convulsion in Under-fives: an Assessment of Perceptions and Practices of Caregivers in Ojokoro Local Council Development Area, Lagos. ... Of the 46 respondents that reported previous history of febrile convulsion, 39(84.8%)carried out inappropriate pre-facility management practices.

  2. DOE Zero Energy Ready Home Case Study: Cobblestone Homes — 2014 Model Home, Midland, MI

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This builder's first DOE Zero Energy Ready Home won a Custom Builder award in the 2014 Housing Innovation Awards, scored HERS 49 without PV or HERS 44 with 1.4 kW of PV, and served as a prototype and energy efficiency demonstration model while performance testing was conducted.

  3. Managing Medications During Home Hospice Cancer Care: The Needs of Family Caregivers.

    Science.gov (United States)

    Tjia, Jennifer; Ellington, Lee; Clayton, Margaret F; Lemay, Celeste; Reblin, Maija

    2015-11-01

    Family caregivers (FCGs) are often at the frontline of symptom management for patients with advanced illness in home hospice. FCGs' cognitive, social, and technical skills in complex medication management have been well studied in the literature; however, few studies have tested existing frameworks in clinical cases in home hospice. This study sought to assess the applicability of caregiver medication management skills framework by Lau et al. in the context of family caregiving in home hospice to further the understanding of FCGs' essential medication management skills. This was a secondary data analysis of 18 audio recorded home hospice visits transcribed verbatim; deductive content analysis of caregiver-nurse interactions was conducted. The target sample included FCGs of hospice patients who had cancer diagnoses in hospices located in the greater urban area of the Rocky Mountain West. Caregiver medication management skills were identified and categorized into the five domains of caregiver expertise. Exemplars of each domain were identified. An average of four medications (SD = 3.5) was discussed at each home hospice visit. Medication knowledge skills were observed in most home hospice visits (15 of 18). Teamwork skills were observed in 11 of 18 cases, followed by organizational and personhood skills (10 of 18). Symptom management skills occurred in 12 of 18 cases. An additional two subconstructs of the personhood domain-1) advocacy for the caregiver and 2) skills in discontinuing medications-were proposed. These findings support framework by Lau et al. for caregiver medication management skills and expands on the existing domains proposed. Future interventions to assess FCGs' skills are recommended. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  4. A service manager model: instituting case management.

    Science.gov (United States)

    Eckett, K; Vassallo, L M; Flett, M

    1996-02-01

    Using a service manager model as opposed to a traditional nurse case manager archetype fosters multidisciplinary team interaction. Benefits of this approach to the hospital, the staff and the patients are identified.

  5. Process Evaluation to Explore Internal and External Validity of the "Act in Case of Depression" Care Program in Nursing Homes

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.F.J.

    2012-01-01

    Background: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): " Act in case of Depression" (AiD). Objective: Before effect analyses, to evaluate AiD

  6. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.J.F.J.

    2012-01-01

    BACKGROUND: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). OBJECTIVE: Before effect analyses, to evaluate AiD

  7. DOE Zero Energy Ready Home Case Study: KB Home — Double ZeroHouse, Lancaster, CA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    The home that won a Production Builder award in the 2014 Housing Innovation Awards serves as a model for this builder, showcasing high-tech features including an electric car charging station; a compressed natural gas (CNG) car fueling station; a greywater recycling system that filters shower, sink, and clothes washer water for yard irrigation; smart appliances; and an electronic energy management system.

  8. DOE Zero Energy Ready Home Case Study: Nexus EnergyHomes, Frederick, Maryland

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    This urban infill community with 24 duplexes, 19 townhomes, and 7 single-family homes features SIP walls, geothermal heat pumps, solar PV, and a proprietary energy management system. The builder won a 2013 Housing Innovation Award in the production builder category.

  9. HIA 2016 DOE Zero Energy Ready Home Case Study: Mandalay Homes, Cathedral Point at The Dells, Prescott, AZ

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2016-09-01

    Case study of a DOE 2016 Housing Innovation Award winning production home in the mixed-dry climate that met the DOE Zero Energy Ready Home criteria and achieved a HERS 47 without PV or HERS -2 with PV.

  10. Managing home nursing care: visibility, accountability and exclusion.

    Science.gov (United States)

    Purkis, M E

    2001-09-01

    The paper examines managerial practices shaping contemporary home nursing care. Foucault's writings on governmentality are used to appraise managerial and nursing practices understood as exemplars of forms of government of people's health. An ethnographic study of organizational practices shaping contemporary home nursing care reveals that the everyday work of managers involves making particular forms of nursing practice visible. Through careful scripting of these visible forms of practice, managers and nurses together work to exclude the local knowledge of patients and of nurses regarding experiences of living with chronic illness. Recommendations are offered for managers and nurses who seek to develop more autonomous roles for nurses: roles that require the inclusion of people's own knowledge of how they live at home with their chronic illness.

  11. BTS Case Study: The Galloway Family Home

    Energy Technology Data Exchange (ETDEWEB)

    Brandegee Group

    1999-03-08

    Case study of an energy-efficient Habitat for Humanity house that uses 30% less energy than conventional residential construction. The project was part of the Jimmy Carter Work Project in rural Appalachia in 1997.

  12. Acceptance of home-based telehealth problem-solving therapy for depressed, low-income homebound older adults: qualitative interviews with the participants and aging-service case managers.

    Science.gov (United States)

    Choi, Namkee G; Wilson, Nancy L; Sirrianni, Leslie; Marinucci, Mary Lynn; Hegel, Mark T

    2014-08-01

    To report low-income homebound older adults' experience of telehealth problem-solving therapy (tele-PST) and aging-service case managers' (CMs') experience/perception of client-level personal barriers to accessing psychotherapy in general and PST specifically. The study sample consisted of 42 homebound older adults who participated in the feasibility and efficacy trial of tele-PST and completed 36-week follow-up assessments and 12 CMs of a large home-delivered meals program who referred their clients to the tele-PST trial. In-depth interviews with the older adults and written feedback and focus group discussions with the CMs provided the data. Older adults reported a high rate of approval of PST procedures and acknowledged its positive treatment effect. Tele-PST participants were satisfied with videoconferenced sessions because they were convenient and allowed them to see their therapist. However, CMs reported that only about 10%-20% of potentially eligible older adults gave oral consent for PST. Significant treatment engagement barriers were the older adults' lack of motivation, denial of depression, perceived stigma, and other personal attitudinal factors. The real-world implementation of tele-PST or other psychotherapies needs to include educating and motivating depressed homebound elders to recognize their depression and accept treatment. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  13. Home ranges of raccoon dogs in managed and natural areas.

    Directory of Open Access Journals (Sweden)

    Karmen Süld

    Full Text Available Knowledge of space use is central to understand animals' role in ecosystems. The raccoon dog Nyctereutes procyonoides is considered as one of the most influential alien mesopredator species in Europe, having the potential to cause loss of local biodiversity and act as a vector for zoonotic diseases. We collared 12 animals to study their home range and habitat use in two areas with different management regimes in Estonia: in a protected natural area and in an intensively managed area. From May to October raccoon dogs inhabiting the natural area had considerably smaller home ranges compared to the managed area, 193.3ha±37.3SD and 391.9ha±292.9SD, respectively. This result contradicts somewhat earlier findings in other European raccoon dog populations, where the home range sizes in natural areas in summer and autumn period have usually been larger compared to managed areas. In both study areas raccoon dogs preferred watersides, where amphibians and other semi-aquatic prey are abundant, to other habitats available in their home ranges. We also studied movements of a raccoon dog pair in the managed study area in winter period. Due to mild weather conditions during the study period, raccoon dogs changed their resting sites quite often, covering a relatively large 599 ha area from November 2012 to January 2013, indicating the absence of usual winter lethargy during the mild winters.

  14. Business Solutions Case Study: Marketing Zero Energy Homes: Tommy Williams Homes, Gainesville, Florida

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    Building America research has shown that high-performance homes can potentially give builders an edge in the marketplace and can boost sales, but it doesn't happen automatically. It requires a tailored, easy-to-understand marketing campaign, and sometimes a little flair. This case study highlights the successful marketing approach of Tommy Williams Homes, which devotes resources to advertising, targeted social media outlets and blogs, realtor education seminars, and groundbreaking and open house celebrations. As a result, in one community, 2013 property sales records show that TWH outsells the only other builder in the development at a higher price, with fewer days on the market.

  15. DOE Zero Energy Ready Home Case Study: Healthy Efficient Homes - Spirit Lake, Iowa

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-11-01

    This case study describes a DOE Zero Energy Ready Home in Spirit Lake, Iowa, that scored HERS 41 without PV and HERS 28 with PV. This 3,048 ft2 custom home has advanced framed walls filled with 1.5 inches closed-cell spray foam, a vented attic with spray foam-sealed top plates and blown fiberglass over the ceiling deck. R-23 basement walls are ICF plus two 2-inch layers of EPS. The house also has a mini-split heat pump, fresh air fan intake, and a solar hot water heater.

  16. Monitors Enable Medication Management in Patients' Homes

    Science.gov (United States)

    2014-01-01

    Glenn Research Center awarded SBIR funding to ZIN Technologies to develop a platform that could incorporate sensors quantifying an astronaut’s health status and then communicate with the ground. ZIN created a device, developed the system further, and then formed Cleveland-based FlexLife Health to commercialize the technology. Today it is part of an anti-coagulation management system for people with cardiovascular disease.

  17. Evaluation of home care management of umbilical cord stumps by ...

    African Journals Online (AJOL)

    Background: Umbilical cord care is an integral part of neonatal care in all communities and cultures and appropriate cord care reduces the risk of infection in the newborn infant. Objective: The present study assessed the home care management of the umbilical stump by the mothers at Ilesa, Southwestern Nigeria. Subjects ...

  18. Knowledge of malaria and practice of home management of malaria ...

    African Journals Online (AJOL)

    Background: Malaria is a preventable and treatable disease associated with high morbidity and mortality. It is the 3rd leading cause of death for children under five years worldwide. Home-based management of malaria may go a long way in reducing the attending morbidity and mortality associated with malaria in this group ...

  19. Home-Based Contingency Management Programs that Teachers Can Use.

    Science.gov (United States)

    Taylor, Vincent L.; And Others

    1984-01-01

    Offers three guidelines to aid teachers in selecting effective contingency management programs, based on degree of positiveness, effectiveness, and costs to teachers and parents. Describes how to use a simple home-based program, which resulted in successful reduction of mild classroom disruptive behavior. (JAC)

  20. On Managed Services Lanes and their Use in Home Networks

    NARCIS (Netherlands)

    Hartog, F.T.H. den; Nooren, P.A.; Delphinanto, A.; Fledderus, E.R

    2013-01-01

    Home networks show an increasing level of heterogeneity regarding the devices connected, network technologies used, and services supported. Heterogeneity inhibits quality assurance for new services, such as online gaming, energy management, and health care. This paper focuses on the role that the

  1. Small Homes: A Case Study of Westport Associates.

    Science.gov (United States)

    Biklen, Douglas

    A case study is presented of Westport Associates, a corporation in Westport, Massachusetts, which operates small group homes for formerly institutionalized men and women with severe disabilities. Westport Associates was founded to create the antithesis of an institution, to treat residents as individuals worthy of respect, and to offer residents…

  2. Best Practices Case Study: Tommy Williams Homes -Gainesville, FL

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2011-04-01

    Case study of Tommy Williams Homes who has continued to outsell the competition with sales increasing despite the recession thanks to a systems-engineering approach developed with DOE’s Building America that yields high energy efficiency, comfort, and indoor air quality. The company offers to pay buyers’ energy bills for the first year.

  3. Business Solutions Case Study: Marketing Zero Energy Homes: LifeStyle Homes, Melbourne, Florida

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    Building America research has shown that high-performance homes can potentially give builders an edge in the marketplace and can boost sales. But it doesn't happen automatically. It requires a tailored, easy to understand marketing campaign and sometimes a little flair. This case study highlights LifeStyle Homes’ successful marketing approach for their SunSmart home package, which has helped to boost sales for the company. SunSmart marketing includes a modified logo, weekly blog, social media, traditional advertising, website, and sales staff training. Marketing focuses on quality, durability, healthy indoor air, and energy efficiency with an emphasis on the surety of third-party verification and the scientific approach to developing the SunSmart package. With the introduction of SunSmart, LifeStyle began an early recovery, nearly doubling sales in 2010; SunSmart sales now exceed 300 homes, including more than 20 zero energy homes. Completed homes in 2014 far outpaced the national (19%) and southern census region (27%) recovery rates for the same period. As technology improves and evolves, this builder will continue to collaborate with Building America.

  4. Management & Communication: Project Management Case Study

    CERN Multimedia

    Nathalie Dumeaux

    2004-01-01

    We are pleased to announce the recent launch of a new workshop on Project Management. This is designed for People with budgetary, scheduling and/or organizational responsibilities in a project or a sub-project. The objectives through a management case study specially suited to CERN are: to become familiar with modern management techniques in use for structuring, planning, scheduling, costing and progress monitoring of a project or a sub-project. to understand in-depth issues associated with Deliverable-oriented Project Management, Earned Value Management, Advanced Project Cost Engineering and Project Risk Management. The full description of this workshop can be found here. The next session will be held on 8 October 2004. If you are interested in this workshop, please contact Nathalie Dumeaux, email or 78144. Programme of Seminars October to December 2004 Situation : 21.09.2004 Séminaires bilingues Dates Jours Places disponibles Project Management Case study 8 October 1 oui Intr...

  5. Home management of childhood diarrhoea among mothers in ...

    African Journals Online (AJOL)

    Diarrhoea diseases are major causes of childhood morbidity and mortality in developing countries. Treatment guidelines by the World Health Organization indicate that most cases of childhood diarrhoea can be treated at home by increased fluid intake and continued feeding during diarrhoea episodes. The aim of this study ...

  6. DOE ZERH Case Study: Evolutionary Home Builders, The Adaptation Home, Geneva, IL

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning custom home in the cold climate that got a HERS 30 without PV, with 2x8 24” on center walls with blown fiberglass and 4” polysio rigid foam; basement with 2” XPS interior, 4” under slab, 4” exterior of foundation wall; vented attic with R-100 blown cellulose; wo air-to-air heat pumps SEER 14.1; HSPF 9.6; heat pump water heater.

  7. Feasibility of home management using ACT for childhood malaria episodes in an urban setting

    Directory of Open Access Journals (Sweden)

    Nsagha DS

    2011-12-01

    Full Text Available Dickson S Nsagha1,2, Jean-Bosco N Elat2,3, Proper AB Ndong2,4, Peter N Tata2,5, Maureen-Nill N Tayong2, Francios F Pokem2, Christian C Wankah61Department of Public Health and Hygiene, Faculty of Health Sciences, University of Buea, Buea, Cameroon; 2Public Health Research Group, Yaounde, Cameroon; 3National AIDS Control Committee, Ministry of Public Health, Cameroon; 4National Malaria Control Programme, Ministry of Public Health, Cameroon; 5Department of Anthropology, Faculty of Arts, Letters and Social Sciences, University of Yaounde 1, Yaounde, Cameroon; 6Department of Public Health, Faculty of Medicine and Biomedical Sciences, University of Yaounde 1, Yaounde, CameroonBackground: Over 90% of malaria cases occur in Sub-Saharan Africa, where a child under the age of 5 years dies from this illness every 30 seconds. The majority of families in Sub-Saharan Africa treat malaria at home, but therapy is often incomplete, hence the World Health Organization has adopted the strategy of home management of malaria to solve the problem. The purpose of this study was to determine community perception and the treatment response to episodes of childhood malaria in an urban setting prior to implementation of home management using artemisinin-based combination therapy (ACT.Methods: This qualitative exploratory study on the home management of malaria in urban children under 5 years of age used 15 focus group discussions and 20 in-depth interviews in various categories of caregivers of children under 5 years. One hundred and eighteen people participated in the focus group discussions and 20 in the in-depth interviews. The study explored beliefs and knowledge about malaria, mothers' perception of home management of the disease, health-seeking behavior, prepackaged treatment of malaria using ACT and a rapid diagnostic test, preferred channels for home management of uncomplicated malaria, communication, the role of the community in home management of malaria, and

  8. Supporting the information domains of fall-risk management in home care via health information technology.

    Science.gov (United States)

    Alhuwail, Dari; Koru, Güneş; Mills, Mary Etta

    2016-01-01

    In the United States, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from 30 clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians' fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity. Substantial improvement in addressing the FRM information domains is possible by effectively modifying the existing solutions and purposefully adopting new solutions.

  9. Home care organization impacts patient management and survival in ALS.

    Science.gov (United States)

    Lavernhe, Sylvie; Antoine, Jean-Christophe; Court-Fortune, Isabelle; Dimier, Nathalie; Costes, Frédéric; Lacour, Arnaud; Camdessanché, Jean-Philippe

    2017-11-01

    Progression of amyotrophic lateral sclerosis (ALS) depends on several factors linked to the disease. However, both the patient's living place and care organization role need to be evaluated. We analysed the effect on survival of factors linked to ALS or the socio-geographical context in a prospective cohort of 203 patients followed between 2003 and 2011. Patients were 97 females and 106 males with a mean age of 65.5 years. Survival was longer in younger patients, in case of upper limb involvement, longer time to diagnosis, and initially higher forced vital capacity. Non-invasive positive pressure ventilation (NIPPV) and percutaneous gastrostomy (PEG) failed to demonstrate benefit. Patients who lived at home had longer survival. The nature of non-medical organization at home statistically influenced survival, which was longer with an organized network than with an unorganized one and shorter in absence of non-medical organization. In patients with indication of PEG and NIPPV, the proposition was statistically different according to the care givers. Besides the natural history of ALS, survival depended on home organization and the presence or the nature of a home-care system. Home organization was an important factor of decision for NIPPV and PEG proposals.

  10. DOE ZERH Case Study: Addison Homes, Cobbler Lane, Simpsonville, SC

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning custom home in the mixed humid climate that got a HERS 41 without PV, with 2x4 16” on-center walls with 1 inch rigid foam, a sealed conditioned crawl space insulated on inside with 2 inches poly iso, a vented attic with R-38 blown fiberglass, a central heat pump with fresh air intake.

  11. Does Assisted Living Capacity Influence Case Mix at Nursing Homes?

    OpenAIRE

    Clement, Jan P.; Khushalani, Jaya

    2015-01-01

    Assisted living facilities (ALFs) have grown over the past few decades. If they attract residents with lower care needs away from nursing homes (NHs), NHs may be left with higher case mix residents. We study the relationship between ALF bed market capacity and NH case mix in a state (Virginia) where ALF bed capacity stabilized after a period of growth. Similarly, NH capacity and use had been stable. While it is interesting to study markets in flux, for planning purposes, it is also important ...

  12. Examining End-of-Life Case Management: Systematic Review

    Directory of Open Access Journals (Sweden)

    Roger E. Thomas

    2014-01-01

    Full Text Available Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL case management identified 17 research articles, with content analysis revealing two themes: (a seeking to determine or establish the value of EOL case management and (b identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

  13. Assessing the home fire safety of urban older adults: a case study.

    Science.gov (United States)

    Twyman, Stephanie; Fahey, Erin; Lehna, Carlee

    2014-01-01

    Older adults are at a higher risk for fatal house fire injury due to decreased mobility, chronic illness, and lack of smoke alarms. The purpose of this illustrative case study is to describe the home fire safety (HFS) status of an urban older adult who participated in a large study funded by the Federal Emergency Management Agency (FEMA). During a home visit with the participant, HFS data were collected from documents, observation, physical artifacts, reflective logs, and interviews. Numerous HFS hazards were identified including non-working smoke alarms, inadequate number and inappropriate placement of smoke alarms, lack of carbon monoxide (CO) alarms, inability to identify a home fire escape plan, hot water heater temperature set too high, and cooking hazards. Identification of HFS risk factors will assist in the development of educational materials that can be tailored to the older adult population to decrease their risk of fire-related injuries and death.

  14. DOE Zero Energy Ready Home Case Study: Clifton View Homes, Coupeville, Washington

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    Ted Clifton, founder of Clifton View Homes, achieved an impressive Home Energy Rating System (HERS) score of 34 (without solar panels) on a two-story home completed in July 2011 that also earned him his first Challenge Home certification from the U.S. Department of Energy (DOE). This home also garnered a 2013 Housing Innovation Award in the "systems builder" category.

  15. DOE Zero Energy Ready Home Case Study: Sterling Brook Custom Homes — Village Park Eco Home, Double Park, TX

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This builder won a Custom Builder honor in the 2014 Housing Innovation Awards for this showcase home that serves as an energy-efficient model home for the custom home builder: 1,300 visitors toured the home, thousands more learned about the home’s advanced construction via the webpage, YouTube, Twitter, Facebook, Instagram, and Pinterest.

  16. Efficient Solutions for New Homes Case Study: BrightBuilt Home, Modular Zero Energy

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-04-11

    When done well, modular home production can provide lower costs and excellent quality control (QC)—compared to conventional home building methods— while still allowing a great deal of customization. The Consortium for Advanced Residential Buildings (CARB) is a U.S. Department of Energy Building America team that worked with three Maine companies to compare standard codecompliant modular homes with a modular zero energy home. Those companies were BrightBuilt Home (BBH), Black Bros. Builders, and Keiser Homes.

  17. Impact of human resource management practices on nursing home performance.

    Science.gov (United States)

    Rondeau, K V; Wagar, T H

    2001-08-01

    Management scholars and practitioners alike have become increasingly interested in learning more about the ability of certain 'progressive' or 'high-performance' human resource management (HRM) practices to enhance organizational effectiveness. There is growing evidence to suggest that the contribution of various HRM practices to impact firm performance may be synergistic in effect yet contingent on a number of contextual factors, including workplace climate. A contingency theory perspective suggests that in order to be effective, HMR policies and practices must be consistent with other aspects of the organization, including its environment. This paper reports on empirical findings from research that examines the relationship between HRM practices, workplace climate and perceptions of organizational performance, in a large sample of Canadian nursing homes. Data from 283 nursing homes were collected by means of a mail survey that included questions on HRM practices, programmes, and policies, on human resource aspects of workplace climate, as well as a variety of indicators that include employee, customer/resident and facility measures of organizational performance. Results derived from ordered probit analysis suggest that nursing homes in our sample which had implemented more 'progressive' HRM practices and which reported a workplace climate that strongly values employee participation, empowerment and accountability tended to be perceived to generally perform better on a number of valued organizational outcomes. Nursing homes in our sample that performed best overall were found to be more likely to not only have implemented more of these HRM practices, but also to report having a workplace climate that reflects the seminal value that it places on its human resources. This finding is consistent with the conclusion that simply introducing HRM practices or programmes, in the absence of an appropriately supportive workplace climate, will be insufficient to attain

  18. Strategy Guideline: Quality Management in Existing Homes; Cantilever Floor Example

    Energy Technology Data Exchange (ETDEWEB)

    Taggart, J.; Sikora, J.; Wiehagen, J.; Wood, A.

    2011-12-01

    This guideline is designed to highlight the QA process that can be applied to any residential building retrofit activity. The cantilevered floor retrofit detailed in this guideline is included only to provide an actual retrofit example to better illustrate the QA activities being presented. The goal of existing home high performing remodeling quality management systems (HPR-QMS) is to establish practices and processes that can be used throughout any remodeling project. The research presented in this document provides a comparison of a selected retrofit activity as typically done versus that same retrofit activity approached from an integrated high performance remodeling and quality management perspective. It highlights some key quality management tools and approaches that can be adopted incrementally by a high performance remodeler for this or any high performance retrofit. This example is intended as a template and establishes a methodology that can be used to develop a portfolio of high performance remodeling strategies.

  19. When professional kindness is misunderstood: boundaries and stalking issues: a case study for the home health clinician.

    Science.gov (United States)

    Holz, Cheryl L

    2009-01-01

    There is the potential for home health nurses and other home care clinicians to be subjected to intrusive and possibly stalking behavior by current and former clients. Most healthcare clinicians do not receive training on the risk of intrusive interactions or stalking, nor on strategies to manage this objectionable client behavior. This article informs nurses and other home health clinicians about the potential risk of stalking. Included is a true case vignette, the legal definition of stalking, incidence occurrence among clinicians, the basic profile and behaviors of a stalker, the victimology and psychological consequences, and implications for policy and procedures and prevention techniques.

  20. How individuals with dementia in nursing homes maintain their dignity through life storytelling - a case study.

    Science.gov (United States)

    Heggestad, Anne Kari Tolo; Slettebø, Åshild

    2015-08-01

    The aim of this article was to present and discuss findings on what individuals with dementia do by themselves to maintain or promote their dignity of identity when they live in a nursing home. The majority of residents living in Norwegian nursing homes suffer from dementia. Individuals who suffer from dementia are particularly vulnerable, and their dignity of identity is at risk. It is therefore of great importance to explore how we can maintain their dignity of identity. The study builds on a phenomenological and hermeneutic design. The article reports three cases or life stories based on participant observation in two different nursing homes and interviews with five residents with dementia living in these nursing homes. Fifteen residents with dementia from these nursing home wards were included in the overall study. Individuals with dementia living in nursing homes may use life storytelling or narratives to manage chaos and to find safety in their lives. Storytelling is also used as a way to present and maintain identity. We can see this as a way of maintaining dignity of identity or social dignity. Life storytelling can be seen as an important way of preserving dignity for people with dementia. It is of great importance that health care professionals are open to and listen to the life stories people with dementia tell. As nurses we have an obligation to ensure that dignity is enhanced in care for people with dementia. Knowledge about how residents with dementia use life storytelling as a way to maintain dignity is therefore of great importance to health care workers in nursing homes. © 2015 John Wiley & Sons Ltd.

  1. Load Balancing Integrated Least Slack Time-Based Appliance Scheduling for Smart Home Energy Management

    OpenAIRE

    Bhagya Nathali Silva; Murad Khan; Kijun Han

    2018-01-01

    The emergence of smart devices and smart appliances has highly favored the realization of the smart home concept. Modern smart home systems handle a wide range of user requirements. Energy management and energy conservation are in the spotlight when deploying sophisticated smart homes. However, the performance of energy management systems is highly influenced by user behaviors and adopted energy management approaches. Appliance scheduling is widely accepted as an effective mechanism to manage...

  2. DOE Zero Energy Ready Home Case Study: One Sky Homes — Cottle Zero Net Energy Home, San Jose, CA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This builder took home the Grand Winner prize in the Custom Builder category in the 2014 Housing Innovation Awards for its high performance building science approach. The builder used insulated concrete form blocks to create the insulated crawlspace foundation for its first DOE Zero Energy Ready Home, the first net zero energy new home certified in the state of California.

  3. Care home managers' views of dental services for older people living in nursing and residential homes in inner city London.

    Science.gov (United States)

    Belsi, A; Gonzalez-Maffe, J; Jones, K; Wright, D; Gallagher, J E

    2013-06-01

    To investigate care home managers' views on the provision of dental care (current and future; urgent, check-up and follow-up) for their residents, barriers to care and the impact of policy changes, by type of home (nursing vs residential), with a view to informing the planning and provision of care. A cross sectional postal questionnaire survey and follow-up semi-structured interviews. Care homes in South East London. PARTCIPANTS: All care home managers in three south east London boroughs. A 72% response rate (n=152) was achieved, 140 of which were designated as nursing and/or residential homes (92%). Almost all managers reported that the care homes had arrangements in place for residents to access some elements of dental care (99%, n=148). Reported barriers to care included residents' fear of treatment (53%), patients' limited mobility (45%) and waiting times for services (42%). Limited mobility (p=0.01) and transport issues (p=0.01) were more significant barriers for nursing homes, whereas fear (p=0.02) was more significant for residential homes. Access to a range of dental services and modes of service delivery were requested for the future; most notable were the demands for domiciliary services to be available to nursing homes and for residential homes to access local general dental practitioners to meet the needs of their residents. Managers report having arrangements in place for residents to access dental services; however, there was a clear view that future arrangements should be more appropriate to the needs and vulnerabilities of their residents.

  4. Energy Management System and Interactive Functions of Smart Plug for Smart Home

    OpenAIRE

    Win Thandar Soe; Innocent Mpawenimana; Mathieu Di Fazio; Cécile Belleudy; Aung Ze Ya

    2017-01-01

    Intelligent electronic equipment and automation network is the brain of high-tech energy management systems in critical role of smart homes dominance. Smart home is a technology integration for greater comfort, autonomy, reduced cost, and energy saving as well. These services can be provided to home owners for managing their home appliances locally or remotely and consequently allow them to automate intelligently and responsibly their consumption by individual or collective control systems. I...

  5. Perceptions of risk and risk management among 735 women who opted for a home birth.

    Science.gov (United States)

    Lindgren, Helena E; Rådestad, Ingela J; Christensson, Kyllike; Wally-Bystrom, Kristina; Hildingsson, Ingegerd M

    2010-04-01

    home birth is not included in the Swedish health-care system and the rate for planned home births is less than one in a thousand. The aim of this study was to describe women's perceptions of risk related to childbirth and the strategies for managing these perceived risks. a nationwide study including all women who had given birth at home in Sweden was conducted between 1 January 1992 and 31 July 2005. a total of 735 women had given birth to 1038 children. Of the 1038 questionnaires sent to the women, 1025 (99%) were returned. two open questions regarding risk related to childbirth and two questions answered using a scale were investigated by content analysis. regarding perceived risks about hospital birth, three categories, all related to loss of autonomy, were identified: (1) being in the hands of strangers; (2) being in the hands of routines and unnecessary interventions; and (3) being in the hands of structural conditions. Perceived risks related to a home birth were associated with a sense of being beyond help: (1) worst-case scenario; and (2) distance to the hospital. The perceived risks were managed by using extrovert activities and introvert behaviour, and by avoiding discussions concerning risks with health-care professionals. women who plan for a home birth in Sweden do consider risks related to childbirth but they avoid talking about the risks with health-care professionals. to understand why women choose to give birth at home, health-care professionals must learn about the perceived beneficial effect of doing so. Copyright 2008 Elsevier Ltd. All rights reserved.

  6. DOE Zero Energy Ready Home Case Study: Thrive Home Builders, Lowry Plan

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2017-09-01

    Thrive Home Builders built this 4,119-ft2 home at the Lowry development in Denver, Colorado, to the high-performance criteria of the U.S. Department of Energy’s Zero Energy Ready Home Program. Despite the dense positioning of the homes, mono-plane roof designs afforded plenty of space for the 8.68 kW of photovoltaic panels. With the PV, the home achieves a Home Energy Rating System (HERS) score of 4 and the home owners should enjoy energy bills of about $-11 a year. Without the PV, the home would score a HERS 38 (far lower than the HERS 80 to 100 of typical new homes).

  7. Does Assisted Living Capacity Influence Case Mix at Nursing Homes?

    Directory of Open Access Journals (Sweden)

    Jan P. Clement PhD

    2015-05-01

    Full Text Available Assisted living facilities (ALFs have grown over the past few decades. If they attract residents with lower care needs away from nursing homes (NHs, NHs may be left with higher case mix residents. We study the relationship between ALF bed market capacity and NH case mix in a state (Virginia where ALF bed capacity stabilized after a period of growth. Similarly, NH capacity and use had been stable. While it is interesting to study markets in flux, for planning purposes, it is also important to examine what happens after periods of turbulence and adaptation. Our findings show some substitution of ALF for NH care, but the relationship is not linear with ALF market capacity. Communities need to consider the interplay of ALFs and NHs in planning for long-term care services and supports. Policies supporting ALFs may enable care needs to be met in a lower cost setting than the NH.

  8. For Professors' Children, the Case for Home Schooling

    Science.gov (United States)

    Pannapacker, W. A.

    2005-01-01

    The number of families who home school their children is growing between five and 15% per year and it is believed that home schoolers outperform their public-educated peers, though critics believe that home schooling is a form of religious fanaticism and a means of avoiding diversity. A professor explains how he and his wife, home school their…

  9. Evaluating fidelity in home-visiting programs a qualitative analysis of 1058 home visit case notes from 105 families.

    Directory of Open Access Journals (Sweden)

    Thomas Saïas

    Full Text Available Implementation fidelity is a key issue in home-visiting programs as it determines a program's effectiveness in accomplishing its original goals. This paper seeks to evaluate fidelity in a 27-month program addressing maternal and child health which took place in France between 2006 and 2011.To evaluate implementation fidelity, home visit case notes were analyzed using thematic qualitative and computer-assisted linguistic analyses.During the prenatal period, home visitors focused on the social components of the program. Visitors discussed the physical changes in pregnancy, and psychological and social environment issues. Discussing immigration, unstable employment and financial related issues, family relationships and dynamics and maternity services, while not expected, were found in case notes. Conversely, health during pregnancy, early child development and postpartum mood changes were not identified as topics within the prenatal case notes. During the postnatal period, most components of the intervention were addressed: home visitors observed the mother's adaptation to the baby; routine themes such as psychological needs and medical-social networks were evaluated; information on the importance of social support and on adapting the home environment was given; home visitors counseled on parental authority, and addressed mothers' self-esteem issues; finally, they helped to find child care, when necessary. Some themes were not addressed or partially addressed: health education, child development, home environment, mother's education plans and personal routine, partner support and play with the child. Other themes were not expected, but found in the case notes: social issues, mother-family relationship, relation with services, couple issues, quality of maternal behavior and child's language development.In this program, home visitors experienced difficulties addressing some of the objectives because they gave precedence to the families' urgent needs

  10. Care home manager attitudes to balancing risk and autonomy for residents with dementia.

    Science.gov (United States)

    Evans, Elizabeth A; Perkins, Elizabeth; Clarke, Pam; Haines, Alina; Baldwin, Ashley; Whittington, Richard

    2018-02-01

    To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individual's autonomy and the need to protect their residents' dignity. Finally, care home managers highlighted the ways in which an individual's needs were framed by the needs of other residents to the extent that on some occasions an individual's needs were subjugated to the needs of the general population of a home. There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers.

  11. DOE Zero Energy Ready Home Case Study: Amaris Homes, Afton Model

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2017-09-01

    Amaris Homes built this 3,734-ft2 home in Afton, Minnesota, to the performance criteria of the DOE Zero Energy Ready Home (ZERH) program. A high-efficiency gas boiler provides hot water for the zoned radiant floor system as well as for faucets and showers. A high-efficiency heat pump provides zoned cooling.

  12. DOE Zero Energy Ready Home Case Study: Clifton View Homes — Kaltenbach Residence, Clinton, WA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This home on Whidbey Island won a Custom Builder award in the 2014 Housing Innovation Awards. The DOE Zero Energy Ready Home scores HERS 37 without PV or HERS -13 with 10 kW PV, enough to power the home and an electric car.

  13. DOE Zero Energy Ready Home Case Study: Mandalay Homes — Pronghorn Ranch, Prescott Valley, AZ

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    The builder has certified 20 homes to DOE Zero Energy Ready Home program and plans are underway for 50 more. Winner of a Production Builder prize in the 2014 Housing Innovation Awards, the homes achieved a HERS score of 48 without photovoltaics (PV) or HERS 25 with 3.5 kW PV included.

  14. DOE Zero Energy Ready Home Case Study: Garbett Homes, Herriman, Utah

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    As the first net zero-energy production home certified in Utah, this house incorporates two 94% efficient tankless water heaters and two roof-mounted solar panels that preheat the home's water supply. This home won a 2013 Housing Innovation Award in the production builder category.

  15. Factors contributing to fecal incontinence in older people and outcome of routine management in home, hospital and nursing home settings

    Directory of Open Access Journals (Sweden)

    Asangaedem Akpan

    2007-04-01

    Full Text Available Asangaedem Akpan1,2,3, Margot A Gosney2, James Barrett3,4, 1Directorate of Medicine and Elderly Care, Warrington Hospital, Warrington, Cheshire, UK; 2School of Food Biosciences, The University of Reading, Whiteknights, Reading, UK; 3Liverpool John Moores University, Liverpool, UK; 4Directorate of Elderly Medicine and Rehabilitation, Clatterbridge Hospital, Merseyside, UKObjective: Fecal loading, cognitive impairment, loose stools, functional disability, comorbidity and anorectal incontinence are recognized as factors contributing to loss of fecal continence in older adults. The objective of this project was to assess the relative distribution of these factors in a variety of settings along with the outcome of usual management. Methods: One hundred and twenty adults aged 65 years and over with fecal incontinence recruited by convenience sampling from four different settings were studied. They were either living at home or in a nursing home or receiving care on an acute or rehabilitation elderly care ward. A structured questionnaire was used to elicit which factors associated with fecal incontinence were present from subjects who had given written informed consent or for whom assent for inclusion in the study had been obtained.Results: Fecal loading (Homes 6 [20%]; Acute care wards 17 [57%]; Rehabilitation wards 19 [63%]; Nursing homes 21 [70%] and functional disability (Homes 5 [17%]; Acute care wards 25 [83%]; Rehabilitation wards 25 [83%]; Nursing homes 20 [67%] were significantly more prevalent in the hospital and nursing home settings than in those living at home (P < 0.01. Loose stools were more prevalent in the hospital setting than in the other settings (Homes 11 [37%]; Acute care wards 20 [67%]; Rehabilitation wards 17 [57%]; Nursing homes 6 [20%] (P < 0.01. Cognitive impairment was significantly more common in the nursing home than in the other settings (Nursing homes 26 [87%], Homes 5 [17%], Acute care wards 13 [43%], Rehabilitation

  16. DOE Zero Energy Ready Home Case Study, Weiss Building & Development, LLC., System Home, River Forest, Illinois

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    The Passive House Challenge Home located in River Forest, Illinois, is a 5-bedroom, 4.5-bath, 3,600 ft2 two-story home (plus basement) that costs about $237 less per month to operate than a similar sized home built to the 2009 IECC. For a home with no solar photovoltaic panels installed, it scored an amazingly low 27 on the Home Energy Rating System (HERS) score.An ENERGY STAR-rated dishwasher, clothes washer, and refrigerator; an induction cooktop, condensing clothes dryer, and LED lighting are among the energy-saving devices inside the home. All plumbing fixtures comply with EPA WaterSense criteria. The home was awarded a 2013 Housing Innovation Award in the "systems builder" category.

  17. Existing Whole-House Solutions Case Study: Greenbelt Homes, Inc. Pilot Retrofit Project

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc., (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. With the community upgrade fully funded by the cooperative through their membership without outside subsidies, this project presents a unique opportunity to evaluate and prioritize the wide range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects that include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy-savings benefits of improvements. Phase 1—baseline evaluation for a representative set of 28 homes sited in seven buildings; Phase 2—installation of the building envelope improvements and continued monitoring of the energy consumption for the heating season; Phase 3—energy simulations supporting recommendations for HVAC and water heating upgrades.

  18. Environmental impacts and benefits of smart home automation:life cycle assessment of home energy management system

    OpenAIRE

    Louis, J.-N. (Jean-Nicolas); Calo, A. (Antonio); Leiviskä, K. (Kauko); Pongrácz, E. (Eva)

    2015-01-01

    Abstract This paper discusses the life-cycle environmental impact of Home Energy Management System (HEMS), in terms of their potential benefits and detrimental impacts. It is the expectation that adapting smart home automation (SHA) would lead to reduced electricity usage in the household and overall environmental advantages. The purpose of this research was to quantify the negative environmental impacts of SHA and balance them with their benefits. The evaluation of SHA has been done by co...

  19. Post-operative symptoms at home in children following day case ...

    African Journals Online (AJOL)

    Adele

    beyond the recovery room to the ward and the home. This study was undertaken to evaluate the incidence and duration of postoperative symptoms in children at home following day case surgery and anaesthesia. We also evaluated instructions given to parents in the hospital following surgery for care of the child at home.

  20. Top Nurse-Management Staffing Collapse and Care Quality in Nursing Homes

    Science.gov (United States)

    Hunt, Selina R.; Corazzini, Kirsten; Anderson, Ruth A.

    2014-01-01

    Director of nursing turnover is linked to staff turnover and poor quality of care in nursing homes; however the mechanisms of these relationships are unknown. Using a complexity science framework, we examined how nurse management turnover impacts system capacity to produce high quality care. This study is a longitudinal case analysis of a nursing home (n = 97 staff) with 400% director of nursing turnover during the study time period. Data included 100 interviews, observations and documents collected over 9 months and were analyzed using immersion and content analysis. Turnover events at all staff levels were nonlinear, socially mediated and contributed to dramatic care deficits. Federal mandated, quality assurance mechanisms failed to ensure resident safety. High multilevel turnover should be elevated to a sentinel event for regulators. Suggestions to magnify positive emergence in extreme conditions and to improve quality are provided. PMID:24652943

  1. Social Workers in Home Care: The Israeli Case

    Science.gov (United States)

    Ayalon, Liat; Baum, Nehami

    2010-01-01

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

  2. Managers' Compensation in a Mixed Ownership Industry: Evidence from Nursing Homes.

    Science.gov (United States)

    Huang, Sean Shenghsiu; Hirth, Richard A; Smith, Dean G

    2016-01-01

    An extensive literature is devoted to differences between for-profit and non-profit health-care providers' prices, utilization, and quality. Less is known about for-profit and non-profit managers' compensation and its relationship with financial and quality performance. The aim of this study is to examine whether for-profit and non-profit nursing homes place differential weights on financial and quality performance in determining managers' compensation. Using a unique 8-year dataset on Ohio nursing homes, fixed-effect regression models of managers' compensation include financial and quality performance as well as other explanatory variables concerning firm and market characteristics and manager qualifications. Among for-profit nursing homes, compensation of owner-managers and non-owner managers are compared. Compensation of for-profit managers is significantly positively associated with profit margin and return-on-assets, while compensation of non-profit managers does not exhibit any consistent relationship with financial measures. Compensation of neither for-profit nor non-profit managers is significantly related to quality measures. Nursing home size and managers' years of experience are the only consistent determinants of compensation. Owner-managers earn significantly higher compensation than non-owner managers and their compensation is less related to nursing home performance. Finding that home size and experience are strong determinants of compensation, and the association with ownership and financial performance for for-profit nursing homes are as expected. The insignificant relationship between compensation and quality performance is potentially troublesome.

  3. A Solution Based on Bluetooth Low Energy for Smart Home Energy Management

    OpenAIRE

    Collotta, Mario; Pau, Giovanni

    2015-01-01

    The research and the implementation of home automation are getting more popular because the Internet of Things holds promise for making homes smarter through wireless technologies. The installation of systems based on wireless networks can play a key role also in the extension of the smart grid towards smart homes, that can be deemed as one of the most important components of smart grids. This paper proposes a fuzzy-based solution for smart energy management in a home automation wireless netw...

  4. A user behaviour-driven smart-home gateway for energy management

    OpenAIRE

    Vastardis, N.; Kampouridis, Michael; Yang, K.

    2016-01-01

    Current smart-home and automation systems have reduced generality and modularity, thus confining users in terms of functionality. This paper proposes a novel system architecture and describes the implementation of a user-centric smart-home gateway that is able to support home-automation, energy usage management and reduction, as well as smart-grid operations. This is enabled through a middleware service that exposes a control API, allowing the manipulation of the home network devices and info...

  5. The "wins" of change: evaluating the impact of predicted changes on case management practice.

    Science.gov (United States)

    Stanton, Marietta P; Barnett Lammon, Carol Ann

    2008-01-01

    A variety of strategies were employed to identify current and future trends that would impact the practice of case management. Historical review, consultation with case management experts, literature review, and environmental scanning by practicing case managers were strategies employed to determine the impact of current and future trends on case management. The trends identified in this article have implications for case managers in a variety of settings. Case managers participating in the environmental scanning process to evaluate the impact of the identified trends on their organization included representation from acute care, home care, behavioral health, workers' compensation, and private insurance settings. The top 7 trends identified by experts in the field of case management included pay for performance, recovery audit contractors, Medicare demonstration projects, transitions of care, informatics in healthcare and case management, metrics for case management, and the impact of an aging population in case management. Practicing case managers were asked to react to these trends in terms of likelihood of occurrence in their organization and impact of these trends on their case management practice. Case management will ultimately have a higher degree of accountability for its practice if metrics to evaluate and reimbursement for case management become a reality. A multitude of performance measures exist that will be monitored and be tied to reimbursement. To ensure that agencies are accomplishing these performance measures, case management will potentially have a growing importance. Case managers perceive that these trends have a predominantly positive impact on case management.

  6. Infection prevention and control in home nursing: case study of four organisations in Australia.

    Science.gov (United States)

    Felemban, Ohood; St John, Winsome; Shaban, Ramon Zenel

    2015-09-01

    The aim of this case study was to explore the environmental challenges nurses experience with infection control practice, and the strategies they use to overcome those challenges. An exploratory case study was conducted in four home visiting nursing organisations in southeast Queensland, Australia, using data triangulation (document review, individual interviews, and focus groups). Data were analysed using a framework approach to identify themes. Three major infection prevention and control challenges were experienced in the community context. The first challenge is the nature of the work environment, including: poor cleanliness in clients' home environments, pets or vermin, inadequate hand-washing facilities, and a lack of appropriate storage space for clinical materials. The second challenge occurs when nurses lack access to appropriate infection control equipment, including wound-management materials and sharps containers. The third challenge is dealing with clients' poor personal hygiene and health status. Participants addressed these issues by offering assistance, using clean surfaces at clients' homes, applying an alcohol-based hand rub, providing client education, and reducing the cost of purchasing equipment for clients. It is imperative that policy is developed to support nurses' decision making and practices as they address infection control challenges in the community environment. Ensuring staff are well-supported with resources, education, policy, and guidelines to address these challenges is important for the delivery of safe and high-quality care in community settings.

  7. DOE Zero Energy Ready Home Case Study: TC Legend Homes, Seattle, Washington

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    This house incorporates slab-on-grade, EPS roof, and radiant heating with an air-to-water heat pump that also preheats domestic hot water. Without counting in the solar panels, the home earns a home energy rating system (HERS) score of 37, with projected utility bills of about $740 a year. With the 6.4-kW photovoltaic power system installed on the roof, the home’s HERS scores drops to -1 and utility bills for the all-electric home drop to zero. This home was awarded a 2013 Housing Innovation Award in the affordable builder category.

  8. Medication kits for managing symptomatic emergencies in the home: a survey of common hospice practice.

    Science.gov (United States)

    Bishop, Margaret F; Stephens, Lisa; Goodrich, Martha; Byock, Ira

    2009-01-01

    Alleviation of symptoms associated with advanced illness and dying is a fundamental goal and core principle of palliative care. Little research exists regarding hospice programs' practices for prescribing, dispensing, and utilizing medication kits in the home for management of uncontrolled symptoms. We conducted a telephone survey of all 22 agencies in New Hampshire providing home hospice care. The survey inquired about the timing of medication kit ordering and availability, characteristics of prescribers and pharmacies, kit contents, costs, frequency of use, and perceived impact of kits. All programs' kits contained medications to treat pain and dyspnea, 81% for nausea and vomiting, and 76% for seizures. Eighty-six percent of agencies (18/21) reported that a medication within the kits was used in more than 50% of cases. Eighty-six percent reported the kits often averted hospital or emergency department visits. Oral, sublingual, and rectal routes of administration were common as was topical preparations of combination medications. Three programs included parenteral morphine in kits. Kits cost less than $50 for the majority of programs. Hospice programs commonly utilize kits containing prescription medications for the purpose of managing uncontrolled symptoms in the home. There is considerable variation in kit contents and practice. Programs believe that kits diminish emergency department visits and hospitalizations. Research is needed to more fully describe and study the outcomes of these practices.

  9. A disease management program for heart failure: collaboration between a home care agency and a care management organization.

    Science.gov (United States)

    Gorski, Lisa A; Johnson, Kathy

    2003-01-01

    This article describes a collaborative approach to manage patients with heart failure between a home care agency and a care management agency. The resulting disease management program used a combination of home visits and phone contact. Care management plans emphasized patient education on increasing adherence to medical and diet regimens, and recognizing early symptoms of exacerbation that could lead to rehospitalization. Clinician activities and patient outcomes are described.

  10. DOE Zero Energy Ready Home Case Study: M Street Homes — Smartlux on Greenpark, Houston, TX

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This builder certified its first DOE Zero Energy Ready Home and won a Production Builder honor in the 2014 Housing Innovation Awards. It is the first home in the world to use a tri-generation system to supply electricity, heating, and cooling on site.

  11. A controlled clinical trial of home care management versus hospital care management for preterm labour.

    Science.gov (United States)

    Goulet, C; Gévry, H; Gauthier, R J; Lepage, L; Fraser, W; Aita, M

    2001-06-01

    Prenatal hospitalisation has not been shown to reduce perinatal morbidity and mortality, yet it is still the treatment of choice for women who experience preterm labour. Home care management may be an alternative means of delivering safe, efficacious and care for these women. The objectives of this controlled clinical trial were to examine differences in neonate's gestational age and birthweight, and antenatal stress, social support satisfaction, and family functioning among pregnant women receiving home care and those receiving hospital care management. Pregnant women experiencing preterm labour (N=250) were randomly assigned to home care management (the experimental group [EG]) or hospital care management (the control group [CG]). A Perinatal Information Form was used to collect data on sociodemographic and pregnancy variables. The High-Risk Pregnancy Stress Scale, Brown's Social Behaviors Inventory, and the Family Assessment Measure III Dyadic Relationships Scale were administered to the women at randomisation (T1) and at 1-week (T2) and 2-weeks (T3) after randomisation. Gestational age and birthweight were similar in the two groups of neonates. Women in the EG reported that antenatal stress was significantly lower at T3 than at T1 and T2, while for those in the CG, antenatal stress was significantly lower at T3 than at T1, and significantly lower at T2 than at T1. Women in the EG were more satisfied with support from the male partner at T3 than women in the CG. There was no significant difference between the two groups in family functioning at T1, T2 and T3. These findings indicate that home care management is a safe and efficacious mode of health care delivery for women experiencing preterm labour.

  12. DOE Zero Energy Ready Home Case Study: Amaris Custom Homes, St. Paul, Minnesota

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    For this project, Amaris worked with U.S. Department of Energy (DOE) team, NorthernSTAR Building America Partnership, to develop the first Zero Energy Ready Home (ZERH) in Minnesota's cold climate using reasonable, cost-effective, and replicable construction materials and practices. The result is a passive solar, super-efficient 3542-ft2 walkout ranch-style home with all the creature comforts. Along with meeting ZERH standards, Amaris also achieved certifications for Leadership in Energy & Environmental Design for Homes v4, MN Green Path Emerald, and a Builders Association of the Twin Cities Reggie Award of Excellence. The home achieves a HERS score of 41 without photovoltaics; with PV, the home achieves a HERS score of 5.

  13. DOE Zero Energy Ready Home Case Study: Green Extreme Homes & Carl Franklin Homes — First DOE Zero Energy Ready Home Retrofit, Garland, TX

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This builder was honored with an Affordable Builder award in the 2014 Housing Innovation Awards, for the first retrofit home certified to the DOE Zero Energy Ready home requirements.The 60-year-old, three-bedroom ranch home is expected to save its homeowner more than $1,000 a year in utility bills compared to a home built to the current 2009 International Energy Conservation Code.

  14. The impact of staff case manager-case management supervisor relationship on job satisfaction and retention of RN case managers.

    Science.gov (United States)

    Hogan, Tierney D

    2005-01-01

    A positive relationship between staff RN case managers and their case management supervisor significantly impacts job satisfaction and retention in case managers. Literature review supports the premise that staff need to trust their supervisor and that there is a connection between this trust and job satisfaction. Staff case managers need to have a voice at work and feel empowered, and a supervisor's leadership style can influence job satisfaction and retention in their staff.

  15. DOE Zero Energy Ready Home Case Study: Mandalay Homes, Phoenix, Arizona

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    This builder built fourteen homes in the Gordon Estates subdivision that achieved Challenge Home certification with HERS 38–58 on an affordable budget for homeowners. Every Mandalay home in the development also met the National Green Building Standard gold level. The Gordon Estates subdivision is also serving as a showcase of energy efficiency, and Mandalay is hosting education workshops for realtors, state and local officials, other builders, students, potential homeowners, and the public. The builder won a 2013 Housing Innovation Award in the affordable builder category.

  16. Effectiveness of post-discharge case management in general-medical outpatients: a randomized, controlled trial

    NARCIS (Netherlands)

    Latour, Corine H. M.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.

    2006-01-01

    This study was initiated to determine the impact of post-discharge, nurse-led, home-based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N=147) were

  17. Effectiveness of post-discharge case management in general-medical outpatients: A randomized, controlled trial

    NARCIS (Netherlands)

    Latour-Delfgaauw, C.H.M.; Vos, R.; Huyse, F.J.; de Jonge, P.; van Gemert, L.A.M.; Stalman, W.A.B.

    2006-01-01

    This study was initiated to determine the impact of post-discharge, nurse-led, home-based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N=147) were

  18. Effectiveness of post-discharge case management in general-medical outpatients: A randomized, controlled trial

    NARCIS (Netherlands)

    Latour, C.H.M.; de Vos, R.; Huyse, F.J.; De Jonge, P.; van Gemert, L.A.M.; Stalman, W.A.B.

    2006-01-01

    This study was initiated to determine the impact of post- discharge, nurse- led, home- based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N = 147)

  19. Effectiveness of post-discharge case management in general-medical outpatients : A randomized, controlled trial

    NARCIS (Netherlands)

    Latour, Corine H. M.; de Vos, Rien; Huyse, Frits J.; de Jonge, Peter; van Gemert, Liesbeth A. M.; Stalman, Wim A. B.

    2006-01-01

    This study was initiated to determine the impact of post- discharge, nurse- led, home- based case management intervention on the number of emergency readmissions, level of care utilization, quality of life, and psychological functioning. Patients discharged home from a general hospital (N = 147)

  20. Experimental Study of 6LoPLC for Home Energy Management Systems

    Directory of Open Access Journals (Sweden)

    Augustine Ikpehai

    2016-12-01

    Full Text Available Ubiquitous connectivity is already transforming residential dwellings into smart homes. As citizens continue to embrace the smart home paradigm, a new generation of low-rate and low-power communication systems is required to leverage the mass market presented by energy management in homes. Although Power Line Communication (PLC technology has evolved in the last decade, the adaptation of PLC for constrained networks is not fully charted. By adapting some features of IEEE 802.15.4 and IPv6 over Low-power Wireless Personal Area Network (6LoWPAN into power lines, this paper demonstrates a low-rate, low-power PLC system over the IPv6 network (referred to as 6LoPLC, for Home Energy Management System (HEMS applications. The overall idea is to provide a framework for assessing various scenarios that cannot be easily investigated with the limited number of evaluation hardware available. In this respect, a network model is developed in NS-3 (Version 21 to measure several important characteristics of the designed system and then validated with experimental results obtained using the Hanadu evaluation kits. Following the good agreement between the two, the NS-3 model is utilised to investigate more complex scenarios and various use-cases, such as the effects of impulsive noise, the number of nodes and packet size on the latency and Bit Error Rate (BER performances. We further demonstrate that for different network and application configurations, optimal data sizes exist. For instance, the results reveal that in order to guarantee 99% system reliability, the HEMS application data must not exceed 64 bytes. Finally, it is shown that with impulsive noise in a HEMS network comprising 50 appliances, provided the size of the payload does not exceed 64 bytes, monitoring and control applications incur a maximum latency of 238.117 ms and 248.959 ms, respectively; both of which are within acceptable limits.

  1. Use of pre-packaged chloroquine for the home management of presumed malaria in Malagasy children

    Directory of Open Access Journals (Sweden)

    Malvy Denis

    2006-09-01

    Full Text Available Abstract Objective The main objective of this study was to assess the quality of home malaria management with pre-packaged chloroquine in two areas in the Moramanga district of Madagascar. The knowledge, attitude and practices of care providers in terms of home treatment options were evaluated and compared. The availability of treatment options by studying retailers and community-based service providers was also investigated. Methods A cross-sectional investigation in two communities, in the hamlets and villages located close to carers, retailers, community-based service providers and primary health centres was carried out. Results Carers in the two districts were equally well aware of the use of pre-packaged chloroquine. Their first response to the onset of fever was to treat children with this antimalarial drug at home. The dose administered and treatment compliance were entirely satisfactory (100% with pre-packaged chloroquine and rarely satisfactory (1.6% to 4.5% with non pre-packaged chloroquine. In cases of treatment failure, the carers took patients to health centres. Chloroquine was supplied principally by private pharmacies and travelling salesmen selling unpackaged chloroquine tablets. Non pre-packaged chloroquine was the most common drug used at health centres. The frequency of positive rapid malaria tests (P = 0.01 was significantly higher in children treated with non pre-packaged chloroquine (38% than in children treated with pre-packaged chloroquine (1.3%. Conclusion Home malaria management should be improved in Madagascar. Efforts should focus on communication, the training of community-based service providers, access to pre-packaged drugs and the gradual withdrawal of pre-packaged chloroquine and its replacement by pre-packaged artemisinin-based combination therapies.

  2. [The importance of Dysphagia management during the peri-operative period to home elderly care].

    Science.gov (United States)

    Doi, Seiko; Iwai, Akiko; Mito, Saori; Utsumi, Tsukasa; Shinoki, Keiji; Nakashita, Chisako; Hata, Akiko; Ibata, Takeshi; Komuro, Ryutaro; Iijima, Andshohei

    2010-12-01

    Dysphagia is usually a major problem for the elderly to go home after a surgical treatment for the bone fracture of the thigh bone cervix or trochanter part in the leg. We analyzed each clinical course with regard to a change of the oral intake and the nutritional status, the activity of daily living(ADL)and a nutritional management and the place after the patient was discharged. According to our results, about 20% of the patients among those surgical cases were pointed with dysphagia, and there were many cases that ADL was ultimately gotten worse. We took care of disphagia by doing a best practice of changing in feedings and deglutition function. However, some of the patients with the problem finally moved to another elderly health care institute against their primary wishes to go home. Furthermore, 55% of the disphagia patients became dementia. It seems that dementia might be a high risk factor of disphagia. We should do more better job for managing disphargia during a peri-operative period just after admission.

  3. Nursing Home Litigation and Tort Reform: A Case for Exceptionalism

    Science.gov (United States)

    Studdert, David M.; Stevenson, David G.

    2004-01-01

    The medical malpractice crisis that is currently spreading across the United States bears many similarities to earlier crises. One novel aspect of the current crisis is the explicit inclusion of litigation against nursing homes as a target of reform. Encouraged by the nursing home industry, policymakers are considering the extension of…

  4. Classification of educational subject matter: the case of Home ...

    African Journals Online (AJOL)

    Although it represents an individual view, this article was submitted to the Department of Education by the Cape Higher Education Consortium (CHEC) as an outcome of the review of the field of Home Economics in the Western Cape region. By presenting some history, it argues that the category of Home Economics is no ...

  5. Observing Privacy, Modesty and Hospitality in the Home Domain: Three Case Studies of Muslim Homes in Brisbane, Australia

    Directory of Open Access Journals (Sweden)

    Zulkeplee Othman

    2014-12-01

    Full Text Available A home embodies a sensorial space that is layered with personal memories and traces of history. The success of a home in providing a strong sense of place depends on various factors such as geographical location, climatic conditions, and occupants’ world-views and perceptions. This paper explores Muslims’ perceptions of privacy, modesty and hospitality within their homes through their lived experiences. This case study focuses on three Muslim families living in Australian designed homes within the same suburb of Brisbane, Australia. The study provides prefatory insight into the ways in which these families perform their daily activities and entertain their guests without jeopardizing their privacy needs. The study examines the significance of modesty in the design of Muslim homes as a means by which family members are able to achieve optimum privacy while simultaneously extending hospitality to guests inside and outside their homes. The findings of this study provide opportunities too, for expanding research into culturally adaptable housing systems to help meet the changing needs of Australian multicultural society.

  6. Case management with homeless mentally ill people.

    Science.gov (United States)

    Rife, J C; First, R J; Greenlee, R W; Miller, L D; Feichter, M A

    1991-02-01

    This article reports the findings of a National Institute of Mental Health (NIMH) services demonstration project that used a mobile case management team to serve homeless mentally ill clients. The project examined three issues: (1) factors associated with client engagement in case management, (2) clients' perceptions of how case management affected their quality of life, and (3) significant differences between clients who remained engaged in case management services and those who discontinued involvement. The results indicated that clients who received more frequent case management contact, had higher assessed independent living skills, were older, were less likely to be substance abusers, and had experienced fewer periods of homelessness and fewer prior psychiatric hospitalizations were more likely to remain engaged in case management services. After six months of case management, clients perceived significant improvement in their global well-being, living situation, use of leisure time, finances, and physical health. Implications for providing case management services to homeless mentally ill people are presented.

  7. Factors Determining Correct Case Management of Acute ...

    African Journals Online (AJOL)

    ARIs) is one of the factors responsible for the high ARI mortality in developing countries. Identification of factors which influence ARI case management by health workers is key for interventions to improve Quality of case management. Objective: ...

  8. DOE ZERH Case Study: Carl Franklin Homes, L.C./Green Extreme Homes, CDC, McKinley Project, Garland TX

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning affordable home in the hot-humid climate that got a HERS 56 without PV or HERS 26 with PV, with 4.5” SIP walls and 8.5” SIP roof; uninsulated slab; ductless minisplit heat pump 15.5 SEER, and tankless hot water.

  9. Research of home energy management system based on technology of PLC and ZigBee

    Science.gov (United States)

    Wei, Qi; Shen, Jiaojiao

    2015-12-01

    In view of the problem of saving effectively energy and energy management in home, this paper designs a home energy intelligent control system based on power line carrier communication and wireless ZigBee sensor networks. The system is based on ARM controller, power line carrier communication and wireless ZigBee sensor network as the terminal communication mode, and realizes the centralized and intelligent control of home appliances. Through the combination of these two technologies, the advantages of the two technologies complement each other, and provide a feasible plan for the construction of energy-efficient, intelligent home energy management system.

  10. Delphi-research for exploring essential components and preconditions for case management for people with dementia.

    NARCIS (Netherlands)

    Verkade, P.J.; Meijel, B. van; Brink, C.; Os-Medendorp, H. van; Koekkoek, B.; Francke, A.L.

    2010-01-01

    Background: Case management programmes for home-dwelling people with dementia and their informal carers exist in multiple forms and shapes. The aim of this research was to identify the essential components of case management for people with dementia as well as the preconditions for an effective

  11. Stochastic control of smart home energy management with plug-in electric vehicle battery energy storage and photovoltaic array

    Science.gov (United States)

    Wu, Xiaohua; Hu, Xiaosong; Moura, Scott; Yin, Xiaofeng; Pickert, Volker

    2016-11-01

    Energy management strategies are instrumental in the performance and economy of smart homes integrating renewable energy and energy storage. This article focuses on stochastic energy management of a smart home with PEV (plug-in electric vehicle) energy storage and photovoltaic (PV) array. It is motivated by the challenges associated with sustainable energy supplies and the local energy storage opportunity provided by vehicle electrification. This paper seeks to minimize a consumer's energy charges under a time-of-use tariff, while satisfying home power demand and PEV charging requirements, and accommodating the variability of solar power. First, the random-variable models are developed, including Markov Chain model of PEV mobility, as well as predictive models of home power demand and PV power supply. Second, a stochastic optimal control problem is mathematically formulated for managing the power flow among energy sources in the smart home. Finally, based on time-varying electricity price, we systematically examine the performance of the proposed control strategy. As a result, the electric cost is 493.6% less for a Tesla Model S with optimal stochastic dynamic programming (SDP) control relative to the no optimal control case, and it is by 175.89% for a Nissan Leaf.

  12. Home

    Directory of Open Access Journals (Sweden)

    Rokeya Sakhawat Hossain

    2012-11-01

    Full Text Available A fiery feminist piece that argues that Indian women are all homeless; animals have homes but Indian women have none, because they have to depend on the mercy of their "keepers"; therefore, Indian women live a life worse than animals.

  13. Guidelines for the management of unethical behaviour in homes for ...

    African Journals Online (AJOL)

    The purpose of this research study is to formulate guidelines to counteract unethical behaviour of auxiliary nurses and care workers in homes for the older persons. The study explored and described: · the perceptions and behaviour of auxiliary nurses and care workers relating to unethical behaviour in homes for older ...

  14. Appliance Recognition in an OSGi-based Home Energy Management Gateway

    OpenAIRE

    Federica, Paganelli; Francesca, Paradiso; Stefano, Turchi; Antonio, Luchetta; Pino, Castrogiovanni; Dino, Giuli

    2015-01-01

    The rational use and management of energy is considered a key societal and technological challenge. Home energy management systems (HEMS) have been introduced especially in private home domains to support users in managing and controlling energy consuming devices. Recent studies have shown that informing users about their habits with appliances as well as their usage pattern can help to achieve energy reduction in private households. This requires instruments able to monitor energy consumptio...

  15. Involved accounting and control in health care : Different perceptions of management accounting and control systems in the Dutch branch of nursing homes, homes for the elderly and homecare

    NARCIS (Netherlands)

    Wil van Erp

    2014-01-01

    The purpose of this study is to explore why and how Management Accounting and Control Systems (MACS) enact and are enacted upon in the Dutch branch of nursing homes, homes for the elderly and home care. In search for answers, this study chooses an actor-network theory (ANT) perspective combined with

  16. New Whole-House Solutions Case Study: Quadrant Homes

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-02-01

    Quadrant moved ducts and high efficiency furnace inside conditioned space on nearly all 300 customizable house plans. The builder uses dry, true factory-assembled walls, extensive air sealing, and just in time delivery for pre-sold homes.

  17. The case of Mr. Martinez: ethical conflicts in home care.

    Science.gov (United States)

    Green, M V

    1997-06-01

    Mr. Martinez recently was accepted into the Valley Hospice Program with a diagnosis of end-stage lung cancer. He currently lives with his daughter, Amelia, after moving from Puerto Rico 2 years ago after his wife died. His two sons and another daughter live within 20 minutes of Amelia's home. They are a close-knit family, and the children are committed to honoring Martinez' wishes to die in his room in Amelia's home.

  18. DOE Zero Energy Ready Home Case Study: The Imery Group — Proud Green Home, Serenbe, GA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    The first certified Zero Energy Ready Home in Georgia was honored in the Custom Builder category of the 2014 Housing Innovation Awards. The 2,811-ft2, two-story custom home has 2x6 advanced framed walls filled with R-20 of open-cell spray foam, plus an R-6.6 insulated coated OSB sheathing. Also included is electronic monitoring equipment that tracks the PV, solar thermal water heater, ERV, mini-split heat pump with three indoor heads, solar water heater, and LED and CFL lighting.

  19. Energy Management strategies for Smart Home Regarding Uncertainties: State of the art, Trends, and Challenges

    DEFF Research Database (Denmark)

    Yousefi, Mojtaba; Hajizadeh, Amin; N. Soltani, Mohsen

    2018-01-01

    The advent of Smart grid and high-energy demand for electricity has provided new opportunities for energy management systems (EMSs) in a smart home (SH). Energy management strategies play a key role in performance and economy of smart homes integrating renewable energy resources, Heat Pumps (HP......), and Plug-in Electrical Vehicle (PEV) energy storages. This paper presents a critical review and analysis of different energy management strategies for SH to handle the uncertainties involved in renewable energy resources, home load demands, PEV charging requirements, and household comfort. In addition...

  20. Development of a Context-Aware Smart Home Energy Manager (CASHEM)

    Energy Technology Data Exchange (ETDEWEB)

    Srivastava, Viraj [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Makhmalbaf, Atefe [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Parker, Graham B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2013-03-01

    The research reported is part of a collaborative with Honeywell, Inc. to bring novel home energy management concepts and technologies to reduce energy consumption, reduce peak electricity demand, integrate renewable energy and storage technology, and change homeowner behavior to manage and consume less energy. The objective of the collaborative is to create a Context-Aware Smart Home Energy Manager (CASHEM) that dynamically schedules major home appliances according to conditions and homeowner convenience of service (CoS) preferences, monitors and analyzes energy consumption of appliances, recommends further energy saving actions, and engages/motivates the homeowner to adopt those recommendations.

  1. Aspects of family-managed care at home

    DEFF Research Database (Denmark)

    Grönvall, Erik

    More and more care, for example of older adults, is performed at home. Municipality home-care workers and novel technologies support this translocation of care. At home, an important care provider is also the immediate family. A recent trend is to formalize this volunteer-, and family-based care....... However, this formalization requires new support systems for collaboration and communication. Also, when informal care turns formal there is a risk that a caring family-member might have to give up professional goals such as a career, or suffer economically as one may not be able to work fulltime while...

  2. Best Practices Case Study: Pulte Homes and Communities of Del Webb, Las Vegas Division

    Energy Technology Data Exchange (ETDEWEB)

    None

    2009-10-01

    Case study of Pulte Homes Las Vegas Division, who certified nearly 1,200 homes to the DOE Builders Challenge between 2008 and 2012. All of the homes by Las Vegas’ biggest builder achieved HERS scores of lower than 70, and many floor plans got down to the mid 50s, with ducts located in sealed attics insulated along the roof line, advanced framing, and extra attention to air sealing.

  3. Home education in the post-communist countries: Case study of the Czech Republic

    OpenAIRE

    Yvona Kostelecka

    2017-01-01

    The paper analyzes the emergence of home education in European post-communist countries after 1989. The case of the Czech Republic representing the development and characteristic features of home education in the whole region is studied in detail. Additional information about homeschooling in other post-communist countries are provided wherever they are available in order to provide a more comprehensive picture of the issue. The driving forces and history of home education afte...

  4. Efficient Solutions for Existing Homes Case Study: Rehabilitations of USDA Multifamily Homes

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-04-01

    Rea Ventures Group, LLC, partnered with Southface Energy Institute (Southface), a member of the U.S. Department of Energy's Partnership for Home Innovation Building America research team, to develop a prescriptive approach for rehabilitating a portfolio of rural multifamily rental properties in Georgia, which was funded by the U.S. Department of Agriculture (USDA).

  5. caregivers' knowledge and home management of fever in children

    African Journals Online (AJOL)

    2014-05-05

    . Public Health Education should be implemented in order to enlighten caregivers on fever and advocate for the use of a clinical thermometer to monitor fever at home. INTRODUCTION. Fever is controlled increase in body ...

  6. Home care business management software not just for scheduling.

    Science.gov (United States)

    Morey, Rick

    2012-10-01

    Rule number one for running a successful, profitable home care company: It is essential to have an efficient, cost-effective administrative operation. A hard fact of the home care industry is that the location of an agency, to a large extent, dictates the billing rates as well as caregiver pay. Therefore, agency profitability is primarily dependent on how efficiently the company is run. Software, used in the right way, helps agencies become more productive andmore profitable.

  7. Investigation of the Home Reading Patterns of Families with Children with Hearing Impairment: ICEM Case

    Science.gov (United States)

    Girgin, Umit

    2012-01-01

    Parents play a critical role in the literacy development of their children. The current case study explores the reading patterns that parents have with their children with hearing impairment. First, the home reading patterns of parents with their children were investigated. Then, the home reading patterns preferred by children were addressed along…

  8. DOE Zero Energy Ready Home Case Study: Boulder ZED Design Build - Boulder, Colorado

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-11-01

    This case study describes a DOE Zero Energy Ready Home in Boulder, Colorado, that scored HERS 38 without PV and 0 with PV. This 2,504 ft2 custom home has advanced framed walls, superior insulation a ground-source heat pump, ERV, and triple-pane windows.

  9. What Happens to a Nursing Home Chain When Private Equity Takes Over? A Longitudinal Case Study

    NARCIS (Netherlands)

    Bos, A.; Harrington, Charlene

    2017-01-01

    We analyzed what happens to a nursing home chain when private equity takes over, with regard to strategy, financial performance, and resident well-being. We conducted a longitudinal (2000-2012) case study of a large nursing home chain that triangulated qualitative and quantitative data from 5

  10. Home Education in the Post-Communist Countries: Case Study of the Czech Republic

    Science.gov (United States)

    Kostelecká, Yvona

    2010-01-01

    The paper analyzes the emergence of home education in European post-communist countries after 1989. The case of the Czech Republic representing the development and characteristic features of home education in the whole region is studied in detail. Additional information about homeschooling in other post-communist countries are provided wherever…

  11. Examining the lived experience of nursing home quality improvement: the case of a multifacility falls reduction project.

    Science.gov (United States)

    Abrahamson, Kathleen; Davila, Heather; Mueller, Christine; Inui, Thomas; Arling, Greg

    2013-09-01

    We conducted a case study based on interviews with nursing home employees (staff and management) participating in a falls reduction project to better understand the lived experience of nursing home quality improvement. Our case study was part of an evaluation of an innovative pay-for-performance policy in the state of Minnesota. In-depth semi-structured interviews were conducted with 37 nursing home employees from within each of the 13 facilities participating in the successful falls reduction project. Our analysis focused on respondent perceptions of the quality improvement implementation process. Interview respondents noted the importance of organizational flexibility and adaptation to change; communication and connections between residents, family members, and staff; and the importance of input from diverse roles. Importantly, interview respondents noted changes that extended well beyond the domain of falls. Knowledge from this study highlights the experiences of care providers enacting change and potentially informs the development of management and program policies that encourage and reward quality nursing home care. Copyright 2013, SLACK Incorporated.

  12. The managerial nature of case management.

    Science.gov (United States)

    Wolk, J L; Sullivan, W P; Hartmann, D J

    1994-03-01

    Case managers have been viewed as engaging in direct practice, community practice, or both. This article offers a third view: Case managers also engage in the practice of management. Employing Mintzberg's seminal research on chief executive behavior, the authors argue that case managers' work is similarly characterized by brevity, variety, and fragmentation. Case managers perform the 10 roles developed in Mintzberg's original study. These roles are divided into three groups: interpersonal, including figurehead, leader, and liaison; informational, including monitor, disseminator, and spokesperson; and decision-making, including entrepreneur, disturbance handler, resource allocator, and negotiator. Case managers' tasks associated with each role are presented. Considering their work as managerial in nature will help case managers more effectively assist clients in goal achievement.

  13. Personalized Medication Management: Towards a Design of Individualized Support for Elderly Citizens at Home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo; Olsen, Jesper Wolff

    2012-01-01

    Several technologies have been developed to support people's medication management, including pillboxes, specialized software applications, reminders and paper-based medication lists. Several of these technologies were discovered in older adults' homes during user studies carried out with the main...

  14. Efficient Solutions for New Homes Case Study: Savannah Gardens

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-03-15

    The Savannah Housing Department is leading sustainable and affordable housing development in Georgia. It partnered with Southface Energy Institute, a member of the U.S. Department of Energy’s Partnership for Home Innovation Building America research team, to seek cost-effective solutions for increasing the energy efficiency of the Savannah Housing Department’s standard single-family home plans in the Savannah Gardens Community. Based on engineering, cost, and constructability analyses, the combined research team chose to pilot two technologies to evaluate efficiency and comfort impacts for homeowners: a heat-pump water heater in an encapsulated attic and an insulated exterior wall sheathing.

  15. Portfolio Manager Selection – A Case Study

    DEFF Research Database (Denmark)

    Christensen, Michael

    2017-01-01

    Within a delegated portfolio management setting, this paper presents a case study of how the manager selection process can be operationalized in practice. Investors have to pursue a thorough screening of potential portfolio managers in order to discover their quality, and this paper discusses how...... such a screening process can be performed—represented by a case study....

  16. DOE Zero Energy Ready Home Case Study: KB Homes, San Marcos, California

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    Designed to produce as much energy as it uses, the ZeroHouse incorporates a PV system, R-15 fiberglass batts in walls, and slab-on-grade foundation. The builder ranked fifth in the nation on Builder Magazine’s 2012 Top 100 ranking of U.S. home builders based on number of housing starts, and won a 2013 Housing Innovation Award in the production builder category.

  17. DOE Zero Energy Ready Home Case Study: TC Legend Homes — Cedarwood, Bellingham, WA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This house was the Grand Winner in the Affordable Builder category of the 2014 Housing Innovation Awards, and has 6-inch SIP walls, a 10-inch structural insulated panel roof, and insulating concrete forms foundation walls with R-20 high-density rigid EPS foam under the slab.A single ductless heat pump heats and cools the home, which also gets passive solar heating from south-facing triple-pane windows that heat a concrete slab floor plus a connected greenhouse.

  18. Skin tears: care and management of the older adult at home.

    Science.gov (United States)

    Holmes, Regina F; Davidson, Martha W; Thompson, Bonnie J; Kelechi, Teresa J

    2013-02-01

    Skin tears experienced by older adults require special skills to promote healing. Home healthcare providers are in key positions to manage skin tears and prevent further skin trauma. Several guidelines, risk assessments, classifications, and products exist to manage high-risk patients. Frequent evaluation of the effectiveness of the treatment and prevention strategies in an overall skin care protocol for home care patients is critical to reduce skin tear incidence and promote prompt healing when skin tears are present.

  19. Study on Case Teaching of Financial Management

    Science.gov (United States)

    Che, Zhenghong; Che, Zhengmei

    2011-01-01

    Case teaching is an efficient teaching method of management. It plays an important role to enhance the students' ability to practice the theory. However, case teaching of financial management has not achieved the expected results. The paper aims to study the importance, characteristics and corresponding methods of case teaching method of financial…

  20. Home education in the post-communist countries: Case study of the Czech Republic

    Directory of Open Access Journals (Sweden)

    Yvona KOSTELECKÁ

    2010-10-01

    Full Text Available The paper analyzes the emergence of home education in European post-communist countries after 1989. The case of the Czech Republic representing the development and characteristic features of home education in the whole region is studied in detail. Additionalinformation about homeschooling in other post-communist countries are provided wherever they are available in order to provide a more comprehensive picture of the issue. The driving forces and history of home education after 1989 are described. Current homeschooling legislation is analyzed with special attention paid to the processes of the legal enrolment of individuals into home education, supervision and assessment of educational results. The article concludes that despite the existence of country-specificcharacteristics, many features of home education in post-communist countries are similar. These generally include the rather strict regulation of home education and the high importance of schools as both gate-keeping and supervising institutions.

  1. Home education in the post-communist countries: Case study of the Czech Republic

    Directory of Open Access Journals (Sweden)

    Yvona Kostelecka

    2017-11-01

    Full Text Available The paper analyzes the emergence of home education in European post-communist countries after 1989. The case of the Czech Republic representing the development and characteristic features of home education in the whole region is studied in detail. Additional information about homeschooling in other post-communist countries are provided wherever they are available in order to provide a more comprehensive picture of the issue. The driving forces and history of home education after 1989 are described. Current homeschooling legislation is analyzed with special attention paid to the processes of the legal enrolment of individuals into home education, supervision and assessment of educational results. The article concludes that despite the existence of country-specific characteristics, many features of home education in post-communist countries are similar. These generally include the rather strict regulation of home education and the high importance of schools as both gate-keeping and supervising institutions.

  2. Behavioural and psychological symptoms of dementia and their management in care homes within the East of England: a postal survey.

    Science.gov (United States)

    Backhouse, Tamara; Killett, Anne; Penhale, Bridget; Burns, Diane; Gray, Richard

    2014-03-01

    To determine the prevalence of antipsychotic use in care homes. To explore which behaviours care home staff can find difficult to manage and which non-pharmacological interventions are currently used within care homes to help cope with behavioural and psychological symptoms of dementia. A postal survey sent to all care homes registered as specialising in the care of older people or/and older people with dementia within four counties in the East of England (n = 747). Questionnaires were returned from 299 care home managers (40%). The vast majority (n = 200, 73%) reported having at least one resident with an antipsychotic prescription in their home. Twelve percent (n = 1027) of care home residents were reported to be prescribed antipsychotic medications. Aggression was most frequently reported, by 37% (n = 109) of care home managers, as a difficult behaviour to manage. Non-pharmacological interventions were reported to be used in 87% (n = 253) of care homes. The interventions most commonly used in care homes to manage difficult behaviours were reminiscence (75%, n = 219) and music therapy (73%, n = 213). This survey was a first attempt to estimate the use of antipsychotics in care homes. Despite measures to reduce antipsychotic use for all people with dementia in England, we found that 12% of care home residents were still prescribed antipsychotic medication. Around half of all care home managers reported they had experienced behaviours they found difficult. Antipsychotic medications and a variety of non-pharmacological interventions appear to be used concurrently in many care homes.

  3. Posthumous Pardons, the Home Office and the Timothy Evans Case

    OpenAIRE

    Rubin, Gerry

    2007-01-01

    Examines the legal issues surrounding the exercise of the prerogative of mercy to grant posthumous pardons either to those convicted of a capital offence or those executed for offences under military law, specifically during the First World War. Focuses on the policy considerations leading to the Home Secretary’s decision to recommend the grant of a posthumous pardon for Timothy Evans in 1966.

  4. Medicines Education at Home--A Case Study in Finland

    Science.gov (United States)

    Hokkanen, Johanna; Elorinne, Anna-Liisa; Hämeen-Anttila, Katri; Keinonen, Tuula

    2017-01-01

    Background: Educating children about medicines and medicine use is part of health education and is often seen as parents' responsibility. However, to date, little research has been conducted on medicines education as provided in the home. Objective: To explore (1) parents' attitudes towards medicines, (2) medicines education practices in the home…

  5. A Case for 'Prevailing Ecology' as Premium Determinant in Home ...

    African Journals Online (AJOL)

    If the quantitative terminology 'indices' can be used to define them, then those human acts ... The paper proposes a re-evaluation of the tools of assessment of home-based child care costs in order to be able to .... aggravated the situation where poor households barely have enough good food to eat. Migration of men and ...

  6. Zero Energy Ready Home Multifamily Case Study Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Dentz, Jordan [Advanced Residential Integrated Energy Solutions Collaborative, New York, NY (United States); Alaigh, Kunal [Advanced Residential Integrated Energy Solutions Collaborative, New York, NY (United States)

    2016-02-01

    Two multifamily buildings planned in Climate Zone 4 were analyzed to determine the cost, energy and performance implications of redesigning them to comply with Zero Energy Ready Home, a recognition program of the U.S. Department of Energy. Energy modeling was conducted on one representative apartment in each building using BEopt.

  7. Electric Energy Management in the Smart Home: Perspectives on Enabling Technologies and Consumer Behavior

    Energy Technology Data Exchange (ETDEWEB)

    Zipperer, A. [Colorado State Univ., Fort Collins, CO (United States); Aloise-Young, P. A. [Colorado State Univ., Fort Collins, CO (United States); Suryanarayanan, S. [Colorado State Univ., Fort Collins, CO (United States); Zimmerle, D. [Colorado State Univ., Fort Collins, CO (United States); Roche, R. [Univ. of Technology, Belfort-Montebeliard (France); Earle, L. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Christensen, D. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Bauleo, P. [Fort Collins Utilities, CO (United States)

    2013-08-01

    Smart homes hold the potential for increasing energy efficiency, decreasing costs of energy use, decreasing the carbon footprint by including renewable resources, and trans-forming the role of the occupant. At the crux of the smart home is an efficient electric energy management system that is enabled by emerging technologies in the electricity grid and consumer electronics. This article presents a discussion of the state-of-the-art in electricity management in smart homes, the various enabling technologies that will accelerate this concept, and topics around consumer behavior with respect to energy usage.

  8. Electric Energy Management in the Smart Home: Perspectives on Enabling Technologies and Consumer Behavior

    Energy Technology Data Exchange (ETDEWEB)

    Zipperer, Adam; Aloise-Young, Patricia A.; Suryanarayanan, Siddharth; Roche, Robin; Earle, Lieko; Christensen, Dane; Bauleo, Pablo; Zimmerle, Daniel

    2013-11-01

    Smart homes hold the potential for increasing energy efficiency, decreasing costs of energy use, decreasing the carbon footprint by including renewable resources, and transforming the role of the occupant. At the crux of the smart home is an efficient electric energy management system that is enabled by emerging technologies in the electric grid and consumer electronics. This article presents a discussion of the state-of-the-art in electricity management in smart homes, the various enabling technologies that will accelerate this concept, and topics around consumer behavior with respect to energy usage.

  9. Building America Case Study: Whole-House Solutions for Existing Homes: Greenbelt Homes, Inc. Pilot Retrofit Program; Whole-House Solutions for Existing Homes, Energy Efficiency & Renewable Energy (EERE)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a decade-long community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. With the community upgrade fully funded by the cooperative through their membership without outside subsidies, this project presents a unique opportunity to evaluate and prioritize the wide-range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects to include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy savings benefits of improvements. Phase 1: baseline evaluation for a representative set of 28 homes sited in seven buildings; Phase 2: installation of the building envelope improvements and continued monitoring of the energy consumption for the heating season and energy simulations supporting recommendations for HVAC and water heating upgrades to be implemented in Phase 3.

  10. Management of Fruit Species in Urban Home Gardens of Argentina Atlantic Forest as an Influence for Landscape Domestication.

    Science.gov (United States)

    Furlan, Violeta; Pochettino, María L; Hilgert, Norma I

    2017-01-01

    Home gardens are considered germplasm repositories and places for experimentation, thus they are key sites for the domestication of plants. Domestication is considered a constant process that occurs along a continuum from wild to managed to domesticated populations. Management may lead to the modification of populations and in other cases to their distribution, changing population structure in a landscape. Our objective is focused on the management received in home gardens by perennial species of fruits. For this, the management practices applied to native and exotic perennial fruits species by a group of 20 women in the periurban zone of Iguazú, Argentina, were analyzed. In-depth interviews were conducted, as well as guided tours for the recognition and collection of specimens of species and ethnovarieties. Sixty-six fruit species managed in the home gardens were recorded. The predominant families are Rutaceae, Myrtaceae, and Rosaceae. The fruit species with the highest number of associated management practices are pitanga ( Eugenia uniflora ) and pindó ( Syagrus rommanzoffiana ). The 10 species with the highest management intensity are (in decreasing order of intensity) banana ( Musa x paradisiaca ), palta ( Persea americana ), pitanga ( E. uniflora ), mango ( Mangifera indica ), cocú ( Allophylus edulis ), mamón ( Carica papaya ), guayaba ( Psidium guajava ), limón mandarina ( Citrus x taitensis ), güembé ( Philodendron bipinnatifidum ), and mandarina ( Citrus reticulata ). Among the families with the greatest modifications in their distribution, abundance and presence of ethnovarieties in domestic gardens, are the native Myrtaceae and the exotic Rutaceae. The main management practices involved are cultivation, tolerance, transplant and enhancement in decreasing order. It can be concluded that in Iguazú, fruit species management shows both in plant germplasm as in environment a continuum that through tolerance, transplant and cultivation latu sensu has

  11. Management of Fruit Species in Urban Home Gardens of Argentina Atlantic Forest as an Influence for Landscape Domestication

    Directory of Open Access Journals (Sweden)

    Violeta Furlan

    2017-09-01

    Full Text Available Home gardens are considered germplasm repositories and places for experimentation, thus they are key sites for the domestication of plants. Domestication is considered a constant process that occurs along a continuum from wild to managed to domesticated populations. Management may lead to the modification of populations and in other cases to their distribution, changing population structure in a landscape. Our objective is focused on the management received in home gardens by perennial species of fruits. For this, the management practices applied to native and exotic perennial fruits species by a group of 20 women in the periurban zone of Iguazú, Argentina, were analyzed. In-depth interviews were conducted, as well as guided tours for the recognition and collection of specimens of species and ethnovarieties. Sixty-six fruit species managed in the home gardens were recorded. The predominant families are Rutaceae, Myrtaceae, and Rosaceae. The fruit species with the highest number of associated management practices are pitanga (Eugenia uniflora and pindó (Syagrus rommanzoffiana. The 10 species with the highest management intensity are (in decreasing order of intensity banana (Musa x paradisiaca, palta (Persea americana, pitanga (E. uniflora, mango (Mangifera indica, cocú (Allophylus edulis, mamón (Carica papaya, guayaba (Psidium guajava, limón mandarina (Citrus x taitensis, güembé (Philodendron bipinnatifidum, and mandarina (Citrus reticulata. Among the families with the greatest modifications in their distribution, abundance and presence of ethnovarieties in domestic gardens, are the native Myrtaceae and the exotic Rutaceae. The main management practices involved are cultivation, tolerance, transplant and enhancement in decreasing order. It can be concluded that in Iguazú, fruit species management shows both in plant germplasm as in environment a continuum that through tolerance, transplant and cultivation latu sensu has derived in a

  12. Home Management of Febrile Children Under-Five Years in ...

    African Journals Online (AJOL)

    An assessment of the prevalence and the factors associated with home treatment of children less than five years with febrile illnesses was carried out at Mmuhungura Ward in Kahama District, Shinyanga, Tanzania. Out of the 400 under-fives who participated in the study, 79% had fallen sick during the previous six months.

  13. Caregivers' Knowledge and Home Management of Fever in Children

    African Journals Online (AJOL)

    Background: Fever is one of the most common complaints presented to the Paediatric Emergency Unit (PEU). It is a sign that there is an underlying pathologic process, the most common being infection. Many childhood illnesses are accompanied by fever, many of which are treated at home prior to presentation to hospital.

  14. Disaster case management and individuals with disabilities.

    Science.gov (United States)

    Stough, Laura M; Sharp, Amy N; Decker, Curt; Wilker, Nachama

    2010-08-01

    To examine the case management and disaster recovery needs of individuals with disabilities following Hurricane Katrina. The case managers and supervisors in this study provided case management to individuals with disabilities as part of the largest coordinated disaster case management program in U.S. history, the Katrina Aid Today consortium. This study provides an account of the disaster case management needs of individuals with disabilities as well as a picture of their long-term recovery process two years following the disaster. Forty-two case managers and 12 case management supervisors from this program provided services to a collective caseload of 2,047 individuals with disabilities and their families. Interviews and telephone surveys were conducted with these participants 20-24 months after the disaster. The qualitative data were analyzed using grounded theory methodology, and descriptive statistics summarize the demographic data. Findings suggest that the disaster recovery process is typically more complex and lengthy for individuals with disabilities and requires negotiation of a service system sometimes unprepared for disability-related needs. Barriers to disaster recovery for individuals with disabilities included a lack of accessible housing, transportation, and disaster services. Supports to disaster recovery included the individual effort and advocacy of a case manager, connecting with needed resources, collaboration with other agencies, and client motivation and persistence. Results suggest that disaster recovery is facilitated by case managers with disability expertise, including knowledge about the needs of individuals with disabilities and about disability-related services.

  15. What do we know about care home managers? Findings of a scoping review.

    Science.gov (United States)

    Orellana, Katharine; Manthorpe, Jill; Moriarty, Jo

    2017-03-01

    This article reports selected findings from a scoping review of the literature about care home managers in England. The review was undertaken between December 2013 and April 2014, with searches conducted in December 2013, and completed in July 2014. Its aim was to identify the characteristics of care home managers, descriptions of their leadership and managerial roles, their experience, skills and support, and the managers' perceptions of their work and status and to identify knowledge gaps. The databases searched included Web of Knowledge, EBSCO, ASSIA, Embase, AgeInfo, NHS Evidence, Social Care Online and the publication platforms IngentaConnect, Wiley Online and JSTOR together with specialist sites and national information providers. Sixteen relevant studies directly about care home managers, reported in 24 articles, were identified. A further body of literature pertinent to the questions was located (n = 84), including sector reports, professional press, expert opinion, enquiries and reviews, and other material, which also informed the review. A consultation exercise with stakeholders informed the findings of the review. The review found that, despite frequent allusions to their impact on organisational culture, few studies have focused on care home managers, and, such as there are, mainly relate to managers of care homes for older people. This is despite managers' major responsibilities for the care of many frail and disabled people. © 2016 John Wiley & Sons Ltd.

  16. [Infection control management and practice in home care - analysis of structure quality].

    Science.gov (United States)

    Spegel, H; Höller, C; Randzio, O; Liebl, B; Herr, C

    2013-02-01

    Surveillance of infection control management and practices in home care is an important task of the public health service. While infection control aspects in residential homes for the aged and nursing are increasingly being discussed this subject has been poorly recognised in home care. The aim of this study was to identify problems in hygiene regarding the transmission of infectious diseases as well as quality assessment in home care. Based on the results of this study implications for infection control in home care facilities for public health services should be developed. Statistical analyses were performed on the primary quality assessment data of home care facilities collected by the medical service of health insurances via computer-assisted personal interviews between March 2006 and March 2009. Structure quality in 194 home care facilities was analysed as well as human resources and organisational conditions. Analyses were also done in the context of the clients' risk factor load. All analyses were performed by stratifying for the size of the home care services. To assess how the involved characteristics vary according to the size of the home care services chi-square tests and non-parametric tests were calculated. About 80% of the assessed home care services disposed of an infection control management plan. Compared to larger services smaller home care services, especially services with less than 10 clients had a poor structure in infection control management and practice. They also carried a higher load of risk factors in clients. The larger services had significantly less human resources. Surveillance of infection control management and practices by the public health services should focus on the structure of the smaller home care services. At the same time smaller home care services should be supported by offering training for the staff or counselling regarding hygiene-related aspects. Furthermore, the outcome quality of the larger home care services with

  17. Managing children's risk of injury in the home: does parental teaching about home safety reduce young children's hazard interactions?

    Science.gov (United States)

    Morrongiello, Barbara A; McArthur, Brae Anne; Bell, Melissa

    2014-10-01

    Past research confirms that parents extend much effort to teach their young children about safety, but little is known about this process. The present study examined mothers' use of teaching as a strategy to manage young children's risk of home injury and how this impacts children's hazard interactions. Mothers of three-year-olds completed an in-home room-by-room interview in which they identified injury hazards that concern them, reported on use of teaching to manage risk of injury from these hazards, rated children's understanding of these safety issues and compliance with behavioral guidelines regarding these safety issues, and reported on children's recent interactions with these hazards. They also completed questionnaire measures of how difficult the child is to manage and the child's typical level of risk taking. Results revealed that children's understanding of safety impacted both their compliance and hazard interactions, moderating the impact of risk taking on compliance and also the impact of children's difficult-to-manage score on hazard interactions. These findings demonstrate that teaching strategies need to effectively enhance children's understanding of the safety issue in order to reduce children's risk of hazard interactions. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Home-based Healthcare Technology

    DEFF Research Database (Denmark)

    Verdezoto, Nervo

    of these systems target a specific treatment or condition and might not be sufficient to support the care management work at home. Based on a case study approach, my research investigates home-based healthcare practices and how they can inform future design of home-based healthcare technology that better account...

  19. Final Scientific/Technical Report: Context-Aware Smart Home Energy Manager (CASHEM)

    Energy Technology Data Exchange (ETDEWEB)

    Foslien, Wendy K. [Honeywell International Inc., Golden Valley, MN (United States); Curtner, Keith L. [Honeywell International Inc., Golden Valley, MN (United States)

    2013-01-15

    Because of growing energy demands and shortages, residential home owners are turning to energy conservation measures and smart home energy management devices to help them reduce energy costs and live more sustainably. In this context, the Honeywell team researched, developed, and tested the Context Aware Smart Home Energy Manager (CASHEM) as a trusted advisor for home energy management. The project focused on connecting multiple devices in a home through a uniform user interface. The design of the user interface was an important feature of the project because it provided a single place for the homeowner to control all devices and was also where they received coaching. CASHEM then used data collected from homes to identify the contexts that affect operation of home appliances. CASHEM's goal was to reduce energy consumption while keeping the user's key needs satisfied. Thus, CASHEM was intended to find the opportunities to minimize energy consumption in a way that fit the user's lifestyle.

  20. Families' perceived benefits of home visits for managing paediatric obesity outweigh the potential costs and barriers.

    Science.gov (United States)

    Gehring, Nicole D; Ball, Geoff D C; Perez, Arnaldo; Holt, Nicholas L; Neuman, Daniel; Spence, Nicholas; Mercier, Laura; Jetha, Mary

    2018-02-01

    Home visits have successfully been used to deliver various health services, but what role could they play in paediatric weight management? Low treatment initiation and high attrition prompted our multidisciplinary paediatric weight management clinic to investigate how families perceived the benefits and barriers of home visits. We focused on children with obesity aged 2-17 who were enrolled in our tertiary-level clinic in Alberta, Canada. None had received a home visit. The families were interviewed face-to-face from October 2015 to October 2016, and we used a qualitative description methodological framework and manifest content analysis. The parents were the main interviewees. Of the 56 families, 89% were interested in a home visit, 82% wanted support from a dietician and 54% from an exercise specialist. The perceived benefits of home visits included comprehensive assessment (95%), convenience (86%), tailored care (29%) and family involvement (13%), while the costs and barriers included clinicians' potential judgmental attitudes (30%), loss of privacy (19%) and distractions (10%). Some thought clinicians would find home visits inconvenient (25%), with bureaucratic challenges (14%) and sustainability issues (5%). Families felt home visits were a convenient option for managing paediatric obesity and identified important benefits and barriers that could guide such interventions. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  1. [Cases of MRSA in nursing homes in Oslo 2005-11].

    Science.gov (United States)

    Steen, Tore Wælgaard; Jørgensen, Silje Bakken; Garder, Kirsten Marie; Kollerud, Ruby del Risco; Kvalvaag, Gunnar; Blomfeldt, Anita

    2013-09-17

    The number of infections caused by MRSA has increased substantially in Norway in the past decade. It is an objective to prevent MRSA from becoming established in nursing homes and hospitals. The purpose of the article is to describe the features of the development of MRSA cases found in nursing homes in Oslo. We carried out a retrospective study of registered cases of MRSA (both sufferers and carriers) in Oslo in 2005-11. Data were obtained from the City of Oslo municipal health services' MRSA database and from genotyping carried out at Akershus University Hospital. The annual number of cases of MRSA found in Oslo increased during the period 2005-11 from 92 in 2005 to 268 in 2011, a total of 1198 cases. Of these, 224 cases (19%) were registered in nursing homes, distributed among 22 institutions, 158 residents and 66 staff, with an average of 32 cases annually (14-58 spread). Twenty-eight of 50 nursing homes had no cases of MRSA, while 159 of the cases were related to outbreaks of MRSA. Three of 20 outbreaks affected residents only. The nursing home isolates consisted of 40 different spa types, of which 160 (71%) of the isolates were clustered in three clonal complexes. The most common spa type t304 was found in 116 (52%) of the cases. Cases of MRSA in Oslo in total increased sharply from 2005 to 2011, while the number of cases in nursing homes was stable. It is, however, uncertain whether this reflects the actual incidence.

  2. Optimal procedures for home visits — A case study

    Science.gov (United States)

    Alves, Filipe; Fernandes, Florbela P.; Pereira, Ana I.; Fernandes, Adília

    2017-07-01

    In Portugal the population is ageing. Therefore, the provision of health care at patients' home is becoming an important social and health area; this health service is provided by professional teams (usually composed by nurses) of the Health Centers. Nowadays, the scheduling of the visits is made manually. The proposal of this work is to do the scheduling automatically in order to minimize the overall time spent by the professional teams in the visiting activity. In this work the genetic algorithm was used to solve the optimization problem. Some numerical results are presented.

  3. Treatment in the home setting with intermittent pneumatic compression for a woman with chronic leg ulcers: a case report.

    Science.gov (United States)

    Young, Katrina; Ng Chok, Harrison; Wilkes, Lesley

    2017-01-01

    Intermittent Pneumatic Compression (IPC) is shown to improve the healing rate of Venous Leg Ulcers (VLU) in the hospital setting. The current Australian "Gold Standard" treatment according to the Australian and New Zealand Wound Management Associations' (AWMA) Prevention & Management of Venous Leg Ulcer guidelines is compression, generally in the form of bandaging then progressing to hosiery once wounds are healed to prevent recurrence. This is recommended in conjunction with other standards of wound management including; nutrition, exercise, client education and addressing underlying pathophysiology and psychosocial factors. Compression bandaging is predominantly attended by community nurses in the clients' home. Barriers to delivery of this treatment include; client concordance and or suitability for bandaging including client habitus, (shape of legs), client lifestyle, clinician knowledge and clinicians physical ability to attend bandaging, in particular for obese clients with limited mobility who pose a manual handling risk to the clinician themselves. The use of IPC may assist in mitigating some of these concerns, therefore it would seem wise to explore the use of IPC within the home setting. This paper will present an original case report on the successful treatment of a woman living with chronic bilateral lower leg ulcers using IPC as an adjunct treatment in her home. This paper supports recommendations to explore the use of IPC therapy in the home setting, for treatment of chronic leg ulcers requiring compression. Use of IPC in the home is anticipated to improve client involvement, concordance, client outcomes and reduce risk to staff applying conventional compression bandaging systems, particularly for obese clients with limited mobility.

  4. 75 FR 27375 - Postal Rate Case Management

    Science.gov (United States)

    2010-05-14

    ... POSTAL REGULATORY COMMISSION [Docket No. PI2010-3; Order No. 456] Postal Rate Case Management AGENCY: Postal Regulatory Commission. ACTION: Notice. SUMMARY: The Commission is seeking comments relevant to management of an anticipated exigent postal rate case. It has scheduled a technical conference...

  5. Iowa Case Management for Rural Drug Abuse

    Science.gov (United States)

    Hall, James A.; Vaughan Sarrazin, Mary S.; Huber, Diane L.; Vaughn, Thomas; Block, Robert I.; Reedy, Amanda R.; Jang, MiJin

    2009-01-01

    Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual…

  6. Case manager satisfaction in public health.

    Science.gov (United States)

    Schutt, Russell K; Fawcett, Jacqueline; Gall, Gail B; Harrow, Brooke; Woodford, Mary Lou

    2010-01-01

    The purpose of this study was to examine correlates of case managers' satisfaction with their work, services, and service network and to identify connections to service performance and service costs. A decentralized public health program that exemplifies the trend toward more diverse clients and networked services. A mixed method design with 34 case managers. As hypothesized, the case managers' experiences with clients and the service network, and their service effectiveness, were associated with their satisfaction with their jobs and the services they provide. Satisfaction was also positively associated with more timely service delivery. These associations were explained in part by case managers' education and training. Case managers can achieve high levels of job and service satisfaction in outreach programs serving a diverse client population in a decentralized service network. Case managers' job and service satisfaction improves with reduced service problems and service delays and when case managers can devise work-arounds for persistent service problems. Using advanced practice nurses (APN) and providing more on-the-job training may increase case manager satisfaction with their jobs and the services they provide. Special efforts may be needed to prevent a decline in job satisfaction with years of experience.

  7. Load Balancing Integrated Least Slack Time-Based Appliance Scheduling for Smart Home Energy Management.

    Science.gov (United States)

    Silva, Bhagya Nathali; Khan, Murad; Han, Kijun

    2018-02-25

    The emergence of smart devices and smart appliances has highly favored the realization of the smart home concept. Modern smart home systems handle a wide range of user requirements. Energy management and energy conservation are in the spotlight when deploying sophisticated smart homes. However, the performance of energy management systems is highly influenced by user behaviors and adopted energy management approaches. Appliance scheduling is widely accepted as an effective mechanism to manage domestic energy consumption. Hence, we propose a smart home energy management system that reduces unnecessary energy consumption by integrating an automated switching off system with load balancing and appliance scheduling algorithm. The load balancing scheme acts according to defined constraints such that the cumulative energy consumption of the household is managed below the defined maximum threshold. The scheduling of appliances adheres to the least slack time (LST) algorithm while considering user comfort during scheduling. The performance of the proposed scheme has been evaluated against an existing energy management scheme through computer simulation. The simulation results have revealed a significant improvement gained through the proposed LST-based energy management scheme in terms of cost of energy, along with reduced domestic energy consumption facilitated by an automated switching off mechanism.

  8. Top Management Leadership Style and Quality of Care in Nursing Homes

    Science.gov (United States)

    Castle, Nicholas G.; Decker, Frederic H.

    2011-01-01

    Purpose: The purpose of this study was to examine the association of Nursing Home Administrator (NHA) leadership style and Director of Nursing (DON) leadership style with quality of care. Design and Methods: Leaders were categorized into 4 groups: consensus managers, consultative autocrats, shareholder managers, or autocrats. This leadership style…

  9. Continuity of care in home health-care practice: two management paradoxes.

    Science.gov (United States)

    Gjevjon, Edith R; Romøren, Tor I; Kjøs, Bente Ø; Hellesø, Ragnhild

    2013-01-01

      To explore continuity of care from a manager's perspective: How do managers understand the concept of continuity of care and how do they assess continuity of care in home health-care? How do managers work to ensure continuity of care when managing care provision for patients in their homes?   Continuity of care is considered a prerequisite for service quality. Managers can influence continuity of care through managing day-to-day work.   Semi-structured interviews of a purposive sample of 16 managers from 12 municipal units. Theory-driven and data-driven analysis was applied.   Ideally, to promote continuity of care, the number of carers should be limited. Yet, in practice, discontinuity of care was accepted as a working compromise. The managers faced two paradoxes: the continuity ideal vs. the practicalities of home health-care, and caring for patients vs. caring for staff.   The managers were forced to prioritize, in conflict with ideals or professional standards, patients' wellbeing or the wellbeing of the staff. Ensuring continuity of care for all patients did not seem feasible.   The study highlights management paradoxes: possible unintended consequences of prioritizing needs for continuity of care should be objects of reflection in care management. © 2012 Blackwell Publishing Ltd.

  10. Providers' Perspectives on Case Management of a Healthy Start Program: A Qualitative Study.

    Directory of Open Access Journals (Sweden)

    Imelda K Moise

    Full Text Available Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1 the structural challenges faced in implementing case management for program participants, and 2 possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were audio recorded and the case managers' comments were transcribed verbatim. Transcripts were analyzed using thematic analysis, a deductive approach. Data were collected in 2013 and analyzed in 2015. Case managers are challenged by externalities (demographic shifts in target populations, poverty; contractual requirements (predefined catchment neighborhoods, caseload; limited support (client incentives, tailored training, and a high staff turnover rate; and logistic difficulties (organizational issues. Their approach to case management tends to be focused on linking Although Healthy Start case managers recognized the benefits of case management for facilitating optimal service delivery to women and their families, structural factors impact effective implementation. This study investigated case managers' views of 1 the structural challenges faced in implementing case management for program participants, and 2 possible strategies to enhance case management in medical home settings. Two focus groups were conducted separately with case managers from the four program service sites to gain insight into these issues noted above. Each group was co-facilitated by two evaluators using a previously developed semi-structured interview guide. The group discussions were

  11. Digital transformation in home care. A case study.

    Science.gov (United States)

    Bennis, Sandy; Costanzo, Diane; Flynn, Ann Marie; Reidy, Agatha; Tronni, Catherine

    2007-01-01

    Simply implementing software and technology does not assure that an organization's targeted clinical and financial goals will be realized. No longer is it possible to roll out a new system--by solely providing end user training and overlaying it on top of already inefficient workflows and outdated roles--and know with certainty that targets will be met. At Virtua Health's Home Care, based in south New Jersey, implementation of their electronic system initially followed this more traditional approach. Unable to completely attain their earlier identified return on investment, they enlisted the help of a new role within their health system, that of the nurse informaticist. Knowledgeable in complex clinical processes and not bound by the technology at hand, the informaticist analyzed physical workflow, digital workflow, roles and physical layout. Leveraging specific tools such as change acceleration, workouts and LEAN, the informaticist was able to redesign workflow and support new levels of functionality. This article provides a view from the "finish line", recounting how this role worked with home care to assimilate information delivery into more efficient processes and align resources to support the new workflow, ultimately achieving real tangible returns.

  12. Safety in home care: A research protocol for studying medication management

    Directory of Open Access Journals (Sweden)

    Easty Anthony

    2010-06-01

    Full Text Available Abstract Background Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. Yet, we have little understanding of the supports and barriers to safe medication management in the Canadian home care environment. There is a clear need to engage the providers and recipients of care in studying and improving medication safety with collaborative approaches to exploring the nature and safety of medication management in home care. Methods A socio-ecological perspective on health and health systems drives our iterative qualitative study on medication safety with elderly home care clients, family members and other informal caregivers, and home care providers. As we purposively sample across four Canadian provinces: Alberta (AB, Ontario (ON, Quebec (QC and Nova Scotia (NS, we will collect textual and visual data through home-based interviews, participant-led photo walkabouts of the home, and photo elicitation sessions at clients' kitchen tables. Using successive rounds of interpretive description and human factors engineering analyses, we will generate robust descriptions of managing medication at home within each provincial sample and across the four-province group. We will validate our initial interpretations through photo elicitation focus groups with home care providers in each province to develop a refined description of the phenomenon that can inform future decision-making, quality improvement efforts, and research. Discussion The application of interpretive and human factors lenses to the visual and textual data is expected to yield findings that advance our understanding of the issues, challenges, and risk-mitigating strategies related to medication safety in home care. The images are powerful knowledge translation tools for sharing what we learn with participants, decision makers, other healthcare audiences, and the public. In addition, participants engage in knowledge exchange

  13. Nursing homes: Development of elderly care management in the Buddhist way

    Directory of Open Access Journals (Sweden)

    Warakorn Poolswat

    2015-11-01

    Full Text Available This research aims to study the historical background and current situation of care management in nursing homes for the elderly in Western Thailand and develop care management according to Buddhist principles. This qualitative research analyzes three nursing homes using interview, observation, focus group discussion and workshop as data collection tools. The researchers used a snowball sampling method to identify 109 respondents, made up of 35 key informants, 34 casual informants and 40 general informants. The researchers verified data with a triangulation method and analyzed information descriptively. Results found that the most eminent problems in care management of elderly nursing homes are the image of experts, environment and activity management. Nursing homes do not respond to spiritual requests because of a lack of social and spiritual development. It is necessary to find a new way to emphasize responsibility and respond to spiritual requests by Buddhist means. In this paper, the researchers propose a set of guidelines for the care management of nursing homes in Western Thailand.

  14. Home care nurses' knowledge of evidence-based education topics for management of heart failure.

    Science.gov (United States)

    Delaney, Colleen; Apostolidis, Beka; Lachapelle, Leeanne; Fortinsky, Richard

    2011-01-01

    We primarily sought to evaluate home care nurses' knowledge of evidence-based education topics in managing heart failure (HF). Moreover, we wanted to determine if differences were evident in nurses' knowledge based on education and work experience, and to identify home care nurses' specific educational needs. A cross-sectional survey design was used. Home care nurses (n = 94) were recruited from 4 home care agencies. A previously published 20-item HF knowledge questionnaire was administered to participants, and an open-ended question determined participants' need for further HF-related education. Home care nurses' scores demonstrated a 78.9% knowledge level in overall HF education principles. The mean HF knowledge score was 15.78 (SD, ±1.69) out of a possible 20 points. Nurses scored lowest on knowledge related to asymptomatic hypotension (24.5% answered correctly), daily weight monitoring (26.6% answered correctly), and transient dizziness (30.9% answered correctly). Nurses requested further information on all HF topics addressed in the survey as well as on psychosocial issues, research evidence, and more information from other healthcare providers. Our findings suggest that home care nurses may not be sufficiently knowledgeable in evidence-based education topics for managing HF. The results help confirm the need to develop educational programs for home care nurses in managing HF, which may lead to improved quality of patient education. Further research is needed to address specific deficits in the knowledge of home care nurses, and to determine if HF educational programs for nurses would enhance and sustain nurses' knowledge of HF management education. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Standardising Home Range Studies for Improved Management of the Critically Endangered Black Rhinoceros.

    Directory of Open Access Journals (Sweden)

    Roan D Plotz

    Full Text Available Comparisons of recent estimations of home range sizes for the critically endangered black rhinoceros in Hluhluwe-iMfolozi Park (HiP, South Africa, with historical estimates led reports of a substantial (54% increase, attributed to over-stocking and habitat deterioration that has far-reaching implications for rhino conservation. Other reports, however, suggest the increase is more likely an artefact caused by applying various home range estimators to non-standardised datasets. We collected 1939 locations of 25 black rhino over six years (2004-2009 to estimate annual home ranges and evaluate the hypothesis that they have increased in size. A minimum of 30 and 25 locations were required for accurate 95% MCP estimation of home range of adult rhinos, during the dry and wet seasons respectively. Forty and 55 locations were required for adult female and male annual MCP home ranges, respectively, and 30 locations were necessary for estimating 90% bivariate kernel home ranges accurately. Average annual 95% bivariate kernel home ranges were 20.4 ± 1.2 km(2, 53 ± 1.9% larger than 95% MCP ranges (9.8 km(2 ± 0.9. When home range techniques used during the late-1960s in HiP were applied to our dataset, estimates were similar, indicating that ranges have not changed substantially in 50 years. Inaccurate, non-standardised, home range estimates and their comparison have the potential to mislead black rhino population management. We recommend that more care be taken to collect adequate numbers of rhino locations within standardized time periods (i.e., season or year and that the comparison of home ranges estimated using dissimilar procedures be avoided. Home range studies of black rhino have been data deficient and procedurally inconsistent. Standardisation of methods is required.

  16. DOE Zero Energy Ready Home Case Study: Durable Energy Builders - Houston, Texas

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-11-01

    This case study describes a DOE Zero Energy Ready Home in Houston, Texas, that scored HERS 39 without PV and HERS 29 with PV. This 5,947 ft2 custom home has 11.5-inch ICF walls. The attic is insulated along the roof line with 5 to 7 inches of open-cell spray foam. Most of the home's drinking water is supplied by a 11,500-gallon rainwater cistern. Hurricane strapping connects the roof to the walls. The triple-pane windows are impact resistant. The foundation is a raised slab.

  17. What Happens to a Nursing Home Chain When Private Equity Takes Over? A Longitudinal Case Study.

    Science.gov (United States)

    Bos, Aline; Harrington, Charlene

    2017-01-01

    We analyzed what happens to a nursing home chain when private equity takes over, with regard to strategy, financial performance, and resident well-being. We conducted a longitudinal (2000-2012) case study of a large nursing home chain that triangulated qualitative and quantitative data from 5 different data sources. Results show that private equity owners continued and reinforced several strategies that were already put in place before the takeover, including a focus on keeping staffing levels low; the new owners added restructuring, rebranding, and investment strategies such as establishing new companies, where the nursing home chain served as an essential "launch customer."

  18. Best Practices Case Study: David Weekley Homes - Eagle Springs and Waterhaven, Houston, TX

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2011-04-01

    Case study describing David Weekley Homes, Houston Division, has qualified more than 1,240 homes for the DOE Builders Challenge. Advanced framed 2x6 walls with open headers and two-stud corners allow more room for R-20 damp sprayed cellulose wall cavity insulation that is covered with R-5 rigid XPS foam. A radiant barrier cuts heat gain in the R-38 insulated vented attics. Draft stopping at fireplace and duct chases and behind tubs, gluing sheetrock to framing, and extensive caulking make for air-tight homes at 3.0 ACH50.

  19. Improving patients' home cooking - A case series of participation in a remote culinary coaching program.

    Science.gov (United States)

    Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J

    2017-08-01

    This case series describes and examines the outcomes of a remote culinary coaching program aimed at improving nutrition through home cooking. Participants (n = 4) improved attitudes about the perceived ease of home cooking (p culinary skills (p = 0.02); and also improved in confidence to continue online learning of culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health-related culinary interventions.

  20. Building America Energy Renovations. A Business Case for Home Performance Contracting

    Energy Technology Data Exchange (ETDEWEB)

    Baechler, Michael C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Antonopoulos, C. A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sevigny, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Gilbride, T. L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hefty, M. G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2012-10-01

    This research report gives an overview of the needs and opportunities that exist in the U.S. home performance contracting industry. The report discusses industry trends, market drivers, different business models, and points of entry for existing and new businesses hoping to enter the home performance contracting industry. Case studies of eight companies who successfully entered the industry are provided, including business metrics, start-up costs, and marketing approaches.

  1. DOE Zero Energy Ready Home Case Study: Leganza Residence - Greenbank, Washington

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-11-01

    This case study describes a DOE Zero Energy Ready Home in Greenbank, Washington that scored HERS 37 without PV and a -5 with PV. This 1,955 ft2 custom home has 6.5-inch structural insulated panel (SIPs) walls, a 10.25-inch SIPS roof, an R-20 insulated slab, a 2-ton ground source heat pump, radiant floor heat, 7.1 kWh PV, and triple-pane windows.

  2. Care home managers' knowledge of palliative care: a Northern Irish study.

    Science.gov (United States)

    Mitchell, Gary; McGreevy, Jessie; Preshaw, Deborah Hl; Agnelli, Joanne; Diamond, Monica

    2016-05-01

    The aim of this study was to determine care home managers' knowledge of palliative care using the palliative care quiz for nursing (PCQN). Palliative care is strongly advocated for all people living with advancing incurable illness. Within a care home setting there should be a particular emphasis on the importance of palliative care, particularly for those residents who, because of their advancing age, are likely to live with non-malignant diseases such as dementia, chronic obstructive pulmonary disease or heart failure to name a few. Before the beginning of a workshop on optimising palliative care for people living in care homes, 56 care home managers (all nurses) completed the PCQN, a validated questionnaire that is used to assess a nurse's knowledge of palliative care, as part of a learning exercise. The quiz consisted of 20 questions for which participants could answer true, false or don't know. The average score was 12.89 correct answers out of a possible 20 (64.45%). This study highlights the need to develop the knowledge and competence of care home managers in relation to palliative care. This is particularly important given the increasing number of people who are living with non-malignant disease within a care home setting.

  3. A Solution Based on Bluetooth Low Energy for Smart Home Energy Management

    Directory of Open Access Journals (Sweden)

    Mario Collotta

    2015-10-01

    Full Text Available The research and the implementation of home automation are getting more popular because the Internet of Things holds promise for making homes smarter through wireless technologies. The installation of systems based on wireless networks can play a key role also in the extension of the smart grid towards smart homes, that can be deemed as one of the most important components of smart grids. This paper proposes a fuzzy-based solution for smart energy management in a home automation wireless network. The approach, by using Bluetooth Low Energy (BLE, introduces a Fuzzy Logic Controller (FLC in order to improve a Home Energy Management (HEM scheme, addressing the power load of standby appliances and their loads in different hours of the day. Since the consumer is involved in the choice of switching on/off of home appliances, the approach introduced in this work proposes a fuzzy-based solution in order to manage the consumer feedbacks. Simulation results show that the proposed solution is efficient in terms of reducing peak load demand, electricity consumption charges with an increase comfort level of consumers. The performance of the proposed BLE-based wireless network scenario are validated in terms of packet delivery ratio, delay, and jitter and are compared to IEEE 802.15.4 technology.

  4. Managing migration: the Brazilian case

    OpenAIRE

    Eduardo L. G. Rios-Neto

    2005-01-01

    The objective of this paper is to present the Brazilian migration experience and its relationship with migration management. The article is divided into three parts. First, it reviews some basic facts regarding Brazilian immigration and emigration processes. Second, it focuses on some policy and legal issues related to migration. Finally, it addresses five issues regarding migration management in Brazil.

  5. Software requirements management based on use cases

    International Nuclear Information System (INIS)

    Xiao Jin

    2009-01-01

    In this paper, the requirements management based on use cases is theoretically explored, and a multi-layer use-case model is introduced, which combined with three levels of use cases and a single use-case refinement model. Through the practice in a software project, the multi-layer use-case model provides a good solution on how to control the requirements scope and change, and provides the balance of work assignment between customer departments, information management departments and software development outsourcing team. (authors)

  6. A Domestic Microgrid with Optimized Home Energy Management System

    Directory of Open Access Journals (Sweden)

    Zafar Iqbal

    2018-04-01

    Full Text Available Microgrid is a community-based power generation and distribution system that interconnects smart homes with renewable energy sources (RESs. Microgrid efficiently and economically generates power for electricity consumers and operates in both islanded and grid-connected modes. In this study, we proposed optimization schemes for reducing electricity cost and minimizing peak to average ratio (PAR with maximum user comfort (UC in a smart home. We considered a grid-connected microgrid for electricity generation which consists of wind turbine and photovoltaic (PV panel. First, the problem was mathematically formulated through multiple knapsack problem (MKP then solved by existing heuristic techniques: grey wolf optimization (GWO, binary particle swarm optimization (BPSO, genetic algorithm (GA and wind-driven optimization (WDO. Furthermore, we also proposed three hybrid schemes for electric cost and PAR reduction: (1 hybrid of GA and WDO named WDGA; (2 hybrid of WDO and GWO named WDGWO; and (3 WBPSO, which is the hybrid of BPSO and WDO. In addition, a battery bank system (BBS was also integrated to make our proposed schemes more cost-efficient and reliable, and to ensure stable grid operation. Finally, simulations were performed to verify our proposed schemes. Results show that our proposed scheme efficiently minimizes the electricity cost and PAR. Moreover, our proposed techniques, WDGA, WDGWO and WBPSO, outperform the existing heuristic techniques.

  7. Database Management Systems: New Homes for Migrating Bibliographic Records.

    Science.gov (United States)

    Brooks, Terrence A.; Bierbaum, Esther G.

    1987-01-01

    Assesses bibliographic databases as part of visionary text systems such as hypertext and scholars' workstations. Downloading is discussed in terms of the capability to search records and to maintain unique bibliographic descriptions, and relational database management systems, file managers, and text databases are reviewed as possible hosts for…

  8. Case Study on Inventory Management Improvement

    Directory of Open Access Journals (Sweden)

    Plinere Darya

    2015-12-01

    Full Text Available Inventory management is a challenging problem area in supply chain management. Companies need to have inventories in warehouses in order to fulfil customer demand, meanwhile these inventories have holding costs and this is frozen fund that can be lost. Therefore, the task of inventory management is to find the quantity of inventories that will fulfil the demand, avoiding overstocks. This paper presents a case study for the assembling company on inventory management. It is proposed to use inventory management in order to decrease stock levels and to apply an agent system for automation of inventory management processes.

  9. [Challenges for home care services in the pain management of cancer patients : A qualitative study].

    Science.gov (United States)

    Gnass, I; Krutter, S; Nestler, N

    2018-03-21

    People with cancer are increasingly supported by home care services. Pain is a relevant symptom of these diseases and nurses of home care services are involved in the treatment. The German National Expert Standard "Pain management in nursing" includes evidence-based recommendations for the implementation of adequate pain management. Considering the given structural conditions of home care services, nurses describe both barriers and challenges with the implementation. By means of five guideline-based discussion groups, nurses of 14 home care services were questioned about the challenges they had experienced in pain management. The questioning focuses on the level of implementation of the recommendation for each aspect: pain assessment, pharmacological pain therapy, non-pharmacological pain therapy, pain-related side effects, information, training, and counseling in the care of people with cancer. A qualitative content analysis was conducted. On the one hand, the results illustrate a need for further knowledge and possibilities, e.g., for the assessment of pain as a multidimensional phenomenon and, on the other hand, that the conditions for continuous pain monitoring of cancer patients in home care services are limited. The need for short-term reconciliation with the treatment team and the practitioners proved to be more difficult than the cooperation with the palliative care network. Involvement of family members is important to ensure uninterrupted treatment. Beside knowledge and competencies regarding nursing care, structures and processes for interprofessional pain management need further development and research.

  10. Home Health Care (HHC) Managers Perceptions About Challenges and Obstacles that Hinder HHC Services in Jordan

    Science.gov (United States)

    Ajlouni, Musa T.; Dawani, Hania; Diab, Salah M.

    2015-01-01

    Home care aims at supporting people with various degrees of dependency to remain at home rather than use residential, long-term, or institutional-based nursing care. Demographic, epidemiological, social, and cultural trends in Jordan as in other countries are changing the traditional patterns of care with growing emphasis on home care. The purpose of this study is to highlight the most common challenges related to home health care (HHC) services in Jordan as perceived by the managers of HHC agencies. Methods: a descriptive qualitative design that depends on focus group discussions has been used to collect data from a sample of 18 managers who met the selection criteria and who are willing to participate, the study found that, the main challenges of HHC services as perceived by managers were: shortage of female staff, lack of governance and regulation, poor management, unethical practices, lack of referral systems, and low accessibility of the poor and less privileged as HHC services are not included in health insurance schemes, it concludes also that the home health care industry in Jordan is facing many challenges and problems that may have negative effects on the effectiveness, efficiency, equity and quality of services and should be addressed by health policy makers. PMID:25946949

  11. SymptomCare@Home: Developing an Integrated Symptom Monitoring and Management System for Outpatients Receiving Chemotherapy.

    Science.gov (United States)

    Beck, Susan L; Eaton, Linda H; Echeverria, Christina; Mooney, Kathi H

    2017-10-01

    SymptomCare@Home, an integrated symptom monitoring and management system, was designed as part of randomized clinical trials to help patients with cancer who receive chemotherapy in ambulatory clinics and often experience significant symptoms at home. An iterative design process was informed by chronic disease management theory and features of assessment and clinical decision support systems used in other diseases. Key stakeholders participated in the design process: nurse scientists, clinical experts, bioinformatics experts, and computer programmers. Especially important was input from end users, patients, and nurse practitioners participating in a series of studies testing the system. The system includes both a patient and clinician interface and fully integrates two electronic subsystems: a telephone computer-linked interactive voice response system and a Web-based Decision Support-Symptom Management System. Key features include (1) daily symptom monitoring, (2) self-management coaching, (3) alerting, and (4) nurse practitioner follow-up. The nurse practitioner is distinctively positioned to provide assessment, education, support, and pharmacologic and nonpharmacologic interventions to intensify management of poorly controlled symptoms at home. SymptomCare@Home is a model for providing telehealth. The system facilitates using evidence-based guidelines as part of a comprehensive symptom management approach. The design process and system features can be applied to other diseases and conditions.

  12. A multiagent system enhancing home-care health services for chronic disease management.

    Science.gov (United States)

    Koutkias, Vassilis G; Chouvarda, Ioanna; Maglaveras, Nicos

    2005-12-01

    In this paper, a multiagent system (MAS) is presented, aiming to enhance monitoring, surveillance, and educational services of a generic medical contact center (MCC) for chronic disease management. In such a home-care scenario, a persistent need arises for efficiently monitoring the patient contacts and the MCC's functionality, in order to effectively manage and interpret the large volume of medical data collected during the patient sessions with the system, and to assess the use of MCC resources. Software agents were adopted to provide the means to accomplish such real-time information-processing tasks, due to their autonomous, reactive and/or proactive nature, and their effectiveness in dynamic environments by incorporating coordination strategies. Specifically, the objective of the MAS is to monitor the MCC environment, detect important cases, and inform the healthcare and administrative personnel via alert messages, notifications, recommendations, and reports, prompting them for actions. The main aim of this paper is to present the overall design and implementation of a proposed MAS, emphasizing its functional model and architecture, as well as on the agent interactions and the knowledge-sharing mechanism incorporated, in the context of a generic MCC.

  13. [Poliomyelitis case surveillance data management in Burkina Faso].

    Science.gov (United States)

    Drabo, Koiné Maxime; Nana, Félicité; Kouassi, Kouassi Lazare; Konfé, Salifou; Hien, Hervé; Saizonou, Jacques; Ouedraogo, Tinoaga Laurent

    2015-01-01

    The global initiative for poliomyelitis eradication can only remain relevant if survey systems are regularly assessed. In order to identify shortcomings and to propose improvement, the data collection and transmission during case investigation were assessed in the Banfora health district in Burkina Faso. The survey targeted six (6) primary health centres, the district laboratory and the national laboratory, all involved in the poliomyelitis surveillance system. Data from registers, forms documenting suspected cases, stool sample forms and weekly reports were collected by means of a data grid. Data from actors involved in the poliomyelitis case investigation system were collected by means of an individual questionnaire. The reactivity of investigating suspected cases was satisfactory with a median alert questionnaire notification time of 18 hours. The completeness of the reporting system was satisfactory. Nevertheless, the promptness of data management by primary heath centres and the national laboratory remained unsatisfactory. Evaluation of data management revealed logistic and organization shortcomings. The overall efficacy of the poliomyelitis surveillance could be improved by using management tools for laboratory supplies, collecting data related to the homes of suspected cases and implementing a cold chain maintenance plan.

  14. Adjusting for case mix and social class in examining variation in home visits between practices.

    Science.gov (United States)

    Sullivan, Caoimhe O; Omar, Rumana Z; Forrest, Christopher B; Majeed, Azeem

    2004-08-01

    The purpose of this study was to investigate whether adjusting for clinical case mix and social class explains more of the variation in home visits between general practices than adjusting for age and sex alone. The setting was 60 general practices in England and Wales taking part in the 1 year Fourth National Morbidity Survey. The participants comprised 349 505 patients who were registered with one of the participating general practices for at least 180 days, and who had at least one consultation during the period. The outcome measure is whether or not a patient received a home visit in that year. A clinical case mix category (morbidity class) based on 1 year's diagnostic information was assigned to each patient using the Johns Hopkins Adjusted Clinical Groups (ACG) Case Mix System. The social class measure was derived from occupation and employment status and is similar to that of the 1991 UK census. Variations in home visits between practices were examined using multilevel logistic regression models. The variability between practices before and after adjusting for clinical case mix and social class was estimated using the intracluster correlation coefficient (ICC). The overall percentage of patients receiving a home visit over the 1 year study period was 17%, and this varied from 7 to 31% across the 60 practices. The percentage of the total variation in home visits attributable to differences between practices was 2.5% [95% confidence interval (CI) 1.4-3.2%] after adjusting for age and sex. This reduced to 1.6% (95% CI 1.1-2.4%) after taking into account morbidity class. The results were similar when social class was included instead of morbidity class. Morbidity and social class together reduced variation in home visits between practices to 1.5% (95% CI 1.1-2.2%). Age, sex, social class and clinical case mix are strong determinants of home visits in the UK. Adjusting for morbidity and social class results in a small improvement in explaining the variability in

  15. A Fuzzy-Logic Subsumption Controller for Home Energy Management Systems

    Energy Technology Data Exchange (ETDEWEB)

    Ainstworth, Nathan; Johnson, Brian; Lundstrom, Blake

    2015-10-05

    Presentation for NAPS 2015 associated with conference publication CP-64392. Home Energy Management Systems (HEMS) are controllers that manage and coordinate the generation, storage, and loads in a home. These controllers are increasingly necessary to ensure that increasing penetrations of distributed energy resources are used effectively and do not disrupt the operation of the grid. In this paper, we propose a novel approach to HEMS design based on behavioral control methods, which do not require accurate models or predictions and are very responsive to changing conditions.

  16. Zero Energy Ready Home Multifamily Case Study Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Dentz, Jordan [Advanced Residential Integrated Energy Solutions Collaborative, New York, NY (United States); Alaigh, Kunal [Advanced Residential Integrated Energy Solutions Collaborative, New York, NY (United States)

    2016-02-05

    Two multifamily buildings planned in Climate Zone 4 were analyzed to determine the cost, energy and performance implications of redesigning them to comply with Zero Energy Ready Home, a recognition program of the U.S. Department of Energy. Energy modeling was conducted on one representative apartment in each building using BEopt. Construction costs were obtained from the developer and subcontractors to determine savings and cost increases over ENERGY STAR. It was found that seven items would be necessary to change to comply with ZERH criteria when starting from the original design which was compliant with ENERGY STAR version 3.0. Design changes were made to the exterior walls, domestic water heating system, duct protection, duct design, garage ventilation, and pest control to comply with ZERH requirements. Energy impacts of upgrading from the original design to ZERH resulted in 2 to 8% reduction in modeled source energy consumption, or 1.7 to 10.4 MMBtu per year, although the original design was already about 8% better than a design configured to minimum ENERGY STAR criteria. According to the BEopt analysis, annualized energy related costs of the ZERH design were slightly higher for the apartment and slightly lower for the townhome when compared to the original design.

  17. Home and Online Management and Evaluation of Blood Pressure (HOME BP) digital intervention for self-management of uncontrolled, essential hypertension: a protocol for the randomised controlled HOME BP trial.

    Science.gov (United States)

    Band, Rebecca; Morton, Katherine; Stuart, Beth; Raftery, James; Bradbury, Katherine; Yao, Guiqing Lily; Zhu, Shihua; Little, Paul; Yardley, Lucy; McManus, Richard J

    2016-11-07

    Self-management of hypertension, including self-monitoring and antihypertensive medication titration, lowers blood pressure (BP) at 1 year compared to usual care. The aim of the current trial is to assess the effectiveness of the Home and Online Management and Evaluation of Blood Pressure (HOME BP) intervention for the self-management of hypertension in primary care. The HOME BP trial will be a randomised controlled trial comparing BP self-management-consisting of the HOME BP online digital intervention with self-monitoring, lifestyle advice and antihypertensive drug titration-with usual care for people with uncontrolled essential hypertension. Eligible patients will be recruited from primary care and randomised to usual care or to self-management using HOME BP. The primary outcome will be the difference in mean systolic BP (mm Hg) at 12-month follow-up between the intervention and control groups adjusting for baseline BP and covariates. Secondary outcomes (also adjusted for baseline and covariates where appropriate) will be differences in mean BP at 6 months and diastolic BP at 12 months; patient enablement; quality of life, and economic analyses including all key resources associated with the intervention and related services, adopting a broad societal perspective to include NHS, social care and patient costs, considered within trial and modelled with a lifetime horizon. Medication beliefs, adherence and changes; self-efficacy; perceived side effects and lifestyle changes will be measured for process analyses. Qualitative analyses will explore patient and healthcare professional experiences of HOME BP to gain insights into the factors affecting acceptability, feasibility and adherence. This study has received NHS ethical approval (REC reference 15/SC/0082). The findings from HOME BP will be disseminated widely through peer-reviewed publications, scientific conferences and workshops. If successful, HOME BP will be directly applicable to UK primary care

  18. Resorts, second home owners and distance: a case study in northern Finland

    Directory of Open Access Journals (Sweden)

    Pekka Kauppila

    2010-11-01

    Full Text Available One of the most important factors for the site selection of a second home is the space-time dimension. For example, the popularity of second home tourism in the hinterland of population centres is based on the short distance between second homes and the permanent residence of second home owners. In the case of peripheral resorts, however, the main reason for a large number of second homes is the attractiveness of the area associated with a high level of touristic elements. The study examines the municipalities of residence of the second home owners in four large resorts – Levi, Ruka, Saariselkä and Ylläs – in northern Finland. After analysing the geographical distribution of the owners with maps and diagrams the aim of the paper is to present a distance model for the resorts located in a northern periphery from the viewpoint of the regions of destination. Generally speaking, the model resembles a U-letter. In this respect, the resorts have three zones – day trip, weekend and vacation – and each of them has their own characteristics based on accessibility and regional structure, the number and structure of population (potential owners and land ownership. In the planning context, the proposed model can be utilised as a tool for the marketing of resorts as a second home environment as well as for analysing and comparing the overall attractiveness of resorts.

  19. Case management and adherence to an online disease management system.

    Science.gov (United States)

    Robertson, Lucy; Smith, Michael; Tannenbaum, Dennis

    2005-01-01

    Non-adherence to treatment presents a significant obstacle to achieving favourable health outcomes. We have studied consumers' adherence to an online disease management system for depression, called Recovery Road. Recovery Road was implemented on a pilot basis for mental health care in Western Australia. Recovery Road was available for use by consumers and clinicians to augment usual treatment. One hundred and thirty consumers who had been diagnosed with major depression were enrolled. Consumers who used Recovery Road (n = 98) were provided with education, progress monitoring, e-consultation, e-diary and online evidenced-based therapy. Consumers received either standard, automated adherence reminders by email (n = 69), or case management, which included personalized email and telephone follow-up in response to non-adherence (n = 29). After the first eight sessions, the adherence was 84% in the case management group and 55% in the automatic reminders group. The results suggest that case management increases adherence to online disease management systems.

  20. The impact of managed competition on diversity, innovation and creativity in the delivery of home-care services.

    Science.gov (United States)

    Randall, Glen E

    2008-07-01

    Reforming publicly funded healthcare systems by introducing elements of competition, often by allowing for-profit providers to compete with not-for-profit providers, is a strategy that has become commonplace in Western democracies. It is widely thought that the competitive forces of the marketplace will lead to greater efficiency, diversity and even innovation in the delivery of services. Between 1997 and 2000, a model of 'managed competition' was introduced as a major reform to the delivery of home-care services in Ontario, Canada. It was expected that by allowing greater competition within the home-care sector, this model would constrain costs and encourage provider agencies to become more innovative and creative in meeting service delivery needs. The purpose of this case study is to explore the impact of the managed competition reform on the for-profit and the not-for-profit organisations that provided rehabilitation home-care services, and, more specifically, to assess the extent to which the goal of greater diversity, innovation and creativity was achieved following implementation of the reform. A purposive sample of 49 key informants were selected for in-depth interviews, and a survey of the 36 organisations that provided rehabilitation home-care services and the 43 community care access centres that purchased services from these provider agencies was conducted. Data were collected between November 2002 and May 2003. Findings demonstrate that a combination of coercive, mimetic and normative isomorphic pressures have constrained diversity, innovation and creativity within the home-care sector. The implication is that the features that have traditionally distinguished for-profit and not-for-profit provider agencies from each other are rapidly disappearing, and a new hybrid organisational structure is evolving.

  1. Integrative solutions for intelligent energy management. Smart metering, smart home, smart grid; Integrative Loesungsansaetze fuer ein intelligentes Energiemanagement. Smart Metering, Smart Home and Smart Grid

    Energy Technology Data Exchange (ETDEWEB)

    Jungfleisch, Achim [Hager Vertriebsgesellschaft mbH und Co. KG, Blieskastel (Germany). Marketing

    2011-07-01

    Smart Metering, Smart Home, Smart Grid - these key words significantly determine the current debate about intelligent energy management, or new energy concepts. The author of the contribution under consideration describes the interactions between Smart Metering, Smart Home and Smart Grids and the technical connection of these interactions. Thus, the compact tebis KNX demovea server connects Windows computer and the Internet with the building automation based on KNX. The technically simple combination of smart metering and smart home via Hager radio tower of the building automation provides an access to key energy data for an intelligent load management.

  2. First-Line Nursing Home Managers in Sweden and their Views on Leadership and Palliative Care.

    Science.gov (United States)

    Håkanson, Cecilia; Cronfalk, Berit Seiger; Henriksen, Eva; Norberg, Astrid; Ternestedt, Britt-Marie; Sandberg, Jonas

    2014-01-01

    The aim of this study was to investigate first-line nursing home managers' views on their leadership and related to that, palliative care. Previous research reveals insufficient palliation, and a number of barriers towards implementation of palliative care in nursing homes. Among those barriers are issues related to leadership quality. First-line managers play a pivotal role, as they influence working conditions and quality of care. Nine first-line managers, from different nursing homes in Sweden participated in the study. Semi-structured interviews were conducted and analysed using qualitative descriptive content analysis. In the results, two categories were identified: embracing the role of leader and being a victim of circumstances, illuminating how the first-line managers handle expectations and challenges linked to the leadership role and responsibility for palliative care. The results reveal views corresponding to committed leaders, acting upon demands and expectations, but also to leaders appearing to have resigned from the leadership role, and who express powerlessness with little possibility to influence care. The first line managers reported their own limited knowledge about palliative care to limit their possibilities of taking full leadership responsibility for implementing palliative care principles in their nursing homes. The study stresses that for the provision of high quality palliative care in nursing homes, first-line managers need to be knowledgeable about palliative care, and they need supportive organizations with clear expectations and goals about palliative care. Future action and learning oriented research projects for the implementation of palliative care principles, in which first line managers actively participate, are suggested.

  3. New association formed for hospital case managers.

    Science.gov (United States)

    1999-09-01

    A national board of case management professionals has established the Little Rock, AR-based American Case Management Association (ACMA), the first case management association specifically designed to address the needs and concerns of hospital and health system-based case managers. The formation of ACMA was motivated in part by the desire to foster closer cooperation between nurses and social workers in the acute care setting. The association's board and officers have equal representation from the nursing and social work professions. Members of ACMA will be able to take advantage of the following services: a job opportunities network, an information resource center, a director's forum, and a mentoring service. Annual membership dues are $135.

  4. Outage management: A case study

    International Nuclear Information System (INIS)

    Haber, S.B.; Barriere, M.T.; Roberts, K.H.

    1992-01-01

    Outage management issues identified from a field study conducted at a two-unit commercial pressurized water reactor (PWR), when one unit was in a refueling outage and the other unit was at full power operation, are the focus of this paper. The study was conduced as part of the US Nuclear Regulatory Commission's (NRC) organizational factors research program, and therefore the issues to be addressed are from an organizational perspective. Topics discussed refer to areas identified by the NRC as critical for safety during shutdown operations, including outage planning and control, personnel stress, and improvements in training and procedures. Specifically, issues in communication, management attention, involvement and oversight, administrative processes, organizational culture, and human resources relevant to each of the areas are highlighted by example from field data collection. Insights regarding future guidance in these areas are presented based upon additional data collection subsequent to the original study

  5. Managing occupations in everyday life for people with advanced cancer living at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen

    2017-01-01

    Background: People with advanced cancer are able to live for extended periods of time. Advanced cancer can cause functional limitations influencing the ability to manage occupations. Although studies have shown that people with advanced cancer experience occupational difficulties, there is only...... limited research that specifically explores how these occupational difficulties are managed. Objective: To describe and explore how people with advanced cancer manage occupations when living at home. Material and methods: A sub-sample of 73 participants from a larger occupational therapy project took part...... in the study. The participants were consecutively recruited from a Danish university hospital. Qualitative interviews were performed at the homes of the participants. Content analysis was applied to the data. Results: Managing occupations were manifested in two main categories; 1) Conditions influencing...

  6. Investigating the management of diabetes in nursing homes using a mixed methods approach.

    LENUS (Irish Health Repository)

    Hurley, L

    2017-03-21

    As populations age there is an increased demand for nursing home (NH) care and a parallel increase in the prevalence of diabetes. Despite this, there is growing evidence that the management of diabetes in NHs is suboptimal. The reasons for this are complex and poorly understood. This study aimed to identify the current level of diabetes care in NHs using a mixed methods approach.

  7. Hospice Care in Nursing Homes: Does It Contribute to Higher Quality Pain Management?

    Science.gov (United States)

    Kayser-Jones, Jeanie S.; Kris, Alison E.; Miaskowski, Christine A.; Lyons, William L.; Paul, Steven M.

    2006-01-01

    Purpose: The purpose of this study was to investigate pain management among 42 hospice and 65 non-hospice residents in two proprietary nursing homes. Design and Methods: In this prospective, anthropological, quantitative, and qualitative study, we used participant observation, event analysis, and chart review to obtain data. The Medication…

  8. The interdisciplinary approach to the implementation of a diabetes home care disease management program.

    Science.gov (United States)

    Rosa, Mary Ann; Lapides, Shawn; Hayden, Corrine; Santangelo, Roxanne

    2014-02-01

    Diabetes is a national epidemic and a leading cause of hospitalizations in the United States. Home care agencies need to be able to provide effective Diabetes Disease Management to help prevent avoidable hospitalizations and assist patients to live a good quality of life. This article describes one organization's journey toward providing patients with better diabetes care resulting in an improved quality of life.

  9. A cross-sectional study of home-based management of malaria in ...

    African Journals Online (AJOL)

    A community-based cross-sectional study was designed to assess knowledge on signs, symptoms and treatment options for malaria in Bakaano, a suburb of Cape Coast, to determine the extent to which malaria is managed at homes. Our observations showed that the community had good knowledge of signs and ...

  10. COMET: a multicomponent home-based disease-management programme versus routine care in severe COPD.

    Science.gov (United States)

    Kessler, Romain; Casan-Clara, Pere; Koehler, Dieter; Tognella, Silvia; Viejo, Jose Luis; Dal Negro, Roberto W; Díaz-Lobato, Salvador; Reissig, Karina; Rodríguez González-Moro, José Miguel; Devouassoux, Gilles; Chavaillon, Jean-Michel; Botrus, Pierre; Arnal, Jean-Michel; Ancochea, Julio; Bergeron-Lafaurie, Anne; De Abajo, Carlos; Randerath, Winfried J; Bastian, Andreas; Cornelissen, Christian G; Nilius, Georg; Texereau, Joëlle B; Bourbeau, Jean

    2018-01-01

    The COPD Patient Management European Trial (COMET) investigated the efficacy and safety of a home-based COPD disease management intervention for severe COPD patients.The study was an international open-design clinical trial in COPD patients (forced expiratory volume in 1 s management intervention or to the usual management practices at the study centre. The disease management intervention included a self-management programme, home telemonitoring, care coordination and medical management. The primary end-point was the number of unplanned all-cause hospitalisation days in the intention-to-treat (ITT) population. Secondary end-points included acute care hospitalisation days, BODE (body mass index, airflow obstruction, dyspnoea and exercise) index and exacerbations. Safety end-points included adverse events and deaths.For the 157 (disease management) and 162 (usual management) patients eligible for ITT analyses, all-cause hospitalisation days per year (mean±sd) were 17.4±35.4 and 22.6±41.8, respectively (mean difference -5.3, 95% CI -13.7 to -3.1; p=0.16). The disease management group had fewer per-protocol acute care hospitalisation days per year (p=0.047), a lower BODE index (p=0.01) and a lower mortality rate (1.9% versus 14.2%; pmanagement intervention did not significantly reduce unplanned all-cause hospitalisation days, but reduced acute care hospitalisation days and mortality in severe COPD patients. Copyright ©ERS 2018.

  11. The structuring of management control in Swedish home care units : An explorative discourse study

    OpenAIRE

    Lindström, Linda

    2014-01-01

    Background. The research on management in Swedish home care has been conductedmainly from sociological perspectives where structural conditions have been of interest (see for example Hagerman et al., 2013; Andersson, 2014; Österlind, 2013). The conditions impacting on management are described as differing ideals where the main ideals are the care perspective and the cost perspective (see for example Andersson, 2014; Österlind, 2013). The conflict between ideals create tensions between ideolog...

  12. Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single Family Homes (Revised)

    Energy Technology Data Exchange (ETDEWEB)

    Cummings, J.; Withers, C.; Martin, E.; Moyer, N.

    2012-10-01

    This document focuses on managing the driving forces which move air and moisture across the building envelope. While other previously published Measure Guidelines focus on elimination of air pathways, the ultimate goal of this Measure Guideline is to manage drivers which cause air flow and water vapor transport across the building envelope (and also within the home), control air infiltration, keep relative humidity (RH) within acceptable limits, avoid combustion safety problems, improve occupant comfort, and reduce house energy use.

  13. Adherence of Pain Assessment to the German National Standard for Pain Management in 12 Nursing Homes

    Directory of Open Access Journals (Sweden)

    Jürgen Osterbrink

    2014-01-01

    Full Text Available BACKGROUND: Pain is very common among nursing home residents. The assessment of pain is a prerequisite for effective multiprofessional pain management. Within the framework of the German health services research project, ‘Action Alliance Pain-Free City Muenster’, the authors investigated pain assessment adherence according to the German national Expert Standard for Pain Management in Nursing, which is a general standard applicable to all chronic/acute pain-affected persons and highly recommended for practice.

  14. DOE Zero Energy Ready Home Case Study: Amerisips Homes — Miller-Bloch Residence, Johns Island, SC

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    For this DOE Zero Energy Ready Home that won a Custom Builder award in the 2014 Housing Innovation Awards, the builder uses structural insulated panels to construct the entire building shell, including the roof, walls, and floor of the home.

  15. DOE ZERH Case Study: High Performance Homes, Chamberlain Court #75, Gettysburg, PA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning production home in the cold climate that got a HERS 37 without PV, or HERS 23 with PV, with R-24 SIP walls, Basement with R-10 under slab, and R-15 unfaced batt on walls, sealed attic with R-49 ocsf under roof deck; ground source heat pump COP 4.4.

  16. Impact of home industries on water quality in a tributary of the Marimba River, Harare: implications for urban water management

    Science.gov (United States)

    Mvungi, A.; Hranova, R. K.; Love, D.

    Sustainable use of water resources requires the integration of demand management with source quality management. The City of Harare is a case in point, where wastewater and runoff from the city flow into its reservoirs. Little has yet been established on the quality of runoff from home industries in the high-density urban environment. In Harare, most of these are located close to streams draining into the city’s reservoirs. The impact of runoff from different land uses on water quality in a tributary of the Marimba River, Kuwadzana high-density suburb, Harare, was assessed. The water quality from two sub-catchments, one of which contained home industries and residential areas and the other, which contained residential areas only, was compared over the 2001-2002 rainy season. It was found that phosphate (1.08 mg/l), TKN (3.2 mg/l), ammonia (1.14 mg/l), faecal coliforms (1000/100 ml), iron (6.9 mg/l), and lead (0.53 mg/l) were the major water quality pollutants. The SCS-SA model was used to estimate the runoff in different sampling points. Pollution loads for certain parameters were, on average, four times higher in the sub-catchment containing home industries (287 kg total phosphates, 319 kg TKN nitrate, 115 kg ammonia, 744 kg iron and 41 kg lead), than in the sub-catchment containing residential areas only (74kg total phosphates, 50 kg TKN nitrate, 21 kg ammonia, 138 kg iron and 12 kg lead). This is due to the higher runoff volumes from the area containing the home industries, while the pollution concentrations at both representative points where not statistically different. Accordingly, it is recommended that the City authorities should reassess current practice and make provision for sewer and drainage systems and adequate disposal of solid and hazardous wastes in areas zoned for home industries and to improve the solid waste management in high-density areas. Efforts should be made to control the storage of materials and scrap in these areas. Most importantly

  17. Molecular markers in management of ex situ PGR - A case study

    Indian Academy of Sciences (India)

    Home; Journals; Journal of Biosciences; Volume 37; Issue 5. Molecular markers in management of ex situ PGR - A case study. Andreas Börner Elena K Khlestkina Sabina Chebotar Manuela Nagel Mian Abdur Rehman Arif Kerstin Neumann Borislav Kobiljski Ulrike Lohwasser Marion S Röder. Articles Volume 37 Issue 5 ...

  18. Teaching Cases in Management - Amendopar

    Directory of Open Access Journals (Sweden)

    Renata Cesar Torres

    2011-05-01

    Full Text Available This study is a teaching case that deals with a managerial problem faced by a medium-size Brazilian company. Amendopar was a family business in the peanut products industry that operated in the Brazilian market for 47 years. The Londrina, Paraná unit was operating close to its maximum production capacity, imposing a limit to the company’s growth. Having an already well established position in its state of origin, the owners were considering expanding into other markets. There was also interest on their part because of the tax benefits they would reap by establishing a new production unit in São Paulo State. However, the challenge at this time was to decide whether it was the right time to make this move and how much investment would be required. These decisions would be made at a meeting to be held and for which the Industrial Director was preparing.

  19. New Whole-House Solutions Case Study: Lancaster County Career and Technology Center Green Home 3 - Mount Joy, Pennsylvania

    Energy Technology Data Exchange (ETDEWEB)

    None

    2014-12-01

    This case study describes a unique vocational program at Lancaster County Career Technology Center in Mount Joy, PA, where high school students are gaining hands-on construction experience in building high performance homes with help from Building America team, Home Innovation Research Labs. This collaboration resulted in the Green Home 3, the third in a series of high performance homes for Apprentice Green. As one of LCCTC’s key educational strategies for gaining practical experience, students are involved in building real houses that incorporate state-of-the-art energy efficiency and green technologies. With two homes already completed, the Green Home 3 achieved a 44% whole-house energy savings over the Building America New Construction B10 Benchmark, DOE Zero Energy Ready Home (formerly Challenge Home) certification, and National Green Building Standard Gold-level certification.

  20. Caseload management, work-related stress and case manager self-efficacy among Victorian mental health case managers.

    Science.gov (United States)

    King, Robert

    2009-05-01

    In Australia and comparable countries, case management has become the dominant process by which public mental health services provide outpatient clinical services to people with severe mental illness. There is recognition that caseload size impacts on service provision and that management of caseloads is an important dimension of overall service management. There has been little empirical investigation, however, of caseload and its management. The present study was undertaken in the context of an industrial agreement in Victoria, Australia that required services to introduce standardized approaches to caseload management. The aims of the present study were therefore to (i) investigate caseload size and approaches to caseload management in Victoria's mental health services; and (ii) determine whether caseload size and/or approach to caseload management is associated with work-related stress or case manager self-efficacy among community mental health professionals employed in Victoria's mental health services. A total of 188 case managers responded to an online cross-sectional survey with both purpose-developed items investigating methods of case allocation and caseload monitoring, and standard measures of work-related stress and case manager personal efficacy. The mean caseload size was 20 per full-time case manager. Both work-related stress scores and case manager personal efficacy scores were broadly comparable with those reported in previous studies. Higher caseloads were associated with higher levels of work-related stress and lower levels of case manager personal efficacy. Active monitoring of caseload was associated with lower scores for work-related stress and higher scores for case manager personal efficacy, regardless of size of caseload. Although caseloads were most frequently monitored by the case manager, there was evidence that monitoring by a supervisor was more beneficial than self-monitoring. Routine monitoring of caseload, especially by a workplace

  1. DOE Zero Energy Ready Home Case Study: Shore Road Project - Old Greenwich, Connecticut

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-11-01

    This case study describes a DOE Zero Energy Ready Home in Old Greenwich, CT, that scored HERS 40 without PV and HERS 27 with PV. This 4,100 ft2 custom home has 13-inch ICF basement walls and 11-inch ICF above-grade walls with a closed-cell spray foam-insulated roof deck, and a continuously running ERV. The house has a dual-fuel heat pump, an instantaneous condensing water heater, and 4.5-kW solar shingles.

  2. DOE Zero Energy Ready Home Case Study: Montlake Modern - Seattle, Washington

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-11-01

    This case study describes a DOE Zero Energy Ready Home in Seattle, WA, that scored HERS 42 without PV and a -1 with PV. This 3,192 ft2 custom home has 6-inch SIP walls, a 12-inch SIP roof, an R-28 ICF-insulated foundation slab edge with R-20 rigid foam under the slab; an air-to-water heat pump plus radiant floor heat; 100% LED lighting; filtered-fan-powered fresh air intake; triple-pane windows, 9.7 kWh PV for electric car charging station.

  3. Nurse Case Managers' Experiences on Case Management for Long-term Hospitalization in Korea.

    Science.gov (United States)

    Oh, Jinjoo; Oh, Seieun

    2017-12-01

    The implementation of case management for long-term hospitalization use has been approved for controlling medical cost increases in other countries. But, introduction of the case management in Korea has created issues that hinder its effective operation. This qualitative study aimed to obtain further understanding of the issues surrounding the management of Medical Aid beneficiaries' use of long-term hospitalization from the case managers' perspectives and to provide suggestions for successful case management. Thematic analysis was employed to analyze the data. Medical Aid case managers with 3 or more years of case management experience were recruited from urban, suburban, and rural regions. Data were collected through in-depth interviews: 12 nurse case managers participated in focus group interviews and 11 participated in individual one-on-one interviews. Four major themes emerged: on-site obstacles that hinder work progress; going in an opposite direction; ambiguous position of case managers; and work-related emotions. Eleven subthemes were discovered: chasing potential candidates; becoming an enemy; discharging patients who have nowhere to go; welfare-centered national policies increasing medical costs; Medical Aid Program that encourages hospitalization; misuse of hospitalization; feeling limited; working without authority; fulfilling the expected role; fretting about social criticism; and feeling neglected and unprotected. The findings highlight the complexity and ambiguity of the issues faced by case managers. Successful management of Medical Aid resources requires the orchestrated efforts and collaboration of multiple stakeholders. More systematized support and resources for nurse case managers are essential to fully implement this nursing innovation in Korea. Copyright © 2017. Published by Elsevier B.V.

  4. Managing occupations in everyday life for people with advanced cancer at home

    DEFF Research Database (Denmark)

    Peoples, Hanne; Brandt, Åse; Wæhrens, Eva Elisabet Ejlersen

    university hospital. Qualitative interviews were performed in the participant’s homes. Interviews were audio recorded and transcribed verbatim. Information on demographic and use of social service was included. Thematic and content analysis were performed. Results: The analysis resulted in a core category......Background: People with advanced cancer are increasingly able to live for extended periods of time. Advanced cancer influences the ability to manage occupations in the everyday life. Although studies have showed that people with advanced cancer experience occupational difficulties......, there are limited research that more specifically explore how these are managed. The objective was to describe and explore how people with advanced cancer manage occupations at home. Material and methods: A qualitative descriptive design was applied. 73 participants were consecutively recruited from a Danish...

  5. Can we improve parents' management of their children's postoperative pain at home?

    Science.gov (United States)

    MacLaren Chorney, Jill; Twycross, Alison; Mifflin, Katherine; Archibald, Karen

    2014-01-01

    Thousands of children undergo surgery each year, and a shift toward same-day surgeries and decreased lengths of hospital stay results in parents being increasingly responsible for their child's postoperative care. Recent studies have tested interventions designed to improve parent management of their children's postoperative pain at home, but progress in this area has been limited by a lack of synthesis of these findings. To conduct a systematic review of interventions to improve parent management of children's postoperative pain at home. Articles evaluating interventions to improve management of their children's postoperative pain were identified using a library scientist-designed search strategy applied in EMBASE, PubMed, CINAHL and PsycINFO. Two independent raters assessed each study for eligibility and extracted data. Of the 147 articles identified for the review, eight met the inclusion criteria. Interventions included pain education, training in pain assessment, education on distraction, instruction in around-the-clock dosing and nurse coaching. Overall, results of comparisons of pain intensity and analgesic administration were modest. The intervention with the largest effect size was instruction in around-the-clock dosing, either alone or in combination with nurse coaching. Results of studies investigating pain assessment, pain education and distraction trials revealed small to medium effect sizes. Results of trials investigating interventions to improve parent management of their children's postoperative pain at home were modest. Future studies should further examine barriers and facilitators to pain management to design more effective interventions.

  6. Self-management approaches among hypertensive residents in nursing homes in Malaysia.

    Science.gov (United States)

    Wei, T M; Omar, M S

    2017-01-01

    The prevalence of hypertension in Malaysia is increasing and an effective management of hypertension is important to reduce cardiovascular morbidity and mortality. To determine the knowledge, awareness and perception towards hypertension among residents in nursing homes as well as the roles of caregivers in hypertension management. A face-to-face survey with 200 hypertensive residents and 30 caregivers from 24 nursing homes in Kuala Lumpur and Selangor, Malaysia was conducted. Of all the hypertensive residents, 90.5% ( n = 181) knew that lowering their blood pressure could improve their health. Most residents strongly believed that taking antihypertensive drugs is important for keeping their high blood pressure under control ( n = 162, 81%). Taking medication was perceived as the most important factor in controlling the high blood pressure (58%, n = 116) compared to lifestyle or diet modification. The majority of the caregivers reported that they played a major role in managing hypertension, especially with regards to medication-taking. task (66.7%, n = 20). The knowledge, attitude and perceptions of hypertension play a relatively major role in the self-management of hypertension. The role of caregivers also needed to be recognised in managing hypertension in nursing homes.

  7. The Impact of Comprehensive Case Management on HIV Client Outcomes.

    Directory of Open Access Journals (Sweden)

    Mark Brennan-Ing

    Full Text Available In 1990, New York State instituted Comprehensive Medicaid Case Management, also known as Target Case Management (TCM, for people dealing with multiple comorbid conditions, including HIV. The goal of TCM is to assist clients in navigating the health care system to increase care engagement and treatment adherence for individuals with complex needs. HIV-positive individuals engaged in care are more likely to be virally suppressed, improving clinical outcomes and decreasing chances of HIV transmission. The purpose of this study was to understand the impact of TCM management on outcomes for people with HIV. Data were obtained from Amida Care, which operates not-for-profit managed care Medicaid and Medicare Special Needs Plans (SNPs for HIV clients. Changes in clinical, cost, as well as medical and pharmacy utilization data among TCM clients were examined between January 2011 through September 2012 from the start of case management enrollment through the end of the study period (i.e., up to 6 months after disenrollment. Additionally, CD4 counts were compared between Amida Care TCM clients and non-TCM clients. Notable findings include increased CD4 counts for TCM clients over the one-year study period, achieving parity with non-TCM clients (i.e., Mean CD4 count > 500. When looking exclusively at TCM clients, there were increases in medication costs over time, which were concomitant with increased care engagement. Current findings demonstrate that TCM is able to achieve its goals of improving care engagement and treatment adherence. Subsequent policy changes resulting from the Affordable Care Act and the New York State Medicaid Redesign have made the Health Home the administrator of TCM services. Government entities charged with securing and managing TCM and care coordination for people with HIV should provide thoughtful and reasonable guidance and oversight in order to maintain optimal clinical outcomes for TCM clients and reduce the transmission of

  8. Dissociative amnesia: a case with management challenges

    Directory of Open Access Journals (Sweden)

    Priti Singh

    2015-07-01

    Full Text Available A case of dissociative amnesia with regressed behaviour was diagnosed applying the existing criteria for dissociative disorder in the tenth revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10. Though there are number of cases of such condition, but when coupled with regressed behaviour it adds to new dimension in the management. An applied strategy in lines with both pharmacological and non pharmacological was used, and we found that it helped our patient to gradually improve her behaviour. This is one of the few cases reported and we hope more such cases should be reported in understanding the psychopathology.

  9. Influencia de las Enfermeras Gestoras de Casos hospitalarias sobre la preparación de las cuidadoras para asumir el cuidado domiciliario Nursing Case Management of caregiver emotional heatlh at hospital setting and it's influence on caregivers decission to take care at home

    Directory of Open Access Journals (Sweden)

    Francisco Pedro García-Fernández

    2009-12-01

    Full Text Available Objetivos: a Determinar la influencia de las intervenciones de las Enfermas Gestoras de Casos (EGC sobre el cansancio en el rol de cuidador y en la decisión de éstos de asumir la atención del paciente en su domicilio. b Cuantificar el ahorro de estancias y de costes. Metodología: Estudio observacional restrospectivo sobre pacientes con cansancio en el rol del cuidador gestionados por las EGC entre abril y septiembre de 2008. Se analiza la efectividad de las intervenciones midiendo la puntuación al ingreso y al alta del CRE Salud Emocional del Cuidador Principal. El ahorro de estancias y costes se ha calculado mediante la fórmula: total de pacientes con ingreso/alta precoz conseguida x estancia media x coste diario. Resultados: Sesenta y cuatro pacientes presentaban el diagnóstico. En todos los casos se activó el criterio de salud emocional. Las intervenciones fueron efectivas mejorando el CRE de 2,41 al ingreso a 3,81 al alta (p ó 0,006. La intervención de las EGC ha ahorrado un total de 798 días de estancia tasados en 360.270 euros en 6 meses. Conclusiones: Las intervenciones de las EGC mejoran la salud emocional de las cuidadoras, sitúa a la cuidadora en disposición de asumir el cuidado en el domicilio, lo que tiene impacto directo en la estancia media y sus costes asociados.Aims: a To determine the influence of the interventions of Nurse Case-Manager (NCM at Hospital on "Caregiver Role Strain" and on the decision to take care of the patient at home. b To quantify saving hospital stays and economic cost. Methodology: A retrospective observational study on caregivers with "Role Strain" managed by the NCM between April and September 2008. We analysed effectiveness of interventions by measuring the score at admission and at discharge on Nursing Outcome (NOC "Caregiver emotional health" . Saving hospital stays and economic cost have been calculated using the formula: Total number of patients with income / early Hospital discharge x

  10. Rehabilitation Risk Management: Enabling Data Analytics with Quantified Self and Smart Home Data.

    Science.gov (United States)

    Hamper, Andreas; Eigner, Isabella; Wickramasinghe, Nilmini; Bodendorf, Freimut

    2017-01-01

    A variety of acute and chronic diseases require rehabilitation at home after treatment. Outpatient rehabilitation is crucial for the quality of the medical outcome but is mainly performed without medical supervision. Non-Compliance can lead to severe health risks and readmission to the hospital. While the patient is closely monitored in the hospital, methods and technologies to identify risks at home have to be developed. We analyze state-of-the-art monitoring systems and technologies and show possibilities to transfer these technologies into rehabilitation monitoring. For this purpose, we analyze sensor technology from the field of Quantified Self and Smart Homes. The available sensor data from this consumer grade technology is summarized to give an overview of the possibilities for medical data analytics. Subsequently, we show a conceptual roadmap to transfer data analytics methods to sensor based rehabilitation risk management.

  11. BOOK REVIEW: Case Studies in Knowledge Management

    OpenAIRE

    Reviewed by Dr. Adnan BOYACI

    2005-01-01

    161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM) as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…...

  12. The Pediatric Home Care/Expenditure Classification Model (P/ECM: A Home Care Case-Mix Model for Children Facing Special Health Care Challenges

    Directory of Open Access Journals (Sweden)

    Charles D. Phillips

    2015-01-01

    Full Text Available Case-mix classification and payment systems help assure that persons with similar needs receive similar amounts of care resources, which is a major equity concern for consumers, providers, and programs. Although health service programs for adults regularly use case-mix payment systems, programs providing health services to children and youth rarely use such models. This research utilized Medicaid home care expenditures and assessment data on 2,578 children receiving home care in one large state in the USA. Using classification and regression tree analyses, a case-mix model for long-term pediatric home care was developed. The Pediatric Home Care/Expenditure Classification Model (P/ECM grouped children and youth in the study sample into 24 groups, explaining 41% of the variance in annual home care expenditures. The P/ECM creates the possibility of a more equitable, and potentially more effective, allocation of home care resources among children and youth facing serious health care challenges.

  13. Nurse-physician collaboration in pain management for terminally ill cancer patients treated at home in Japan.

    Science.gov (United States)

    Ishikawa, Hirono; Kawagoe, Koh; Kashiwagi, Masayo; Yano, Eiji

    2007-01-01

    Collaboration between nurses and physicians is essential for successful pain management, especially in home care settings. This study describes how physicians collaborate with nurses for the pain management of terminally ill cancer patients treated at home in Japan, and evaluates the use of standing orders in pain management. Self-administered questionnaires were sent to all 565 institutions listed in a nationwide database of home care service providers for terminally ill cancer patients; 177 responding institutions were analyzed. In general, institutions caring for fewer patients per year were less likely to make specific efforts to collaborate with nurses and less likely to use standing orders in pain management. Given that many institutions provide home palliative care services on a small scale, a standard protocol for care should be developed and applied across all institutions to ensure the availability of quality home palliative care throughout the country.

  14. Paramedics׳ involvement in planned home birth: A one-year case study.

    Science.gov (United States)

    McLelland, Gayle; McKenna, Lisa; Morgans, Amee; Smith, Karen

    2016-07-01

    to report findings from a study performed prior to the introduction of publicly funded home birth programmes in Victoria, Australia, that investigated the incidence of planned home births attended by paramedics and explored the clinical support they provided as well as the implications for education and practice. retrospective data previously collected via an in-field electronic patient care record (VACIS(®)) was provided by a state-wide ambulance service. Cases were identified via a comprehensive filter, manually screened and analysed using SPSS version 19. over a 12-month period paramedics attended 26 intended home births. Eight women were transported in labour, most for failure to progress. Three called the ambulance service and their pre-organised midwife simultaneously. Paramedics were required for a range of complications including post partum haemorrhage, perineal tears and neonatal resuscitation. Procedures performed for mothers included IV therapy and administering pain relief. For infants, paramedics performed intermittent positive pressure ventilation, endotracheal intubation and external cardiac compression. Of the 23 women transferred to hospital, 22 were transported to hospital within 32minutes. findings highlight that paramedics can provide clinical support, as well as efficient transportation, during perinatal emergencies at planned home births. Cooperative collaboration between ambulance services, privately practising midwives and maternity services to develop guidelines for emergency clinical support and transportation service may minimise risk associated with planned home births. This could also lead to opportunities for interprofessional education between midwives and paramedics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  15. Nurses’ information management at patients’ discharge from hospital to home care

    Directory of Open Access Journals (Sweden)

    Ragnhild Hellesø

    2005-07-01

    Full Text Available Purpose: The purpose of this paper is to explore and compare hospital and home care nurses’ assessment of their information management at patients’ discharge from hospital to home care before and after the hospital implemented an electronic nursing discharge note. Theory: This paper draws on the concept of inter-organizational continuity of care, and specifically addresses the contribution of the implementation of an electronic patient record (EPR. Methods: The study has a prospective descriptive design. A questionnaire addressing the information that hospital and home care nurses exchange when patients need continuing care after hospitalization was developed and used. Results: Hospital and home care nurses differed in the way they assessed the structures and content of the information they exchanged, both before and after the EPR implementation. Conclusion and discussion: There is a need to take account of the different organizational contexts within which the two nursing groups work. The organizational context (hospital versus home care has implications for the nurses’ assessment of the information they exchange. In further development of EPR, it is therefore essential to clarify the context-related information needs of the various health care provider groups as part of the commitment to patient safety.

  16. Service oriented network architecture for control and management of home appliances

    Science.gov (United States)

    Hayakawa, Hiroshi; Koita, Takahiro; Sato, Kenya

    2005-12-01

    Recent advances in multimedia network systems and mechatronics have led to the development of a new generation of applications that associate the use of various multimedia objects with the behavior of multiple robotic actors. The connection of audio and video devices through high speed multimedia networks is expected to make the system more convenient to use. For example, many home appliances, such as a video camera, a display monitor, a video recorder, an audio system and so on, are being equipped with a communication interface in the near future. Recently some platforms (i.e. UPnP1, HAVi2 and so on) are proposed for constructing home networks; however, there are some issues to be solved to realize various services by connecting different equipment via the pervasive peer-to-peer network. UPnP offers network connectivity of PCs of intelligent home appliances, practically, which means to require a PC in the network to control other devices. Meanwhile, HAVi has been developed for intelligent AV equipments with sophisticated functions using high CPU power and large memory. Considering the targets of home alliances are embedded systems, this situation raises issues of software and hardware complexity, cost, power consumption and so on. In this study, we have proposed and developed the service oriented network architecture for control and management of home appliances, named SONICA (Service Oriented Network Interoperability for Component Adaptation), to address these issues described before.

  17. Should home ipecac-induced emesis be routinely recommended in the management of toxic berry ingestions?

    Science.gov (United States)

    Wax, P M; Cobaugh, D J; Lawrence, R A

    1999-12-01

    Poison center (PC) management of toxic berry ingestions may include recommendations to administer syrup of ipecac (SI) regardless of the number of berries ingested. We investigated whether the routine use of SI in the home management of asymptomatic single or few (berry ingestions may be unnecessary. A prospective, randomized clinical trial compared SI + home observation (HO) to HO alone for management of pediatric toxic berry ingestions. Subjects were children 9 mo to 5 y who ingested a small number (berries. Exclusions were symptomatic subjects, ingestion of more than 1 type of berry or other plant part, or contraindication to SI. Outcome variables consisting of symptom assessment and disposition were assessed 24 h following the ingestion. Over a 27-mo period 103 subjects were entered into the study; 45 received SI/HO and 51 received only HO. While 100% of the SI/HO group experienced vomiting, none of the HO group vomited. Diarrhea and sedation were more common in the SI/HO group. Use of SI in the home management of young children who ingest fewer than 6 toxic berries (yew, nightshade, holly or unknown) and who are asymptomatic when the PC is contacted may be responsible for the majority of symptoms. Ingestion of small amounts of berries may require no intervention beyond observation. Methodological limitations of this study included the lack of confirmed identification of the berries and the inability to confirm ingestion and absorption.

  18. Technology Solutions for Existing Homes Case Study: Accelerating the Delivery of Home-Performance Upgrades Using a Synergistic Business Model

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-04-14

    The Building America team NorthernSTAR investigated opportunities to use the massive customer networks of the home service industry as a means to connect homeowners to home-performance solutions. Home service companies could provide a pathway to advance building-science-guided upgrades by being in close proximity to homeowners when a decision-making moment is at hand. Established trust provides an opportunity for the company to deliver sound information and influence during a remodeling decision.

  19. In-Home Care for Optimizing Chronic Disease Management in the Community

    Science.gov (United States)

    2013-01-01

    Background The emerging attention on in-home care in Canada assumes that chronic disease management will be optimized if it takes place in the community as opposed to the health care setting. Both the patient and the health care system will benefit, the latter in terms of cost savings. Objectives To compare the effectiveness of care delivered in the home (i.e., in-home care) with no home care or with usual care/care received outside of the home (e.g., health care setting). Data Sources A literature search was performed on January 25, 2012, using OVID MEDLINE, OVID MEDLINE In-Process and Other Non-Indexed Citations, OVID EMBASE, EBSCO Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Wiley Cochrane Library, and the Centre for Reviews and Dissemination database, for studies published from January 1, 2006, until January 25, 2012. Review Methods An evidence-based analysis examined whether there is a difference in mortality, hospital utilization, health-related quality of life (HRQOL), functional status, and disease-specific clinical measures for in-home care compared with no home care for heart failure, atrial fibrillation, coronary artery disease, stroke, chronic obstructive pulmonary disease, diabetes, chronic wounds, and chronic disease / multimorbidity. Data was abstracted and analyzed in a pooled analysis using Review Manager. When needed, subgroup analysis was performed to address heterogeneity. The quality of evidence was assessed by GRADE. Results The systematic literature search identified 1,277 citations from which 12 randomized controlled trials met the study criteria. Based on these, a 12% reduced risk for in-home care was shown for the outcome measure of combined events including all-cause mortality and hospitalizations (relative risk [RR]: 0.88; 95% CI: 0.80–0.97). Patients receiving in-home care had an average of 1 less unplanned hospitalization (mean difference [MD]: –1.03; 95% CI: –1.53 to –0.53) and an average of 1 less

  20. The economic implications of case-mix Medicaid reimbursement for nursing home care.

    Science.gov (United States)

    Grabowski, David C

    2002-01-01

    In recent years, there has been large growth in the nursing home industry in the use of case-mix adjusted Medicaid payment systems that employ resident characteristics to predict the relative use of resources in setting payment levels. Little attention has been paid to the access and quality incentives that these systems provide in the presence of excess demand conditions due to certificate-of-need (CON) and construction moratoria. Using 1991 to 1998 panel data for all certified U.S. nursing homes, a fixed-effects model indicates that adoption of a case-mix payment system led to increased access for more dependent residents, but the effect was modified in excess demand markets. Quality remained relatively stable with the introduction of case-mix reimbursement, regardless of the presence of excess demand conditions. These results suggest that CON and construction moratoria are still important barriers within the nursing home market, and recent quality assurance activities related to the introduction of case-mix payment systems may have been effective.

  1. The Effects of Environmental Management Systems on Source Separation in the Work and Home Settings

    Directory of Open Access Journals (Sweden)

    Chris von Borgstede

    2012-06-01

    Full Text Available Measures that challenge the generation of waste are needed to address the global problem of the increasing volumes of waste that are generated in both private homes and workplaces. Source separation at the workplace is commonly implemented by environmental management systems (EMS. In the present study, the relationship between source separation at work and at home was investigated. A questionnaire that maps psychological and behavioural predictors of source separation was distributed to employees at different workplaces. The results show that respondents with awareness of EMS report higher levels of source separation at work, stronger environmental concern, personal and social norms, and perceive source separation to be less difficult. Furthermore, the results support the notion that after the adoption of EMS at the workplace, source separation at work spills over into source separation in the household. The potential implications for environmental management systems are discussed.

  2. Case Management of Adolescents with Chronic Disease.

    Science.gov (United States)

    Lankard, Bettina A.

    This training guide presents a model for optimum delivery of the primary duties, tasks, and steps required in the comprehensive case management of adolescents with chronic disease. Using a team approach to coordinated health care, the guide involves the patient and family as key members of the care team along with the physician, nurse, dietitian,…

  3. The Cocoa Shop: A Database Management Case

    Science.gov (United States)

    Pratt, Renée M. E.; Smatt, Cindi T.

    2015-01-01

    This is an example of a real-world applicable case study, which includes background information on a small local business (i.e., TCS), description of functional business requirements, and sample data. Students are asked to design and develop a database to improve the management of the company's customers, products, and purchases by emphasizing…

  4. Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single-Family Homes

    Energy Technology Data Exchange (ETDEWEB)

    Cummings, James [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Withers, Charles [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Martin, Eric [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Moyer, Neil [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States)

    2012-10-01

    This report is a revision of an earlier report titled: Measure Guideline: Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single-Family Homes. Revisions include: Information in the text box on page 1 was revised to reflect the most accurate information regarding classifications as referenced in the 2012 International Residential Code. “Measure Guideline” was dropped from the title of the report. An addition was made to the reference list.

  5. Home-Based Diagnosis and Management of Sleep-Related Breathing Disorders in Spinal Cord Injury

    Science.gov (United States)

    2012-10-01

    form of sleep -disordered breathing in SCI is nocturnal hypoventilation (NH) due to respiratory muscle paralysis and/or reduced ventilatory drive...DATES COVERED 2011 – 29 2012 4. TITLE AND SUBTITLE 5a. CONTRACT NUMBER W81XWH-11-1-0826 Home-Based Diagnosis and Management of Sleep ...with spinal cord injury (SCI) commonly have sleep -disordered breathing due to obstructive sleep apnea (OSA) and/or nocturnal hypoventilation (NH) due to

  6. Predictors of Nursing Staff Voluntary Termination in Nursing Homes: A Case-Control Study.

    Science.gov (United States)

    Zhang, Yuan; Punnett, Laura; Gore, Rebecca

    2017-08-01

    Workforce instability in the long-term care sector has raised wide attention about nursing staff turnover. Most attention has been devoted to understanding the relationship between facility's characteristics and organizational turnover. This case-control study examined the contribution of work characteristics to individual staff turnover. Surveys were collected with nursing staff in 18 for-profit nursing homes on up to five occasions between 2006 and 2012. A list of nursing staff voluntarily terminating jobs was provided by the company. Cases and controls (628 of each) were selected from survey respondents by matching on age, job category, and survey occasion. Multiple predictor conditional logistic regression models showed that evening shift work (hazards ratio [HR] = 2.00, p 8 hr (HR = 1.42, p voluntary termination. This study provides different perspectives of nursing staff voluntary termination in nursing homes. Future qualitative research would be valuable to explore and understand nursing staff turnover in the health care industry.

  7. XML technologies for the Omaha System: a data model, a Java tool and several case studies supporting home healthcare.

    Science.gov (United States)

    Vittorini, Pierpaolo; Tarquinio, Antonietta; di Orio, Ferdinando

    2009-03-01

    The eXtensible markup language (XML) is a metalanguage which is useful to represent and exchange data between heterogeneous systems. XML may enable healthcare practitioners to document, monitor, evaluate, and archive medical information and services into distributed computer environments. Therefore, the most recent proposals on electronic health records (EHRs) are usually based on XML documents. Since none of the existing nomenclatures were specifically developed for use in automated clinical information systems, but were adapted to such use, numerous current EHRs are organized as a sequence of events, each represented through codes taken from international classification systems. In nursing, a hierarchically organized problem-solving approach is followed, which hardly couples with the sequential organization of such EHRs. Therefore, the paper presents an XML data model for the Omaha System taxonomy, which is one of the most important international nomenclatures used in the home healthcare nursing context. Such a data model represents the formal definition of EHRs specifically developed for nursing practice. Furthermore, the paper delineates a Java application prototype which is able to manage such documents, shows the possibility to transform such documents into readable web pages, and reports several case studies, one currently managed by the home care service of a Health Center in Central Italy.

  8. Home garden: a potential strategy for food and nutrition security in HIV households : a case study in rural Ghana

    NARCIS (Netherlands)

    Akrofi, S.

    2012-01-01

    Keywords: Home garden, HIV and AIDS, dietary diversity, plant species diversity, coping strategy index, food security, Ghana. The aim of this thesis was to explore how rural households with HIV and AIDS in Ghana are employing home garden management strategies to enhance food and nutrition security

  9. An Event-Triggered Online Energy Management Algorithm of Smart Home: Lyapunov Optimization Approach

    Directory of Open Access Journals (Sweden)

    Wei Fan

    2016-05-01

    Full Text Available As an important component of the smart grid on the user side, a home energy management system is the core of optimal operation for a smart home. In this paper, the energy scheduling problem for a household equipped with photovoltaic devices was investigated. An online energy management algorithm based on event triggering was proposed. The Lyapunov optimization method was adopted to schedule controllable load in the household. Without forecasting related variables, real-time decisions were made based only on the current information. Energy could be rapidly regulated under the fluctuation of distributed generation, electricity demand and market price. The event-triggering mechanism was adopted to trigger the execution of the online algorithm, so as to cut down the execution frequency and unnecessary calculation. A comprehensive result obtained from simulation shows that the proposed algorithm could effectively decrease the electricity bills of users. Moreover, the required computational resource is small, which contributes to the low-cost energy management of a smart home.

  10. DOE ZERH Case Study: Amaris Homes, Fishers Circle, Vadnais Heights, MN

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning custom home in the cold climate that got a HERS 47 without PV or HERS 22 with PV, with 2x4 24” on-center walls with 1 inch rigid foam plus 3” ccsf in cavity, a slab on grade foundation with 2” rigid foam under and around slab, a vented attic with with 2” ccsf plus R-15 blown cellulose, a central heat pump and HRV.

  11. DOE ZERH Case Study: Palo Duro Homes, Via del Cielo, Santa Fe, NM

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning production home in the mixed-dry climate that got a HERS 48 without PV, with 2x6 24” on center walls with R-21 blown fiberglass; slab foundation with R-10 under slab and R-5rigid foam at slab edge; vented attic with R-75 blown fiberglass; ducted minisplit heat pump 16.5 SEER, 9.5 HSPF.

  12. DOE ZERH Case Study: Charles Thomas Homes, Anna Model, Omaha, NE

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning custom home in the cold climate that got a HERS 48 without PV, with 2x6 24” on center walls with R-23 blown fiberglass, ocsf at rim joists, basement with plus 2x4 stud walls with R-23 blown fiberglass, with R-20 around slab, R-38 under slab; a vented attic with R-100 blown cellulose; 95% AFUE furnace, 14 SEER AC, ERV; heat pump water heater.

  13. DOE ZERH Case Study: Mandalay Homes, Vision Hill Lot 1, Glendale, AZ

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning production home in the hot-dry climate that got a HERS 52 without PV, or HERS -2 with PV, with 2x6 16” on center walls with R-14 ocsf plus R-4 rigid exterior; slab on grade with R-8 slab edge; sealed attic with R-31 ocsf under roof deck; 92 AFUE furnace, 15 SEER AC, 100% LED.

  14. DOE ZERH Case Study: BrightLeaf Homes, McCormick Avenue, Brookfield, IL

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning production home in the cold climate that got a HERS 38 without PV, with staggered 2x4 studs every 8”on a 2x6 plate with dense-packed R-25 cellulose, basement with 3” XPS exterior and 2: XPS under slab; a vented attic with spray foam top plates and R-60 blown cellulose; 96% AFUE furnace, 14 SEER AC, plus fresh air intake.

  15. DOE ZERH Case Study: TC Legend Homes, Bellingham Power House, Bellingham, WA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of a DOE 2015 Housing Innovation Award winning custom home in the marine climate that got HERS 34 without PV or HERS -12 with PV, with 6” SIP walls and 10” SIP roof; R-28 ICF around slab, R-20 rigid foam under slab; radiant floor heat and passive design; air-to-water heat pump COP 4.4; HRV; earth tube ventilation; triple-pane windows, 100% LED.

  16. Using Prompted Voiding to Manage Urinary Incontinence in Nursing Homes: Can It Be Sustained?

    Science.gov (United States)

    Lai, Claudia K Y; Wan, Xiaojuan

    2017-06-01

    Studies reporting prompted voiding (PV) interventions were of short duration and were delivered by research personnel rather than nursing home staff. This study examined the effectiveness of the use of PV by nursing home staff in managing urinary incontinence among residents over a 6-month period. A randomized controlled trial. Five nursing homes in Hong Kong. Data were collected from 52 nursing home residents who had been admitted to the facility for at least 6 months prior to the initiation of the study and whose incontinence had been stable over the 6-month period. The PV intervention was delivered by the staff for 6 months. All nursing home staff were trained to ensure that they would be able to correctly deliver the intervention before initiating the intervention. The control group received the usual care. Outcomes were defined in terms of wet episodes per day, incontinence rate per day, self-initiated toileting per day, and total continent toileting per day. Data were collected at baseline, 3 months postintervention (T1), and 6 months postintervention (T2). There were significant differences between the two groups in wet episodes per day, incontinence rate per day, and total continent toileting per day at 6 months post-intervention, with positive results found in the intervention group. A decrease of 9.1% was observed in the incontinence rate of the intervention group. PV was shown to have positive effects, although the effects in this study were not as powerful as those found in overseas studies. The intervention delivered by staff was sustainable for a 6-month period. Nursing home operators should promote better continence care through PV, as it is a sustainable noninvasive behavioral intervention that can be mastered by staff with training. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  17. Determinant factors of home delivery among women in Northern Ethiopia: a case control study

    Directory of Open Access Journals (Sweden)

    Resom Tsegay

    2017-04-01

    Full Text Available Abstract Background Maternal mortality remains a major challenge to health systems worldwide. Although most pregnancies and births are uneventful, approximately 15% of all pregnant women develop potentially life-threatening complications. Home delivery in this context can be acutely threatening, particularly in developing countries where emergency care and transportation are less available. This study identifies factors associated with home delivery in Tanqua-Abergele District, Tigray, northern Ethiopia. Methods Unmatched case-control study was conducted in April 2014 in Tanqua-Abergele, Tigray, northern Ethiopia. Simple random sampling was employed to select study participants. Data were analyzed using SPSS 20. Multi variable logistic regression analysis was used to identify independent predictors of home delivery. Results A total of 275 women (92 cases and 183 controls participated in the study, giving a response rate of 96.5%. Not owning a radio or television (AOR: 7.2, 95% CI: 2.7–19.3, not pursuing ANC visits at all (AOR: 10.4, 95% CI: 2.9–37.1 orhaving1–3 ANC visits only (AOR: 4.75, 95% CI: 1.69–13.31,poor knowledge of obstetric complications (AOR: 8.7, 95% CI: 2.3–32.9 and walking time greater than two hours to the nearest health center (AOR: 5.1, 95% CI: 1.2–20.7 were strong predictors of home delivery. Conclusion Unable to meet the minimum requirement WHO of ANC service had a potential to give birth at home. Investing in infrastructure will contribute to improving maternal health. Having a different source of media (radio or television could have a role in increasing the institutional delivery. Policy makers and other concerned bodies should give due attention to the fulfillment of infrastructure and educate women on the importance of institutional delivery.

  18. Surgical management of palatine Torus - case series

    Directory of Open Access Journals (Sweden)

    Thaís Sumie Nozu Imada

    Full Text Available INTRODUCTION: Torus palatinus is a specific name to identify exostoses developed in the hard palate along the median palatine suture. Despite of not being a pathological condition, its presence requires attention and knowledge regarding its management. Surgical removal of exostoses is indicated when the patient frequently traumatizes the area of palatine torus during mastication and speech or when it is necessary for the rehabilitation of the upper arcade with complete dentures. OBJECTIVE: The aim of this article is to present three cases of Torus palatinus and to discuss the management of them. CASE REPORT: In the first case, a 57-year-old Caucasian man sought oral rehabilitation of his edentulous maxilla but presented a hard nodules in the hard palate; in the second case, a 40-year-old Caucasian woman was referred for frequent trauma of palatal mucosa during mastication, aesthetic complaint, and discomfort caused by the trauma of her tongue in this area; and in the third case, a 45-year-old Caucasian woman presented with a lesion on the palate that caused difficulty swallowing. When the Torus palatinus was impairing the basic physiological functions of the patients, all cases were surgically treated, improving the patients' quality of life. FINAL CONSIDERATION: The dentist should be properly prepared to choose the best from among the existing surgical approaches for each individual lesion in order to improve the results and avoid possible complications.

  19. Reducing turnover and improving health care in nursing homes: the potential effects of self-managed work teams.

    Science.gov (United States)

    Yeatts, D E; Seward, R R

    2000-06-01

    This article describes the use of self-managed work teams (SMWTs) in a nursing home, their potential impacts on the provision of health care and employee satisfaction and turnover, and the factors reported to be important to SMWT effectiveness. Three SMWTs in a midsized nursing home in Wisconsin provide examples. Steps for implementing SMWTs are described.

  20. Hybrid Risk Management Methodology: A Case Study

    Directory of Open Access Journals (Sweden)

    Jacky Siu-Lun Ting

    2009-10-01

    Full Text Available Risk management is a decision-making process involving considerations of political, social, economic and engineering factors with relevant risk assessments relating to a potential hazard. In the last decade, a number of risk management tools are introduced and employed to manage and minimize the uncertainty and threats realization to the organizations. However, the focus of these methodologies are different; in which companies need to adopt various risk management principles to visualize a full picture of the organizational risk level. Regarding to this, this paper presents a new approach of risk management that integrates Hierarchical Holographic Modeling (HHM, Enterprise Risk Management (ERM and Business Recovery Planning (BCP for identifying and assessing risks as well as managing the consequences of realized residual risks. To illustrate the procedures of the proposed methodology, a logistic company ABC Limited is chosen to serve as a case study Through applying HHM and ERM to investigate and assess the risk, ABC Limited can be better evaluated the potential risks and then took the responsive actions (e.g. BCP to handle the risks and crisis in near future.

  1. Multilingual home environment and specific language impairment: a case-control study in Chinese children.

    Science.gov (United States)

    Cheuk, Daniel Ka Leung; Wong, Virginia; Leung, Gabriel Matthew

    2005-07-01

    Specific language impairment (SLI) is a common developmental disorder in young children. To investigate the association between multilingual home environment and SLI, we conducted a case-control study in Hong Kong Chinese children over a 4-year period in the Duchess of Kent Children's Hospital. Consecutive medical records of all new referrals below 5 years of age were reviewed and children diagnosed with SLI (case) were compared with those referred with other developmental and behavioural problems who had been assessed as having normal language and overall development (control) using the Griffiths Mental Developmental Scale. SLI was defined as those with a language quotient more than one standard deviation below the mean and below the general developmental quotient in children with normal general developmental quotient, but without neurological or other organic diseases. We used binary and ordinal logistic regression to assess any association between SLI and multilingual exposure at home, adjusting for age and gender of subjects, parental age, education level and occupational status, number of siblings, family history of language delay and main caregiver at home. Multivariable linear regression was used to examine the effect of covariates on the language comprehension and expression standard scores assessed by the Reynell Developmental Language Scale. A total of 326 cases and 304 controls were included. The mean ages of cases and controls were 2.56 and 2.89 years respectively. Boys predominated in both groups (cases, 75.2%; controls, 60.2%). The children were exposed to between one and four languages at home, the major ones being Cantonese Chinese followed by English. The adjusted odds ratio (OR) of SLI was 2.94; [95% confidence interval (CI) 1.82, 4.74] for multilingual compared with monolingual exposure. A significant linear dose-response relationship was found (OR of SLI = 2.58 [1.72, 3.88] for each additional language to which the child was exposed). Male

  2. HIA 2016 DOE Zero Energy Ready Home Case Study: Imery & Co, High-performance Bungalow, Roswell, GA

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2016-09-01

    Case study of a DOE 2016 Housing Innovation Award winning custom for buyer home in the mixed-humid climate that met the DOE Zero Energy Ready Home criteria and achieved a HERS 41 without PV or HERS 6 with PV.

  3. Case management for the elderly with complex needs: cross-linking the views of their role held by elderly people, their informal caregivers and the case managers.

    Science.gov (United States)

    Balard, Frédéric; Gely-Nargeot, Marie-Christine; Corvol, Aline; Saint-Jean, Olivier; Somme, Dominique

    2016-11-08

    In 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006-2010). People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users' (old people and their informal caregivers) and case managers' first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation. The study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19), their informal caregivers (11) and the case managers (5) who participated in the program during the first 6 months. Thematic analysis of the data was carried out. The analysis revealed that each group of people generated its own representations of the case manager's role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager. The innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual's projected expectations of this social service. Analyzing the first representations

  4. A context management system for a cost-efficient smart home platform

    Science.gov (United States)

    Schneider, J.; Klein, A.; Mannweiler, C.; Schotten, H. D.

    2012-09-01

    This paper presents an overview of state-of-the-art architectures for integrating wireless sensor and actuators networks into the Future Internet. Furthermore, we will address advantages and disadvantages of the different architectures. With respect to these criteria, we develop a new architecture overcoming these weaknesses. Our system, called Smart Home Context Management System, will be used for intelligent home utilities, appliances, and electronics and includes physical, logical as well as network context sources within one concept. It considers important aspects and requirements of modern context management systems for smart X applications: plug and play as well as plug and trust capabilities, scalability, extensibility, security, and adaptability. As such, it is able to control roller blinds, heating systems as well as learn, for example, the user's taste w.r.t. to home entertainment (music, videos, etc.). Moreover, Smart Grid applications and Ambient Assisted Living (AAL) functions are applicable. With respect to AAL, we included an Emergency Handling function. It assures that emergency calls (police, ambulance or fire department) are processed appropriately. Our concept is based on a centralized Context Broker architecture, enhanced by a distributed Context Broker system. The goal of this concept is to develop a simple, low-priced, multi-functional, and save architecture affordable for everybody. Individual components of the architecture are well tested. Implementation and testing of the architecture as a whole is in progress.

  5. Waiting list management practices for home-care occupational therapy in the province of Quebec, Canada.

    Science.gov (United States)

    Raymond, Marie-Hélène; Demers, Louise; Feldman, Debbie E

    2016-03-01

    Referral prioritisation is commonly used in home-based occupational therapy to minimise the negative impacts of waiting, but this practice is not standardised. This may lead to inequities in access to care, especially for clients considered as low priority, who tend to bear the brunt of lengthy waiting lists. This cross-sectional study aimed to describe waiting list management practices targeting low-priority clients in home-based occupational therapy in the province of Quebec, Canada, and to investigate the association between these practices and the length of the waiting list. A structured telephone interview was conducted in 2012-2013 with the person who manages the occupational therapy waiting list in 55 home care programmes across Quebec. Questions pertained to strategies aimed at servicing low-priority clients, the date of the oldest referral and the number of clients waiting. Results were analysed using descriptive statistics and non-parametric tests. The median wait time for the oldest referral was 18 months (range: 2-108 months). A variety of strategies were used to service low-priority clients. Programmes that used no strategies to service low-priority clients (n = 16) had longer wait times (P occupational therapy programmes. However, in programmes where none of these strategies are used, low-priority clients may be denied access to services indefinitely. © 2015 John Wiley & Sons Ltd.

  6. Disruption Management for the Real-Time Home Caregiver Scheduling and Routing Problem

    Directory of Open Access Journals (Sweden)

    Biao Yuan

    2017-11-01

    Full Text Available The aggravating trend of the aging population, the miniaturization of the family structure, and the increase of families with empty nesters greatly affect the sustainable development of the national economy and social old-age security system of China. The emergence of home health care or home care (HHC/HC service mode provides an alternative for elderly care. How to develop and apply this new mobile service mode is crucial for the government. Therefore, the pertinent optimization problems regarding HHC/HC have constantly attracted the attention of researchers. Unexpected events, such as new requests of customers, cancellations of customers’ services, and changes of customers’ time windows, may occur during the process of executing an a priori visiting plan. These events may sometimes make the original plan non-optimal or even infeasible. To cope with this situation, we introduce disruption management to the real-time home caregiver scheduling and routing problem. The deviation measurements on customers, caregivers, and companies are first defined. A mathematical model that minimizes the weighted sum of deviation measurements is then constructed. Next, a tabu search (TS heuristic is developed to efficiently solve the problem, and a cost recorded mechanism is used to strengthen the performance. Finally, by performing computational experiments on three real-life instances, the effectiveness of the TS heuristic is tested, and the advantages of disruption management are analyzed.

  7. Application of the FOCUS-PDCA model to home care equipment management.

    Science.gov (United States)

    Watrous, J; Zappia, P

    1993-01-01

    Issuing durable medical equipment to patients for use at home is a costly and complex process. Selection, delivery, setup, and maintenance of home care equipment and the education of patients in its use are currently included in Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) accreditation surveys for those health care organizations that issue equipment. In this Department of Veterans Affairs teaching hospital, the process was complicated by eligibility regulations and frequently rotating housestaff. We organized a team who studied the process and identified opportunities for improvement in three areas: the selection of equipment items ordered, management of equipment-related data, and standardization of equipment delivery contracts. We produced a reference manual for staff, developed a simple database, and incorporated JCAHO home care equipment management standards into equipment delivery vendor contracts. The results of the team's efforts were an increase in efficiency, a decrease in discharge delays, and improved continuity of care. We chose to use the FOCUS-PDCA model to illustrate our approach to improving these processes.

  8. Electronic case management with homeless youth.

    Science.gov (United States)

    Bender, Kimberly; Schau, Nicholas; Begun, Stephanie; Haffejee, Badiah; Barman-Adhikari, Anamika; Hathaway, Jessica

    2015-06-01

    Case management, a widely practiced form of service brokerage, is associated with a variety of positive outcomes for homeless youth, but it may be difficult to implement, as youth face logistical barriers to attending in-person meetings. As part of a larger clinical trial, the current study investigates the feasibility of providing electronic case management (ECM) to homeless youth, using cell-phones, texts, email, and Facebook. Youth were given prepaid cell-phones and a case manager who provided four ECM sessions every 2-3 weeks over a 3-month period. Contact logs were used to record how many youth engaged in ECM, how many attempts were necessary to elicit engagement, and youths' preferred technology methods for engaging. Although engagement in the number of ECM sessions varied, the majority of youth (87.5%) engaged in at least one ECM session. Youth (41%) most commonly needed one contact before they engaged in an ECM session, and the majority responded by the third attempt. While youth most commonly answered calls directly, their chosen method of returning calls was texting. The majority of youth (80%) described ECM positively, reporting themes of convenience, connection, and accountability. The use of ECM, particularly of texting, offers promising implications for providing services to homeless youth. Copyright © 2015 Elsevier Ltd. All rights reserved.

  9. A Survey of Communications and Networking Technologies for Energy Management in Buildings and Home Automation

    Directory of Open Access Journals (Sweden)

    Aravind Kailas

    2012-01-01

    Full Text Available With the exploding power consumption in private households and increasing environmental and regulatory restraints, the need to improve the overall efficiency of electrical networks has never been greater. That being said, the most efficient way to minimize the power consumption is by voluntary mitigation of home electric energy consumption, based on energy-awareness and automatic or manual reduction of standby power of idling home appliances. Deploying bi-directional smart meters and home energy management (HEM agents that provision real-time usage monitoring and remote control, will enable HEM in “smart households.” Furthermore, the traditionally inelastic demand curve has began to change, and these emerging HEM technologies enable consumers (industrial to residential to respond to the energy market behavior to reduce their consumption at peak prices, to supply reserves on a as-needed basis, and to reduce demand on the electric grid. Because the development of smart grid-related activities has resulted in an increased interest in demand response (DR and demand side management (DSM programs, this paper presents some popular DR and DSM initiatives that include planning, implementation and evaluation techniques for reducing energy consumption and peak electricity demand. The paper then focuses on reviewing and distinguishing the various state-of-the-art HEM control and networking technologies, and outlines directions for promoting the shift towards a society with low energy demand and low greenhouse gas emissions. The paper also surveys the existing software and hardware tools, platforms, and test beds for evaluating the performance of the information and communications technologies that are at the core of future smart grids. It is envisioned that this paper will inspire future research and design efforts in developing standardized and user-friendly smart energy monitoring systems that are suitable for wide scale deployment in homes.

  10. Exploring the relationship between nursing home financial performance and management entrepreneurial attributes.

    Science.gov (United States)

    Davis, Jullet A; Marino, Louis D; Vecchiarini, Mariangela

    2013-01-01

    degrees, nursing home administrators may view themselves as being entrepreneurial despite the intense pressures from governments, poor public perceptions, decreasing reimbursement, more impaired residents, and increasing competition from substitute providers. Further administrators may need to manage the expectations of key stakeholders when they undertake innovative programs that will support social outcomes but which may not enhance short term financial performance. This paper demonstrates the complex relationship between entrepreneurial activities and firm performance in nursing homes and has implications for the broader health care setting.

  11. Home in the heat: Dramatic seasonal variation in home range of desert golden eagles informs management for renewable energy development

    Science.gov (United States)

    Braham, Melissa A.; Miller, Tricia A.; Duerr, Adam E.; Lanzone, Michael J.; Fesnock, Amy; LaPre, Larry; Driscoll, Daniel; Katzner, Todd E.

    2015-01-01

    Renewable energy is expanding quickly with sometimes dramatic impacts to species and ecosystems. To understand the degree to which sensitive species may be impacted by renewable energy projects, it is informative to know how much space individuals use and how that space may overlap with planned development. We used global positioning system–global system for mobile communications (GPS-GSM) telemetry to measure year-round movements of golden eagles (Aquila chrysaetos) from the Mojave Desert of California, USA. We estimated monthly space use with adaptive local convex hulls to identify the temporal and spatial scales at which eagles may encounter renewable energy projects in the Desert Renewable Energy Conservation Plan area. Mean size of home ranges was lowest and least variable from November through January and greatest in February–March and May–August. These monthly home range patterns coincided with seasonal variation in breeding ecology, habitat associations, and temperature. The expanded home ranges in hot summer months included movements to cooler, prey-dense, mountainous areas characterized by forest, grasslands, and scrublands. Breeding-season home ranges (October–May) included more lowland semi-desert and rock vegetation. Overlap of eagle home ranges and focus areas for renewable energy development was greatest when eagle home ranges were smallest, during the breeding season. Golden eagles in the Mojave Desert used more space and a wider range of habitat types than expected and renewable energy projects could affect a larger section of the regional population than was previously thought.

  12. Description and outcomes of a Medicare case management program by nurses.

    Science.gov (United States)

    Allen, S A

    1999-01-01

    During the current environment of cost-cutting and restructuring, case management is viewed as a means of providing comprehensive, coordinated care while reducing costs. Studies of community-based case management have been disappointing. This study evaluates a Medicare service, Management and Evaluation of the Care Plan (MAE), as a model of nurses providing case management in the home. Three groups were compared: MAE (N = 176), non-MAE (N = 187) and newly discharged (N = 93). Utilization data was collected over one year. Overall, subjects were unmarried older women with three functional limitations, four medical diagnoses and averaged 43 home care visits and one hospitalization. MAE patients were older, had more functional and environmental limitations, less ADL independence, and a worse prognosis, yet used significantly less health care than non-MAE recipients did. Regression analysis was performed using group membership and hospital and home care utilization as dependent variables. Although the project was conducted at one site, overall the sample was similar to the national Medicare population.

  13. Estimating the impact of the home appliances trade-in policy on WEEE management in China.

    Science.gov (United States)

    Zhu, Shuguang; He, Wenzhi; Li, Guangming; Zhuang, Xuning; Huang, Juwen; Liang, Honggen; Han, Yuebin

    2012-11-01

    The ever-increasing amount of waste electric and electronic equipment (WEEE) has become a global problem. In view of the deleterious effects of WEEE on the environment and the valuable materials that can be reused in them, many countries have focused their attention on the management of WEEE and the recovery technologies of WEEE. The Chinese government has been active in creating a legislative and institutional framework to realize WEEE recycling. In June 2009, Chinese government launched home appliances and electronics trade-in implementation solution. This paper elaborates the home appliances trade-in policy and its significant impact on the WEEE management. The trade-in policy is not only conducive to expanding the consumption demand and promoting the balance of domestic and overseas demand, but also favorable to improving the energy efficiency and reducing environmental pollution. Under this policy, China has successfully established an effective WEEE recycling system, using the financial means and network design. Experiences gained from the trade-in policy have shown that management systems of WEEE need to be designed and implemented in a multi-stakeholder dialogue.

  14. Machine Learning for Identifying Demand Patterns of Home Energy Management Systems with Dynamic Electricity Pricing

    Directory of Open Access Journals (Sweden)

    Derck Koolen

    2017-11-01

    Full Text Available Energy management plays a crucial role in providing necessary system flexibility to deal with the ongoing integration of volatile and intermittent energy sources. Demand Response (DR programs enhance demand flexibility by communicating energy market price volatility to the end-consumer. In such environments, home energy management systems assist the use of flexible end-appliances, based upon the individual consumer’s personal preferences and beliefs. However, with the latter heterogeneously distributed, not all dynamic pricing schemes are equally adequate for the individual needs of households. We conduct one of the first large scale natural experiments, with multiple dynamic pricing schemes for end consumers, allowing us to analyze different demand behavior in relation with household attributes. We apply a spectral relaxation clustering approach to show distinct groups of households within the two most used dynamic pricing schemes: Time-Of-Use and Real-Time Pricing. The results indicate that a more effective design of smart home energy management systems can lead to a better fit between customer and electricity tariff in order to reduce costs, enhance predictability and stability of load and allow for more optimal use of demand flexibility by such systems.

  15. An Evaluation and Implementation of Rule-Based Home Energy Management System Using the Rete Algorithm

    Directory of Open Access Journals (Sweden)

    Tomoya Kawakami

    2014-01-01

    Full Text Available In recent years, sensors become popular and Home Energy Management System (HEMS takes an important role in saving energy without decrease in QoL (Quality of Life. Currently, many rule-based HEMSs have been proposed and almost all of them assume “IF-THEN” rules. The Rete algorithm is a typical pattern matching algorithm for IF-THEN rules. Currently, we have proposed a rule-based Home Energy Management System (HEMS using the Rete algorithm. In the proposed system, rules for managing energy are processed by smart taps in network, and the loads for processing rules and collecting data are distributed to smart taps. In addition, the number of processes and collecting data are reduced by processing rules based on the Rete algorithm. In this paper, we evaluated the proposed system by simulation. In the simulation environment, rules are processed by a smart tap that relates to the action part of each rule. In addition, we implemented the proposed system as HEMS using smart taps.

  16. Delphi research exploring essential components and preconditions for case management in people with dementia.

    Science.gov (United States)

    Verkade, Paul-Jeroen; van Meijel, Berno; Brink, Cindy; van Os-Medendorp, Harmieke; Koekkoek, Bauke; Francke, Anneke L

    2010-08-09

    Case management programmes for home-dwelling people with dementia and their informal carers exist in multiple forms and shapes. The aim of this research was to identify the essential components of case management for people with dementia as well as the preconditions for an effective delivery of case management services. The method used to carry out the research was a modified four-phase Delphi design. First, a list of potentially essential components and preconditions for the provision of case management was drawn up on the basis of a literature review and a subsequent focus group interview. The list was then validated by experts in a first Delphi survey round, following which the researchers translated the list items into 75 statements. In the second Delphi survey, the experts rated the statements; in the third Delphi round, they rated 18 statements on which no consensus had been reached in the second round. The experts were able to build consensus on 61 of the 75 statements. Essential components of case management for people with dementia are: information, support and counselling, coordination of the care provided and, to a lesser extent, practical help. A patient-centred approach was found to be one of the key aspects of providing case management services. Essential preconditions are: vision, care relationship, structured methodology, integration of case management into the health care chain, and the case manager's level of training and expertise. We recommend that, based on the essential components and preconditions referred to above, quality criteria be developed for the provision of case management for people with dementia. Furthermore, we suggest the conduct of additional research to assess the effectiveness of case management in people with dementia.

  17. Delphi-research exploring essential components and preconditions for case management in people with dementia

    Directory of Open Access Journals (Sweden)

    Verkade Paul-Jeroen

    2010-08-01

    Full Text Available Abstract Background Case management programmes for home-dwelling people with dementia and their informal carers exist in multiple forms and shapes. The aim of this research was to identify the essential components of case management for people with dementia as well as the preconditions for an effective delivery of case management services. Method The method used to carry out the research was a modified four-phase Delphi design. First, a list of potentially essential components and preconditions for the provision of case management was drawn up on the basis of a literature review and a subsequent focus group interview. The list was then validated by experts in a first Delphi survey round, following which the researchers translated the list items into 75 statements. In the second Delphi survey, the experts rated the statements; in the third Delphi round, they rated 18 statements on which no consensus had been reached in the second round. Results The experts were able to build consensus on 61 of the 75 statements. Essential components of case management for people with dementia are: information, support and counselling, coordination of the care provided and, to a lesser extent, practical help. A patient-centred approach was found to be one of the key aspects of providing case management services. Essential preconditions are: vision, care relationship, structured methodology, integration of case management into the health care chain, and the case manager's level of training and expertise. Conclusions We recommend that, based on the essential components and preconditions referred to above, quality criteria be developed for the provision of case management for people with dementia. Furthermore, we suggest the conduct of additional research to assess the effectiveness of case management in people with dementia.

  18. NREL/Habitat for Humanity Zero Energy Home: A Cold-Climate Case Study for Affordable Zero Energy Homes

    Energy Technology Data Exchange (ETDEWEB)

    Norton, P.; Christensen, C.; Hancock, E.; Barker, G.; Reeves, P.

    2008-06-01

    The design of this 1,280-square-foot, three-bedroom Habitat for Humanity of Metro Denver zero energy home carefully combines envelope efficiency, efficient equipment, appliances and lighting, and passive and active solar features to reach the zero energy goal. The home was designed with an early version (July 22, 2004) of the BEOpt building optimization software; DOE2 and TRNSYS were used to perform additional analysis. This engineering approach was tempered by regular discussions with Habitat construction staff and volunteers. These discussions weighed the applicability of the optimized solutions to the special needs and economics of a Habitat house--moving the design toward simple, easily maintained mechanical systems and volunteer-friendly construction techniques. A data acquisition system was installed in the completed home to monitor its performance.

  19. Baking soda misuse as a home remedy: case experience of the California Poison Control System.

    Science.gov (United States)

    Al-Abri, S A; Kearney, T

    2014-02-01

    Baking soda is a common household product promoted by the manufacturer as an antacid. It contains sodium bicarbonate and has the potential for significant toxicity when ingested in excessive amounts. Characterizing the patterns and outcomes from the misuse of baking soda as a home remedy can guide the clinical assessment and preventative counselling of patients at risk for use of this product. We conducted a retrospective review of all symptomatic cases involving ingestion and misuse of a baking soda powder product that were reported to the California Poison Control System between the years 2000 and 2012. Of the 192 cases we identified, 55·8% were female, ages ranged 2 months to 79 years, and the most common reasons for misuse included antacid (60·4%), 'beat a urine drug test' (11·5%) and treat a UTI (4·7%). Most cases (55·2%) had significant symptoms warranting a medical evaluation, whereas 12 patients required hospital admission developed either electrolyte imbalances, metabolic alkalosis or respiratory depression. Misuse of baking soda can result in serious electrolyte and acid/base imbalances. Patients at highest risk of toxicity may include those who chronically use an antacid, those who use the method to 'beat' urine drug screens, pregnant women and young children. Self-treatment with baking soda as a home remedy may also mask or delay medical care thereby complicating or exacerbating an existing medical problem. We suggest that healthcare providers counsel high-risk patients about the potential complications of misuse of baking soda as a home remedy. © 2013 John Wiley & Sons Ltd.

  20. Successful management of stuttering priapism using home self-injections of the alpha-agonist metaraminol

    Directory of Open Access Journals (Sweden)

    Mcdonald Michael

    2004-01-01

    Full Text Available Low-flow priapism can result in impotence if treatment is delayed, yet patients with recurrent priapism often suffer delay before therapy. We describe management of recurrent priapism using self-administered injections of intracavernosal metaraminol (Aramine™, Merck, a long-acting vasoconstricting amine that is considered safer than epinephrine. The patient injects as often as once daily using 5-10 mg of drug. Our patient reports rapid detumescence and has not required emergency room visits since starting injections. He denies complications. Treatment of priapism using metaraminol has been suggested in the hospital setting; however, this is the first report of successful home self-administration of the drug.

  1. Impact of distance on the network management capability of the home base firm

    DEFF Research Database (Denmark)

    Mykhaylenko, Alona; Wæhrens, Brian Vejrum; Slepniov, Dmitrij

    For many globally dispersed organizations the home base (HB) is historically the locus of integrative, coordinating and innovating efforts, important for the overall performance. The growing concerns about the offshoring strategies posing threats to the capabilities of the HB draw attention to how...... a HB can continuously sustain its centrality. The well-known challenges of distance in the distributed working arrangements may be regarded as a major threat to the network management capabilities (NMCs) of the HB. Therefore, this paper investigates what role does distance between the HB and its...

  2. Electronic Document Management: A Human Resource Management Case Study

    Directory of Open Access Journals (Sweden)

    Thomas Groenewald

    2004-11-01

    Full Text Available This case study serve as exemplar regarding what can go wrong with the implementation of an electronic document management system. Knowledge agility and knowledge as capital, is outlined against the backdrop of the information society and knowledge economy. The importance of electronic document management and control is sketched thereafter. The literature review is concluded with the impact of human resource management on knowledge agility, which includes references to the learning organisation and complexity theory. The intervention methodology, comprising three phases, follows next. The results of the three phases are presented thereafter. Partial success has been achieved with improving the human efficacy of electronic document management, however the client opted to discontinue the system in use. Opsomming Die gevalle studie dien as voorbeeld van wat kan verkeerd loop met die implementering van ’n elektroniese dokumentbestuur sisteem. Teen die agtergrond van die inligtingsgemeenskap en kennishuishouding word kennissoepelheid en kennis as kapitaal bespreek. Die literatuurstudie word afgesluit met die inpak van menslikehulpbronbestuur op kennissoepelheid, wat ook die verwysings na die leerorganisasie en kompleksietydsteorie insluit. Die metodologie van die intervensie, wat uit drie fases bestaan, volg daarna. Die resultate van die drie fases word vervolgens aangebied. Slegs gedeelte welslae is behaal met die verbetering van die menslike doeltreffendheid ten opsigte van elektroniese dokumentbestuur. Die klient besluit egter om nie voort te gaan om die huidige sisteem te gebruik nie.

  3. Anticoagulant and anti-thrombotic treatments in the management of hematological malignancies in a home care program

    Directory of Open Access Journals (Sweden)

    Andrea Tendas

    2011-01-01

    Full Text Available Aim: Anticoagulants (AC and anti-platelet (AP agents are widely administered to patients with hematological malignancies (HM. However, HM patients may be at high risk of bleeding and hemorrhagic complications, because of different form of coagulopathies and several degrees of thrombocytopenia. Materials and Methods: A prospective evaluation of the use of anticoagulant and anti-thrombotic agents as well as of bleeding and thrombotic complications in a consecutive cohort of patients, which were followed during the first semester of 2010 by our home care service, was performed. In this regard, three pharmacological class of agents, such as oral anticoagulants (warfarin and acenocumarine, low molecular weight heparin (LMWH and anti-platelet (AP drugs were considered. Results: Out of 129 patients, 26 (20% were treated with AC/AP drugs. Warfarin, acenocumarine, LMWH as well as AP were used in 7, 11 and 12 patients, respectively. Adverse events (bleeding were observed in 3 patients (11.5%, 2 cases being on warfarin (replaced by LMWH and 1 being AP (suspension without replacement; out of the 3 patients with bleeding, none presented thrombocytopenia. Conclusions: Despite the frequent findings of hemostatic disorders in a population of frail patients managed in a home care setting, our experience demonstrated that the use of AC/AP drugs has been very rarely responsible for significant complications.

  4. Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2017-11-07

    This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

  5. Case management for the elderly with complex needs: cross-linking the views of their role held by elderly people, their informal caregivers and the case managers

    Directory of Open Access Journals (Sweden)

    Frédéric Balard

    2016-11-01

    Full Text Available Abstract Background In 2009, case management interventions were a new social service in France implemented within the framework of the PRISMA-France program (2006–2010. People who had benefitted from case management intervention were individuals, over 60 years old living at home in situations deemed complex by professionals. Their informal caregivers were also considered as users of the service. This research accompanied the interventions during the implementation of PRISMA-France attempting to explore the users’ (old people and their informal caregivers and case managers’ first experiences of case management. Its aim is to provide a thorough knowledge of the dispositive in order to reveal any initial failings and to ensure optimum conditions for the onset of full implementation. Methods The study had a qualitative explorative design. Cross-linked representations of case-management were obtained through opened-ended and guided interviews with three types of informants: old people (19, their informal caregivers (11 and the case managers (5 who participated in the program during the first 6 months. Thematic analysis of the data was carried out. Results The analysis revealed that each group of people generated its own representations of the case manager’s role, even though the three groups of informants shared the idea that the case manager is first and foremost a helper. The case managers insisted on their proximity to the old people and their role as coordinators. The informal caregivers saw the professional as a partner and potential provider of assistance in accompanying old people. The old people focused on the personal connections established with the case manager. Conclusion The innovative and experimental dimension of case management in France and the flexible nature of the role generated a broad spectrum of representations by those involved. These different representations are, in part, the fruit of each individual’s projected

  6. DOE Zero Energy Ready Home Case Study: Manatee County Habitat for Humanity, Ellenton, Florida

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    In this 18-home community, all homes are LEED Platinum and meet ENERGY STAR for Homes Version 3 requirements, HERS 23–53. Half way through the project, Habitat for Humanity heard about the DOE Challenge Home program and signed on, committing to build the next home, a three-bedroom, two-bath, 1,143 ft2 duplex, to Challenge Home criteria. The home is the first DOE Challenge Home in Manatee County, and was awarded a 2013 Housing Innovation Award in the affordable builder category.

  7. Primary immunodeficiency disease: a model for case management of chronic diseases.

    Science.gov (United States)

    Burton, Janet; Murphy, Elyse; Riley, Patty

    2010-01-01

    Patient-centered chronic care management is a new model for the management of rare chronic diseases such as primary immunodeficiency disease (PIDD). This approach emphasizes helping patients become experts on the management of their disease as informed, involved, and interactive partners in healthcare decisions with providers. Because only a few patients are affected by rare illnesses, these patients are forced to become knowledgeable about their disease and therapies and to seek treatment from a healthcare team, which includes physicians and nurse specialists who are equipped to manage the complexity of the disease and its comorbidities. Importantly, therapy for PIDD can be self-administered at home, which has encouraged the transition toward a proactive stance that is at the heart of patient-centered chronic care management. We discuss the evolution of therapy, the issues with the disease, and challenges with its management within the framework of other chronic disease management programs. Suggestions and rationale to move case management of PIDD forward are presented with the intent that sharing our experiences will improve process and better manage outcomes in this patient population. The patient-centered model for the management of PIDD is applicable to the primary care settings, where nurse case managers assist patients through education, support them and their families, and facilitate access to community resources in an approach, which has been described as "guided care." The model also applies specifically to immunology centers where patients receive treatment or instruction on its self-administration at home. Patient-centered management of PIDD, with its emphasis on full involvement of patients in their treatment, has the potential to improve compliance with treatment, and thus patient outcomes, as well as patients' quality of life. The patient-centered model expands the traditional model of chronic disease management, which relies on evidence

  8. The effects of critical peak pricing for electricity demand management on home-based trip generation

    Directory of Open Access Journals (Sweden)

    Masanobu Kii

    2014-03-01

    Full Text Available This paper examines electricity critical peak pricing (CPP as a measure for controlling electricity demand at critical peak times. This pricing scheme is designed to facilitate energy conservation not only inside but also outside the home. For this study, we surveyed consumer propensity to leave the home under CPP schemes and analyzed the impact of CPP on consumer cost. The results indicated that higher prices induce a higher rate of going out, while residential conditions such as population density and access to public transportation have a relatively small impact on leaving the home and average energy conservation. However, this is not always the case for aged households with limited mobility; residential conditions have a substantial effect on this segment of the population. Combined with a reduced ability to go out, electricity pricing has a greater negative impact on aged people. These results imply that improving accessibility through transportation development and urban compaction is an effective means of saving electricity alleviating the negative impact of CPP on the aged society of the future.

  9. Home Care Providers to the Rescue

    DEFF Research Database (Denmark)

    Hansen, Steen M; Brøndum, Stig; Thomas, Grethe

    2015-01-01

    and shock was delivered in one case. For 26 of the 28 cases, the cardiac arrest occurred in a private home. Ninety-five per cent of the providers who had been dispatched to a cardiac arrest reported feeling prepared for managing the initial resuscitation, including use of AED. CONCLUSION: Home care...... providers are suited to act as first-responders in predominantly rural and residential districts. Future follow-up will allow further evaluation of home care provider arrivals and patient survival....

  10. Case for domestic electrical load management

    Energy Technology Data Exchange (ETDEWEB)

    Giddens, E.P.

    1986-07-01

    At the present time electricity generation and distribution systems have sufficient capacity to cope with maximum peak loads that occur infrequently and only for short periods. The average load factor is significantly below unity. As the demand for power inevitably increases, the capacities of the supply and distribution systems simultaneously have to be enlarged to maintain this margin of excess capacity. A case is presented for use of existing technology to facilitate a gradual transition to a more cost effective basis for electricity consumption and supply. The basis of the proposed method lies in domestic load management. A research team of architects and engineers is suggested.

  11. Case Management of Dengue: Lessons Learned.

    Science.gov (United States)

    Kalayanarooj, Siripen; Rothman, Alan L; Srikiatkhachorn, Anon

    2017-03-01

    The global burden of dengue and its geographic distribution have increased over the past several decades. The introduction of dengue in new areas has often been accompanied by high case-fatality rates. Drawing on the experience in managing dengue cases at the Queen Sirikit National Institute of Child Health in Bangkok, Thailand, this article provides the authors' perspectives on key clinical lessons to improve dengue-related outcomes. Parallels between this clinical experience and outcomes reported in randomized controlled trials, results of efforts to disseminate practice recommendations, and suggestions for areas for further research are also discussed. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  12. Essentials of Advocacy in Case Management: Part 2: Client Advocacy Model and Case Manager's Advocacy Strategies and Competencies.

    Science.gov (United States)

    Tahan, Hussein M

    2016-01-01

    This article describes a client advocacy model for use by case managers. It delineates necessary competencies for the case manager and shares important strategies for effective client advocacy. All practice settings across the continuum of health and human services and case managers of diverse professional backgrounds. Advocacy is a primary role and necessary competency of professional case managers functioning in various care settings. It is rooted in ethical theory and principles. Successful case managers apply ethical principles of advocacy at every step of the case management process and in the decisions they make. Part II of this two-part article presents a client advocacy model for case managers to apply in their practice, describes the role of advocacy in client engagement, and identifies important strategies and a set of essential competencies for effective case management advocacy. Part I already explored the ethical theories and principles of advocacy, the perception of case management-related professional organizations of advocacy, and the common types of advocacy based on scope, complexity, impact, and reach. Acquiring foundational knowledge, skills, and competencies in what advocacy is and how to effectively enact its related behaviors is essential for success of case managers and for achieving desired outcomes for both the clients and health care agencies/providers alike. Case management leaders are urged to use the knowledge shared in this article to develop advocacy training and competency management programs for their case managers.

  13. Hybrid LSA-ANN Based Home Energy Management Scheduling Controller for Residential Demand Response Strategy

    Directory of Open Access Journals (Sweden)

    Maytham S. Ahmed

    2016-09-01

    Full Text Available Demand response (DR program can shift peak time load to off-peak time, thereby reducing greenhouse gas emissions and allowing energy conservation. In this study, the home energy management scheduling controller of the residential DR strategy is proposed using the hybrid lightning search algorithm (LSA-based artificial neural network (ANN to predict the optimal ON/OFF status for home appliances. Consequently, the scheduled operation of several appliances is improved in terms of cost savings. In the proposed approach, a set of the most common residential appliances are modeled, and their activation is controlled by the hybrid LSA-ANN based home energy management scheduling controller. Four appliances, namely, air conditioner, water heater, refrigerator, and washing machine (WM, are developed by Matlab/Simulink according to customer preferences and priority of appliances. The ANN controller has to be tuned properly using suitable learning rate value and number of nodes in the hidden layers to schedule the appliances optimally. Given that finding proper ANN tuning parameters is difficult, the LSA optimization is hybridized with ANN to improve the ANN performances by selecting the optimum values of neurons in each hidden layer and learning rate. Therefore, the ON/OFF estimation accuracy by ANN can be improved. Results of the hybrid LSA-ANN are compared with those of hybrid particle swarm optimization (PSO based ANN to validate the developed algorithm. Results show that the hybrid LSA-ANN outperforms the hybrid PSO based ANN. The proposed scheduling algorithm can significantly reduce the peak-hour energy consumption during the DR event by up to 9.7138% considering four appliances per 7-h period.

  14. Dementia behaviour management programme at home: impact of a palliative care approach on care managers and professional caregivers of home care services.

    Science.gov (United States)

    Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Nakashima, Taeko; Morimoto, Yuko; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi

    2017-05-29

    Care managers and professional caregivers of home care services are sometimes unaware of the psychosocial approaches to the challenging behaviour of dementia. Therefore, we developed a Behaviour Analytics & Support Enhancement (BASE) programme. We investigated the effects of the programme on the attitudes towards dementia care among professionals. Forty-six participants in Japan received training in August 2016. The ongoing monitoring and assessment system was introduced to the participants for repeated measures of challenging behaviour. A 1-day follow-up meeting for debriefing was also performed after two months. A baseline and follow-up questionnaire survey was administered to the participating caregivers using a Japanese version of the Approaches to Dementia Questionnaire (ADQ) and the Zarit Burden Interview (ZBI). A significant improvement was observed in the total ADQ score among the participating caregivers from baseline to follow-up assessment. There was no significant difference between the baseline and follow-up assessment in the ZBI scores. In the follow-up meeting, several participants reported challenges and suggested solutions in facilitating a discussion on an action plan among professionals from various organizations. The implementation of the programme resulted in enhanced attitudes towards dementia care among the participants without an increased burden of care. Future studies should examine the programme's effectiveness on the challenging behaviour of persons with dementia.

  15. Establishing a culturally specific nursing home for Finnish-speaking older persons in Sweden: A case study.

    Science.gov (United States)

    Hadziabdic, Emina; Hjelm, Katarina

    2018-04-01

    The study aims to describe the establishment of a culturally specific nursing home for Finnish-speaking older persons in Sweden. A descriptive qualitative study. A descriptive case study based on a review of 14 public documents and individual interviews with two experts in the area, analysed with qualitative content analysis. This study found that shared language, preservation of customs and habits and collaboration between the representatives of the municipality, Finnish-speaking migrant associations and staff at the nursing home influenced the development of the culturally specific nursing home for older Finnish-speaking people intended to avoid loneliness, isolation and misunderstandings among older Finnish-speaking. Collaboration between healthcare service for older persons and minority people resulted in an optimal culturally specific nursing home, simultaneously encountering the majority culture. Nursing and healthcare services need to be aware of positive effects of collaboration with stakeholders to achieve optimal culturally specific nursing homes.

  16. The myth of the stay-at-home family firm : How family-managed SMEs can overcome their internationalization limitations

    NARCIS (Netherlands)

    Hennart, Jean-Francois; Majocchi, A.; Forlani, E.

    The prevalent view among family-firm internationalization scholars is that family management discourages internationalization. This is because selling abroad is said to require more specialized managers and more resources than selling at home, and yet family firms are unwilling to recruit non-family

  17. Summer-fall home-range fidelity of female elk in northwestern Colorado: Implications for aspen management

    Science.gov (United States)

    April M. Brough; R. Justin DeRose; Mary M. Conner; James N. Long

    2017-01-01

    Understanding the degree of spatial fidelity exhibited by individuals within a species increases our ability to manage for desired future outcomes. Elk (Cervus elaphus) is a closely managed species in the Western US, but there is little research evaluating their summer home-range fidelity. Elk summer-fall homeranges overlap considerably with aspen (Populus tremuloides...

  18. ROSA: Resource-Oriented Service Management Schemes for Web of Things in a Smart Home.

    Science.gov (United States)

    Liao, Chun-Feng; Chen, Peng-Yu

    2017-09-21

    A Pervasive-computing-enriched smart home environment, which contains many embedded and tiny intelligent devices and sensors coordinated by service management mechanisms, is capable of anticipating intentions of occupants and providing appropriate services accordingly. Although there are a wealth of research achievements in recent years, the degree of market acceptance is still low. The main reason is that most of the devices and services in such environments depend on particular platform or technology, making it hard to develop an application by composing the devices or services. Meanwhile, the concept of Web of Things (WoT) is becoming popular recently. Based on WoT, the developers can build applications based on popular web tools or technologies. Consequently, the objective of this paper is to propose a set of novel WoT-driven plug-and-play service management schemes for a smart home called Resource-Oriented Service Administration (ROSA). We have implemented an application prototype, and experiments are performed to show the effectiveness of the proposed approach. The results of this research can be a foundation for realizing the vision of "end user programmable smart environments".

  19. Co-designing the next generation of home energy management systems with lead-users.

    Science.gov (United States)

    Peacock, Andrew D; Chaney, Joel; Goldbach, Kristin; Walker, Guy; Tuohy, Paul; Santonja, Salvador; Todoli, David; Owens, Edward H

    2017-04-01

    Home energy management systems are widely promoted as essential components of future low carbon economies. It is argued in this paper that assumptions surrounding their deployment, and the methods used to design them, emerge from discredited models of people and energy. This offers an explanation for why their field trial performance is so inconsistent. A first of a kind field trial is reported. Three eco communities took part in a comprehensive participatory design exercise as lead users. The challenge was to help users synchronise their energy use behaviours with the availability of locally generated renewable energy sources. To meet this aim, a set of highly novel Home Energy Management interfaces were co-designed and tested. Not only were the designs radically different to the norm, but they also yielded sustained user engagement over a six-month follow-up period. It is argued that user-centred design holds the key to unlocking the energy saving potential of new domestic technologies, and this study represents a bold step in that direction. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Load shifting with the use of home energy management system implemented in FPGA

    Science.gov (United States)

    Bazydło, Grzegorz; Wermiński, Szymon

    2017-08-01

    The increases for power demand in the Electrical Power System (EPS) causes a significant increase of power in daily load curve and transmission line overload. The large variability in energy consumption in EPS combined with unpredictable weather events can lead to a situation in which to save the stability of the EPS, the power limits must be introduced or even industrial customers in a given area have to be disconnected, which causes financial losses. Nowadays, a Transmission System Operator is looking for additional solutions to reduce peak power, because existing approaches (mainly building new intervention power unit or tariff programs) are not satisfactory due to the high cost of services in combination with insufficient power reduction effect. The paper presents an approach to load shifting with the use of home Energy Management System (EMS) installed at small end-users. The home energy management algorithm, executed by EMS controller, is modeled using Unified Modeling Language (UML). Then, the UML model is translated into Verilog description, and is finally implemented in the Field Programmable Gate Arrays. The advantages of the proposed approach are the relatively low cost of reduction service, small loss of end-users' comfort, and the convenient maintenance of EMS. A practical example illustrating the proposed approach and calculation of potential gains from its implementation are also presented.

  1. Distributed Demand Side Management with Battery Storage for Smart Home Energy Scheduling

    Directory of Open Access Journals (Sweden)

    Omowunmi Mary Longe

    2017-01-01

    Full Text Available The role of Demand Side Management (DSM with Distributed Energy Storage (DES has been gaining attention in recent studies due to the impact of the latter on energy management in the smart grid. In this work, an Energy Scheduling and Distributed Storage (ESDS algorithm is proposed to be installed into the smart meters of Time-of-Use (TOU pricing consumers possessing in-home energy storage devices. Source of energy supply to the smart home appliances was optimized between the utility grid and the DES device depending on energy tariff and consumer demand satisfaction information. This is to minimize consumer energy expenditure and maximize demand satisfaction simultaneously. The ESDS algorithm was found to offer consumer-friendly and utility-friendly enhancements to the DSM program such as energy, financial, and investment savings, reduced/eliminated consumer dissatisfaction even at peak periods, Peak-to-Average-Ratio (PAR demand reduction, grid energy sustainability, socio-economic benefits, and other associated benefits such as environmental-friendliness.

  2. Management case study: Tampa Bay, Florida

    Science.gov (United States)

    Morrison, Gerold; Greening, Holly; Yates, Kimberly K.; Wolanski, Eric; McLusky, Donald S.

    2011-01-01

    Tampa Bay, Florida, USA, is a shallow, subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of seagrasses and other selected habitat types, to support estuarine-dependent faunal guilds. Over the past three decades, nitrogen controls involving sources such as wastewater treatment plants, stormwater conveyance systems, fertilizer manufacturing and shipping operations, and power plants have been undertaken to meet these and other management objectives. Cumulatively, these controls have resulted in a 60% reduction in annual total nitrogen (TN) loads relative to earlier worse-case (latter 1970s) conditions. As a result, annual water-clarity and chlorophyll a targets are currently met in most years, and seagrass cover measured in 2008 was the highest recorded since 1950. Factors that have contributed to the observed improvements in Tampa Bay over the past several decades include the following: (1) Development of numeric, science-based water-quality targets to meet a long-term goal of restoring seagrass acreage to 1950s levels. Empirical and mechanistic models found that annual average chlorophyll a concentrations were a primary manageable factor affecting light attenuation. The models also quantified relationships between TN loads, chlorophyll a concentrations, light attenuation, and fluctuations in seagrass cover. The availability of long-term monitoring data, and a systematic process for using the data to evaluate the effectiveness of management actions, has allowed managers to track progress and

  3. HIA 2016 DOE Zero Energy Ready Home Case Study: United Way of Long Island, United Veterans, Beacon House, Deer Park, NY

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2016-09-01

    Case study of a DOE 2016 Housing Innovation Award winning affordable home in the mixed-humid climate that met the DOE Zero Energy Ready Home criteria and achieved a HERS 32 without PV or HERS 9 with PV.

  4. Background on Establishing a Working Group to Create Home Clinical Cases for Education.

    Science.gov (United States)

    Yoshitake, Taketo

    2017-01-01

    In Japan there are concerns that there will be a surge in social insurance costs such as medical and nursing care expenses as a result of the baby boom generation reaching the late stages of old age (75 years old and beyond) around 2025 ("The 2025 Problem"). In 2012, the "Outline on Social Insurance and Tax Reform" was approved by the Japanese cabinet and government, including "construction of regional comprehensive care". To promote participation in home medical care by pharmacists, this article presents the roles demanded of pharmacists in regional comprehensive care from the standpoint of physicians, and the discussion of case studies bridging the gap from knowledge learned in lectures to practical applications. In the field of medical education, "The 2023 Problem", regarding standards of education on a global level, caused medical schools across Japan to scramble for curriculum reform, specifically in the demand for increased time spent in clinical training and the expansion of community-based medical education. The current state of community-based medical education will be reviewed. In light of these developments, "the working group to create home clinical cases for education" was developed by clinical pharmacists in the field and university faculty members at Daiichi University of Pharmacy.

  5. Quick management of accidental tritium exposure cases.

    Science.gov (United States)

    Singh, Vishwanath P; Badiger, N M; Managanvi, S S; Bhat, H R

    2012-07-01

    Removal half-life (RHL) of tritium is one of the best means for optimising medical treatment, reduction of committed effective dose (CED) and quick/easy handling of a large group of workers for medical treatment reference. The removal of tritium from the body depends on age, temperature, relative humidity and daily rainfall; so tritium removal rate, its follow-up and proper data analysis and recording are the best techniques for management of accidental acute tritium exposed cases. The decision of referring for medical treatment or medical intervention (MI) would be based on workers' tritium RHL history taken from their bodies at the facilities. The workers with tritium intake up to 1 ALI shall not be considered for medical treatment as it is a derived limit of annual total effective dose. The short-term MI may be considered for tritium intake of 1-10 ALI; however, if the results show intake ≥100 ALI, extended strong medical/therapeutic intervention may be recommended based on the severity of exposure for maximum CED reduction requirements and annual total effective dose limit. The methodology is very useful for pressurized heavy water reactors (PHWRs) which are mainly operated by Canada and India and future fusion reactor technologies. Proper management will optimise the cases for medical treatment and enhance public acceptance of nuclear fission and fusion reactor technologies.

  6. Quick management of accidental tritium exposure cases

    International Nuclear Information System (INIS)

    Singh, V. P.; Badiger, N. M.; Managanvi, S. S.; Bhat, H. R.

    2008-01-01

    Removal half-life (RHL) of tritium is one of the best means for optimising medical treatment, reduction of committed effective dose (CED) and quick/easy handling of a large group of workers for medical treatment reference. The removal of tritium from the body depends on age, temperature, relative humidity and daily rainfall; so tritium removal rate, its follow-up and proper data analysis and recording are the best techniques for management of accidental acute tritium exposed cases. The decision of referring for medical treatment or medical intervention (MI) would be based on workers' tritium RHL history taken from their bodies at the facilities. The workers with tritium intake up to 1 ALI shall not be considered for medical treatment as it is a derived limit of annual total effective dose. The short-term MI may be considered for tritium intake of 1-10 ALI; however, if the results show intake ≥100 ALI, extended strong medical/therapeutic intervention may be recommended based on the severity of exposure for maximum CED reduction requirements and annual total effective dose limit. The methodology is very useful for pressurized heavy water reactors (PHWRs) which are mainly operated by Canada and India and future fusion reactor technologies. Proper management will optimise the cases for medical treatment and enhance public acceptance of nuclear fission and fusion reactor technologies. (authors)

  7. Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

    Science.gov (United States)

    Davitt, Joan K.

    2014-01-01

    Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…

  8. Management case study: Tampa Bay, Florida

    Science.gov (United States)

    Morrison, Gerold; Greening, Holly; Yates, Kimberly K.; Wolanski, Eric; McLusky, Donald S.

    2011-01-01

    Tampa Bay, Florida, USA, is a shallow, subtropical estuary that experienced severe cultural eutrophication between the 1940s and 1980s, a period when the human population of its watershed quadrupled. In response, citizen action led to the formation of a public- and private-sector partnership (the Tampa Bay Estuary Program), which adopted a number of management objectives to support the restoration and protection of the bay’s living resources. These included numeric chlorophyll a and water-clarity targets, as well as long-term goals addressing the spatial extent of seagrasses and other selected habitat types, to support estuarine-dependent faunal guilds. Over the past three decades, nitrogen controls involving sources such as wastewater treatment plants, stormwater conveyance systems, fertilizer manufacturing and shipping operations, and power plants have been undertaken to meet these and other management objectives. Cumulatively, these controls have resulted in a 60% reduction in annual total nitrogen (TN) loads relative to earlier worse-case (latter 1970s) conditions. As a result, annual water-clarity and chlorophyll a targets are currently met in most years, and seagrass cover measured in 2008 was the highest recorded since 1950. Factors that have contributed to the observed improvements in Tampa Bay over the past several decades include the following: (1) Development of numeric, science-based water-quality targets to meet a long-term goal of restoring seagrass acreage to 1950s levels. Empirical and mechanistic models found that annual average chlorophyll a concentrations were a primary manageable factor affecting light attenuation. The models also quantified relationships between TN loads, chlorophyll a concentrations, light attenuation, and fluctuations in seagrass cover. The availability of long-term monitoring data, and a systematic process for using the data to evaluate the effectiveness of management actions, has allowed managers to track progress and

  9. Logistics management skills development: A Zimbabwean case

    Directory of Open Access Journals (Sweden)

    Jacobus N. Cronjé

    2015-02-01

    Full Text Available Background: Since logistics emerged as an applied discipline during the latter part of the 20th century, there has been an increased need for skills development in logistics and supply chain management. However, literature suggests a general shortage of educated and skilled logistics and supply chain managers worldwide. Objectives: The purpose of this article was to benchmark an in-house training programme in logistics management in the beverage industry of Zimbabwe with international best practice. Method: A case study approach was followed focusing on the programme curriculum, content and delivery. The article reports on the nature and effectiveness of the programme. The curriculum was benchmarked with skills requirements identified in literature. Relevance was evaluated based on participant perceptions over a period of 3 years using questionnaires with both closed- and open-ended questions. Results: Findings suggested that the programme offering is in line with international practice whilst it also addresses particular issues in Third World countries. Participants perceived the programme as being practical and valuable for enhancing their job performance and career development. Conclusion: The article provides a framework for evaluating logistics training programmes. Future research could include an evaluation that measures changes in on-the-job behaviour of participants.

  10. Logistics management skills development: A Zimbabwean case

    Directory of Open Access Journals (Sweden)

    Jacobus N. Cronjé

    2015-02-01

    Full Text Available Background: Since logistics emerged as an applied discipline during the latter part of the 20th century, there has been an increased need for skills development in logistics and supply chain management. However, literature suggests a general shortage of educated and skilled logistics and supply chain managers worldwide.Objectives: The purpose of this article was to benchmark an in-house training programme in logistics management in the beverage industry of Zimbabwe with international best practice.Method: A case study approach was followed focusing on the programme curriculum, content and delivery. The article reports on the nature and effectiveness of the programme. The curriculum was benchmarked with skills requirements identified in literature. Relevance was evaluated based on participant perceptions over a period of 3 years using questionnaires with both closed- and open-ended questions.Results: Findings suggested that the programme offering is in line with international practice whilst it also addresses particular issues in Third World countries. Participants perceived the programme as being practical and valuable for enhancing their job performance and career development.Conclusion: The article provides a framework for evaluating logistics training programmes. Future research could include an evaluation that measures changes in on-the-job behaviour of participants.

  11. Applying e-health to case management.

    Science.gov (United States)

    Adams, J M

    2000-01-01

    The healthcare industry is only beginning to understand e-health. E-health can be defined as the use of technology to directly improve healthcare delivery-affording patients the opportunity to participate in their own healthcare management, provider, and institution. The market is changing rapidly, and innovations, partnerships, and mergers are taking place daily. For healthcare institutions, setting a long-term, yet adaptable e-health strategy is of vital importance for the continued success of the organization. For clinicians, an understanding of and familiarity with technologies can significantly improve workflow, organization, and patient interaction. For the patient, technology can be leveraged as a means to take initiative and responsibility for his/her own health. This article defines e-health and explains the implications and benefits of e-health to nurses and their patients. The article also identifies unique opportunities e-health/e-commerce can provide case managers in promoting patient connectivity, care management, and economy in cost of care.

  12. Case managers' experiences of personal growth: learning from consumers.

    Science.gov (United States)

    Stein, Catherine H; Craft, Scott A

    2007-04-01

    This study examines aspects of case managers' perceived personal growth in their work with consumers. Using a sample of 98 case managers, the psychometric properties of a brief self-report measure of personal growth of case managers were examined. The Case Manager Personal Growth Scale (CMPG) showed good reliability and construct validity as evidenced by negative correlations with scores on professional burnout and positive correlations with personal accomplishment and job satisfaction scores. CMPG scores were unrelated to social desirability scores or caseload size and positively related to age and tenure in the mental health system. Results suggest the strong relevance of the construct of personal growth for case managers.

  13. DOE Zero Energy Ready Home Case Study: Weiss Building & Development, Downers Grove, Illinois

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    This single-family home built in a peat bog has underground storage tanks and drainage tanks, blown fiberglass insulation, coated rigid polyisocyanurate, and flashing. The 3,600-square-foot custom home built by Weiss Building & Development LLC is the first home in Illinois certified to the DOE Challenge Home criteria, which requires that homes meet the EPA Indoor airPlus guidelines.The builder won a 2013 Housing Innovation Award in the custom builder category.

  14. BOOK REVIEW: Case Studies in Knowledge Management

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    Reviewed by Dr. Adnan BOYACI

    2005-10-01

    Full Text Available 161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…etc. Because of the growingimportance and the popularity of the KM either as a research topic or specialized coursesubject, a crucial need for understanding, conceptualization and implementation of KM asa system has emerged since the mid 1990’s. In this sense, the book contributes criticallyto fill the gap between theory and implementation as a teaching material.This edited book is published by Idea Group Publishing. The book has twenty chaptersdivided into seven sections. In addition to a section of authors’ biography contributing thebook and an index, there is a preface that the basic terms and key concepts underliningthe cases discussed following chapters, which is explained in a schematized way.Besides the editor, total of 47 authors have contributed to the book. These authors arefrom different countries, academic backgrounds, and institutions. Although approximatelyone third of the authors are from USA, the rest of the authors are from Canada, England,Austria, Germany, Australia, New Zealand, Egypt, Bahrain and China. The authorsrepresent a variety of universities, private companies, and military institutions. Most ofthem have strong professional backgrounds, which help them address the issues bothfrom theoretical and practical perspectives. Contributions of authors having differentbackgrounds and institutions enable the book to have very comprehensive spectrum andthis makes the book attractive practically for those working different sectors

  15. Leadership development and succession planning in case management.

    Science.gov (United States)

    Miodonski, Kathleen; Hines, Patricia

    2013-01-01

    The director of case management is one of health care's leadership positions most frequently in demand. The lack of qualified and effective case management leaders will continue to be an issue for organizations for years to come, influenced by increasing pressures on health care reimbursement and the aging case management workforce. Organizations have an opportunity to create a program to develop future case management leaders from their internal talent. The proposed strategies are designed for the acute care hospital but also have applicability in other health care settings where there are case managers and a need for case management leadership. The business community offers leadership research and leadership development models with relevance to case management. Identifying and developing internal talent for leadership roles has been proven to be effective in preparation for advanced responsibilities, has a positive effect on staff morale, and minimizes the impact of vacant leadership positions during recruitment and onboarding activities. Creating a case management leadership development program for an organization can be an alternative to the process of external recruitment for case management department leaders. Such a program can be undertaken even in today's budget conscious environment by accessing existing resources in an organization in a creative and organized manner. The authors outline an approach for case management leaders to accept responsibility for succession planning and for case managers to accept responsibility for promoting their own career development through creation of a leadership development program.

  16. Improving Chronic Disease Self-Management by Older Home Health Patients through Community Health Coaching

    Directory of Open Access Journals (Sweden)

    Cheryl Dye

    2018-04-01

    Full Text Available The purpose of the study was to pilot test a model to reduce hospital readmissions and emergency department use of rural, older adults with chronic diseases discharged from home health services (HHS through the use of volunteers. The study’s priority population consistently experiences poorer health outcomes than their urban counterparts due in part to lower socioeconomic status, reduced access to health services, and incidence of chronic diseases. When they are hospitalized for complications due to poorly managed chronic diseases, they are frequently readmitted for the same conditions. This pilot study examines the use of volunteer community members who were trained as Health Coaches to mentor discharged HHS patients in following the self-care plan developed by their HHS RN; improving chronic disease self-management behaviors; reducing risk of falls, pneumonia, and flu; and accessing community resources. Program participants increased their ability to monitor and track their chronic health conditions, make positive lifestyle changes, and reduce incidents of falls, pneumonia and flu. Although differences in the ED and hospital admission rates after discharge from HHS between the treatment and comparison group (matched for gender, age, and chronic condition were not statistically significant, the treatment group’s rate was less than the comparison group thus suggesting a promising impact of the HC program (90 day: 263 comparison vs. 129 treatment; p = 0.65; 180 day 666.67 vs. 290.32; p = 0.19. The community health coach model offers a potential approach for improving the ability of discharged older home health patients to manage chronic conditions and ultimately reduce emergent care.

  17. [Hyperemesis gravidarum: management and nutritional implications; case report and review of literature].

    Science.gov (United States)

    De Haro, Karina; Toledo, Karen; Fonseca, Yolanda; Arenas, Diego; Arenas, Humberto; Leonher, Karla

    2014-10-03

    Hyperemesis gravidarum is a state of severe nausea and vomiting during pregnancy, leading to dehydration, electrolyte and acid-base disorders, malnutrition and weight loss (> 5%). The prevalence of hyperemesis gravidarum is 0.3-2.3% of all pregnancies. To demonstrate the effectiveness of nutritional support in a case of a complicated hyperemesis gravidarum. A case of a 25 years old woman with hyperemesis gravidarum, who had weight loss of 17.7%, dehydration, electrolyte disorders and arrhythmias, managed with enteral and parenteral nutrition at home until week 26 of gestation reaching to cover 70% of her caloric requirements orally, getting a healthy product and a stable nutritionally mother in late pregnancy. The multidisciplinary management and specialized nutritional management in such cases it is compulsory to carry the patient and the product at the end of pregnancy in optimal conditions. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  18. Fitting clinical workflow: the case for wound care in a residential aged care home.

    Science.gov (United States)

    Qian, Siyu; Yu, Ping

    2014-01-01

    Residential aged care homes have, or are in the process of implementing, electronic health record (EHR) systems to improve quality of care and reduce cost. For the system to deliver benefits, it must support nursing tasks and be seamlessly integrated into the nursing workflow. To identify whether and how an EHR system can do this most effectively, direct observation was conducted in a residential aged care home on nurses' use of EHR for wound care. The work processes of wound care and its documentation were investigated. Problems in the use of EHR were identified: 1) functional deficiencies of the EHR system which included a lack of functions to remind nurses of the existence of a wound chart, unavailability of an existent function when needed and a lack of sufficient detail in the information provided; 2) a lack of mobile devices to allow nurses to access the EHR system at the point-of-care, resulting in nurses using paper for point-of-care documentation. The findings suggest that continuous improvement in both the EHR system and its management is required to achieve integration of people, task, process and technology for the optimal benefits of EHR.

  19. Home humidity increased risk of tuberculosis in children living with adult active tuberculosis cases

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    Pudji Lestari

    2016-02-01

    Full Text Available Indonesia is one of the countries with the largest number of tuberculosis (TB cases in the world. Environmental factors play significant roles in infection and disease development in children living with adult active TB cases. The aim of this study was to explore the environmental factors affecting TB risk in children, including humidity and number of people living in the same house with the children.  Using a cross-sectional study design, children living with active TB adults for at least 8 weeks were recruited. The subjects underwent clinical examination, tuberculin skin test (TST and radiological investigations. Home visits were conducted three times daily, namely in the morning, at midday, and in the evening, to measure humidity by digital hygrometer and to observe home conditions. Of 56 index cases living with active TB adults in an urban low socio-economic setting, 64 contact TB children were recruited. These children were classified as class I with negative TST and no clinical signs, class II with positive TST and no clinical signs, and class III with both positive TST and clinical signs. There were 32 (50% class I, 10 (15.6% class II and 22 (34.3% class III children. However, a sub-sample of 43 showed positive results for Mtb 16S rRNA, indicating that all children were infected. The humidity cut-off point was set at 75%, p=0.04 and EP 2.09 (CI= 1.32-3.29, signifying that children living in houses with a humidity higher than 75%, were twice more likely to be tuberculin positive. Environmental conditions playing a role in disease development were humidity and number of people living in the house.

  20. Effect of Hospital to Home nutrition management model on postoperative clinical outcomes of patients with laryngeal carcinoma

    OpenAIRE

    Song, Guihua; Liu, Haizhen

    2017-01-01

    The purpose of this investigation was to determine the effectiveness of a Hospital to Home (H2H) nutrition management model on the postoperative clinical outcomes of patients with laryngeal carcinoma. Eighty-six patients with laryngeal carcinoma were randomly divided into an observation (H2H nutrition management) or control group (routine nutrition management). The ratios of urine lactulose to mannitol (L/M) in serum orexin-A levels of patients in both groups on the 1st postoperative day were...

  1. [Prolonged hospitalization versus home management for women with arrested preterm labour: a before-after study].

    Science.gov (United States)

    Salzmann, M; Gaucherand, P; Doret, M

    2013-04-01

    To compare gestational age at birth and incidence of preterm birth inferior to 37 weeks of gestation (WG) in single pregnancies with either prolonged hospitalization, or early home discharge after arrested preterm labour. Management of preterm labour was changed in our public academic hospital because no evidence of benefits for prolonged hospitalization was found and because adverse effects related to long-term hospitalization were described. In this retrospective before-after study, we compare the attitude A (December 2006 to April 2008), a prolonged hospitalization until 32 or 34WG, with new attitude B (May 2008 to February 2010), an early discharge home if the cervical exam was unchanged since admission. A total of 140 patients were included: 70 in each group. Initial hospitalization stay was significantly shorter in Group B (respectively, 5.4±5.4 days and 11.4±12.1 days; P0.05). Gestational ages at birth were 33(5/7) and 33(0/7) WG in groups A and B, respectively (P>0.05). If we focus on patients who were discharged home in the two groups (women who did not deliver no matter the hospitalization length), the gestational age at birth (38(4/7) and 38WG; ns) and the prematurity rate inferior to 37WG (17.2% and 22.4%; ns) were statistically similar. This study suggests that shorter hospitalization does not decrease the delivery term, nor does it increase the premature delivery incidence. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  2. Efficacy of Lactic Acid Bacteria (LAB supplement in management of constipation among nursing home residents

    Directory of Open Access Journals (Sweden)

    Kim Jung

    2010-02-01

    Full Text Available Abstract Background Constipation is a significant problem in the elderly, specifically nursing home and/or extended-care facility residents are reported to suffer from constipation. Lactic acid bacteria (LAB are beneficial probiotic organisms that contribute to improved nutrition, microbial balance, and immuno-enhancement of the intestinal tract, as well as diarrhea and constipation effect. The objective of this study was to investigate the efficacy of this LAB supplement in the management of nursing home residents. Methods Nineteen subjects (8M, 11F; mean age 77.1 ± 10.1 suffering with chronic constipation were assigned to receive LAB (3.0 × 1011 CFU/g twice (to be taken 30 minutes after breakfast and dinner a day for 2 weeks in November 2008. Subjects draw up a questionnaire on defecation habits (frequency of defecation, amount and state of stool, and we collected fecal samples from the subjects both before entering and after ending the trial, to investigate LAB levels and inhibition of harmful enzyme activities. Results were tested with SAS and Student's t-test. Results Analysis of questionnaire showed that there was an increase in the frequency of defecation and amount of stool excreted in defecation habit after LAB treatment, but there were no significant changes. And it also affects the intestinal environment, through significantly increase (p p Conclusion LAB, when added to the standard treatment regimen for nursing home residents with chronic constipation, increased defecation habit such as frequency of defecation, amount and state of stool. So, it may be used as functional probiotics to improve human health by helping to prevent constipation.

  3. Children's education and home electrification: A case study in northwestern Madagascar

    Energy Technology Data Exchange (ETDEWEB)

    Rajaona Daka, Karen, E-mail: karen_rajaona@yahoo.f [University of Versailles St Quentin en Yvelines, 47 Bd Vauban, 78047 Guyancourt Cedex (France); Ballet, Jerome, E-mail: jballetfr@yahoo.f [Centre of Ethics and Economics for Environment and Development in Madagascar, University of Antananarivo, BP905, 101 Antananarivo (Madagascar); Institut de Recherche pour le Developpement, UMI Resiliences, 32 Avenue Henri Varagnat, 93143 Bondy Cedex (France)

    2011-05-15

    Assessments of the impact of electrification on the quality of life of households in developing countries have increased over the last decade. One aspect that has still received little attention is education and the ability of children to keep up at school. The underlying hypothesis is that electrification enables children to do their homework in the evening and so keep up with their school work. To this first hypothesis we add a second one, concerning the relation between access to electricity and attendance to school according to gender. Although most household tasks are carried out by the mothers, their daughters are also involved, and electrification could have a beneficial effect by making easier for girls to do their homework in the evening and easier for the mothers to help them. We will check the validity of these hypotheses using a case study of 162 children attending school in a small town in northwestern Madagascar. - Research Highlights: {yields} We use a sample of 162 children in Madagascar to test the effect of access to the electricity supply in home to the education of children. {yields} We also test the effect to the electricity supply in home to gender-specificities. {yields} Our results confirm that electrification can contribute to reduce social reproduction with regard to education. {yields} Our results also show that electrification helps to reduce gender inequalities.

  4. Children's education and home electrification: A case study in northwestern Madagascar

    International Nuclear Information System (INIS)

    Rajaona Daka, Karen; Ballet, Jerome

    2011-01-01

    Assessments of the impact of electrification on the quality of life of households in developing countries have increased over the last decade. One aspect that has still received little attention is education and the ability of children to keep up at school. The underlying hypothesis is that electrification enables children to do their homework in the evening and so keep up with their school work. To this first hypothesis we add a second one, concerning the relation between access to electricity and attendance to school according to gender. Although most household tasks are carried out by the mothers, their daughters are also involved, and electrification could have a beneficial effect by making easier for girls to do their homework in the evening and easier for the mothers to help them. We will check the validity of these hypotheses using a case study of 162 children attending school in a small town in northwestern Madagascar. - Research Highlights: → We use a sample of 162 children in Madagascar to test the effect of access to the electricity supply in home to the education of children. → We also test the effect to the electricity supply in home to gender-specificities. → Our results confirm that electrification can contribute to reduce social reproduction with regard to education. → Our results also show that electrification helps to reduce gender inequalities.

  5. Making the case for OWTS management: lessons from case studies and research

    Science.gov (United States)

    Rahm, B.; Woods, F.; Hwang, S.; Walter, M. T.; Grantham, D. G.; Riha, S. J.

    2016-12-01

    On-site wastewater treatment systems (OWTS) are used in 20-25% of homes in the United States and can be an efficient and cost-effective alternative to conventional centralized systems. However, OWTS also represent a source of non-point nutrient, pathogen, and micro-contaminant pollution to surface and groundwater if they are poorly designed, sited and/or maintained. Despite their ubiquity and potential to negatively impact water resources, the contribution of OWTS to local and regional water contamination issues is poorly understood. There are no federal regulations or uniform standards for the operation, maintenance, and management of these systems. The effectiveness of educational programs and best management practices developed by the US Environmental Protection Agency, along with local and regional governments, remains uncertain. Here we describe attempts to increase our knowledge of the state of OWTS in relation to water resources and their management. Specifically, we summarize 1) efforts to modernize a NY State-wide inventory of residential OWTS using GIS-based tools; 2) research aimed at better understanding the impact of OWTS on surface and ground water in 5 upstate NY counties across a gradient of land uses; 3) lessons learned from 13 case studies of municipal OWTS management programs across the US; and 4) observations on the roles of data, education and policy in creating and evaluating successful municipal OWTS management programs. Initial results show that total numbers of OWTS in NY State continue to grow, particularly in areas associated with ex-urban migration. Research into the relationship between OWTS and nutrient and pathogen contamination in ground and surface waters, respectively, suggests location-specific variation. This has implications for management approaches: preventing failure of any individual OWTS may be just as effective as programs attempting to bring all OWTS up to a high level of performance. Case studies of management programs

  6. Home-based malaria management in children by women: Evidence from a malaria endemic community in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Doreen Nkiru Eugene-Ezebilo

    2015-07-01

    Full Text Available Objective: To examine the medicines and dosage that mothers who engage in home-based malaria management administer to children aged ≤ 5 years having signs and symptoms associated with malaria and to discuss the possibilities of designing an effective home-based malaria management strategy. Methods: The data were obtained from face-to-face semi-structured interviews conducted with mothers in the Ugbowo Community of Benin City, Nigeria who were selected using multistage systematic random sampling technique. The data were analyzed by qualitative content analysis, arithmetic mean, simple percentages and bar chart. Results: Approximately 90% of the interviewees engaged in home-based malaria management and 10% patronized the hospital. Most of the interviewees who engaged in home-based malaria management administered medicines that stimulates the production of red blood cells and supplies vitamins to children having signs and symptoms of malaria, followed by painkillers and anti-malaria and cough medicine was the least. Of the anti-malaria medicines administered to children, almost 80% of the interviewees administered chloroquine to children, 15% quinine and 3% halfan. Approximately 60% of the interviewees had the correct knowledge of the dosage regime for chloroquine, 38% for quinine and 9% for halfan. Conclusions: Although home-based malaria management is important, it cannot serve as a substitute to the hospital. Some diseases have signs and symptoms that are similar to that of malaria which implies that administering anti-malaria medicines to a child without confirmatory tests might lead to irredeemable complications in that child. If the strategy is to make home-based malaria management effective and sustainable mothers, community health officials should be involved in designing the strategy. Simple rapid diagnostic test kits for malaria should be made available to community health officials and pharmacists so that confirmatory tests could be

  7. Wireless home monitoring and health care activity management through the Internet in patients with chronic diseases.

    Science.gov (United States)

    Tura, Andrea; Quareni, Luca; Longo, David; Condoluci, Claudia; van Rijn, Astrid; Albertini, Giorgio

    2005-12-01

    A project was developed for the creation of an Internet-based network aimed at improved management of home care activities in brain-injured children. At the patient's side, a home care unit was provided, made of a portable medical device, and a tablet PC. Measured clinical data were blood oxygen saturation, heart rate, breath rate and quantity of movement. Thanks to device portability, the patient was free to move while measurements were taken. At prescribed time intervals, measured data were automatically transmitted to the tablet PC via Bluetooth. From the tablet PC, data were transmitted remotely to a Service Centre (via ADSL or GPRS) and made available for consultation by health care professionals through the project Web portal. At the portal, other functionalities were also available, both for patients and families, and for professionals (such as weekly planning agenda, access to relevant information resources, communication tools). Information was delivered for the right participant through a workflow engine. A first trial involving nine patients was performed for two months. At the end, although some improvements were suggested, good acceptance was detected, and 78% of patients and families claimed to be interested in further use of the platform.

  8. Assessment of pharmaceutical waste management at selected hospitals and homes in Ghana.

    Science.gov (United States)

    Sasu, Samuel; Kümmerer, Klaus; Kranert, Martin

    2012-06-01

    The practice of use and disposal of waste from pharmaceuticals compromises the safety of the environment as well as representing a serious health risk, as they may accumulate and stay active for a long time in the aquatic environment. This article therefore presents the outcome of a study on pharmaceutical waste management practices at homes and hospitals in Ghana. The study was conducted at five healthcare institutions randomly selected in Ghana, namely two teaching hospitals (hospital A, hospital B), one regional hospital (hospital C), one district hospital (hospital D) and one quasi-governmental hospital (hospital E). Apart from hospital E which currently has a pharmaceutical waste separation programmr as well as drug return programme called DUMP (Disposal of Unused Medicines Program), all other hospitals visited do not have any separate collection and disposal programme for pharmaceutical waste. A survey was also carried out among the general public, involving the questioning of randomly selected participants in order to investigate the household disposal of unused and expired pharmaceuticals. The results from the survey showed that more than half of the respondents confirmed having unused, left-over or expired medicines at home and over 75% disposed of pharmaceutical waste through the normal waste bins which end up in the landfills or dump sites.

  9. Migrating Home Computer Audio Waveforms to Digital Objects: A Case Study on Digital Archaeology

    Directory of Open Access Journals (Sweden)

    Mark Guttenbrunner

    2011-03-01

    Full Text Available Rescuing data from inaccessible or damaged storage media for the purpose of preserving the digital data for the long term is one of the dimensions of digital archaeology. With the current pace of technological development, any system can become obsolete in a matter of years and hence the data stored in a specific storage media might not be accessible anymore due to the unavailability of the system to access the media. In order to preserve digital records residing in such storage media, it is necessary to extract the data stored in those media by some means.One early storage medium for home computers in the 1980s was audio tape. The first home computer systems allowed the use of standard cassette players to record and replay data. Audio cassettes are more durable than old home computers when properly stored. Devices playing this medium (i.e. tape recorders can be found in working condition or can be repaired, as they are usually made out of standard components. By re-engineering the format of the waveform and the file formats, the data on such media can then be extracted from a digitised audio stream and migrated to a non-obsolete format.In this paper we present a case study on extracting the data stored on an audio tape by an early home computer system, namely the Philips Videopac+ G7400. The original data formats were re-engineered and an application was written to support the migration of the data stored on tapes without using the original system. This eliminates the necessity of keeping an obsolete system alive for enabling access to the data on the storage media meant for this system. Two different methods to interpret the data and eliminate possible errors in the tape were implemented and evaluated on original tapes, which were recorded 20 years ago. Results show that with some error correction methods, parts of the tapes are still readable even without the original system. It also implies that it is easier to build solutions while original

  10. A case of shotgun injury which occurred while an unconventional home security alarm system was being checked.

    Science.gov (United States)

    Asirdizer, Mahmut; Yavuz, Mehmet Sunay

    2009-11-20

    Installation of devices involving shotguns is rarely encountered in forensic medicine practice. In this case report, authors aimed to present an unusual and rare case of shotgun injury due to a home security alarm system and its legal assessment. An electrical technician was invited to a summer house to check a home security alarm system installed by another firm which he worked for previously. It was an unconventional home security alarm system attached to a shotgun. The technician was injured with 18 buckshot pellets (no: 4) while checking the system. The host was convicted of a possible intent to cause a life-threatening injury to the technician. We think that this verdict will set a precedent for similar cases.

  11. Prehospital airway management: A prospective case study.

    Science.gov (United States)

    Wilbers, N E R; Hamaekers, A E W; Jansen, J; Wijering, S C; Thomas, O; Wilbers-van Rens, R; van Zundert, A A J

    2011-01-01

    We conducted a one-year prospective study involving a prehospital Emergency Medical Service in the Netherlands to investigate the incidence of failed or difficult prehospital endotracheal intubation. During the study period the paramedics were asked to fill in a registration questionnaire after every endotracheal intubation. Of the 26,271 patient contacts, 256 endotracheal intubations were performed by paramedics in one year. Endotracheal intubation failed in 12 patients (4.8%). In 12.0% of 249 patients, a Cormack and Lehane grade III laryngoscopy was reported and a grade IV laryngoscopy was reported in 10.4%. The average number of endotracheal intubations per paramedic in one year was 4.2 and varied from zero to a maximum of 12. The median time between arrival on the scene and a positive capnograph was 7 min.38 s in the case of a Cormack and Lehane grade I laryngoscopy and 14 min.58 s in the case of a Cormack and Lehane grade 4 laryngoscopy. The incidence of endotracheal intubations performed by Dutch paramedics in one year was low, but endotracheal intubation was successful in 95.2%, which is comparable with findings in international literature. Early capnography should be used consistently in prehospital airway management.

  12. Pioneering a Nursing Home Quality Improvement Learning Collaborative: A Case Study of Method and Lessons Learned.

    Science.gov (United States)

    Gillespie, Suzanne M; Olsan, Tobie; Liebel, Dianne; Cai, Xueya; Stewart, Reginald; Katz, Paul R; Karuza, Jurgis

    2016-02-01

    To describe the development of a nursing home (NH) quality improvement learning collaborative (QILC) that provides Lean Six Sigma (LSS) training and infrastructure support for quality assurance performance improvement change efforts. Case report. Twenty-seven NHs located in the Greater Rochester, NY area. The learning collaborative approach in which interprofessional teams from different NHs work together to improve common clinical and organizational processes by sharing experiences and evidence-based practices to achieve measurable changes in resident outcomes and system efficiencies. NH participation, curriculum design, LSS projects. Over 6 years, 27 NHs from urban and rural settings joined the QILC as organizational members and sponsored 47 interprofessional teams to learn LSS techniques and tools, and to implement quality improvement projects. NHs, in both urban and rural settings, can benefit from participation in QILCs and are able to learn and apply LSS tools in their team-based quality improvement efforts. Published by Elsevier Inc.

  13. Business Metrics for High-Performance Homes: A Colorado Springs Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Beach, R. [IBACOS, Inc., Pittsburgh, PA (United States); Jones, A. [IBACOS, Inc., Pittsburgh, PA (United States)

    2016-04-26

    The building industry needs to understand how energy ratings can impact homebuilders. Of interest is how energy efficiency may or may not have a positive impact on homebuilders’ business success. Focusing on Colorado Springs, Colorado, as a case study, the U.S. Department of Energy’s Building America research team IBACOS suggests a win–win between a builder’s investment in energy efficiency and that builder’s ability to sell homes. Although this research did not ultimately determine why a correlation may exist, a builder’s investment in voluntary energy-efficiency programs correlated with that builder’s ability to survive the Great Recession of 2007 to 2009. This report explores the relationship between energy-efficiency ratings and the market performance of several builders in Colorado Springs.

  14. Strategies to support spirituality in health care communication: a home hospice cancer caregiver case study.

    Science.gov (United States)

    Reblin, Maija; Otis-Green, Shirley; Ellington, Lee; Clayton, Margaret F

    2014-12-01

    Although there is growing recognition of the importance of integrating spirituality within health care, there is little evidence to guide clinicians in how to best communicate with patients and family about their spiritual or existential concerns. Using an audio-recorded home hospice nurse visit immediately following the death of a patient as a case-study, we identify spiritually-sensitive communication strategies. The nurse incorporates spirituality in her support of the family by 1) creating space to allow for the expression of emotions and spiritual beliefs and 2) encouraging meaning-based coping, including emphasizing the caregivers' strengths and reframing negative experiences. Hospice provides an excellent venue for modeling successful examples of spiritual communication. Health care professionals can learn these techniques to support patients and families in their own holistic practice. All health care professionals benefit from proficiency in spiritual communication skills. Attention to spiritual concerns ultimately improves care. © The Author(s) 2014.

  15. Home-based Self-care: Understanding and Designing Pervasive Technology to Support Care Management Work at Home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo

    -based healthcare. To support self-care activities, an increasingly number of reminders and monitoring systems are being designed. However, most of these systems have been designed taking the healthcare professional’s perspective or targeting a specific treatment or condition that might not sufficient support...... that fit into people’s everyday life. Through a design research approach applying user-centered design methods and prototyping, the main focus of this dissertation is on exploring and providing a holistic understanding of the self-care work practices in non-clinical settings. Several home-based care...

  16. Effects of Home Energy Management Systems on Distribution Utilities and Feeders Under Various Market Structures: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Ruth, Mark; Pratt, Annabelle; Lunacek, Monte; Mittal, Saurabh; Wu, Hongyu; Jones, Wesley

    2015-07-17

    The combination of distributed energy resources (DER) and retail tariff structures to provide benefits to both utility consumers and the utilities is poorly understood. To improve understanding, an Integrated Energy System Model (IESM) is being developed to simulate the physical and economic aspects of DER technologies, the buildings where they reside, and feeders servicing them. The IESM was used to simulate 20 houses with home energy management systems on a single feeder under a time of use tariff to estimate economic and physical impacts on both the households and the distribution utilities. HEMS reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Household savings are greater than the reduction utility net revenue indicating that HEMS can provide a societal benefit providing tariffs are structured so that utilities remain solvent. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices and resulting in a higher peak load.

  17. A clear case. Selective investment in case management applications can yield significant returns.

    Science.gov (United States)

    Hagland, Mark

    2009-03-01

    Strategically conceived case management system implementation makes good patient care and business sense, CIOs agree. Significant financial savings can be achieved from case management IS implementations, if those implementations are executed in the context of partnership between clinical leaders and the CIO's team. CIOs agree that applying the concept of "investment" to the implementation of case management IT can make resource allocation decisions easier.

  18. A Semantic Approach with Decision Support for Safety Service in Smart Home Management.

    Science.gov (United States)

    Huang, Xiaoci; Yi, Jianjun; Zhu, Xiaomin; Chen, Shaoli

    2016-08-03

    Research on smart homes (SHs) has increased significantly in recent years because of the convenience provided by having an assisted living environment. The functions of SHs as mentioned in previous studies, particularly safety services, are seldom discussed or mentioned. Thus, this study proposes a semantic approach with decision support for safety service in SH management. The focus of this contribution is to explore a context awareness and reasoning approach for risk recognition in SH that enables the proper decision support for flexible safety service provision. The framework of SH based on a wireless sensor network is described from the perspective of neighbourhood management. This approach is based on the integration of semantic knowledge in which a reasoner can make decisions about risk recognition and safety service. We present a management ontology for a SH and relevant monitoring contextual information, which considers its suitability in a pervasive computing environment and is service-oriented. We also propose a rule-based reasoning method to provide decision support through reasoning techniques and context-awareness. A system prototype is developed to evaluate the feasibility, time response and extendibility of the approach. The evaluation of our approach shows that it is more effective in daily risk event recognition. The decisions for service provision are shown to be accurate.

  19. A Semantic Approach with Decision Support for Safety Service in Smart Home Management

    Directory of Open Access Journals (Sweden)

    Xiaoci Huang

    2016-08-01

    Full Text Available Research on smart homes (SHs has increased significantly in recent years because of the convenience provided by having an assisted living environment. The functions of SHs as mentioned in previous studies, particularly safety services, are seldom discussed or mentioned. Thus, this study proposes a semantic approach with decision support for safety service in SH management. The focus of this contribution is to explore a context awareness and reasoning approach for risk recognition in SH that enables the proper decision support for flexible safety service provision. The framework of SH based on a wireless sensor network is described from the perspective of neighbourhood management. This approach is based on the integration of semantic knowledge in which a reasoner can make decisions about risk recognition and safety service. We present a management ontology for a SH and relevant monitoring contextual information, which considers its suitability in a pervasive computing environment and is service-oriented. We also propose a rule-based reasoning method to provide decision support through reasoning techniques and context-awareness. A system prototype is developed to evaluate the feasibility, time response and extendibility of the approach. The evaluation of our approach shows that it is more effective in daily risk event recognition. The decisions for service provision are shown to be accurate.

  20. Do home energy management systems make sense? Assessing their overall lifecycle impact

    International Nuclear Information System (INIS)

    Dam, S.S. van; Bakker, C.A.; Buiter, J.C.

    2013-01-01

    An ever-increasing body of research explores the effectiveness of Home Energy Management Systems (HEMS) in achieving energy savings in households. To date, however, the overall life cycle impact of the HEMS itself has not been taken into account. Thus, no assessment has been made whether the amount of energy saved (e saved ) outweighs the energy needed for production, use and disposal (e invested ). Therefore, an eco-cost and a Cumulative Energy Demand (CED) method were used to analyze three distinct types of HEMS. Based on the literature, six scenarios were developed in order to find the break-even point, where e invested =e saved . The results show that the overall impact is dependent on the type of HEMS, and that if the duration of use is short and the achieved savings are small, the benefits do not always outweigh the environmental costs. Care should be taken not to develop HEMS with unnecessarily elaborate parts or functionalities and that their own electricity consumption is minimized. The paper concludes by discussing the implication for polices concerning the implementation of smart meters and HEMS and their design. - Highlights: • We conducted a lifecycle assessment of three Home Energy Management Systems (HEMS). • We developed six scenarios to find the breakeven point where e invested =e saved . • All three HEMS can achieve net energy savings over the course of five years. • Within the scenarios, it can take up to two years to achieve net energy savings. • No HEMS achieve a positive return on investment within five years in all scenarios

  1. The Woodworker's Website: A Project Management Case Study

    Science.gov (United States)

    Jance, Marsha

    2014-01-01

    A case study that focuses on building a website for a woodworking business is discussed. Project management and linear programming techniques can be used to determine the time required to complete the website project discussed in the case. This case can be assigned to students in an undergraduate or graduate decision modeling or management science…

  2. Business Metrics for High-Performance Homes: A Colorado Springs Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Beach, R. [IBACOS, Inc, Pittsburgh, PA (United States); Jones, A. [IBACOS, Inc, Pittsburgh, PA (United States)

    2016-04-26

    This report explores the correlation between energy efficiency and the business success of home builders by examining a data set of builders and homes in the Colorado Springs, Colorado, market between 2006 and 2014. During this time, the Great Recession of 2007 to 2009 occurred, and new-home sales plummeted both nationally and in Colorado Springs. What is evident from an analysis of builders and homes in Colorado Springs is that builders who had Home Energy Rating System (HERS) ratings performed on some or all of their homes during the Recession remained in business during this challenging economic period. Many builders who did not have HERS ratings performed on their homes at that time went out of business or left the area. From the analysis presented in this report, it is evident that a correlation exists between energy efficiency and the business success of home builders, although the reasons for this correlation remain largely anecdotal and not yet clearly understood.

  3. New Whole-House Solutions Case Study: Northwest Energy Efficient Manufactured Housing Program High-Performance Test Homes - Pacific Northwest

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-05-01

    This project represents the third phase of a multi-year effort to develop and bring to market a High Performance Manufactured Home (HPMH). In this project, the Northwest Energy Efficient Manufactured Housing Program worked with Building America Partnership for Improved Residential Construction and Bonneville Power Administration to help four factory homebuilders build prototype zero energy ready manufactured homes, resulting in what is expected to be a 30% savings relative to the Building America Benchmark. (The actual % savings varies depending on choice of heating equipment and climate zone). Previous phases of this project created a HPMH specification and prototyped individual measures from the package to obtain engineering approvals and develop preliminary factory construction processes. This case study describes the project team's work during 2014 to build prototype homes to the HPMH specifications and to monitor the homes for energy performance and durability. Monitoring is expected to continue into 2016.

  4. Pain medication management processes used by oncology outpatients and family caregivers part II: home and lifestyle contexts.

    Science.gov (United States)

    Schumacher, Karen L; Plano Clark, Vicki L; West, Claudia M; Dodd, Marylin J; Rabow, Michael W; Miaskowski, Christine

    2014-11-01

    Despite the increasing complexity of medication regimens for persistent cancer pain, little is known about how oncology outpatients and their family caregivers manage pain medications at home. To describe the day-to-day management of pain medications from the perspectives of oncology outpatients and their family caregivers who participated in a randomized clinical trial of a psychoeducational intervention called the Pro-Self(©) Plus Pain Control Program. In this article, we focus on pain medication management in the context of highly individualized home environments and lifestyles. This qualitative study was conducted as part of a randomized clinical trial, in which an embedded mixed methods research design was used. Audio-recorded dialogue among patients, family caregivers, and intervention nurses was analyzed using qualitative research methods. Home and lifestyle contexts for managing pain medications included highly individualized home environments, work and recreational activities, personal routines, and family characteristics. Pain medication management processes particularly relevant in these contexts included understanding, organizing, storing, scheduling, remembering, and taking the medications. With the exception of their interactions with the intervention nurses, most study participants had little involvement with clinicians as they worked through these processes. Pain medication management is an ongoing multidimensional process, each step of which has to be mastered by patients and their family caregivers when cancer treatment and supportive care are provided on an outpatient basis. Realistic patient- and family-centered skill-building interventions are needed to achieve effective and safe pain medication management in the contexts of individual home environments and lifestyles. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  5. Management games in learning process of business skills : case: global management challenge Finland

    OpenAIRE

    Yuan, Yichuan

    2011-01-01

    The subject of this thesis is management games in learning process of business skills, Case: Global Management Challenge Finland. The thesis seeks to find out how different management games are used worldwide in learning business skills, it introduces the biggest strategic and management game: Global Management Challenge, studies the case of this game in Finland, discusses how management games could help students learn different business skills and proposes future training programs for thi...

  6. DOE Zero Energy Ready Home Case Study: Alliance Green Builders, Casa Aguila

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2017-09-01

    Alliance Green Builders built this 3,129-ft2 home in the hills above Ramona, California, to the high-performance criteria of the DOE Zero Energy Ready Home (ZERH) program. The home should perform far better than net zero thanks to a super-efficient building shell, a wind turbine, three suntracking solar photovoltaic arrays, and solar thermal water heating.

  7. DOE Zero Energy Ready Home Case Study: Brookside Development — Singer Village, Derby, CT

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    This DOE Zero Energy Ready Home is one of a development of seven two-story homes that garnered a Production Builder award in the 2014 Housing Innovation Awards. Exceptional construction quality allowed the home to achieve a HERS score of 45 without photovoltaic, or HERS 26 with a 7-kW photovoltaic system included.

  8. DOE Zero Energy Ready Home Case Study: New Town Builders, Denver, Colorado

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    All homes in the Stapleton community must be ENERGY STAR certified; New Town Builders has announced that it will build 250–300 new homes over the next 7–10 years, all of which will be Challenge Homes. New Town received a 2013 Housing Innovation Award in the production builder category.

  9. Security And Privacy Issues in Health Monitoring Systems: eCare@Home Case Study

    DEFF Research Database (Denmark)

    Wearing, Thomas; Dragoni, Nicola

    2016-01-01

    Automated systems for monitoring elderly people in their home are becoming more and more common. Indeed, an increasing number of home sensor networks for healthcare can be found in the recent literature, indicating a clear research direction in smart homes for health-care. Although the huge amoun...

  10. Collaboration between Hospital and Community Pharmacists to Improve Medication Management from Hospital to Home

    Directory of Open Access Journals (Sweden)

    Judith Kristeller

    2017-05-01

    Full Text Available Objective: The objective of this study is to determine if a model for patient-centered care that integrates medication management between hospital and community pharmacists is feasible and can improve medication adherence. Design: This was a randomized, non-blinded, interventional study of 69 patients discharged from a hospital to home. Process measures include the number and type of medication-related discrepancies or problems identified, patient willingness to participate, the quality and quantity of interactions with community pharmacists, hospital readmissions, and medication adherence. Setting: A 214-bed acute care hospital in Northeastern Pennsylvania and seventeen regional community pharmacies. Patients: Enrolled patients were hospitalized with a primary or secondary diagnosis of heart failure or COPD, had a planned discharge to home, and agreed to speak to one of seventeen community pharmacists within the study network (i.e., a network community pharmacist following hospital discharge. Intervention: Information about a comprehensive medication review completed by the hospital pharmacist was communicated with the network community pharmacist to assist with providing medication therapy management following hospital discharge. Results: Of 180 patients eligible for the study, 111 declined to participate. Many patients were reluctant to talk to an additional pharmacist, however if the patient’s pharmacist was already within the network of 17 pharmacies, they usually agreed to participate. The study enrolled 35 patients in the intervention group and 34 in the control group. An average of 6 medication-related problems per patient were communicated to the patient’s network community pharmacist after discharge. In the treatment group, 44% of patients had at least one conversation with the network community pharmacist following hospital discharge. There was no difference in post-discharge adherence between the groups (Proportion of Days

  11. Psychosocial behaviour management programme for home-dwelling people with dementia: A cluster-randomized controlled trial.

    Science.gov (United States)

    Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi

    2018-03-01

    Little is known about the effectiveness of a psychosocial behaviour management programme on home-dwelling people with dementia. We developed a Behaviour Analytics & Support Enhancement (BASE) programme for care managers and professional caregivers of home care services in Japan. We investigated the effects of BASE on challenging behaviour of home-dwelling people with dementia. A cluster-randomized controlled trial was conducted with home care providers from 3 different districts in Tokyo. Each provider recruited persons with dementia aged 65 years or older to receive home care in the BASE programme in August 2016. An online monitoring and assessment system was introduced to the intervention group for repeated measures of challenging behaviour with a total score of the Neuropsychiatric Inventory. Care professionals in both the intervention and control groups evaluated challenging behaviour of persons with dementia at baseline (September 2016) and follow-up (February 2017). A majority of persons with dementia had Alzheimer disease (59.3%). One-hundred and forty-one persons with dementia were included in the intervention group and 142 in the control group. Multilevel modelling revealed a significant reduction in challenging behaviour in the intervention group after 6 months (mean score, 18.3 to 11.2) compared with that of the control group (11.6 to 10.8; P dwelling people with dementia. Future research should examine the long-term effects of behaviour management programmes on behaviour, nursing home placement, and hospital admission of home-dwelling people with dementia. Copyright © 2017 John Wiley & Sons, Ltd.

  12. Can Organizations Learn without Political Leadership? The Case of Public Sector Reform among South African Home Affairs Officials

    DEFF Research Database (Denmark)

    Segatti, Aurelia; Hoag, Colin Brewster; Vigneswaran, Darshan

    2012-01-01

    This paper deals with the transformation of “institutional culture” in bureaucratic agencies. This is explored in the context of post-Apartheid South African public sector reform, and more particularly that of migration management within the Department of Home Affairs (DHA). The paper assesses...

  13. The postman always rings twice: two cases of shotgun deaths associated with an unconventional home security alarm system.

    Science.gov (United States)

    Asirdizer, Mahmut; Turkmen, Nursel; Akan, Okan; Yavuz, Mehmet Sunay

    2014-06-01

    Injury and death cases caused by booby traps are not common in forensic medicine practice. Besides, installation of booby traps including firearms is generally for suicidal and rarely for homicidal purposes. Although few patents were described about home security alarm system that were created by firearms in the United States, 1 sample of injury with a similar unconventional mechanism of home safety system was reported by Asirdizer and Yavuz in 2009. In the published case report, the story of an electrical technician who was invited to a summer house by the homeowner to check the home security alarm system was reported. In the so-called report, he was stated to be injured by the shotgun attached to the unconventional home security alarm system while checking the system. As a result, the homeowner was convicted of a possible intent to cause a life-threatening injury to the technician.The so-called homeowner and his wife died by the same shotgun attached to the same unconventional home security alarm system 4 years on from the first event. In the present case report, we have aimed to present the findings of the crime scene and the autopsies of these unusual 2 deaths and to discuss individual and legal factors in paving the way for the deaths of 2 people.

  14. Implementation of a quality management system according to 9001 standard in a hospital in the home unit: changes and achievements.

    Science.gov (United States)

    Rodríguez-Cerrillo, Matilde; Fernández-Diaz, Eddita; Iñurrieta-Romero, Amaia; Poza-Montoro, Ana

    2012-01-01

    The purpose of this paper is to describe changes and results obtained after implementation of a quality management system (QMS) according to ISO standards in a Hospital in the Home (HIH) Unit. The paper describes changes made and outcomes achieved. This took part in the HiH Unit, Clinico Hospital, Madrid, Spain, and looked at admissions, mean stay, patient satisfaction, adverse events, returns to hospital, no admitted referrals, complaints, compliance to protocols, equipment failures and resolution of urgent consultations. In June 2008, HiH Unit, Clinico Hospital obtained ISO certification. The main results achieved are as follows. There was an increase in patients' satisfaction--in June 2008, assessment of the quality of care provided by staff was scored at 4.7 (on a scale of 1 to 5); in 2010 it has been scored at 4.96. Patient satisfaction rate has increased from 92 percent to 98.8 percent. No complaints from patients were received. Unscheduled returns to hospital have decreased from 7 percent to 3 percent. There were no medical equipment failures. External suppliers' performance has improved. Material and medication needed by staff was available when necessary. The number of admissions has increased. Compliance to protocols has reached 97 percent. Inappropriate referrals have decreased by 8 percent. Six medications-related incidents were detected; in two cases the incident was not due to an error. In the other four cases error could have been detected before reaching the patient. Implementations of an ISO quality management system allow improved quality of care and patient satisfaction in a HIH Unit.

  15. Knowledge Management Analysis: A Case Study

    Science.gov (United States)

    Mecha, Ezi I.; Desai, Mayur S.; Richards, Thomas C.

    2009-01-01

    It is imperative for businesses to manage knowledge and stay competitive in the marketplace. Knowledge management is critical and is a key to prevent organizations from duplicating their efforts with a subsequent improvement in their efficiency. This study focuses on overview of knowledge management, analyzes the current knowledge management in…

  16. DOE Zero Energy Ready Home Case Study: Dwell Development, Seattle, Washington

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    This Challenge Home is one of 42 homes in a micro-community of ultra-modern, energy-efficient homes built by Dwell Development on an urban gray-field site in South Seattle. Every home will achieve a 5-Star Built Green rating from the regional master builders association and meet the criteria of the Northwest ENERGY STAR program, which is more strict than the national ENERGY STAR criteria. Also, the home won a 2013 Housing Innovation Award in the "systems builder" category.

  17. Modern Management and Diagnosis of Hypertension in the United Kingdom: Home Care and Self-care.

    Science.gov (United States)

    Sheppard, James P; Schwartz, Claire L; Tucker, Katherine L; McManus, Richard J

    2016-01-01

    The effective diagnosis and management of hypertension is one of the most important parts of cardiovascular prevention internationally and this is no different in the United Kingdom. Approximately 14% of the UK population currently receive treatment for hypertension. Recent UK guidelines from the National Institute of Health and Care Excellence have placed greater emphasis on the utilization of out-of-office measurement of blood pressure to more accurately diagnose hypertension. The aim of the present study was to provide a state-of-the-art review of the evidence for screening, diagnosing, and managing hypertension, as implemented in the United Kingdom, with an emphasis on the role of self-monitored and ambulatory blood pressure monitoring in routine clinical care. Consideration was given to the use of ambulatory and home monitoring to confirm a diagnosis of hypertension and the use of self-monitoring and self-management to monitor and guide treatment. The evidence for the use of self-monitoring in patients with hypertension was examined, both in isolation, and in combination with lifestyle and treatment interventions. There is a place for self-monitored blood pressure in specific underresearched populations such as the elderly, specialist conditions, ethnic groups, and during pregnancy and this is discussed here. The evidence supporting the use of out-of-office monitoring in all aspects of routine clinical care has increased substantially in recent years and is reflected in increased utilization by patients and clinicians alike. Several areas require further research but it is clear that out-of-office monitoring is here to stay and is fast becoming an important part of hypertension management in the United Kingdom. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  18. Working conditions and workplace health and safety promotion in home care: A mixed-method study from Swedish managers' perspectives.

    Science.gov (United States)

    Gard, Gunvor; Larsson, Agneta

    2017-11-02

    Today, we can see a trend toward increased psychosocial strain at work among home-care managers and staff. The aim of this study is to describe home care managers' views on their own psychosocial working conditions and on how to promote workplace health and safety in a municipality in northern Sweden. A mixed-methods design was used, including questionnaire and qualitative focus group data. The qualitative data were analyzed by manifest content analysis. The results indicate that most managers perceived increased variety in work and opportunities for development at work, but at the same time increased demands. The managers suggested that workplace health and safety could be improved by risk assessment and improved communication, a clear communication chain by a real as well as a virtual platform for communication. In summary, workplace health and safety could be improved by risk assessments and by a physical as well as a virtual platform for communication.

  19. Effects of Home Energy Management Systems on Distribution Utilities and Feeders Under Various Market Structure; NREL (National Renewable Energy Laboratory)

    Energy Technology Data Exchange (ETDEWEB)

    Ruth, M.; Pratt, A.; Lunacek, M.; Mittal, S.; Wu, H.; Jones, W.

    2015-06-15

    The combination of distributed energy resources (DER) and retail tariff structures to provide benefits to both utility consumers and the utilities is not well understood. To improve understanding, an Integrated Energy System Model (IESM) is being developed to simulate the physical and economic aspects of DER technologies, the buildings where they reside, and feeders servicing them. The IESM was used to simulate 20 houses with home energy management systems on a single feeder under a time-of-use (TOU) tariff to estimate economic and physical impacts on both the households and the distribution utilities. Home energy management systems (HEMS) reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices, resulting in a higher peak load. used to simulate 20 houses with home energy management systems on a single feeder under a time-of-use (TOU) tariff to estimate economic and physical impacts on both the households and the distribution utilities. Home energy management systems (HEMS) reduce consumers’ electric bills by precooling houses in the hours before peak electricity pricing. Utilization of HEMS reduce peak loads during high price hours but shifts it to hours with off-peak and shoulder prices, resulting in a higher peak load.

  20. Home Management and Consumer Education in Rural Development Programmes: Latin America. Nutrition Information Documents Series No. 5.

    Science.gov (United States)

    United Nations Food and Agriculture Organization, Rome (Italy).

    The report represents a preliminary study of a three-month consultantship intended to review field experiences in selected Latin American countries for teaching rural families home management/consumer education concepts and to collect materials based on experiences. A detailed account is presented of the projects visited in Mexico, Argentina, and…

  1. Improved Cost-effectiveness for Management of Chronic Heart Failure by Combined Home-based Intervention with Clinical Nursing Specialists

    Directory of Open Access Journals (Sweden)

    Yi-Lwun Ho

    2007-01-01

    Conclusion: The home- and clinic-based caring system is capable of decreasing adverse outcomes, most notably hospitalization and length of stay, and could trigger significant cost savings in the management of heart failure. [J Formos Med Assoc 2007;106(4:313-319

  2. A novel minimum cost maximum power algorithm for future smart home energy management.

    Science.gov (United States)

    Singaravelan, A; Kowsalya, M

    2017-11-01

    With the latest development of smart grid technology, the energy management system can be efficiently implemented at consumer premises. In this paper, an energy management system with wireless communication and smart meter are designed for scheduling the electric home appliances efficiently with an aim of reducing the cost and peak demand. For an efficient scheduling scheme, the appliances are classified into two types: uninterruptible and interruptible appliances. The problem formulation was constructed based on the practical constraints that make the proposed algorithm cope up with the real-time situation. The formulated problem was identified as Mixed Integer Linear Programming (MILP) problem, so this problem was solved by a step-wise approach. This paper proposes a novel Minimum Cost Maximum Power (MCMP) algorithm to solve the formulated problem. The proposed algorithm was simulated with input data available in the existing method. For validating the proposed MCMP algorithm, results were compared with the existing method. The compared results prove that the proposed algorithm efficiently reduces the consumer electricity consumption cost and peak demand to optimum level with 100% task completion without sacrificing the consumer comfort.

  3. A novel minimum cost maximum power algorithm for future smart home energy management

    Directory of Open Access Journals (Sweden)

    A. Singaravelan

    2017-11-01

    Full Text Available With the latest development of smart grid technology, the energy management system can be efficiently implemented at consumer premises. In this paper, an energy management system with wireless communication and smart meter are designed for scheduling the electric home appliances efficiently with an aim of reducing the cost and peak demand. For an efficient scheduling scheme, the appliances are classified into two types: uninterruptible and interruptible appliances. The problem formulation was constructed based on the practical constraints that make the proposed algorithm cope up with the real-time situation. The formulated problem was identified as Mixed Integer Linear Programming (MILP problem, so this problem was solved by a step-wise approach. This paper proposes a novel Minimum Cost Maximum Power (MCMP algorithm to solve the formulated problem. The proposed algorithm was simulated with input data available in the existing method. For validating the proposed MCMP algorithm, results were compared with the existing method. The compared results prove that the proposed algorithm efficiently reduces the consumer electricity consumption cost and peak demand to optimum level with 100% task completion without sacrificing the consumer comfort.

  4. A facilitated approach to family case conferencing for people with advanced dementia living in nursing homes: perceptions of palliative care planning coordinators and other health professionals in the IDEAL study.

    Science.gov (United States)

    Luckett, Tim; Chenoweth, Lynnette; Phillips, Jane; Brooks, Deborah; Cook, Janet; Mitchell, Geoffrey; Pond, Dimity; Davidson, Patricia M; Beattie, Elizabeth; Luscombe, Georgina; Goodall, Stephen; Fischer, Thomas; Agar, Meera

    2017-10-01

    Palliative care for nursing home residents with advanced dementia is often sub-optimal due to poor communication and limited care planning. In a cluster randomized controlled trial, registered nurses (RNs) from 10 nursing homes were trained and funded to work as Palliative Care Planning Coordinators (PCPCs) to organize family case conferences and mentor staff. This qualitative sub-study aimed to explore PCPC and health professional perceptions of the benefits of facilitated case conferencing and identify factors influencing implementation. Semi-structured interviews were conducted with the RNs in the PCPC role, other members of nursing home staff, and physicians who participated in case conferences. Analysis was conducted by two researchers using a thematic framework approach. Interviews were conducted with 11 PCPCs, 18 other nurses, eight allied health workers, and three physicians. Perceived benefits of facilitated case conferencing included better communication between staff and families, greater multi-disciplinary involvement in case conferences and care planning, and improved staff attitudes and capabilities for dementia palliative care. Key factors influencing implementation included: staffing levels and time; support from management, staff and physicians; and positive family feedback. The facilitated approach explored in this study addressed known barriers to case conferencing. However, current business models in the sector make it difficult for case conferencing to receive the required levels of nursing qualification, training, and time. A collaborative nursing home culture and ongoing relationships with health professionals are also prerequisites for success. Further studies should document resident and family perceptions to harness consumer advocacy.

  5. San Junior Secondary Students' Home-School Literacy Disconnection: A Case Study of a Remote Area Dweller School in Botswana

    Science.gov (United States)

    Ketsitlile, Lone Elizabeth

    2011-01-01

    The study investigated how San students of Botswana, in a junior community secondary school, understood literacy in school and at home. A qualitative, narrative case study approach was used to gain a deeper understanding of what students value and understand by literacy from co-participants' and informants' perspectives. Findings across…

  6. Home energy management (HEM database: A list with coded attributes of 308 devices commercially available in the US

    Directory of Open Access Journals (Sweden)

    Marco Pritoni

    2018-02-01

    Full Text Available Policymakers worldwide are currently discussing whether to include home energy management (HEM products in their portfolio of technologies to reduce carbon emissions and improve grid reliability. However, very little data is available about these products. Here we present the results of an extensive review including 308 HEM products available on the US market in 2015–2016. We gathered these data from publicly available sources such as vendor websites, online marketplaces and other vendor documents. A coding guide was developed iteratively during the data collection and utilized to classify the devices. Each product was coded based on 96 distinct attributes, grouped into 11 categories: Identifying information, Product components, Hardware, Communication, Software, Information - feedback, Information - feedforward, Control, Utility interaction, Additional benefits and Usability. The codes describe product features and functionalities, user interaction and interoperability with other devices. A mix of binary attributes and more descriptive codes allow to sort and group data without losing important qualitative information. The information is stored in a large spreadsheet included with this article, along with an explanatory coding guide. This dataset is analyzed and described in a research article entitled “Categories and functionality of smart home technology for energy management” (Ford et al., 2017 [1]. Keywords: Home energy management, Energy efficiency, Smart home, Home automation, Internet of things

  7. Problems in Office Management: Cases in Practice

    Science.gov (United States)

    Hemby, K. Virginia; Smith, Vincent W.

    2006-01-01

    Office managers face an increasing array of job responsibilities in today's business environment. To prepare new office administration employees and managers, educational institutions must maintain a progressive curriculum to meet position demands. Using a population of members of the Association of Professional Office Managers, this study was…

  8. Building America Case Study: Selecting Ventilation Systems for Existing Homes (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-12-01

    This document addresses adding -or improving - mechanical ventilation systems to existing homes. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including some discussion of relevant codes and standards. Advantages, disadvantages, and approximate costs of various system types are presented along with general guidelines for implementing the systems in homes. CARB intends for this document to be useful to decision makers and contractors implementing ventilation systems in homes. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors. It is the intent of this document to assist contractors in making more informed decisions when selecting systems. Ventilation is an integral part of a high-performance home. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability.

  9. DOE Zero Energy Ready Home Case Study: BPC Green Builders — Trolle Residence, Danbury, CT

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

    The builder of this 1,650-ft2 cabin won a Custom Home honor in the 2014 Housing Innovations Awards. The home meets Passive House Standards with 5.5-in. of foil-faced polysiocyanurate foam boards lining the outside walls, R-55 of rigid EPS foam under the slab, R-86 of blown cellulose in the attic, triple-pane windows, and a single ductless heat pump to heat and cool the entire home.

  10. Performance Results from a Cold Climate Case Study for Affordable Zero Energy Homes: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Norton, P.; Christensen, C.

    2007-11-01

    The design of this 1280 square foot, 3-bedroom Denver zero energy home carefully combines envelope efficiency, efficient equipment, appliances and lighting, a photovoltaic system, and passive and active solar thermal features to exceed the net zero energy goal. In January 2006, a data acquisition system was installed in the home to monitor its performance over the course of a year. This paper presents full year of energy performance data on the home.

  11. [Terminal home care "Ikigai no Yoake--The real aim of our life"--case report].

    Science.gov (United States)

    Funato, T; Funato, H; Kato, A; Matsuoka, Y; Shibuya, R; Usui, Y; Niwa, Y

    1998-12-01

    It is difficult to provide home care especially for terminal cancer patients as their physical conditions deteriorate due to the cancer. It is important to enhance the will of home care providers to make this possible. Although a universal method has been worked out, personal and religious beliefs have made it difficult to create an effective method. We would like to introduce our experience in the paper entitled "Ikigai no Yoake" and subtitled "Influence of scientific study of reincarnation on view of life" by Fumihiko Ida of Fukushima University. It has encouraged home care providers and made it possible to provide home care to terminal patients along with benefits.

  12. Building America Case Study: BrightBuilt Home, Modular Zero Energy, Portland, Maine

    Energy Technology Data Exchange (ETDEWEB)

    2016-04-01

    Kaplan Thompson Architects (KTA) has specialized in sustainable, energy-efficient buildings, and they have designed several custom, zero-energy homes in New England. These zero-energy projects have generally been high-end, custom homes with budgets that could accommodate advanced energy systems. In an attempt to make zero energy homes more affordable and accessible to a larger demographic, KTA explored modular construction as way to provide high-quality homes at lower costs. In mid-2013, KTA formalized this concept when they launched BrightBuilt Home (BBH). The BBH mission is to offer 'a line of architect-designed, high-performance homes that are priced to offer substantial savings off the lifetime cost of a typical home and can be delivered in less time.' For the past two years, CARB has worked with BBH and Keiser Homes (the primary modular manufacturer for BBH) to discuss challenges related to wall systems, HVAC, and quality control. In Spring of 2014, CARB and BBH began looking in detail on a home to be built in Lincolnville, Maine, by Black Bros. Builders. This report details the solution package specified for this modular plan and the challenges that arose during the project.

  13. Discursive Hierarchical Patterning in Law and Management Cases

    Science.gov (United States)

    Lung, Jane

    2008-01-01

    This paper investigates the differences in the discursive patterning of cases in Law and Management. It examines a corpus of 271 Law and Management cases and discusses the kind of information that these two disciplines call for and how discourses are constructed in discursive hierarchical patterns. A discursive hierarchical pattern is a model…

  14. 75 FR 23582 - Annular Casing Pressure Management for Offshore Wells

    Science.gov (United States)

    2010-05-04

    ... actions of MMS, call 1-888-734- 3247. You may comment to the Small Business Administration without fear of... Management Sec. 250.518 What are the requirements for casing pressure management? 250.519 How often do I have... test? 250.525 What do I submit if my casing diagnostic test requires action? 250.526 What must I...

  15. Effectiveness of case management for homeless persons: a systematic review

    NARCIS (Netherlands)

    Vet, R. de; Luijtelaar, M.J.A. van; Brilleslijper-Kater, S.N.; Vanderplasschen, W.; Beijersbergen, M.D.; Wolf, J.R.L.M.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized

  16. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    NARCIS (Netherlands)

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.; Wolf, Judith R. L. M.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized

  17. How technology in care at home affects patient self-care and self-management: a scoping review.

    Science.gov (United States)

    Peeters, José M; Wiegers, Therese A; Friele, Roland D

    2013-10-29

    The use of technology in care at home has potential benefits such as improved quality of care. This includes greater focus on the patients' role in managing their health and increased patient involvement in the care process. The objective of this scoping review is to analyse the existing evidence for effects of technology in home-based care on patients' self-care and self-management. Using suitable search terms we searched the databases of Pubmed, Embase, Cochrane Library, Cinahl, Picarta and NIVEL dating from 2002 to 2012. Thirty-three studies (six review studies and twenty-seven individual studies) were selected. Effects were extracted from each study and were classified. In almost all the studies, the concepts self-care and self-management are not clearly defined or operationalized. Therefore, based on a meta-analysis, we made a new classification of outcome measures, with hierarchical levels: (1) competence (2) illness-management (3) independence (social participation, autonomy). In general, patient outcomes appear to be positive or promising, but most studies were pilot studies. We did not find strong evidence that technology in care at home has (a positive) effect on patient self-care and self-management according to the above classification. Future research is needed to clarify how technology can be used to maximize its benefits.

  18. Case management for persons with substance use disorders

    DEFF Research Database (Denmark)

    Hesse, Morten; Vanderplasschen, Wouter; Rapp, Richard

    2007-01-01

    Background Patients with alcohol and other drug use disorders (AOD) frequently have multiple social, physical, and mental health treatment needs, yet have difficulty accessing community services, including drug abuse treatment.  One strategy for linking patients with AOD with relevant services...... is case management, where a single case manager is responsible for linking patients with multiple relevant services. Objectives To conduct a systematic review  of all RCTs on the use of case management for helping drug abusers in or out of treatment. Outcome criteria included successful linkage with other......). Reference searching; personal communication; conference abstracts; book chapters on case management. Selection criteria Randomized controlled studies that compared a specific model of case management with either treatment as usual or another treatment model, included only patients with at least one alcohol...

  19. Hotel Security Management : Case: Original Sokos Hotel Vaakuna Vaasa

    OpenAIRE

    Koskela, Jere

    2016-01-01

    This thesis studied hotel security management and examined one case hotel more closely on matters of security management. The case hotel in this research was Original Sokos Hotel Vaakuna Vaasa. The aim of the thesis was to find out how security aspects are managed and how they could be developed in the case hotel. This research was conducted to help the case hotel’s security supervisor to develop and improve security. The thesis consists of a theoretical framework and an empirical study. The ...

  20. Outcomes of social work and case management services during inpatient spinal cord injury rehabilitation: the SCIRehab project.

    Science.gov (United States)

    Hammond, Flora M; Gassaway, Julie; Abeyta, Nichola; Freeman, Erma S; Primack, Donna; Kreider, Scott E D; Whiteneck, Gale

    2012-11-01

    To investigate associations of social work/case management (SW/CM) services during inpatient rehabilitation following spinal cord injury (SCI) and patient characteristics with outcomes. Prospective observational cohort of individuals with SCI receiving inpatient rehabilitation. Six inpatient rehabilitation centers. 1032 individuals with traumatic SCI. Not applicable. Type of residence at the time of rehabilitation discharge. Employment/school status, presence of a pressure ulcer, Patient History Questionnaire, Satisfaction with Life Scale, Craig Handicap Assessment and Reporting Technique (CHART) subscales, and rehospitalization at 1-year post-injury. The intensity of specific SW/CM services is associated with multiple outcomes examined. More sessions dedicated to discharge planning for a home discharge and financial planning were associated positively with more discharge to home, while more sessions focused on planning for discharge to a location other than home, e.g. nursing home or long-term acute care facilities, have negative associations with societal participation outcomes (CHART Social Integration, Occupation, and Mobility scores) as well as with residing at home at the time of the 1-year injury anniversary. The intensity and type of SW/CM services are associated with outcomes at rehabilitation discharge and at 1-year post-injury. Discharge to home may require assistance from SW/CM in the area of discharge planning and financial planning, while discharge to non-home residence demands directed SW/CM services for such placement. Note: This is the eighth of nine articles of this SCIRehab series.

  1. Integrated Multimedia and Sensor Data Management in Heterogeneous Home Networks: a Concept Proposal

    OpenAIRE

    Spinsante, Susanna; Gambi, Ennio

    2010-01-01

    Home Area Networks designed for the delivery of both multimedia contents (e.g. TV programs, movies, music) and home automation services (e.g. household appliances commands, lighting and surveillance controls) are becoming widespread, especially thanks to the latest developments in wireless sensor and communication devices. This kind of networks, however, represents a new challenge for the networking field, particularly with respect to the integration of many different home and building automa...

  2. Home-based nursing interventions improve knowledge of disease and management in patients with heart failure

    Directory of Open Access Journals (Sweden)

    Karina de Oliveira Azzolin

    2015-02-01

    Full Text Available OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire.METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered.RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001; and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001. The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01, but weak and non significant at visit 4.CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument.

  3. Prescription drugs in nursing homes: managing costs and quality in a complex environment.

    Science.gov (United States)

    Mendelson, Dan; Ramchand, Rajeev; Abramson, Richard; Tumlinson, Anne

    2002-11-12

    This brief provides a description of prescription drug use in nursing homes and a summary of current policy issues in this area. The brief first profiles the nursing home pharmaceutical market, outlining the major trends in demographics and drug utilization, the supply chain by which drugs go from manufacturers to pharmacies to nursing home residents, and the alternative arrangements by which prescription drugs in nursing homes are financed. The brief then provides a synopsis of current policy issues, focusing in turn on cost containment and quality improvement initiatives.

  4. Pharmacist-Led Home Medicines Review and Residential Medication Management Review: The Australian Model.

    Science.gov (United States)

    Chen, Timothy F

    2016-03-01

    Older people are often prescribed multiple medicines and have a high prevalence of polypharmacy. Polypharmacy is associated with an increased risk of inappropriate use of medicines and drug-related problems. As experts in pharmacotherapy, pharmacists are well placed to review complex medication regimens and identify causes of drug-related problems and recommend solutions to prevent or resolve them. Involvement in medication review services represents a major philosophical shift and paradigm change in the way pharmacists practice, in that the focus is shifted away from the dispensing of prescription medicines to the provision of a professional service for a patient, in collaboration with their general practitioner (GP). In Australia, there are two established medication review programs: Home Medicines Review (HMR) and Residential Medication Management Review (RMMR). The objectives of this article were to describe the process of government-funded medication review services in Australia and to evaluate the contribution of pharmacists to HMR and RMMR, using evidence-based measures, such as the Drug Burden Index (DBI) and the Medication Appropriateness Index (MAI). This review found that there is good evidence to support the role of pharmacists in delivering medication review services across different settings. Although the positive impact of such services has been demonstrated using a variety of validated measures (DBI, MAI), there remains a need to also evaluate actual clinical outcomes and/or patient-reported outcomes.

  5. Enhancing patient engagement and blood pressure management for renal transplant recipients via home electronic monitoring and web-enabled collaborative care.

    Science.gov (United States)

    Aberger, Edward W; Migliozzi, Daniel; Follick, Michael J; Malick, Tom; Ahern, David K

    2014-09-01

    Effective management of hypertension in chronic kidney disease and renal transplantation is a clinical priority and has societal implications in terms of preserving and optimizing the value of scarce organs. However, hypertension is optimally managed in only 37% of people with chronic kidney disease, and poor control can contribute to premature graft loss in renal transplant recipients. This article describes a telehealth system that incorporates home electronic blood pressure (BP) monitoring and uploading to a patient portal coupled with a Web-based dashboard that enables clinical pharmacist collaborative care in a renal transplant clinic. The telehealth system was developed and implemented as a quality improvement initiative in a renal transplant clinic in a large, 700-bed, urban hospital with the aim of improving BP in posttransplant patients. A convenience sample of 66 posttransplant patients was recruited by the clinical pharmacist from consecutive referrals to the Transplant Clinic. Preliminary results show statistically significant reductions in average systolic and diastolic BP of 6.0 mm Hg and 3.0 mm Hg, respectively, at 30 days after enrollment. Two case reports describe the instrumental role of home BP monitoring in the context of medication therapy management. Optimizing BP control for both pre- and post-renal transplant patients is likely to benefit society in terms of preserving scarce resources and reducing healthcare costs due to premature graft failure. Connected health systems hold great promise for supporting team-based care and improved health outcomes.

  6. Cooperation and knowledge challenges in realizing smart homes: The case of small installer businesses

    NARCIS (Netherlands)

    Keijzer-Broers, W.J.W.; de Reuver, G.A.

    2016-01-01

    Despite technological advances, smart home concepts are not receiving widespread adoption. Small businesses that install and maintain heating, security and energy-saving systems could play a major role in bringing advanced technologies to home owners. However, the role of such small installer

  7. Second homes and small-town (re)development: the case of Clarens

    African Journals Online (AJOL)

    Seugnet

    home development. In the second section issues con- cerning the methodology employed in this investiga- tion briefly come into view. Thereafter, in the third and fourth sections, the focus ... In the main, sec- ond homes are seen as part of leisure consumption .... identification and measurement difficult. Clearly the definition ...

  8. DOE Zero Energy Ready Home Case Study: Ferguson Design and Construction,Sagaponack, New York

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    The 6-bedroom home achieves a HERS score of 43 even before PV is installed and will cut utility bills dramatically for its owners. Water-savings faucets, LED lighting, and ENERGY STAR appliances add to energy savings. This home garnered a 2013 Housing Innovation Award in the custom builder category.

  9. DOE Zero Energy Ready Home Case Study: BPC Green Builders, New Fairfield, Connecticut

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    This LEED Platinum home was built on the site of a 60-year-old bungalow that was demolished. It boasts views of Candlewood Lake, a great deal of daylight, and projected annual energy savings of almost $3,000. This home was awarded a 2013 Housing Innovation Award in the custom builder category.

  10. What is Case Management? A Scoping and Mapping Review

    Directory of Open Access Journals (Sweden)

    Sue Lukersmith

    2016-10-01

    Full Text Available The description of case management in research and clinical practice is highly variable which impedes quality analysis, policy and planning. Case management makes a unique contribution towards the integration of health care, social services and other sector services and supports for people with complex health conditions. There are multiple components and variations of case management depending on the context and client population. This paper aims to scope and map case management in the literature to identify how case management is described in the literature for key complex health conditions (e.g., brain injury, diabetes, mental health, spinal cord injury. Following literature searches in multiple databases, grey literature and exclusion by health condition, community-based and adequate description, there were 661 potential papers for data extraction. Data from 79 papers (1988–2013 were analysed to the point of saturation (no new information and mapped to the model, components and activities. The results included 22 definitions, five models, with 69 activities or tasks of case managers mapped to 17 key components (interventions. The results confirm the significant terminological variance in case management which produces role confusion, ambiguity and hinders comparability across different health conditions and contexts. There is an urgent need for an internationally agreed taxonomy for the coordination, navigation and management of care.

  11. Scale-up of home-based management of malaria based on rapid diagnostic tests and artemisinin-based combination therapy in a resource-poor country: results in Senegal

    Directory of Open Access Journals (Sweden)

    Thiam Sylla

    2012-09-01

    Full Text Available Abstract Background Effective case management of malaria requires prompt diagnosis and treatment within 24 hours. Home-based management of malaria (HMM improves access to treatment for populations with limited access to health facilities. In Senegal, an HMM pilot study in 2008 demonstrated the feasibility of integrated use of RDTs and ACT in remote villages by volunteer Home Care Providers (HCP. Scale-up of the strategy began in 2009, reaching 408 villages in 2009 and 861 villages in 2010. This paper reports the results of the scale-up in the targeted communities and the impact of the strategy on malaria in the formal health sector. Methods Data reported by the HCPs were used to assess their performance in 2009 and 2010, while routine malaria morbidity and mortality data were used to assess the impact of the HMM programme. Two high transmission regions where HMM was not implemented until 2010 were used as a comparison. Results and discussion From July 2009 through May 2010, 12582 suspected cases were managed by HCPs, 93% (11672 of whom were tested with an RDT. Among those tested, 37% (4270 had a positive RDT, 97% (4126 of whom were reported treated and cured. Home care providers referred 6871 patients to health posts for management: 6486 with a negative RDT, 119 infants  Conclusion Home-based management of malaria including diagnosis with RDT and treatment based on test results is a promising strategy to improve the access of remote populations to prompt and effective management of uncomplicated malaria and to decrease mortality due to malaria. When scaled-up to serve remote village communities in the regions of Senegal with the highest malaria prevalence, home care providers demonstrated excellent adherence to guidelines, potentially contributing to a decrease in hospital deaths attributed to malaria.

  12. A comprehensive grid to evaluate case management's expected effectiveness for community-dwelling frail older people: results from a multiple, embedded case study.

    Science.gov (United States)

    Van Durme, Thérèse; Schmitz, Olivier; Cès, Sophie; Anthierens, Sibyl; Maggi, Patrick; Delye, Sam; De Almeida Mello, Johanna; Declercq, Anja; Macq, Jean; Remmen, Roy; Aujoulat, Isabelle

    2015-06-18

    Case management is a type of intervention expected to improve the quality of care and therefore the quality of life of frail, community-dwelling older people while delaying institutionalisation in nursing homes. However, the heterogeneity, multidimensionality and complexity of these interventions make their evaluation by the means of classical approaches inadequate. Our objective was twofold: (i) to propose a tool allowing for the identification of the key components that explain the success of case management for this population and (ii) to propose a typology based on the results of this tool. The process started with a multiple embedded case study design in order to identify the key components of case management. Based on the results of this first step, data were collected among 22 case management interventions, in order to evaluate their expected effectiveness. Finally, multiple correspondence analyses was conducted to propose a typology of case management. The overall approach was informed by Wagner's Chronic Care Model and the theory of complexity. The study identified a total of 23 interacting key components. Based on the clustering of response patterns of the 22 case management projects included in our study, three types of case management programmes were evidenced, situated on a continuum from a more "socially-oriented" type towards a more "clinically-oriented" type of case management. The type of feedback provided to the general practitioner about both the global geriatric assessment and the result of the intervention turned out to be the most discriminant component between the types. The study design allowed to produce a tool that can be used to distinguish between different types of case management interventions and further evaluate their effect on frail older people in terms of the delaying institutionalisation, functional and cognitive status, quality of life and societal costs.

  13. Breakdown in informational continuity of care during hospitalization of older home-living patients: A case study

    Directory of Open Access Journals (Sweden)

    Rose Mari Olsen

    2014-05-01

    Full Text Available Introduction: The successful transfer of an older patient between health care organizations requires open communication between them that details relevant and necessary information about the patient's health status and individual needs. The objective of this study was to identify and describe the process and content of the patient information exchange between nurses in home care and hospital during hospitalization of older home-living patients.Methods: A multiple case study design was used. Using observations, qualitative interviews and document reviews, the total patient information exchange during each patient's episode of hospitalization (n = 9, from day of admission to return home, was captured. Results: Information exchange mainly occurred at discharge, including a discharge note sent from hospital to home care, and telephone reports from hospital nurse to home care nurse, and meetings between hospital nurse and patient coordinator from the municipal purchaser unit. No information was provided from the home care nurses to the hospital nurses at admission. Incompleteness in the content of both written and verbal information was found. Information regarding physical care was more frequently reported than other caring dimensions. Descriptions of the patients’ subjective experiences were almost absent and occurred only in the verbal communication. Conclusions: The gap in the information flow, as well as incompleteness in the content of written and verbal information exchanged, constitutes a challenge to the continuity of care for hospitalized home-living patients. In order to ensure appropriate nursing follow-up care, we emphasize the need for nurses to improve the information flow, as well as to use a more comprehensive approach to older patients, and that this must be reflected in the verbal and written information exchange.

  14. Breakdown in informational continuity of care during hospitalization of older home-living patients: A case study

    Directory of Open Access Journals (Sweden)

    Rose Mari Olsen

    2014-05-01

    Full Text Available Introduction: The successful transfer of an older patient between health care organizations requires open communication between them that details relevant and necessary information about the patient's health status and individual needs. The objective of this study was to identify and describe the process and content of the patient information exchange between nurses in home care and hospital during hospitalization of older home-living patients.Methods: A multiple case study design was used. Using observations, qualitative interviews and document reviews, the total patient information exchange during each patient's episode of hospitalization (n = 9, from day of admission to return home, was captured.Results: Information exchange mainly occurred at discharge, including a discharge note sent from hospital to home care, and telephone reports from hospital nurse to home care nurse, and meetings between hospital nurse and patient coordinator from the municipal purchaser unit. No information was provided from the home care nurses to the hospital nurses at admission. Incompleteness in the content of both written and verbal information was found. Information regarding physical care was more frequently reported than other caring dimensions. Descriptions of the patients’ subjective experiences were almost absent and occurred only in the verbal communication.Conclusions: The gap in the information flow, as well as incompleteness in the content of written and verbal information exchanged, constitutes a challenge to the continuity of care for hospitalized home-living patients. In order to ensure appropriate nursing follow-up care, we emphasize the need for nurses to improve the information flow, as well as to use a more comprehensive approach to older patients, and that this must be reflected in the verbal and written information exchange.

  15. UNIVERSITY LIFE AND AUSTRALIAN HOMES: THREE CASE STUDIES OF INTERNATIONAL MUSLIM STUDENTS IN BRISBANE

    Directory of Open Access Journals (Sweden)

    Zulkeplee Othman

    2014-12-01

    Full Text Available Despite a significant increase in enrolments of postgraduate international Muslim students within Australian universities, little is known about their perceptions of life within Australian homes while undertaking their studies. The aim of this study is to investigate the ways in which students’ cultural and religious traditions affect their use of domestic spaces within the homes in which they reside. The research found that participants faced some minor difficulties in achieving privacy, maintaining modesty and extending hospitality while able to perform their daily activities in Australian designed homes. The findings suggest that greater research attention needs to be given to the development of Australian home designs that are adaptable to the needs of a multicultural society. Australian society encompasses diverse cultural customs and requirements with respect to home design, and these are yet to be explored.

  16. Security And Privacy Issues in Health Monitoring Systems: eCare@Home Case Study

    DEFF Research Database (Denmark)

    Wearing, Thomas; Dragoni, Nicola

    2016-01-01

    Automated systems for monitoring elderly people in their home are becoming more and more common. Indeed, an increasing number of home sensor networks for healthcare can be found in the recent literature, indicating a clear research direction in smart homes for health-care. Although the huge amount...... of sensitive data these systems deal with and expose to the external world, security and privacy issues are surpris-ingly not taken into consideration. The aim of this paper is to raise some key security and privacy issues that home health monitor systems should face with. The analysis is based on a real world...... monitoring sensor network for healthcare built in the context of the eCare@Home project....

  17. Facilities Management and Value Adding - The LEGO case

    DEFF Research Database (Denmark)

    Jensen, Per Anker; Katchamart, Akarapong

    on a case study of LEGO. Results: The study shows that the management model for FM creates a relevant starting point but also that stakeholder and relationship management is an essential aspect of Value Adding Management. The case study confirms the relevance of the basic concept and provides an important......Purpose: To investigate how Facilities Management (FM) can add value and develop a management concept that can assist facilities managers in implementing value adding strategies and practices. Background: Earlier research has shown an increased focus on added value of FM and a FM Value Map has been...... developed to analyse and demonstrate the different ways FM can add value. However, there is a need to develop management tools that can be used more directly and proactively by facilities managers to implement adding value strategies and practices. Approach: The development of the concept is based...

  18. Value adding management: A concept and a case

    DEFF Research Database (Denmark)

    Jensen, Per Anker; Katchamart, Akarapong

    2012-01-01

    practice value adding management. It underlines the importance of stakeholder and relationship management as part of adding value. The case study confirms the relevance of the basic concept of Value Adding Management. Practical implications: The concept of Value Adding Management is expected to increase......Purpose: To develop a management concept that can assist facilities managers in implementing value adding strategies and practices. The FM Value Map has been developed to analyse and demonstrate the different ways FM can add value. However, there is a need to develop management tools that can...... be used more directly and proactively by facilities managers to implement adding value strategies and practices. Methodology: The development of the concept of Value Adding Management is based on the management model for FM included in the European FM standards, recent theories on added value of FM...

  19. Delivering early care in diabetes evaluation (DECIDE: a protocol for a randomised controlled trial to assess hospital versus home management at diagnosis in childhood diabetes

    Directory of Open Access Journals (Sweden)

    Robling Michael

    2011-01-01

    Full Text Available Abstract Background There is increased incidence of new cases of type 1 diabetes in children younger than 15 years. The debate concerning where best to manage newly diagnosed children continues. Some units routinely admit children to hospital whilst others routinely manage children at home. A Cochrane review identified the need for a large well-designed randomised controlled trial to investigate any significant differences in comprehensive short and long-term outcomes between the two approaches. The DECIDE study will address these knowledge gaps, providing high quality evidence to inform national and international policy and practice. Methods/Design This is a multi-centre randomised controlled trial across eight UK paediatric diabetes centres. The study aims to recruit 240 children newly diagnosed with type 1 diabetes and their parents/carers. Eligible patients (aged 0-17 years will be remotely randomised to either 'hospital' or 'home' management. Parents/carers of patients will also be recruited. Nursing management of participants and data collection will be co-ordinated by a project nurse at each centre. Data will be collected for 24 months after diagnosis; at follow up appointments at 3, 12 and 24 months and every 3-4 months at routine clinic visits. The primary outcome measure is patients' glycosylated haemoglobin (HbA1c at 24 months after diagnosis. Additional measurements of HbA1c will be made at diagnosis and 3 and 12 months later. HbA1c concentrations will be analysed at a central laboratory. Secondary outcome measures include length of stay at diagnosis, growth, adverse events, quality of life, anxiety, coping with diabetes, diabetes knowledge, home/clinic visits, self-care activity, satisfaction and time off school/work. Questionnaires will be sent to participants at 1, 12 and 24 months and will include a questionnaire, developed and validated to measure impact of the diagnosis on social activity and independence. Additional

  20. INSPIRE: Evaluation of a Smart-Home System for Infotainment Management and Device Control

    NARCIS (Netherlands)

    Möller, S.; Krebber, J.; Raake, A.; Smeele, P.; Rajman, M.; Melichar, M.; Pallotta, V.; Tsakou, G.; Kladis, B.; Vovos, A.; Hoonhout, A.; Schuchardt, D.; Fakotakis, N.; Ganchev, T.; Potamitis, I.

    2004-01-01

    This paper gives an overview of the assessment and evaluation methods which have been used to determine the quality of the INSPIRE smart home system. The system allows different home appliances to be controlled via speech, and consists of speech and speaker recognition, speech understanding,

  1. Mothers Knowledge and Home Management ofNappy Rash in Port ...

    African Journals Online (AJOL)

    ... to the rash, only 10% exposed the bottom. Conclusion Knowledge of, and home treatment of diaper rash is poor amongst our mothers. There is need for awareness I enlightenment campaigns about skin care of young children targeted at mothers. Keywords: Mothers knowledge; Home care; Nappy Rash; Diaper; Napkin, ...

  2. Managing Faecal INcontinence in people with advanced dementia resident in Care Homes (FINCH) study: a realist synthesis of the evidence.

    Science.gov (United States)

    Goodman, Claire; Norton, Christine; Buswell, Marina; Russell, Bridget; Harari, Danielle; Harwood, Rowan; Roe, Brenda; Rycroft-Malone, Jo; Drennan, Vari M; Fader, Mandy; Maden, Michelle; Cummings, Karen; Bunn, Frances

    2017-08-01

    Eighty per cent of care home residents in the UK are living with dementia. The prevalence of faecal incontinence (FI) in care homes is estimated to range from 30% to 50%. There is limited evidence of what is effective in the reduction and management of FI in care homes. To provide a theory-driven explanation of the effectiveness of programmes that aim to improve FI in people with advanced dementia in care homes. A realist synthesis. This was an iterative approach that involved scoping of the literature and consultation with five stakeholder groups, a systematic search and analysis of published and unpublished evidence, and a validation of programme theories with relevant stakeholders. The databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature, The Cochrane Library, Scopus, SocAbs, Applied Social Sciences Index and Abstracts, BiblioMap, Sirius, OpenGrey, Social Care Online and the National Research Register. The scoping identified six programme theories with related context-mechanism-outcome configurations for testing. These addressed (1) clinician-led support, assessment and review, (2) the contribution of teaching and support for care home staff on how to reduce and manage FI, (3) the causes and prevention of constipation, (4) how the cognitive and physical capacity of the resident affect outcomes, (5) how the potential for recovery, reduction and management of FI is understood by those involved and (6) how the care of people living with dementia and FI is integral to the work patterns of the care home and its staff. Data extraction was completed on 62 core papers with iterative searches of linked literature. Dementia was a known risk factor for FI, but its affect on the uptake of different interventions and the dementia-specific continence and toileting skills staff required was not addressed. Most care home residents with FI will be doubly incontinent and, therefore, there is limited value in focusing solely on FI or on

  3. Improvement in Obstructive Sleep Apnea Diagnosis and Management Wait Times: A Retrospective Analysis of a Home Management Pathway for Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Samuel Alan Stewart

    2015-01-01

    Full Text Available Obstructive sleep apnea is a common condition within the Canadian population. The current gold standard for diagnosis and management of patients is in-laboratory (in-lab polysomnography; however, the limited availability of testing options for patients has led to long wait times and increased disease burden within the population. The Sleep Research Laboratory in Saskatoon (Saskatchewan implemented a home management program to run in parallel with the in-lab system several years ago in an effort to increase their capacity and reduce wait times. The present study was a retrospective analysis of all patients referred to the program between 2009 and 2012. The home management system has improved wait times by diagnosing and managing up to one-half of the referred patient population, reducing the wait for in-lab treatment from a median of 152 days in 2009 to 92 days in 2012 (P<0.0001. Moving forward, home management can provide a viable alternative to in-lab testing for patients who meet strict entry criteria, reducing the in-lab workload and, ultimately, reducing wait times.

  4. Labour supply in the home care industry: A case study in a Dutch region.

    Science.gov (United States)

    Breedveld, Elly J; Meijboom, Bert R; de Roo, Aad A

    2006-04-01

    Health organizations have started to become more market-driven. Therefore, it is important for health organizations to analyse the competitive dynamics of their industrial structure. However, relevant theories and models have mainly been developed for organizations acting in the profit sector. In this paper, we adapt Porter's 'five forces model' to the home care industry. In particular, we modify the (determinants of the) bargaining power of labour suppliers. We then apply the modified Porter-model to the home care industry in the Netherlands for the period of 1987-1997 with special attention for labour supply. The new instrument clarifies the complexity of the supply chains and value systems of the home care industry. As can be illustrated by developments in the home care industry in the province of North Brabant during the 1990s, competition between home care providers has influenced labour market relations, but so do other factors as well. Between 1987 and 1997, the bargaining power of labour suppliers was relatively limited. After 1997, however, the demand for home care personnel has increased strongly. In spite of the present economic recession, scarcity on this labour market seems to prevail in the longer term due to a growing demand for home care services.

  5. Using Home-Program Adherence App in Pediatric Therapy: Case Study of Sensory Processing Disorder.

    Science.gov (United States)

    Gal, Eynat; Steinberg, Oren

    2017-12-18

    Pediatric therapies adopt a family-centered approach that encourages a caregiver's involvement in therapy. Contextual interventions in the child's natural environment have been effective in generalization of skills and increasing of child participation in daily activities. The use of home programs is common across a variety of conditions, but adherence has been challenging. Apps have been demonstrated to promote medication adherence and physical activity maintenance. This study suggested and tested a construct for features required for caregivers' behavioral modification during home programs in pediatric therapy. SensoryTreat is an adherence promoting app for home-program treatments of children with sensory processing disorders. The app was evaluated by testing availability of desired features, usage frequency, impact on adherence with home programs, and parental sense of competence. Results suggest a strong significant correlation between SensoryTreat usage frequency and families' adherence with home programs, as well as a strong significant correlation between relevancy and usefulness of SensoryTreat's interventional content, and parental competence and their adherence with home programs. Using SensoryTreat twice or more per week increases parental adherence with home programs. Content plays an important role in promoting adherence and parental sense of competence, yet, as usage frequency grows the interventional content habituates, and other features as goal setting and feedback logs have significant impact on parental competence and adherence with home programs over time. These findings indicate that the content and features of SensoryTreat app have the potential to promote adherence of families with pediatric therapy home programs.

  6. The Case for Library Management Games

    Science.gov (United States)

    Buckland, K.; Hindle, A.

    1971-01-01

    In professional training of librarians, mathematical modeling can be useful in relatively sophisticated library management games if the models simulate the provision and use of library services. (33 references) (MM)

  7. The Case for Software Health Management

    Data.gov (United States)

    National Aeronautics and Space Administration — Software Health Management (SWHM) is a new field that is concerned with the development of tools and technologies to enable automated detection, diagnosis,...

  8. Case studies: Managing nuclear information in Colombia

    International Nuclear Information System (INIS)

    Oviedo, L.G.

    2004-01-01

    The advances in the managing of nuclear information in Colombia are present, this has allowed recapturing the activities starting from 1999 contributing the INIS the results of the investigations related with the AIEA mission, for benefit of the international scientific community. Thanks to the support of the directive and to my own managing, year after year the efforts are reflected, through a constant increase of the records to the INIS, like in the participation in the RRIAN in Latin America. (author)

  9. DOE Zero Energy Ready Home Case Study: United Way of Long Island, United Veterans Beacon House

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2017-09-01

    United Way of Long Island’s Housing Development Corporation built this 3,719-ft2 two–story, 5-bedroom home in Huntington Station, New York, to the rigorous performance requirements of the U.S. Department of Energy’s Zero Energy Ready Home Program. The home is packed with high-performance features like LED lighting and ENERGY STAR appliances. The asymmetrical, optimally angled roof provides plenty of space for roof-mounted solar panels for electric generation and hot water.

  10. Building America Case Study: Accelerating the Delivery of Home-Performance Upgrades Using a Synergistic Business Model, Minneapolis, Minnesota

    Energy Technology Data Exchange (ETDEWEB)

    2016-04-01

    Achieving Building America energy savings goals (40 percent by 2030) will require many existing homes to install energy upgrades. Engaging large numbers of homeowners in building science-guided upgrades during a single remodeling event has been difficult for a number of reasons. Performance upgrades in existing homes tend to occur over multiple years and usually result from component failures (furnace failure) and weather damage (ice dams, roofing, siding). This research attempted to: A) Understand the homeowner's motivations regarding investing in building science based performance upgrades. B) Determining a rapidly scalable approach to engage large numbers of homeowners directly through existing customer networks. C) Access a business model that will manage all aspects of the contractor-homeowner-performance professional interface to ensure good upgrade decisions over time. The solution results from a synergistic approach utilizing networks of suppliers merging with networks of homeowner customers. Companies in the $400 to $800 billion home services industry have proven direct marketing and sales proficiencies that have led to the development of vast customer networks. Companies such as pest control, lawn care, and security have nurtured these networks by successfully addressing the ongoing needs of homes. This long-term access to customers and trust established with consistent delivery has also provided opportunities for home service providers to grow by successfully introducing new products and services like attic insulation and air sealing. The most important component for success is a business model that will facilitate and manage the process. The team analyzes a group that developed a working model.

  11. [Botulism. Therapeutic management. Apropos of 36 cases].

    Science.gov (United States)

    Sudre, Y; Becq-Giraudon, B; Boutaud, P h

    1975-03-08

    Botulism is relatively common in the Vienne department as we have observed 36 cases over a peroid of 7 years. Other French cases, published over the last 10 years, included 10 to 19 cases in the largest series. In a total of 10 series, there were 105 cases. Botulism is caused, in most cases, by eating ham prepared on the farm. It gives rise to the usual clinical picture including paralysis of accommodation, dysphagia, digestive symptoms with abdominal pain and constipation and finally, bladder paralysis. The mild forms are fairly common. We did not observe any severe cases. Our patients were treated in two homogeneous series of 17 cases each ; two patients were given no treatment. Patients treated by sero-anatoxin therapy according to classical methods, evolved towards a cure within 21 days on average. Patients treated by sulfguanidin were cured within 24 days. This study permitted us to confirm that sero-anatoxin therapy is not essential. The disadvantages are the number of injections, the possibility of sometimes fatal hyper-sensitive reactions which, in the opinion of many authors, justifies routine cover with cortisone. This attitude does not seem to us justified owing to the usually benign nature of the botulism. The treatment with sulfaguanidin is well tolerated and is not of any risk to the patient.

  12. Continuous Deep Sedation Until Death in Nursing Home Residents with Dementia: A Case Series

    NARCIS (Netherlands)

    Anquinet, L.; Rietjens, J.A.C.; Vandervoort, A.; van der Steen, J.T.; van der Stichele, R.; Deliens, L.; Block, L.

    2013-01-01

    Objectives To describe the characteristics of continuous deep sedation until death and the prior decision-making process of nursing home residents dying with dementia and to evaluate this practice according to features reflecting sedation guideline recommendations. Design Epidemiological

  13. DOE Zero Energy Ready Home Case Study: StreetScape Development, LLC, Libertyville, Illinois

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-09-01

    These single-family, HERS 45 homes incorporate 2×6 wood framed walls with R-20 open cell spray insulation and OSB. The builder, StreetScape Development, won a 2013 Housing Innovation Award in the custom builder category.

  14. Evaluation of baobab (gonglase) solution for home management of diarrhoea in sudanese children

    International Nuclear Information System (INIS)

    Abdel Galil, Nour Elhuda

    1996-06-01

    A randomized controlled study was carried out in Khartoum North during the year 1994-1995 at Ahmed Gasim children teaching hospital, khatmia, and shabia health centres to evaluate acceptability, safety and efficiency of three formulated baobab home oral rehydration solutions in children with diarrhoeal diseases. 113 children 6-60 months of age were enrolled in the study with mild or no dehydration and without associated diseases. Three baobab solutions were administered beside the control WHO/oral rehydration solution (ORS). 32 were allocated to solution A (baobab pulp extract+home sugar), 35 patients to solution B (baobab pulp extract+domestic salt+sugar), 25 to solution C (baobab pulp extract+WHO/ORS) and 21 to the control solution (WHO/ORS). The solutions were administered for three successive days to the children with diarrhoea. A questionnaire was filled for each child including attitudes and practices of mother regarding diarrhoeal diseases, socioeconomic status of parents, history of the patient health and past nutritional intake during the present diarrhoea. The clinical data were studied. The study showed that the solutions were acceptable, effective and safer than the control. The three solutions A, B and C were good as therapeutic solutions and exceeded that of the WHO/ORS. Clinical data demonstrated that after 24 hours of management of the diarrhoeal diseases with baobab solutions, the recovery rate was 60% for solution A group, 20% for solution B group and 28% for solution C where as the recovery rate for solution D was 5%. By the second 24 hours of management the cumulative recovery rate was 100% for A, 77% for B, 84% for C and 24% for D. None was considered a treatment failure or developed dehydration and all the patients were satisfactorily treated with marked effect on children with diarrhoea , specially bloody diarrhoea. The molar concentration of K in the baobab solution was 21 mmol/litre very close to the molar concentration of K in the WHO

  15. Integrated Heat Pump HVAC Systems for Near-Zero-Energy Homes - Business Case Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Baxter, Van D [ORNL

    2007-05-01

    development. Eleven system concepts with central air distribution ducting and nine multi-zone systems were selected and their annual and peak demand performance estimated for five locations: Atlanta (mixed-humid), Houston (hot-humid), Phoenix (hot-dry), San Francisco (marine), and Chicago (cold). Performance was estimated by simulating the systems using the TRNSYS simulation engine (Solar Energy Laboratory et al. 2006) in two 1800-ft{sup 2} houses--a Building America (BA) benchmark house and a prototype NZEH taken from BEopt results at the take-off (or crossover) point (i.e., a house incorporating those design features such that further progress towards ZEH is through the addition of photovoltaic power sources, as determined by current BEopt analyses conducted by NREL). Results were summarized in a project report, 'HVAC Equipment Design options for Near-Zero-Energy Homes--A Stage 2 Scoping Assessment', ORNL/TM-2005/194 (Baxter 2005). The 2005 study report describes the HVAC options considered, the ranking criteria used, and the system rankings by priority. Table 1 summarizes the energy savings potential of the highest scoring options from the 2005 study for all five locations. All system options were scored by the ORNL building equipment research team and by William Goetzler of Navigant Consulting. These scores were reviewed by DOE/BT's Residential Integration program leaders and Building America team members. Based on these results, the two centrally ducted integrated heat pump (IHP) systems (air source and ground source versions) were selected for advancement to Stage 2 (Exploratory Development) business case assessments in FY06. This report describes results of these business case assessments. It is a compilation of three separate reports describing the initial business case study (Baxter 2006a), an update to evaluate the impact of an economizer cooling option (Baxter 2006b), and a second update to evaluate the impact of a winter humidification option

  16. Building America Case Study: Zero Energy Ready Home Multifamily Project: Mutual Housing at Spring Lake, Woodland, California

    Energy Technology Data Exchange (ETDEWEB)

    2015-09-01

    Building cost effective, high performance homes that provide superior comfort, health, and durability is the goal of the Department of Energy's (DOE's) Zero Energy Ready Homes (ZERH) program. Through Building America research and other innovative programs throughout the country, many of the technical challenges to building to the ZERH standard have been addressed. This case study describes the development of a 62-unit multifamily community constructed by nonprofit developer Mutual Housing at the Spring Lake subdivision in Woodland, CA. The Spring Lake project is expected to be the first ZERH-certified multifamily project nationwide. Building America team Alliance for Residential Building Innovation worked with Mutual Housing throughout the project. The case study discusses challenges encountered, lessons learned, and how obstacles were overcome. An objective of this project was to gain a highly visible foothold for residential buildings built to the DOE ZERH specification that can be used to encourage participation by other California builders.

  17. Technology Solutions for New Homes Case Study: Columbia County Habitat for Humanity Passive Townhomes

    Energy Technology Data Exchange (ETDEWEB)

    None

    2016-04-01

    The Columbia County (New York) Habitat for Humanity (Columbia County Habitat) affiliate has been experimenting with high-performance building since 2012, starting with ENERGY STAR® Certified Homes. In 2013, they constructed their first homes aimed at the Passive House standards. Building off of this effort, in 2014 they began work on a second set of Passive Townhomes in Hudson, New York, in partnership with the Advanced Residential Integrated Energy Solutions (ARIES) Building America team and BarlisWedlick Architects.

  18. DOE Zero Energy Ready Home Case Study: Greenhill Contracting, Inc., Hickory Ridge

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2017-09-01

    Greenhill Contracting built this 3,912-ft2 house in Gardiner, New York, to the high-performance criteria of the DOE Zero Energy Ready Home (ZERH) program. A highly efficient air-source heat pump heats and cools the home’s interior, while the roof-mounted photovoltaic system offsets electricity usage to cut energy bills to nearly zero. Many months the home owners see a credit on their utility bill.

  19. DESTITUTE CHILDREN IN THE CHILDREN HOMES OF IMPHAL-WEST : A CASE STUDY

    OpenAIRE

    Tomba Chingtham

    2014-01-01

    The present investigation aims to study the contribution of the areas related to the Destitute Children in the Children Homes of Imphal. This paper attempts to make a thorough, comprehensive and analytical study by exploring the causes of becoming destitute children, their educational facilities, fooding facilities, clothing facilities, health care system of the destitute children provided by the Children Homes. From the results of the research the causes of becoming destitute child are broke...

  20. Can just-in-time, evidence-based "reminders" improve pain management among home health care nurses and their patients?

    Science.gov (United States)

    McDonald, Margaret V; Pezzin, Liliana E; Feldman, Penny H; Murtaugh, Christopher M; Peng, Timothy R

    2005-05-01

    The purpose of this randomized, controlled, home care intervention was to test the effectiveness of two nurse-targeted, e-mail-based interventions to increase home care nurses' adherence to pain assessment and management guidelines, and to improve patient outcomes. Nurses from a large urban non-profit home care organization were assigned to usual care or one of two interventions upon identification of an eligible cancer patient with pain. The basic intervention consisted of a patient-specific, one-time e-mail reminder highlighting six pain-specific clinical recommendations. The augmented intervention supplemented the initial e-mail reminder with provider prompts, patient education material, and clinical nurse specialist outreach. Over 300 nurses were randomized and outcomes of 673 of their patients were reviewed. Data collection involved clinical record abstraction of nurse care practices and patient interviews completed approximately 45 days after start of care. The intervention had limited effect on nurse-documented care practices but patient outcomes were positively influenced. Patients in the augmented group improved significantly over the control group in ratings of pain intensity at its worst, whereas patients in the basic group had better ratings of pain intensity on average. Other outcomes measures were also positively influenced but did not reach statistical significance. Our findings suggest that although reminders have some role in improving cancer pain management, a more intensive approach is needed for a generalized nursing workforce with limited recent exposure to state-of-the-art pain management practices.

  1. Knowledge Management Aspects of Decommissioning. Case Study

    International Nuclear Information System (INIS)

    Pironkov, Lyubomir

    2017-01-01

    Kozloduy NPP: Units 5&6, type VVER-1000 - in operation. SE RAW SD “Decommissioning of units 1-4” (type VVER-440); SD “Radioactive Waste – Kozloduy”; SD “National Repository for Radioactive Waste“; SD “Permanent Repository for Radioactive Waste – Novi Han”. Decommissioning Strategy: Strategy Target: “Brown Field”. Initial Version: Safe enclosure – completing by 2050. Updated Version: Continuous dismantling of equipment; Completing the process of Decommissioning of Units 1-4 by 2030. Major Phases: 1.Pre-decommissioning activities; 2.Facility shutdown activities; 3.Procurement of equipment; 4.Dismantling activities; 5.Treatment of RAM and RAW and delivery for disposal; 6.Site management and support; 7.Project management and engineering; 8.Management of SNF and activated materials

  2. Substituting physicians with nurse practitioners, physician assistants or nurses in nursing homes: protocol for a realist evaluation case study.

    Science.gov (United States)

    Lovink, Marleen Hermien; Persoon, Anke; van Vught, Anneke J A H; Schoonhoven, Lisette; Koopmans, Raymond T C M; Laurant, Miranda G H

    2017-06-08

    In developed countries, substituting physicians with nurse practitioners, physician assistants and nurses (physician substitution) occurs in nursing homes as an answer to the challenges related to the ageing population and the shortage of staff, as well as to guarantee the quality of nursing home care. However, there is great diversity in how physician substitution in nursing homes is modelled and it is unknown how it can best contribute to the quality of healthcare. This study aims to gain insight into how physician substitution is modelled and whether it contributes to perceived quality of healthcare. Second, this study aims to provide insight into the elements of physician substitution that contribute to quality of healthcare. This study will use a multiple-case study design that draws upon realist evaluation principles. The realist evaluation is based on four concepts for explaining and understanding interventions: context, mechanism, outcome and context-mechanism-outcome configuration. The following steps will be taken: (1) developing a theory, (2) conducting seven case studies, (3) analysing outcome patterns after each case and a cross-case analysis at the end and (4) revising the initial theory. The research ethics committee of the region Arnhem Nijmegen in the Netherlands concluded that this study does not fall within the scope of the Dutch Medical Research Involving Human Subjects Act (WMO) (registration number 2015/1914). Before the start of the study, the Board of Directors of the nursing home organisations will be informed verbally and by letter and will also be asked for informed consent. In addition, all participants will be informed verbally and by letter and will be asked for informed consent. Findings will be disseminated by publication in a peer-reviewed journal, international and national conferences, national professional associations and policy partners in national government. © Article author(s) (or their employer(s) unless otherwise stated

  3. DOE ZERH Case Study: Clifton View Homes, Marine Drive and Port Hadlcok, Coupeville and Port Hadlock WA

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2015-09-01

    Case study of two DOE 2015 Housing Innovation Award winning custom homes in the marine climate that got HERS 39 and 38 without PV or HERS 2-12 and -9 with PV, with 6.5” SIP walls and 10.25” SIP roof; 11.75 ICF around slab, R-20 rigid foam under slab; radiant floor heat and passive design; air-to-water heatpump, fresh air intake with fan, triple-pane windows, 100% LED.

  4. Office Home Care Workers' Occupational Health: Associations with Workplace Flexibility and Worker Insecurity

    OpenAIRE

    Zeytinoglu, Isik U.; Denton, Margaret; Davies, Sharon; Plenderleith, Jennifer Millen

    2009-01-01

    Office home care workers provide support to visiting staff, although their work tends to be invisible in many respects. This paper focuses on managers, supervisors, coor dinators, case managers and office administrative staff in home care. We examine the effects of workplace flexibility and worker insecurity on office home care workers' occupational health, particularly their self-reported stress and musculoskeletal disorders. Data come from our survey of 300 home care office staff in a mid-s...

  5. Strategic Management Analysis: Case of Erzeni LTD

    Directory of Open Access Journals (Sweden)

    Alba KRUJA

    2014-06-01

    Full Text Available In the last two decades Albania had shifted from a closed, communist economy to an open market where private sector has increased its influence, especially in production and trade sector. Today it can be studied and found the leaders of each sector by analyzing the position that these private companies have in the market.Erzeni LTD is a company operating in the market for more than 17 years. The company‘s first operations were production and trade of home, office and school furniture, operations which later on were expanded in new product such as inside and armored doors. Erzeni LTD, known also as the leader in wood/MDF based products, arranges its sale in three different directions: 1. Sales in Albanian free market, 2. Sales through fixed long-term contracts, 3. Export sales. In this paper it will be analyzed the past, present and future of Erzeni LTD, by developing an implementable strategy that would improve the future position of the company not only as an operator in the Albanian market but also abroad. In order to develop the company`s strategies, the SWOT-TOWS analysis will be conducted in which it will be identified the strengths, weaknesses, opportunities and threats that the company is facing.

  6. Schizophrenia, violence, and case management: being supportive and overwhelmed.

    Science.gov (United States)

    Rice, Elizabeth I

    2009-01-01

    The aim of this study is to understand the experiences of case managers as they delivered care to women who were diagnosed with schizophrenia and live with histories of violence. Interpretive phenomenology. Providers valued their relationships with women, yet felt overwhelmed and frustrated with aspects of the case management role. Case managers at times blamed women for the violence in their lives and lacked clarity with regard to their role assisting women in recovery. The violence and poverty that is common for these women is a key factor that increased providers' alienation and confusion as to their role in the provision of care. The educational and supportive needs of case managers must be addressed to uphold recovery-oriented services.

  7. Effectiveness of case management for homeless persons: a systematic review.

    Science.gov (United States)

    de Vet, Renée; van Luijtelaar, Maurice J A; Brilleslijper-Kater, Sonja N; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D; Wolf, Judith R L M

    2013-10-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness.

  8. Effectiveness of Case Management for Homeless Persons: A Systematic Review

    Science.gov (United States)

    de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.

    2013-01-01

    We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309

  9. Energy and environmental quality: case histories of impact management

    International Nuclear Information System (INIS)

    1981-06-01

    A discussion of energy source devlopments and environmental protection dealing with impacts, and legal aspects of pollution controls and resource management, and case history studies of major energy projects is presented

  10. Electronic Freight Management Case Studies : a Summary of Results

    Science.gov (United States)

    2012-04-01

    The Electronic Freight Management (EFM) initiative is a USDOT-sponsored project that applies Web technologies that improve data and message transmissions between supply chain partners. The EFM implementation case studies contained in this document ex...

  11. Organizational diversity and disability management: Dutch cases

    NARCIS (Netherlands)

    Kopnina, H.; Haafkens, J.

    2009-01-01

    Recent EU initiatives promote employability of the growing number of the chronically ill and disabled employees. While HRM professionals and managers could play a significant role in the prevention of job-related problems and in promotion of early job-continuation, the chronically ill remain largely

  12. Proceedings of the CASE Management Workshop

    Science.gov (United States)

    1992-09-01

    Usability, Reliability, Pro- ductivity, Stability) model [ FURPS 90]. FURPS defines a one dimensional partition of metrics that can be combined...SEI-92-TR-6 55 Proceaa modeling Configuration management Version control Workflow contro Quality assurance Requirements tracking Metrics...the software development process. His primary theme was that software productivity, quality , and costs cannot be explained outside the context where

  13. Knowledge Management for Sustainable Development: The Case ...

    African Journals Online (AJOL)

    This paper seeks to demonstrate that knowledge management (KM) is a function of sustainable development (SD). The authors define the two concepts and discuss both the factors that make for successful SD process and the challenges that characterize KM. The conclusion reached is hat KM is emerging as a powerful ...

  14. Managing children's postural risk when using mobile technology at home: Challenges and strategies.

    Science.gov (United States)

    Ciccarelli, Marina; Chen, Janice D; Vaz, Sharmila; Cordier, Reinie; Falkmer, Torbjörn

    2015-11-01

    Maintaining the musculoskeletal health of children using mobile information and communication technologies (ICT) at home presents a challenge. The physical environment influences postures during ICT use and can contribute to musculoskeletal complaints. Few studies have assessed postures of children using ICT in home environments. The present study investigated the Rapid Upper Limb Assessment (RULA) scores determined by 16 novice and 16 experienced raters. Each rater viewed 11 videotaped scenarios of a child using two types of mobile ICT at home. The Grand Scores and Action Levels determined by study participants were compared to those of an ergonomist experienced in postural assessment. All postures assessed were rated with an Action Level of 2 or above; representing a postural risk that required further investigation and/or intervention. The sensitivity of RULA to assess some of the unconventional postures adopted by children in the home is questioned. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  15. [MATCHE: Management Approach to Teaching Consumer and Homemaking Education.] Consumer Approach Strand: Housing. Module I-B-4: Shopping for a Home Loan.

    Science.gov (United States)

    California State Univ., Fresno. Dept. of Home Economics.

    This competency-based preservice home economics teacher education module on shopping for a home loan is the fourth in a set of six modules on consumer education related to housing. (This set is part of a larger series of sixty-seven modules on the Management Approach to Teaching Consumer and Homemaking Education [MATCHE]--see CE 019 901-967.)…

  16. Dynamic Condition Response Graphs for Trustworthy Adaptive Case Management

    DEFF Research Database (Denmark)

    Mukkamala, Raghava Rao; Hildebrandt, Thomas; Slaats, Tijs

    2013-01-01

    semantics that supports both run time changes and formal verification. We show how these techniques are being implemented in industry as a component of the Exformatics case management tools. Finally we discuss the planned future work, which will aim to allow changes to be tested for conformance wrt policies...... specified either as linear time logic (LTL) or DCR Graphs, extend the language with time and data and offer extended support for cross-organizational case management systems....

  17. Congenital eversion of upper eyelids: Case report and management

    Directory of Open Access Journals (Sweden)

    Maheshwari Rajat

    2006-01-01

    Full Text Available Congenital eversion of the upper eyelids is a rare condition, the exact cause of which remains unknown. It is more frequently associated with Down′s syndrome and black babies. If diagnosed early and treated properly, the condition can be managed without surgery. We report a case of congenital bilateral severe upper eyelid eversion in a normal infant, born by vaginal delivery. The case was conservatively managed by lubricants, antibiotics and eyelid patching.

  18. Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

    Science.gov (United States)

    Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

    2015-01-01

    This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.

  19. A randomized controlled trial to assess effectiveness of a nurse-led home-based heart failure management program

    Directory of Open Access Journals (Sweden)

    Mamata Rai

    2017-01-01

    Full Text Available Introduction: The burden of cardiovascular disease is increasing in India. It is a chronic condition, and poor management can increase the risk and frequency of acute episodes resulting in poor quality of life (QOL, frequent hospital admissions, and mortality. Disease management programs can improve medication adherence and patient's QOL. Objective: The aim of this study is to assess the effectiveness of nurse-led home-based heart failure management program (HOME-N. Materials and Methods: This randomized controlled trial was conducted among fifty outpatient heart failure (HF patients visiting a tertiary care hospital. The control group received usual routine care, whereas the experimental group received HOME-N, which included formal health teaching, a HF checklist (Hriday card, telemonitoring of vital parameters (blood pressure, heart rate, and weight weekly through a mobile application named as “Dhadkan” and telephonic follow-up for 3 months. Kansas City Cardiomyopathy Questionnaire (KCCQ and adherence to refills and medications scale were used to assess QOL and drug adherence, respectively, in the study patients. The outcome measures were the QOL, drug compliance, hospitalization, and mortality rate. Results: At baseline, the demographic and morbidity profile, and QOL and drug compliance scores of both groups were comparable. After intervention, the QOL domain score of KCCQ as well as drug compliance improved significantly both within the experimental group (P = 0.001, P = 0.001 and as compared to control group (P = 0.001, P = 0.004, respectively. Conclusion: The HOME-N was significantly effective in improving QOL and drug compliance in HF patients.

  20. Nursing case management in the millennium. Two perspectives.

    Science.gov (United States)

    Coile, R C; Matthews, P

    1999-01-01

    To prepare case managers for the next millennium, Russell Coile, a noted healthcare futurist, and Pamela Matthews, a respected clinician and consultant, participate in a dialogue. Coile takes a broad view of millennial issues, while Matthews responds to those issues with her clinician's perspective. Case management will face challenges and opportunities as a result of internal and external pressures to the healthcare community. These pressures, both near- and far-term, will simultaneously strengthen and tax the case manager's responsibilities. Developments in technology and demands for more and better access to high-quality patient information will require nursing case managers to expand their knowledge of, and influence over, the application of technology and information systems. Case managers will need to participate in advocating, planning, and deploying these systems. Technological challenges will not change case managers' fundamental roles within an organization, but they will strengthen and support those roles by harnessing the information necessary to allow more efficient outcomes, create standards of care, and increase patient satisfaction.

  1. Strategic management in institutions of higher learning: the case of ...

    African Journals Online (AJOL)

    The strategic perspective in which an institution of higher learning is managed aims at ensuring that clear goals and objectives are specified by moving away from routine traditional orientation to management by considering in a systematic way, longer–term considerations of the very future of the institution. In the case of a ...

  2. Data management for genomic mapping applications: A case study

    Energy Technology Data Exchange (ETDEWEB)

    Markowitz, V.M.; Lewis, S.; McCarthy, J.; Olken, F.; Zorn, M.

    1992-05-01

    In this paper we describe a new approach to the construction of data management systems for genomic mapping applications in molecular biology, genetics, and plant breeding. We discuss the architecture of such systems and propose an incremental approach to the development of such systems. We illustrate the proposed approach and architecture with a case study of a prototype data management system for genomic maps.

  3. Case Report Challenges of stroke management in resource-limited ...

    African Journals Online (AJOL)

    personnel, and specific drugs. In this paper, through a case managed at Queen Elizabeth Central Hospital (QECH) in. Blantyre, we discuss the challenges of stroke management in resource-limited settings, provide practical tips for general practitioners, and reflect on the potential avenues for short- and long-term action.

  4. Human capital management in a knowledge economy: The case of ...

    African Journals Online (AJOL)

    This research aims to examine the existence of the human capital management through competencies and knowledge management approach in Scientific Research Centers within knowledge based economy. The study was applied to the case of Scientific Research Centers in Algeria, such as: (CREAD, CRSTRA, CDTA, ...

  5. The management of traumatic ankylosis during orthodontics: a case report.

    LENUS (Irish Health Repository)

    McNamara, T G

    2000-01-01

    Dental ankylosis may be a significant complication in orthodontic clinical practice. This case report describes the management of a malocclusion, complicated by an ankylosed maxillary central incisor, which arose during orthodontic treatment, following an acute traumatic injury. The use of the ankylosed incisor in successfully managing the significant Class II division 1 malocclusion is described.

  6. Surgical Management of Hydatid Liver Cysts: A Case report. EBFK ...

    African Journals Online (AJOL)

    user

    2004-05-17

    May 17, 2004 ... Surgical Management of Hydatid Liver Cysts: A Case report. EBFK Odimba, M. Nthele, D. Ndjovu. ... hypochondrium complaints usually presents a diagnostic and management challenge to the surgeon, especially in clinically high risky patients. .... before the definite suction. (Fig. 2). The pericyst was.

  7. Shift manager workload assessment - A case study

    International Nuclear Information System (INIS)

    Berntson, K.; Kozak, A.; Malcolm, J. S.

    2006-01-01

    In early 2003, Bruce Power restarted two of its previously laid up units in the Bruce A generating station, Units 3 and 4. However, due to challenges relating to the availability of personnel with active Shift Manager licenses, an alternate shift structure was proposed to ensure the safe operation of the station. This alternate structure resulted in a redistribution of responsibility, and a need to assess the resulting changes in workload. Atomic Energy of Canada Limited was contracted to perform a workload assessment based on the new shift structure, and to provide recommendations, if necessary, to ensure Shift Managers had sufficient resources available to perform their required duties. This paper discusses the performance of that assessment, and lessons learned as a result of the work performed during the Restart project. (authors)

  8. Contingency for Cost Control in Project Management: A Case Study

    OpenAIRE

    Jackson, Gary

    2012-01-01

    This paper provides a case study of the application of cost management techniques for project management of capital works within a major Australian electricity corporation. Historical data was collected from the corporation's archived files to establish the performance status of completed capital works projects. A survey of the corporation's project staff was also conducted to determine the current usage of cost management techniques and further explore the findings of the historical data sea...

  9. Performance management in a family business: a case study

    OpenAIRE

    Silva, Paulino; Silva, Rui

    2014-01-01

    This research, still at an early stage, and then presented in a poster format, intended to explain the management of organizational performance of a family business in the succession process using the case study method. The scripts for semi-structured interviews that will apply to managers, owners and other workers who are deemed suitable for the investigation, which include relatives of the owners of the company are being developed. For this work the model of organizational performance manag...

  10. The management of premolar supernumeraries in three orthodontic cases.

    LENUS (Irish Health Repository)

    McNamara, C M

    1997-01-01

    This paper reviews the incidence, etiology and location of supernumerary teeth with emphasis on premolar supernumeraries and examines the management of supernumerary premolars of three patients undergoing orthodontics. These cases demonstrate that the management of premolars is assessed individually and treatments based on potential complications, which may occur during the orthodontic and surgical management of the dentition. Progress and posttreatment radiographs are recommended for the assessment of late forming supernumerary teeth.

  11. Process management in healthcare. Sant Camil Hospital case study

    OpenAIRE

    Sánchez Ruiz, Lidia; Blanco Rojo, Beatriz; Simón, Rosa María

    2013-01-01

    Nowadays due to the crisis, some government measures are aimed at reducing healthcare spending, affecting in some level or another the quality offered. Process management is said to be a useful tool for reducing healthcare costs by improving management without any additional economic investment. That is doing more with the same resources and without reducing the quality offered. In this study an empirical case of a Catalan hospital is presented. Overall, the usefulness of process management i...

  12. Role of Academic Managers in Workload and Performance Management of Academic Staff: A Case Study

    Science.gov (United States)

    Graham, Andrew T.

    2016-01-01

    This small-scale case study focused on academic managers to explore the ways in which they control the workload of academic staff and the extent to which they use the workload model in performance management of academic staff. The links that exist between the workload and performance management were explored to confirm or refute the conceptual…

  13. Keeping children safe at home: protocol for three matched case-control studies of modifiable risk factors for falls.

    Science.gov (United States)

    Kendrick, Denise; Maula, Asiya; Stewart, Jane; Clacy, Rose; Coffey, Frank; Cooper, Nicola; Coupland, Carol; Hayes, Mike; McColl, Elaine; Reading, Richard; Sutton, Alex; Towner, Elizabeth M L; Watson, Michael Craig

    2012-06-01

    Childhood falls result in considerable morbidity, mortality and health service use. Despite this, little evidence exists on protective factors or effective falls prevention interventions in young children. To estimate ORs for three types of medically attended fall injuries in young children in relation to safety equipment, safety behaviours and hazard reduction and explore differential effects by child and family factors and injury severity. Three multicentre case-control studies in UK hospitals with validation of parental reported exposures using home observations. Cases are aged 0-4 years with a medically attended fall injury occurring at home, matched on age and sex with community controls. Children attending hospital for other types of injury will serve as unmatched hospital controls. Matched analyses will use conditional logistic regression to adjust for potential confounding variables. Unmatched analyses will use unconditional logistic regression, adjusted for age, sex, deprivation and distance from hospital in addition to other confounders. Each study requires 496 cases and 1984 controls to detect an OR of 0.7, with 80% power, 5% significance level, a correlation between cases and controls of 0.1 and a range of exposure prevalences. Falls on stairs, on one level and from furniture. As the largest in the field to date, these case control studies will adjust for potential confounders, validate measures of exposure and investigate modifiable risk factors for specific falls injury mechanisms. Findings should enhance the evidence base for falls prevention for young children.

  14. Management of shoulder dysfunction with an alternative model of orthopaedic physical therapy intervention: a case report.

    Science.gov (United States)

    Holmes, C F; Fletcher, J P; Blaschak, M J; Schenck, R C

    1997-12-01

    One common approach to patient care in dealing with many musculoskeletal dysfunctions involves two to three patient visits to physical therapy per week over a period of weeks. Some patients may benefit from an alternative, graduated treatment model emphasizing a minimal number of office visits and focusing on intensive patient education, home program therapeutic exercise, and specific manual interventions. Patient education focuses on home program compliance and empowerment of the patient by adjusting office visits as needed based on patient progress rather than multiple patient contacts in the first weeks. This emphasis may improve long-term patient compliance by preventing the development of an external locus of control in which the patient is dependent upon the therapist for management of his/her condition. This case study is an example of the use of this alternative treatment model for the resolution of impingement syndrome and adhesive capsulitis in a 53-year-old female. A comprehensive program of patient education and home exercise was initiated during the first visit. Joint mobilization and active exercise were performed at each subsequent visit. The patient was seen a total of six visits over a period of approximately 10 1/2 weeks, followed up via telephone at 1 month after the last treatment and reexamined after 1 year. The objective exam revealed no abnormalities after the last visit or after 1 year. The patient subjectively reported compliance with the home program for 6 months after the last visit. This model of patient care was successful for the patient described in this case study. The treatment approach may have contributed to the development of an internal locus of control by allowing the patient to be as actively involved as possible in the treatment of her condition. In addition, this approach is timely when one considers current reimbursement systems. Though successful with this patient, this graduated treatment model is not intended to be

  15. Family physicians' ability to perform population management is associated with adoption of other aspects of the patient-centered medical home.

    Science.gov (United States)

    Ottmar, Jessica; Blackburn, Brenna; Phillips, Robert L; Peterson, Lars E; Jaén, Carlos Roberto

    2015-04-01

    The patient-centered medical home (PCMH) model is considered a promising approach to improving population health, but how elements of these advanced practice models relate to population health capability is unknown. To measure associations between family physicians' performance of population management with PCMH components, a cross-sectional survey was conducted with physicians accessing the American Board of Family Medicine Web site in 2011. Bivariate analysis and logistic regression tested associations between physician and practice demographics and specific PCMH features. The primary outcome was performance of population management. The final sample included 3855 physicians, 37.3% of whom reported performing population management. Demographic characteristics significantly associated with greater use of population management were female sex and graduation from an international medical school. PCMH components that remained associated with population management after adjustment were access to clinical case managers (odds ratio [OR]=2.01, 95% confidence interval [95% CI]: 1.69, 2.39), behavioral health collaboration (OR=1.49, 95% CI: 1.26, 1.77), having an electronic health record that supports meaningful use (OR=1.47, 95% CI: 1.25, 1.74), recent participation in a quality improvement project (OR=2.47, 95% CI: 2.12, 2.89), and routine measurement of patient difficulty securing an appointment (OR=2.87, 95% CI: 2.45, 3.37). Performance of population management was associated with several PCMH elements and resources not present in traditional primary care offices. Attention to these elements likely will enhance delivery of population management services in primary care.

  16. Covert Conditioning: Case Studies in Self-Management.

    Science.gov (United States)

    Yager, Geoffrey G.

    The self-management of thoughts and mental images was used in a series of empirical case studies to influence behavior changes. The target behaviors in the cases reported were smoking, overeating, fingernail biting, thinking self-depreciative thoughts, and responding assertively. Self-monitoring, covert positive reinforcement, covert…

  17. Teaching Cases in Management - Cordilheira de Santana

    Directory of Open Access Journals (Sweden)

    Astor Eugênio Hexsel

    2011-01-01

    Full Text Available The Cordilheira de Santana case, from now on referred to simply as Cordilheira, was conducted and reported with the main purpose of contributing to the understanding of the process of strategy formulation in the winery sector. It presents the case of a recently created small firm aiming to compete in the market by offering high quality based on reduced premium line products, with prices established in accordance. Even so, it has not achieved the expected results. The wine industry with its basis in the wineries of the extreme south of Brazil, which is the most productive sector in the whole country, is also discussed. The case study began in 2008, when Rosana, owner and director of the company, travelled from São Paulo to Porto Alegre and highly concerned that the expected results had not been achieved. Data included as a technical note on the wine industry provides information on the industry as a whole, enabling students to reconsider the firm´s positioning in the market. The teaching note that follows provides the professor with information that will allow him to explore several perspectives that will have to be faced by Rosana further. She may choose to strengthen the present strategy or to take it in a new direction.

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... UOAA). The skills kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Overview The skills kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...