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Sample records for community based home

  1. Volume of Home and Community Based Services and...

    Data.gov (United States)

    U.S. Department of Health & Human Services — Volume of Home- and Community-Based Services and Time to Nursing-Home Placement The purpose of this study was to determine whether the volume of Home and Community...

  2. 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.

  3. Home/community-based services: a two-tier approach.

    Science.gov (United States)

    Aponte, H J; Zarski, J J; Bixenstine, C; Cibik, P

    1991-07-01

    A two-tier model for work with high-risk families is presented. It combines multiple-family groups in the community with home-based family therapy for individual families. The ecostructural conceptual framework of the model is discussed, and its application is illustrated by a case vignette.

  4. Local Medicaid home- and community-based services spending and nursing home admissions of younger adults.

    Science.gov (United States)

    Thomas, Kali S; Keohane, Laura; Mor, Vincent

    2014-11-01

    We used fixed-effect models to examine the relationship between local spending on home- and community-based services (HCBSs) for cash-assisted Medicaid-only disabled (CAMOD) adults and younger adult admissions to nursing homes in the United States during 2001 through 2008, with control for facility and market characteristics and secular trends. We found that increased CAMOD Medicaid HCBS spending at the local level is associated with decreased admissions of younger adults to nursing homes. Our findings suggest that states' efforts to expand HCBS for this population should continue.

  5. Do Medicaid home and community based service waivers save money?

    Science.gov (United States)

    Harrington, Charlene; Ng, Terence; Kitchener, Martin

    2011-10-01

    This article estimates the potential savings to the Medicaid program of using 1915c Home and Community Based Services (HCBS) waivers rather than institutional care. For Medicaid HCBS waiver expenditures of $25 billion in 2006, we estimate the national savings to be over $57 billion, or $57,338 per waiver participant in 2006 compared with the cost of Medicaid institutional care (for which all waiver participants are eligible). When taking into account a potential 50% "woodwork effect" (for people who might have refused institutional services), the saving would be $21 billion. This analysis demonstrates that HCBS waiver programs present significant direct financial savings to Medicaid long-term care (LTC) programs.

  6. Community Nursing Home (CNH)

    Data.gov (United States)

    Department of Veterans Affairs — The Community Nursing Home (CNH) database contains a list of all Community Nursing Home facilities under local contract to Veterans Health Administration (VHA). CNH...

  7. A comparison of home care clients and nursing home residents: can community based care keep the elderly and disabled at home?

    Science.gov (United States)

    Shugarman, L R; Fries, B E; James, M

    1999-01-01

    Admission cohorts from the Michigan Medicaid Home and Community-Based Waiver program and Ohio nursing homes were compared on measures of resource utilization including a modified Resource Utilization Groups (RUG-III) system, Activities of Daily Living (ADLs), and overall case mix. We found that, contrary to previous research, the two samples were remarkably similar across RUG-III categories. However, the nursing home sample was more functionally impaired on measures of ADL functioning and overall case mix. Results of this study may inform policymakers and providers of the potential for maintaining the appropriate population in the home with government-funded home care.

  8. Home Based Training: Main Strategy in Community Based Rehabilitation in Iran

    Directory of Open Access Journals (Sweden)

    Peiman Salamati

    2006-10-01

    Full Text Available Objective: Study of effectiveness of “home based training” in community based rehabilitation program on disabled people, under supervised of 21 pilot cities health and medical networks, who were trained and evaluated at the end of the course. Materials & Methods: In a cross-sectional study, 614 disabled people who had participated in “home based training” were selected with stratified random sampling method. They were evaluated according to function progress level variables by community based rehabilitation programme experts. Age, sex, disability groups, employment state and teacher’s relation variables were studied from their files and recording datas. Statistical analysis was performed with Chi-square test. Results: There was a relationship between age group and disability group with functional progress level (P = 0.014 & P <0.001. Low age groups, visional disabled group, epileptic patients and individuals with learning problems had the best results. High age groups, mixed disability group and individuals with verbal and hearing problems had the least results. There was a relationship between teacher’s relation with progress or nonprogress state (P = 0.038. Individuals that they were own teachers had the best results and individuals with teachers other than first or second relation or health worker had the least results. Conclusion: Home based training in community based rehabilitation programme is an effective method for improving disabled people in some selected groups.

  9. CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

    Science.gov (United States)

    Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

    2018-05-01

    The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

  10. Place of death among older Americans: does state spending on home- and community-based services promote home death?

    Science.gov (United States)

    Muramatsu, Naoko; Hoyem, Ruby L; Yin, Hongjun; Campbell, Richard T

    2008-08-01

    The majority of Americans die in institutions although most prefer to die at home. States vary greatly in their proportion of home deaths. Although individuals' circumstances largely determine where they die, health policies may affect the range of options available to them. To examine whether states' spending on home- and community-based services (HCBS) affects place of death, taking into consideration county health care resources and individuals' family, sociodemographic, and health factors. Using exit interview data from respondents in the Health and Retirement Study born in 1923 or earlier who died between 1993 and 2002 (N = 3362), we conducted discrete-time survival analysis of the risk of end-of-life nursing home relocation to examine whether states' HCBS spending would delay or prevent end-of-life nursing home admission. Then we ran logistic regression analysis to investigate the HCBS effects on place of death separately for those who relocated to a nursing home and those who remained in the community. Living in a state with higher HCBS spending was associated with lower risk of end-of-life nursing home relocation, especially among people who had Medicaid. However, state HCBS support was not directly associated with place of death. States' generosity for HCBS increases the chance of dying at home via lowering the risk of end-of-life nursing home relocation. State-to-state variation in HCBS spending may partly explain variation in home deaths. Our findings add to the emerging encouraging evidence for continued efforts to enhance support for HCBS.

  11. An evaluation of the implementation of integrated community home-based care services in Vhembe District, South Africa

    Directory of Open Access Journals (Sweden)

    Gandi J Moetlo

    2011-01-01

    Conclusion: Community home-based caregivers are largely able to implement home-based care services but would need more support (training, financial, career structure, and health system to improve on their services.

  12. 42 CFR 436.217 - Individuals receiving home and community-based services.

    Science.gov (United States)

    2010-10-01

    ... THE VIRGIN ISLANDS Options for Coverage as Categorically Needy Options for Coverage of Families and... receiving home and community-based services. The agency may provide Medicaid to any group or groups of individuals in the community who meet the following requirements: (a) The group would be eligible for Medicaid...

  13. Community-based home-care program for the management of pre-eclampsia: an alternative.

    OpenAIRE

    Helewa, M; Heaman, M; Robinson, M A; Thompson, L

    1993-01-01

    OBJECTIVE: To evaluate the safety, acceptability and cost of a community-based home-care program for the management of mild pre-eclampsia. DESIGN: A descriptive study of outcomes between Apr. 1, 1985, and Dec. 31, 1989. SETTING: St. Boniface General Hospital, Winnipeg. PATIENTS: Urban Winnipeg residents between 27 and 40 weeks' gestation with mild pre-eclampsia who demonstrated acceptance and compliance with home-care management; 321 patients of 1330 were enrolled in the program. INTERVENTION...

  14. Using conflict theory to explore the role of nursing home social workers in home- and community-based service utilization.

    Science.gov (United States)

    Fogler, Sarah

    2009-11-01

    Nursing home social work (NHSW) practitioners are central to home- and community-based service (HCBS) utilization. They assist residents with long-term care (LTC) decision-making and coordinate community-based LTC supports and services for older adults transitioning back into the community after a rehabilitative nursing home (NH) stay. As members of multiple groups, they must simultaneously balance the needs of NH residents, the NH organization, and social policies related to LTC. To date, policy research on HCBS has been atheoretical in that it has not accounted for the possible inherent conflicts that adversely affect the discharge planning practices of NHSW practitioners. This article applies the Conflict Theory to (a) explore the competing interests of the NH industry and the nation's government, (b) examine the potential effect of these competing interests on the effectiveness of NHSW discharge planning practices, and (c) present a conceptual framework to further investigate the relationship between NHSW and both individual LTC outcomes and national policy initiatives aimed at increasing HCBS utilization.

  15. Medicaid 1915(c) Home- and Community-Based Services Waivers for Children with Autism Spectrum Disorder

    Science.gov (United States)

    Velott, Diana L.; Agbese, Edeanya; Mandell, David; Stein, Bradley D.; Dick, Andrew W.; Yu, Hao; Leslie, Douglas L.

    2016-01-01

    This research aims to describe the characteristics of 1915(c) Home- and Community-Based Services waivers for children with autism spectrum disorder across states and over time. While increasingly popular, little is known about these Medicaid waivers. Understanding the characteristics of these programs is important to clinicians and policymakers in…

  16. Toward smoke-free homes: A community-based study on initiatives of rural Indian women.

    Science.gov (United States)

    Mittal, Srabani; Das, Samiran

    2011-05-01

    Since the home is the primary source of exposure of children to second-hand smoke (SHS), measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children's exposure to SHS at home. A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7%) was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Women's initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.

  17. Toward smoke-free homes: A community-based study on initiatives of rural Indian women

    Directory of Open Access Journals (Sweden)

    Srabani Mittal

    2011-01-01

    Full Text Available Context: Since the home is the primary source of exposure of children to second-hand smoke (SHS, measures to restrict smoking at home should be introduced to protect children from its adverse health consequences. Aims: Objectives of the study were to assess the level of awareness of rural Indian women on the health impacts of SHS on children and to look into the strategies they used to reduce children′s exposure to SHS at home. Materials and Methods: A community-based cross-sectional study was conducted among 438 rural women using a survey questionnaire. Information on socio-demographic characteristics, knowledge on specific health effects of SHS on children, and attitude toward having a smoke-free home were collected. The perceived reasons that made it difficult to have smoke-free homes were also explored. Results: A total of 75.8% of women agreed that SHS was a serious health risk for children. Knowledge on health impacts of SHS on children identified asthma as the most common problem. Smoking by husbands (89.7% was the major source of exposure to SHS at home. While 67.6% of women reported having taken measures to limit SHS exposure in their homes, only 12.8% of them had tried to introduce a complete ban on smoking at home. On a five-point evaluation scale, 73.3% of the women indicated a failure of their initiatives to have smoke-free homes. Conclusions: Women′s initiatives to introduce restrictions on smoking at home had very limited success and did not produce an appreciable change in smoking behavior at home. Lack of empowerment of women in rural India probably rendered the interventional measures ineffective.

  18. Innovation in a Learning Health Care System: Veteran-Directed Home- and Community-Based Services.

    Science.gov (United States)

    Garrido, Melissa M; Allman, Richard M; Pizer, Steven D; Rudolph, James L; Thomas, Kali S; Sperber, Nina R; Van Houtven, Courtney H; Frakt, Austin B

    2017-11-01

    A path-breaking example of the interplay between geriatrics and learning healthcare systems is the Veterans Health Administration's (VHA's) planned roll-out of a program for providing participant-directed home- and community-based services to veterans with cognitive and functional limitations. We describe the design of a large-scale, stepped-wedge, cluster-randomized trial of the Veteran-Directed Home- and Community-Based Services (VD-HCBS) program. From March 2017 through December 2019, up to 77 Veterans Affairs Medical Centers will be randomized to times to begin offering VD-HCBS to veterans at risk of nursing home placement. Services will be provided to community-dwelling participants with support from Aging and Disability Network Agencies. The VHA Partnered Evidence-based Policy Resource Center (PEPReC) is coordinating the evaluation, which includes collaboration from operational stakeholders from the VHA and Administration for Community Living and interdisciplinary researchers from the Center of Innovation in Long-Term Services and Supports and the Center for Health Services Research in Primary Care. For older veterans with functional limitations who are eligible for VD-HCBS, we will evaluate health outcomes (hospitalizations, emergency department visits, nursing home admissions, days at home) and healthcare costs associated with VD-HCBS availability. Learning healthcare systems facilitate diffusion of innovation while enabling rigorous evaluation of effects on patient outcomes. The VHA's randomized rollout of VD-HCBS to veterans at risk of nursing home placement is an example of how to achieve these goals simultaneously. PEPReC's experience designing an evaluation with researchers and operations stakeholders may serve as a framework for others seeking to develop rapid, rigorous, large-scale evaluations of delivery system innovations targeted to older adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  19. Older adults’ home- and community-based care service use and residential transitions: a longitudinal study

    Directory of Open Access Journals (Sweden)

    Chen Ya-Mei

    2012-08-01

    Full Text Available Abstract Background As Home-and Community-Based Services (HCBS, such as skilled nursing services or personal care services, have become increasingly available, it has become clear that older adults transit through different residential statuses over time. Older adults may transit through different residential statuses as the various services meet their needs. The purpose of this exploratory study was to better understand the interplay between community-dwelling older adults’ use of home- and community-based services and their residential transitions. Methods The study compared HCBS service-use patterns and residential transitions of 3,085 older adults from the Second Longitudinal Study of Aging. Based on older adults’ residential status at the three follow-up interviews, four residential transitions were tracked: (1 Community-Community-Community (CCC: Resided in community during the entire study period; (2 Community-Institution-Community (CIC: Resided in community at T1, had lived in an institution at some time between T1 and T2, then had returned to community by T3; (3 Community-Community-Institution (CCI: Resided in community between at T1, and betweenT1 and T2, including at T2, but had used institutional services between T2 and T3; (4 Community-Institution-Institution (CII: Resided in community at T1 but in an institution at some time between T1 and T2, and at some time between T2 and T3.. Results Older adults’ use of nondiscretionary and discretionary services differed significantly among the four groups, and the patterns of HCBS use among these groups were also different. Older adults’ use of nondiscretionary services, such as skilled nursing care, may help them to return to communities from institutions. Personal care services (PCS and senior center services may be the key to either support elders to stay in communities longer or help elders to return to their communities from institutions. Different combinations of PCS with other

  20. Home and Community-Based Service Use by Vulnerable Older Adults.

    Science.gov (United States)

    Weaver, Raven H; Roberto, Karen A

    2017-06-01

    The purpose of this study was to identify different types of clients who use home and community-based services. Enrollment characteristics of 76 clients at risk of nursing home placement and Medicaid spend-down who were enrolled in the Virginia Community Living Program were analyzed. Two-step cluster analysis identified 4 groups of service users. Enabling resources (caregiver relationship to participant, participant living arrangement, and length of time caregiver provided assistance to participant) and disability type (physical, cognitive, traumatic brain injury, or other) differentiated the client groups. Groups differed on average service cost per day and likelihood of nursing home placement if services were not provided. Findings point to the value of having practitioners assist vulnerable clients in tailoring services to meet different care needs and the need for refining policies guiding home and community-based care. © The Author 2015. 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.

  1. Impact of Pharmacists in a Community-Based Home Care Service: A Pilot Program.

    Science.gov (United States)

    Walus, Ashley N; Woloschuk, Donna M M

    2017-01-01

    Historically, pharmacists have not been included on home care teams, despite the fact that home care patients frequently experience medication errors. Literature describing Canadian models of pharmacy practice in home care settings is limited. The optimal service delivery model and distribution of clinical activities for home care pharmacists remain unclear. The primary objective was to describe the impact of a pharmacist based at a community home care office and providing home visits, group education, and telephone consultations. The secondary objective was to determine the utility of acute care clinical pharmacy key performance indicators (cpKPIs) in guiding home care pharmacy services, in the absence of validated cpKPIs for ambulatory care. The Winnipeg Regional Health Authority hired a pharmacist to develop and implement the pilot program from May 2015 to July 2016. A referral form, consisting of consultation criteria used in primary care practices, was developed. The pharmacist also reviewed all patient intakes and all patients waiting in acute care facilities for initiation of home care services, with the goal of addressing issues before admission to the Home Care Program. A password-protected database was built for data collection and analysis, and the data are presented in aggregate. A total of 197 referrals, involving 184 patients, were received during the pilot program; of these, 62 were excluded from analysis. The majority of referrals (95 [70.4%]) were for targeted medication reviews, and 271 drug therapy problems were identified. Acceptance rates for the pharmacist's recommendations were 90.2% (74 of 82 recommendations) among home care staff and 47.0% (55 of 117 recommendations) among prescribers and patients. On average, 1.5 cpKPIs were identified for each referral. The pilot program demonstrated a need for enhanced access to clinical pharmacy services for home care patients, although the best model of service provision remains unclear. More research

  2. Fall risk factors in community-dwelling elderly who receive Medicaid-supported home- and community-based care services.

    Science.gov (United States)

    Yamashita, Takashi; Jeon, Haesang; Bailer, A John; Nelson, Ian M; Mehdizadeh, Shahla

    2011-06-01

    This study identifies fall risk factors in an understudied population of older people who receive community-based care services. Data were collected from enrollees of Ohio's Medicaid home- and community-based waiver program (preadmission screening system providing options and resources today [PASSPORT]). A total of 23,182 participants receiving PASSPORT services in 2005/2006 was classified as fallers and nonfallers, and a variety of risk factors for falling was analyzed using logistic regressions. The following factors were identified as risk factors for falling: previous fall history, older age, White race, incontinence, higher number of medications, fewer numbers of activity of daily living limitations, unsteady gait, tremor, grasping strength, and absence of supervision. Identifying risk factors for the participants of a Medicaid home- and community-based waiver program are useful for a fall risk assessment, but it would be most helpful if the community-based care service programs incorporate measurements of known fall risk factors into their regular data collection, if not already included.

  3. A review of community-based solar home system projects in the Philippines

    Directory of Open Access Journals (Sweden)

    Macabebe Erees Queen B.

    2016-01-01

    Full Text Available Solar Home Systems (SHS are easy to deploy in island and in remote communities where grid connection is costly. However, issues related to maintenance of these systems emerge after they are deployed because of the remoteness and inaccessibility of the communities. This study looked into community-based programs in the Philippines and investigated the following: (1 social preparation, (2 role of the community in the project, and (3 sustainability of the program. In this paper, three communities under two government programs offering SHS are presented. These programs are the Solar Power Technology Support (SPOTS program of the Department of Agrarian Reform (DAR and the Household Electrification Program (HEP of the Department of Energy (DOE. A focused group discussion and key informant interviews were conducted in two communities in Bukidnon province and in a community in Kalinga to obtain information from the project beneficiaries and SHS users on the preparation, implementation and maintenance of the projects. The results revealed that emphasis on the economic value of the technology, proper training of the locals on the technical and management aspects of the project, as well as the establishment of a supply chain for replacement parts are crucial factors for the sustainability of the programs.

  4. Capacity and readiness for quality improvement among home and community-based service providers.

    Science.gov (United States)

    Abrahamson, Kathleen; Myers, Jaclyn; Arling, Greg; Davila, Heather; Mueller, Christine; Abery, Brian; Cai, Yun

    2016-01-01

    The objective of this study was to explore home and community-based service (HCBS) providers' perspectives of organizational readiness for quality improvement (QI). Data were obtained from a survey of participants (N = 56) in a state-sponsored HCBS QI initiative. Quality improvement challenges included lack of time and resources, staff apprehension or resistance, resistance from consumers and families, and project sustainability. Support from leadership was viewed as an important factor in participating organizations' decision to engage in QI. Internal resources available to support QI varied widely between participating organizations, with differences observed between smaller and larger agencies, as well as between provider types and populations served.

  5. 38 CFR 17.57 - Use of community nursing homes.

    Science.gov (United States)

    2010-07-01

    ... MEDICAL Use of Community Nursing Home Care Facilities § 17.57 Use of community nursing homes. (a) Nursing home care in a contract public or private nursing home facility may be authorized for the following... currently receiving VA hospital based home health services. (Authority: 38 U.S.C. 1720; sec. 108, Pub. L. 99...

  6. Medicaid program; state plan home and community-based services, 5-year period for waivers, provider payment reassignment, and home and community-based setting requirements for Community First Choice and home and community-based services (HCBS) waivers. Final rule.

    Science.gov (United States)

    2014-01-16

    This final rule amends the Medicaid regulations to define and describe state plan section 1915(i) home and community-based services (HCBS) under the Social Security Act (the Act) amended by the Affordable Care Act. This rule offers states new flexibilities in providing necessary and appropriate services to elderly and disabled populations. This rule describes Medicaid coverage of the optional state plan benefit to furnish home and community based-services and draw federal matching funds. This rule also provides for a 5-year duration for certain demonstration projects or waivers at the discretion of the Secretary, when they provide medical assistance for individuals dually eligible for Medicaid and Medicare benefits, includes payment reassignment provisions because state Medicaid programs often operate as the primary or only payer for the class of practitioners that includes HCBS providers, and amends Medicaid regulations to provide home and community-based setting requirements related to the Affordable Care Act for Community First Choice State plan option. This final rule also makes several important changes to the regulations implementing Medicaid 1915(c) HCBS waivers.

  7. Should we really be promoting home or community-based malaria ...

    African Journals Online (AJOL)

    Aim:To determine household's practices in utilization of home treatment for childhood malaria and explore their implications for improving prompt appropriate care in communities. Methods: Questionnaires were administered to women from randomly selected households with previous month history of childhood malaria in ...

  8. Surmounting difficulties to provide home based neonatal care - reflections of community health workers.

    Science.gov (United States)

    Prabhughate, Abhijit Shrinivas; Tiwari, Pearl; Sohoni, Shubhangi; Morgaonkar, Vallaree Anant; Phatak, Ajay Gajanan; Nimbalkar, Somashekhar Marutirao; Mahajani, Anagha Anand

    2018-01-15

    In India, community health workers' (CHW) effectiveness in providing home-based neonatal care (HBNC) has been well documented. The nature of challenges faced and strategies adopted while providing HBNC services need to be studied in-depth. A qualitative study to understand the challenges faced and strategies used by Sakhis (women CHW) while providing services as part of a HBNC program implemented by a non-profit organization. Data consisted of 20 in-depth interviews and three focus group discussions (FGD) with Sakhis. Sakhis negotiated with the community to start working as a CHW. They faced challenges while changing behaviors at individual level and also while bringing about a change in harmful normative practices that increased chances of maternal and neonatal mortality. Managing crises at the time of deliveries and facilitating a safe delivery was the most critical challenge faced by many Sakhis. The key strategies used by Sakhis included: proactively and persistently providing services even when they faced resistance from the woman or her family; evolving contextually suitable counseling techniques and tactics to bring about behavioral change; balancing compliance to traditional practices and promoting HBNC; defying traditional practices and assisting the woman in times of an emergency to save lives. Having on-call support from supervisors and cultivating a good working relationship with health providers facilitated effective service provision by Sakhis. CHWs having a strong sense of commitment can develop strategies to address challenges and provide HBNC services effectively if they also have strong supervisory support.

  9. Evaluation of a Home-Based Hospice and Palliative Care Program in a Community Health Center in Korea

    Directory of Open Access Journals (Sweden)

    Su Hyun Kim

    2009-03-01

    Conclusions: A home-based palliative service program delivered by the community health center appears to be an appropriate care model for managing physical symptoms. Reinforcing services for psychosocial and spiritual counseling and encouraging affiliation with free-standing inpatient healthcare providers are warranted. [Asian Nursing Research 2009;3(1:24–30

  10. 'Physical activity at home (PAAH)', evaluation of a group versus home based physical activity program in community dwelling middle aged adults: rationale and study design.

    Science.gov (United States)

    Freene, Nicole; Waddington, Gordon; Chesworth, Wendy; Davey, Rachel; Goss, John

    2011-11-24

    It is well recognised that the adoption and longer term adherence to physical activity by adults to reduce the risk of chronic disease is a challenge. Interventions, such as group and home based physical activity programs, have been widely reported upon. However few studies have directly compared these interventions over the longer term to determine their adherence and effectiveness. Participant preference for home based or group interventions is important. Some evidence suggests that home based physical activity programs are preferred by middle aged adults and provide better long term physical activity adherence. Physiotherapists may also be useful in increasing physical activity adherence, with limited research on their impact. 'Physical Activity at Home' is a 2 year pragmatic randomised control trial, with a non-randomised comparison to group exercise. Middle-aged adults not interested in, or unable to attend, a group exercise program will be targeted. Sedentary community dwelling 50-65 year olds with no serious medical conditions or functional impairments will be recruited via two mail outs using the Australian federal electoral roll. The first mail out will invite participants to a 6 month community group exercise program. The second mail out will be sent to those not interested in the group exercise program inviting them to take part in a home based intervention. Eligible home based participants will be randomised into a 6 month physiotherapy-led home based physical activity program or usual care. Outcome measures will be taken at baseline, 6, 12, 18 and 24 months. The primary outcome is physical activity adherence via exercise diaries. Secondary outcomes include the Active Australia Survey, accelerometry, aerobic capacity (step test), quality of life (SF-12v2), blood pressure, waist circumference, waist-to-hip ratio and body mass index. Costs will be recorded prospectively and qualitative data will be collected. The planned 18 month follow-up post

  11. Advantages and Disadvantages for Receiving Internet-Based HIV/AIDS Interventions at Home or at Community Based Organization

    Science.gov (United States)

    Green, Shana M.; Lockhart, Elizabeth; Marhefka, Stephanie L.

    2015-01-01

    Within recent years public health interventions have become technologically based to reflect the digital age we currently live in and appeal to the public in innovative and novel ways. The Internet breaks down boundaries distance imposes and increases our ability to reach and connect with people. Internet-based interventions have the potential to expand access to effective behavioral interventions. The US National HIV/AIDS Strategy states that people living with HIV should have access to effective behavioral interventions like Healthy Relationships (HR) to help them develop safe sex and disclosure skills. However, access to HR is limited across the country, especially for people in remote or rural areas. Internet-based Healthy Relationships Video Groups (HR-VG) delivered at home or community based organizations (CBOs) can possibly expand access. This study assesses the preferences of women living with HIV (WLH) for participation in HR-VG among 21 WLH who participated in a randomized control trial (RCT) testing HR-VG and completed open-ended semi-structured telephone interviews. Transcripts were thematically analyzed to determine advantages, disadvantages and overall preference for home or agency delivery of HR-VG. Themes relating to convenience, technology access, privacy, distractions, HIV serostatus disclosure and social opportunities were identified as advantages or disadvantages to participating in HR-VG at each location. Overall privacy was the most salient concern of accessing HR-VG at home or at a CBO. Considering the concerns expressed by WLH, further studies are needed to assess how an Internet-based intervention delivered at home for WLH can maintain privacy while being cost effective. PMID:26357907

  12. Advantages and disadvantages for receiving Internet-based HIV/AIDS interventions at home or at community-based organizations.

    Science.gov (United States)

    Green, Shana M; Lockhart, Elizabeth; Marhefka, Stephanie L

    2015-01-01

    Within recent years, public health interventions have become technology based to reflect the digital age we currently live in and appeal to the public in innovative and novel ways. The Internet breaks down boundaries distance imposes and increases our ability to reach and connect with people. Internet-based interventions have the potential to expand access to effective behavioral interventions (EBIs). The US National HIV/AIDS Strategy states that people living with HIV should have access to EBIs such as healthy relationships (HR) to help them develop safe sex and disclosure skills. However, access to HR is limited across the country, especially for people in remote or rural areas. Internet-based healthy relationships video groups (HR-VG) delivered at home or community-based organizations (CBOs) can possibly expand access. This study assesses the preferences of women living with HIV (WLH) for participation in HR-VG among 21 WLH who participated in a randomized control trial (RCT) testing HR-VG and completed open-ended semi-structured telephone interviews. Transcripts were thematically analyzed to determine advantages and disadvantages of home or CBO delivery of HR-VG. Themes relating to convenience, technology access, privacy, distractions, HIV serostatus disclosure, and social opportunities were identified as advantages or disadvantages to participating in HR-VG at each location. Overall, privacy was the most salient concern of accessing HR-VG at home or at a CBO. Considering the concerns expressed by WLH, further studies are needed to assess how an Internet-based intervention delivered at home for WLH can maintain privacy while being cost effective.

  13. Strategies to Prevent MRSA Transmission in Community-Based Nursing Homes: A Cost Analysis.

    Science.gov (United States)

    Roghmann, Mary-Claire; Lydecker, Alison; Mody, Lona; Mullins, C Daniel; Onukwugha, Eberechukwu

    2016-08-01

    OBJECTIVE To estimate the costs of 3 MRSA transmission prevention scenarios compared with standard precautions in community-based nursing homes. DESIGN Cost analysis of data collected from a prospective, observational study. SETTING AND PARTICIPANTS Care activity data from 401 residents from 13 nursing homes in 2 states. METHODS Cost components included the quantities of gowns and gloves, time to don and doff gown and gloves, and unit costs. Unit costs were combined with information regarding the type and frequency of care provided over a 28-day observation period. For each scenario, the estimated costs associated with each type of care were summed across all residents to calculate an average cost and standard deviation for the full sample and for subgroups. RESULTS The average cost for standard precautions was $100 (standard deviation [SD], $77) per resident over a 28-day period. If gown and glove use for high-risk care was restricted to those with MRSA colonization or chronic skin breakdown, average costs increased to $137 (SD, $120) and $125 (SD, $109), respectively. If gowns and gloves were used for high-risk care for all residents in addition to standard precautions, the average cost per resident increased substantially to $223 (SD, $127). CONCLUSIONS The use of gowns and gloves for high-risk activities with all residents increased the estimated cost by 123% compared with standard precautions. This increase was ameliorated if specific subsets (eg, those with MRSA colonization or chronic skin breakdown) were targeted for gown and glove use for high-risk activities. Infect Control Hosp Epidemiol 2016;37:962-966.

  14. 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

  15. Occupational Therapy in Medicaid Home and Community-Based Services Waivers.

    Science.gov (United States)

    Friedman, Carli; VanPuymbrouck, Laura

    Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. Comparisons across states strengthen the profession's ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs. Copyright © 2018 by the American Occupational Therapy Association, Inc.

  16. Occupational Therapy in Medicaid Home and Community-Based Services Waivers

    Science.gov (United States)

    VanPuymbrouck, Laura

    2018-01-01

    OBJECTIVE. Medicaid Home and Community-Based Services (HCBS) 1915(c) waivers are the largest provider of long-term services and supports for people with intellectual and developmental disabilities (IDDs). In this study, we explored how HCBS IDD waivers projected providing occupational therapy services in Fiscal Year (FY) 2015. METHOD. Medicaid HCBS IDD waivers across the nation gathered from the Centers for Medicare and Medicaid Services were qualitatively and quantitatively analyzed to determine how they projected providing occupational therapy services in terms of service expenditures and utilization. RESULTS. In FY 2015, $14.13 million of spending was projected for occupational therapy services of 7,500 participants. However, there was large heterogeneity across states and services in terms of total projected spending, spending per participant, and reimbursement rates. CONCLUSION. Comparisons across states strengthen the profession’s ability to assert the value of its services. These findings can help identify best practices and can advocate for the refinement of state occupational therapy programs. PMID:29426389

  17. Design and development of a mobile exercise application for home care aides and older adult medicaid home and community-based clients.

    Science.gov (United States)

    Danilovich, Margaret K; Diaz, Laura; Saberbein, Gustavo; Healey, William E; Huber, Gail; Corcos, Daniel M

    2017-01-01

    We describe a community-engaged approach with Medicaid home and community-based services (HCBS), home care aide (HCA), client, and physical therapist stakeholders to develop a mobile application (app) exercise intervention through focus groups and interviews. Participants desired a short exercise program with modification capabilities, goal setting, and mechanisms to track progress. Concerns regarding participation were training needs and feasibility within usual care services. Technological preferences were for simple, easy-to-use, and engaging content. The app was piloted with HCA-client dyads (n = 5) to refine the intervention and evaluate content. Engaging stakeholders in intervention development provides valuable user-feedback on both desired exercise program contents and mobile technology preferences for HCBS recipients.

  18. Use of Home- and Community-Based Services in Taiwan's National 10-Year Long-Term Care Plan.

    Science.gov (United States)

    Yu, Hsiao-Wei; Tu, Yu-Kang; Kuo, Po-Hsiu; Chen, Ya-Mei

    2018-05-01

    We aimed to understand the relationships between care recipients' profiles and home- and community-based services (HCBS use patterns. Data were from the 2010 to 2013 Long-Term Care Service Management System in Taiwan ( N = 78,205). We used latent class analysis and multinomial logistic regression analyses. Three HCBS use patterns were found. Care recipients who lived alone, lived in less urbanized areas, and had instrumental activities of daily living disabilities were more likely to be in the home-based personal care group. Those in the home-based personal and medical care group were more likely than others to have a primary caregiver. Care recipients who had poorer abilities at basic activities of daily living and cognitive function, better household income, and lived in a more urbanized area were more likely to be in the non-personal care multiple services group. The findings suggest that policymakers alleviate barriers to accessing various patterns of HCBS should be encouraged.

  19. Pain associated with pressure injury: A qualitative study of community-based, home-dwelling individuals.

    Science.gov (United States)

    Jackson, Debra; Durrant, Lisa; Bishop, Emily; Walthall, Helen; Betteridge, Ria; Gardner, Sarah; Coulton, Wendy; Hutchinson, Marie; Neville, Stephen; Davidson, Patricia M; Usher, Kim

    2017-12-01

    The aim of this study was to provide deep insights into the pain associated with pressure injuries in home-dwelling individuals using narrative accounts. Pressure injuries or pressure ulcers are burdensome and costly. Prevalence data, surveys and systematic reviews demonstrate that pain associated with pressure injury is widespread, but voices of home-dwelling patients have remained largely unheard. Concurrent mixed methods case study of a UK community of approximately 50,000 adults. Qualitative interviews, conducted in 2016, of 12 home-dwelling adult participants with a current pressure injury (n = 10), or a recently healed pressure injury (n = 2). Pain had an adverse impact on activities of daily living, mobility and sleep. Participants described days that were clouded in pain; a pain they felt was poorly understood and often out of control. Thematic content analysis revealed two major themes; these are: Poorly controlled pain: "I just want the pain to go away"; and, Uncertainty for the future: "it almost seems insurmountable." Findings of our study support the need to develop an appropriate assessment tool for pressure injury patients in the community to enable healthcare professionals and patients to recognize and manage pressure injury-related pain effectively. © 2017 John Wiley & Sons Ltd.

  20. The mixed role of local communities in home-based economic activities in Caribbean cities

    NARCIS (Netherlands)

    Verrest, H.; Mason, C.; Reuschke, D.; Syrett, S.; van Ham, M.

    2016-01-01

    This chapter focuses on home-based economic activities (HBEAs) in two Caribbean cities. These income-generating activities are financially, socially and spatially strongly integrated within the household. In the Global South they are, after paid work, the most often performed type of livelihood

  1. Development of project wings home visits, a mental health intervention for Latino families using community-based participatory research.

    Science.gov (United States)

    Garcia, Carolyn; Hermann, Denise; Bartels, Anna; Matamoros, Pablo; Dick-Olson, Linda; Guerra de Patino, Janeth

    2012-11-01

    As the Latino population in the United States experiences rapid growth, the well-being of Latino adolescents is a growing concern because of their high rates of mental health problems. Latino adolescents have higher rates of mental health problems than their peers, including depressive symptoms, suicide attempts, and violence. Sophisticated, realistic health promotion efforts are needed to reduce these risk behaviors and enhance protective factors. Parents and schools can be key protective factors, or assets, in adolescents' lives. This article details the steps undertaken to develop Project Wings Home Visits, a collaborative school-based, community-linked mental health promotion intervention for Latino adolescents and their families. Core to the intervention is the use of a community health worker model to provide home-based outreach and education to parents of Latino adolescents. The intervention was developed using a community-based participatory research approach that involved the cooperation of a community health care system, a public high school, and a university. Our process demonstrates the benefits, strengths, and challenges of using community-based participatory research in creating and implementing health promotion interventions.

  2. Community Palliative Care Nurses' Challenges and Coping Strategies on Delivering Home-Based Pediatric Palliative Care.

    Science.gov (United States)

    Chong, LeeAi; Abdullah, Adina

    2017-03-01

    The aim of this study was to explore the experience of community palliative care nurses providing home care to children. A qualitative study was conducted at the 3 community palliative care provider organizations in greater Kuala Lumpur from August to October 2014. Data were collected with semistructured interviews with 16 nurses who have provided care to children and was analyzed using thematic analysis. Two categories were identified: (1) challenges nurses faced and (2) coping strategies. The themes identified from the categories are (1) communication challenges, (2) inadequate training and knowledge, (3) personal suffering, (4) challenges of the system, (5) intrapersonal coping skills, (6) interpersonal coping strategies, and (7) systemic supports. These results reinforces the need for integration of pediatric palliative care teaching and communication skills training into all undergraduate health care programs. Provider organizational support to meet the specific needs of the nurses in the community can help retain them in their role. It will also be important to develop standards for current and new palliative care services to ensure delivery of quality pediatric palliative care.

  3. Edison Home Community Study Unit.

    Science.gov (United States)

    Lee County School District, Ft. Myers, FL. Dept. of Environmental Education and Instructional Development Services.

    History is not merely events that occurred in the past. The past has influenced the present, as the present will influence the future. The purpose of this community study unit is to provide fourth grade students with an opportunity to investigate some of the history of Lee County, Florida. The unit's focus is on Thomas Edison, who built a home in…

  4. Reckoning HIV/AIDS care: A longitudinal study of community home-based caregivers and clients in Swaziland.

    Science.gov (United States)

    Root, Robin; Van Wyngaard, Arnau; Whiteside, Alan

    2015-01-01

    The article is a descriptive case study of a community home-based care (CHBC) organisation in Swaziland that depicts the convergence of CHBC expansion with substantially improved health outcomes. Comprised of 993 care supporters who tend to 3 839 clients in 37 communities across southern Swaziland, Shiselweni Home-based Care (SHBC) is illustrative of many resource-limited communities throughout Africa that have mobilised, at varying degrees of formality, to address the individual and household suffering associated with HIV/AIDS. To better understand the potential significance of global and national health policy/programming reliance on community health workers (task shifting), we analysed longitudinal data on both care supporter and client cohorts from 2008 to 2013. Most CHBC studies report data from only one cohort. Foremost, our analysis demonstrated a dramatic decline (71.4%) among SHBC clients in overall mortality from 32.2% to 9.2% between 2008 and 2013. Although the study was not designed to establish statistical significance or causality between SHBC expansion and health impact, our findings detail a compelling convergence among CHBC, improved HIV health practices, and declines in client mortality. Our analysis indicated (1) the potential contributions of community health workers to individual and community wellbeing, (2) the challenges of task-shifting agendas, above all comprehensive support of community health workers/care supporters, and (3) the importance of data collection to monitor and strengthen the critical health services assigned to CHBC. Detailed study of CHBC operations and practices is helpful also for advancing government and donor HIV/AIDS strategies, especially with respect to health services decentralisation, in Swaziland and similarly profiled settings.

  5. Outcome prediction in home- and community-based brain injury rehabilitation using the Mayo-Portland Adaptability Inventory.

    Science.gov (United States)

    Malec, James F; Parrot, Devan; Altman, Irwin M; Swick, Shannon

    2015-01-01

    The objective of the study was to develop statistical formulas to predict levels of community participation on discharge from post-hospital brain injury rehabilitation using retrospective data analysis. Data were collected from seven geographically distinct programmes in a home- and community-based brain injury rehabilitation provider network. Participants were 642 individuals with post-traumatic brain injury. Interventions consisted of home- and community-based brain injury rehabilitation. The main outcome measure was the Mayo-Portland Adaptability Inventory (MPAI-4) Participation Index. Linear discriminant models using admission MPAI-4 Participation Index score and log chronicity correctly predicted excellent (no to minimal participation limitations), very good (very mild participation limitations), good (mild participation limitations), and limited (significant participation limitations) outcome levels at discharge. Predicting broad outcome categories for post-hospital rehabilitation programmes based on admission assessment data appears feasible and valid. Equations to provide patients and families with probability statements on admission about expected levels of outcome are provided. It is unknown to what degree these prediction equations can be reliably applied and valid in other settings.

  6. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

    Science.gov (United States)

    Ewen, Heidi H.; Washington, Tiffany R.; Emerson, Kerstin G.; Carswell, Andrew T.; Smith, Matthew Lee

    2017-01-01

    Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS) for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%), homemaker services (19%), and transportation services (18%). More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and mental health needs

  7. Variation in Older Adult Characteristics by Residence Type and Use of Home- and Community-Based Services

    Directory of Open Access Journals (Sweden)

    Heidi H. Ewen

    2017-03-01

    Full Text Available Background: The majority of older adults prefer to remain in their homes, or to “age-in-place.” To accomplish this goal, many older adults will rely upon home- and community-based services (HCBS for support. However, the availability and accessibility of HCBS may differ based on whether the older adult lives in the community or in a senior housing apartment facility. Methods: This paper reports findings from the Pathways to Life Quality study of residential change and stability among seniors in upstate New York. Data were analyzed from 663 older adults living in one of three housing types: service-rich facilities, service-poor facilities, and community-dwelling in single-family homes. A multinomial logistic regression model was used to examine factors associated with residence type. A linear regression model was fitted to examine factors associated with HCBS utilization. Results: When compared to community-dwelling older adults, those residing in service-rich and service-poor facilities were more likely to be older, report more activity limitations, and provide less instrumental assistance to others. Those in service-poor facilities were more likely to have poorer mental health and lower perceived purpose in life. The three leading HCBS utilized were senior centers (20%, homemaker services (19%, and transportation services (18%. More HCBS utilization was associated with participants who resided in service-poor housing, were older, were female, and had more activity limitations. More HCBS utilization was also associated with those who received instrumental support, had higher perceived purpose in life, and poorer mental health. Conclusions: Findings suggest that older adults’ residential environment is associated with their health status and HCBS utilization. Building upon the Person–Environment Fit theories, dedicated efforts are needed to introduce and expand upon existing HCBS available to facility residents to address physical and

  8. Is Telephone Screening Feasible? Accuracy and Cost-Effectiveness of Identifying People Medically Eligible for Home- And Community-Based Services.

    Science.gov (United States)

    Fries, Brant E.; James, Mary; Hammer, Susan S.; Shugarman, Lisa R.; Morris, John N.

    2004-01-01

    Purpose: To determine the accuracy of a telephone-screening system to identify persons eligible for home- and community-based long-term care. Design and Methods: Data from Michigan telephone screens were compared to data from in-person assessments using the Minimum Data Set for Home Care (MDS-HC). Weighted kappa statistics measured the level of…

  9. Community-based distribution of misoprostol to prevent postpartum haemorrhage at home births: results from operations research in rural Ghana.

    Science.gov (United States)

    Geller, S; Carnahan, L; Akosah, E; Asare, G; Agyemang, R; Dickson, R; Kapungu, C; Owusu-Ansah, L; Robinson, N; Mensah-Homiah, J

    2014-02-01

    To report on a rigorous distribution and monitoring plan to track misoprostol for community-based distribution to reduce postpartum haemorrhage (PPH) in rural Ghana. Operations research. Rural Ghana. Women in third trimester of pregnancy presenting to primary health centres (PHCs) for antenatal care (ANC). Ghana Health Service (GHS), Millennium Village Projects, and the University of Illinois at Chicago conducted an operations research study designed to assess the safety, feasibility, and acceptability of community-based distribution of misoprostol to prevent PPH at home deliveries in rural Ghana. One thousand doses (3000 tablets, 200 μg each) were obtained from the Family Health Division of GHS. Three 200-μg tablets of misoprostol (600 μg) in foil packets were packaged together in secured transparent plastic packets labelled with pictorial messages and distributed to midwives at seven PHCs for distribution to pregnant women. Correct use of misoprostol in home deliveries and retrieval of unused misoprostol doses, PPH rates and maternal mortality. Of the 999 doses distributed to midwives, 982 (98.3%) were successfully tracked, with a 1.7% lost to follow-up rate. Midwives distributed 654 doses to women at third-trimester ANC visits. Of women who had misoprostol to use at home, 81% had an institutional delivery and were able to return the misoprostol safely to the midwife. Of the women that used misoprostol, 99% used the misoprostol correctly. This study clearly demonstrates that misoprostol distributed antenatally to pregnant women can be used accurately and reliably by rural Ghanaian women, and should be considered for policy implementation across Ghana and other countries with high home birth rates and maternal mortality ratios. © 2013 Royal College of Obstetricians and Gynaecologists.

  10. "It's Changed Everything": Voices of Veterans in the Veteran-Directed Home and Community Based Services Program.

    Science.gov (United States)

    Mahoney, Ellen K; Milliken, Aimee; Mahoney, Kevin J; Edwards-Orr, Merle; Willis, Danny G

    2018-04-05

    The purpose of this study was to understand the value and impact of the Veteran-Directed Home and Community Based Services program (VD-HCBS) on Veterans' lives in their own voices. Focus groups and individual interviews by telephone were conducted to elicit participant perspectives on what was most meaningful, and what difference VD-HCBS made in their lives. Transcripts were analyzed using content analysis. The sample included 21 Veterans, with a mean age of 66±14, enrolled in VD-HCBS an average of 20.8 months. All were at risk of institutional placement based on their level of disability. Five major categories captured the information provided by participants: What a Difference Choice Makes; I'm a Person!; It's a Home-Saver; Coming Back to Life; and Keeping Me Healthy & Safe. Participants described the program as life changing. This study is the first time that Veterans themselves have identified the ways in which VD-HCBS impacted their lives, uncovering the mechanisms underlying positive outcomes. These categories revealed new ways of understanding VD-HCBS as an innovative approach to meeting the person-centered needs of Veterans wishing to remain at home, while experiencing quality care and leading meaningful lives, areas identified as priorities for improving long term services and supports.

  11. Sociocultural Factors Affecting Unplanned Deliveries at Home: A Community-Based Case Control Study.

    Science.gov (United States)

    Catak, Binali; Oner, Can

    2015-01-01

    Unplanned home deliveries can vary with social and cultural factors. The aim of this study was to define the risk factors of unplanned home births. This case control study was conducted in Istanbul, Turkey. The study group was composed of 229 women who had unplanned home delivery. Six factors (presence of health insurance, duration of living in Istanbul, educational status of the woman, the number of individuals living in the household, the age of the woman at the time of current delivery, and the status of having received care prior to delivery) were determined as independent risk factors for unplanned deliveries at home.

  12. Preferences for home- and community-based long-term care services in Germany: a discrete choice experiment.

    Science.gov (United States)

    Lehnert, T; Günther, O H; Hajek, A; Riedel-Heller, S G; König, H H

    2018-04-06

    Most people prefer to "age in place" and to remain in their homes for as long as possible even in case they require long-term care. While informal care is projected to decrease in Germany, the use of home- and community-based services (HCBS) can be expected to increase in the future. Preference-based data on aspects of HCBS is needed to optimize person-centered care. To investigate preferences for home- and community-based long-term care services packages. Discrete choice experiment conducted in mailed survey. Randomly selected sample of the general population aged 45-64 years in Germany (n = 1.209). Preferences and marginal willingness to pay (WTP) for HCBS were assessed with respect to five HCBS attributes (with 2-4 levels): care time per day, service level of the HCBS provider, quality of care, number of different caregivers per month, co-payment. Quality of care was the most important attribute to respondents and small teams of regular caregivers (1-2) were preferred over larger teams. Yet, an extended range of services of the HCBS provider was not preferred over a more narrow range. WTP per hour of HCBS was €8.98. Our findings on preferences for HCBS in the general population in Germany add to the growing international evidence of preferences for LTC. In light of the great importance of high care quality to respondents, reimbursement for services by HCBS providers could be more strongly linked to the quality of services.

  13. Home-based walking improves cardiopulmonary function and health-related QOL in community-dwelling adults.

    Science.gov (United States)

    Okamoto, N; Nakatani, T; Morita, N; Saeki, K; Kurumatani, N

    2007-12-01

    The objective of our study was to investigate the effects of a home-based walking program on physical fitness and QOL among community residents. Subjects (n = 200, mean age: 64.2 years, range: 42 - 75 years) who participated in the 32-week trial were randomly allocated to one of two groups: an exercise (E) group and a control (C) group. The E group was instructed to increase the number of steps a day that they walked and to perform aerobic walking at a target heart rate for 20 minutes or more daily, 2 or more days a week. The C group was told to continue their normal level of activity. Outcome measures were the 3-minute shuttle stamina walk test (SSWT), 30-second chair-stand test (CS-30), and SF-36. Increases in SSWT values were significantly greater in the E group than in the C group (men 24.1 m vs. 6.3 m; women 8.8 m vs. 2.4 m), as were increases in CS-30 values (men 5.9 vs. 2.6; women 4.5 vs. - 0.1). On the SF-36, the scores in the E group for vitality and mental health increased significantly. Home-based walking is considered to be an effective and feasible method to improve physical fitness and QOL among community residents.

  14. 42 CFR 440.180 - Home or community-based services.

    Science.gov (United States)

    2010-10-01

    ...) If the recipients are compensated, they are compensated at less than 50 percent of the minimum wage... or above the minimum wage is unlikely and who, because of their disabilities, need intensive ongoing... SERVICES (CONTINUED) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.180 Home or...

  15. Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training at Home randomised, controlled trial

    Directory of Open Access Journals (Sweden)

    Amanda Bates

    2018-04-01

    Full Text Available Introduction: Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. Research questions: This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Design: Randomised, controlled trial. Participants and setting: A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Intervention: Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. Outcome measures: The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated

  16. Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training) at Home randomised, controlled trial.

    Science.gov (United States)

    Bates, Amanda; Furber, Susan; Tiedemann, Anne; Ginn, Karen; van den Dolder, Paul; Howard, Kirsten; Bauman, Adrian; Chittenden, Catherine; Franco, Lisa; Kershaw, Michelle; Sherrington, Catherine

    2018-04-01

    Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Randomised, controlled trial. A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated. Negative binomial regression models will be used to estimate the between-group difference in fall rates. Modified

  17. Home- and Community-Based Occupational Therapy Improves Functioning in Frail Older People: A Systematic Review.

    Science.gov (United States)

    De Coninck, Leen; Bekkering, Geertruida E; Bouckaert, Leen; Declercq, Anja; Graff, Maud J L; Aertgeerts, Bert

    2017-08-01

    The objective is to assess the effectiveness of occupational therapy to improve performance in daily living activities in community-dwelling physically frail older people. We conducted a systematic review and meta-analysis. We included randomized controlled trials reporting on occupational therapy as intervention, or as part of a multidisciplinary approach. This systematic review was carried out in accordance with the Cochrane methods of systematic reviews of interventions. Meta-analyses were performed to pool results across studies using the standardized mean difference. The primary outcome measures were mobility, functioning in daily living activities, and social participation. Secondary outcome measures were fear of falling, cognition, disability, and number of falling persons. Nine studies met the inclusion criteria. Overall, the studies were of reasonable quality with low risk of bias. There was a significant increase in all primary outcomes. The pooled result for functioning in daily living activities was a standardized mean difference of -0.30 (95% CI -0.50 to -0.11; P = .002), for social participation -0.44 (95% CI -0.69, -0.19; P = .0007) and for mobility -0.45 (95% CI -0.78 to -0.12; P = .007). All secondary outcomes showed positive trends, with fear of falling being significant. No adverse effects of occupational therapy were found. There is strong evidence that occupational therapy improves functioning in community-dwelling physically frail older people. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  18. Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care.

    Science.gov (United States)

    Sinn, Chi-Ling Joanna; Jones, Aaron; McMullan, Janet Legge; Ackerman, Nancy; Curtin-Telegdi, Nancy; Eckel, Leslie; Hirdes, John P

    2017-11-25

    Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

  19. Derivation and validation of the Personal Support Algorithm: an evidence-based framework to inform allocation of personal support services in home and community care

    Directory of Open Access Journals (Sweden)

    Chi-Ling Joanna Sinn

    2017-11-01

    Full Text Available Abstract Background Personal support services enable many individuals to stay in their homes, but there are no standard ways to classify need for functional support in home and community care settings. The goal of this project was to develop an evidence-based clinical tool to inform service planning while allowing for flexibility in care coordinator judgment in response to patient and family circumstances. Methods The sample included 128,169 Ontario home care patients assessed in 2013 and 25,800 Ontario community support clients assessed between 2014 and 2016. Independent variables were drawn from the Resident Assessment Instrument-Home Care and interRAI Community Health Assessment that are standardised, comprehensive, and fully compatible clinical assessments. Clinical expertise and regression analyses identified candidate variables that were entered into decision tree models. The primary dependent variable was the weekly hours of personal support calculated based on the record of billed services. Results The Personal Support Algorithm classified need for personal support into six groups with a 32-fold difference in average billed hours of personal support services between the highest and lowest group. The algorithm explained 30.8% of the variability in billed personal support services. Care coordinators and managers reported that the guidelines based on the algorithm classification were consistent with their clinical judgment and current practice. Conclusions The Personal Support Algorithm provides a structured yet flexible decision-support framework that may facilitate a more transparent and equitable approach to the allocation of personal support services.

  20. Home-based care

    African Journals Online (AJOL)

    Mrs. Patience Edoho Samson-Akpan

    study was to ascertain the relationship between home-based care and quality of life of PLWHA in support groups in. Calabar South Local Government Area. A correlational design was utilized and a purposive sample of 74 PLWHA participated in the study. A self developed and well validated questionnaire was used for data ...

  1. Recruitment and retention of home support workers in rural communities.

    Science.gov (United States)

    Sharman, Zena

    2014-01-01

    This qualitative study examined recruitment and retention of home support workers (HSWs) providing home support in rural communities. Thirty-two participants were recruited across four island-based communities located in British Columbia, Canada. Thematic analysis of interview data revealed several key themes: (a) how the rural context shapes HSWs' employment decisions and opportunities; (b) why people become (and stay) HSWs in rural communities; and (c) how rurality influences the nature and scope of HSWs' work. These findings suggest that health human resource policies and programs aimed at HSW recruitment and retention should be tailored to characteristics, strengths, and challenges of rural communities.

  2. Effects of psychosocial stimulation on improving home environment and child-rearing practices: results from a community-based trial among severely malnourished children in Bangladesh

    OpenAIRE

    Nahar, Baitun; Hossain, Md Iqbal; Hamadani, Jena D; Ahmed, Tahmeed; Grantham-McGregor, Sally; Persson, Lars-Ake

    2012-01-01

    Abstract Background Parenting programmes are effective in enhancing parenting practices and child development. This study evaluated the effects of a intervention with psychosocial stimulation (PS) on the quality of the home environment and mothers’ child-rearing practices in a community-based trial with severely malnourished Bangladeshi children. Method Severely underweight children (n = 507), 6–24 months of age, were randomly assigned to five groups: PS; food supplementation (FS); PS + FS; c...

  3. Cash and counseling: a promising option for consumer direction of home- and community-based services and supports.

    Science.gov (United States)

    Mahoney, Kevin J; Simon-Rusinowitz, Lori; Simone, Kristin; Zgoda, Karen

    2006-01-01

    The Cash and Counseling Demonstration began as a 3-state social experiment to test the claims of members of the disability community that, if they had more control over their services, their lives would improve and costs would be no higher. The 2004 expansion to 12 states brings us closer to the tipping point when this option will be broadly available. The original demonstration was a controlled experiment with randomized assignment, supplemented by an ethnographic study and a process evaluation. Consumers managing flexible, individualized budgets were much more satisfied, had fewer unmet needs, and had comparable health outcomes. Access to service and supports was greatly improved. Consumer direction is increasingly accepted as a desirable option in home and community services.

  4. Utilization and costs of home-based and community-based care within a social HMO: trends over an 18-year period

    Directory of Open Access Journals (Sweden)

    Walter Leutz

    2005-10-01

    Full Text Available Purpose: Our objective was to describe the utilization and costs of services from 1985 to 2002 of a Social Health Maintenance Organization (SHMO demonstration project providing a benefit for home-based and community-based as well as short-term institutional (HCB care at Kaiser Permanente Northwest (KPNW, serving the Portland, Oregon area. The HCB care benefit was offered by KPNW as a supplement to Medicare's acute care medical benefits, which KPNW provides in an HMO model. KPNW receives a monthly per capita payment from Medicare to provide medical benefits, and Medicare beneficiaries who choose to join pay a supplemental premium that covers prescription drugs, HCB care benefits, and other services. A HCB care benefit of up to $12,000 per year in services was available to SHMO members meeting requirement for nursing home certification (NHC. Methods: We used aggregate data to track temporal changes in the period 1985 to 2002 on member eligibility, enrollment in HCB care plans, age, service utilization and co-payments. Trends in the overall costs and financing of the HCB care benefit were extracted from quarterly reports, management data, and finance data. Results: During the time period, 14,815 members enrolled in the SHMO and membership averaged 4,531. The proportion of SHMO members aged 85 or older grew from 12 to 25%; proportion meeting requirements for NHC rose from 4 to 27%; and proportion with HCB care plans rose from 4 to 18%. Costs for the HCB care benefit rose from $21 per SHMO member per month in 1985 to $95 in 2002. The HCB care costs were equivalent to 12% to 16% of Medicare reimbursement. The HCB program costs were covered by member premiums (which rose from $49 to $180 and co-payments from members with care plans. Over the 18-year period, spending shifted from nursing homes to a range of community services, e.g. personal care, homemaking, member reimbursement, lifeline, equipment, transportation, shift care, home nursing, adult day

  5. First-Year Analysis of a New, Home-Based Palliative Care Program Offered Jointly by a Community Hospital and Local Visiting Nurse Service.

    Science.gov (United States)

    Pouliot, Katherine; Weisse, Carol S; Pratt, David S; DiSorbo, Philip

    2017-03-01

    There is a growing need for home-based palliative care services, especially for seriously ill individuals who want to avoid hospitalizations and remain with their regular outside care providers. To evaluate the effectiveness of Care Choices, a new in-home palliative care program provided by the Visiting Nurse Services of Northeastern New York and Ellis Medicine's community hospital serving New York's Capital District. This prospective cohort study assessed patient outcomes over the course of 1 year for 123 patients (49 men and 74 women) with serious illnesses who were new enrollees in the program. Quality of life was assessed at baseline and after 1 month on service. Satisfaction with care was measured after 1 and 3 months on service. The number of emergency department visits and inpatient hospitalizations pre- and postenrollment was measured for all enrollees. Patients were highly satisfied (72.7%-100%) with their initial care and reported greater satisfaction ( P care service. An in-home palliative care program offered jointly through a visiting nurse service and community hospital may be a successful model for providing quality care that satisfies chronically ill patients' desire to remain at home and avoid hospital admissions.

  6. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border.

    Science.gov (United States)

    Ramírez, Denise Moreno; Ramírez-Andreotta, Mónica D; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A; Kilungo, Aminata; Spitz, Anna H; Betterton, Eric A

    2015-09-09

    Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered "hard-to-reach" by government-led programs.

  7. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border

    Science.gov (United States)

    Moreno Ramírez, Denise; Ramírez-Andreotta, Mónica D.; Vea, Lourdes; Estrella-Sánchez, Rocío; Wolf, Ann Marie A.; Kilungo, Aminata; Spitz, Anna H.; Betterton, Eric A.

    2015-01-01

    Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras) can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered “hard-to-reach” by government-led programs. PMID:26371028

  8. Pollution Prevention through Peer Education: A Community Health Worker and Small and Home-Based Business Initiative on the Arizona-Sonora Border

    Directory of Open Access Journals (Sweden)

    Denise Moreno Ramírez

    2015-09-01

    Full Text Available Government-led pollution prevention programs tend to focus on large businesses due to their potential to pollute larger quantities, therefore leaving a gap in programs targeting small and home-based businesses. In light of this gap, we set out to determine if a voluntary, peer education approach led by female, Hispanic community health workers (promotoras can influence small and home-based businesses to implement pollution prevention strategies on-site. This paper describes a partnership between promotoras from a non-profit organization and researchers from a university working together to reach these businesses in a predominately Hispanic area of Tucson, Arizona. From 2008 to 2011, the promotora-led pollution prevention program reached a total of 640 small and home-based businesses. Program activities include technical trainings for promotoras and businesses, generation of culturally and language appropriate educational materials, and face-to-face peer education via multiple on-site visits. To determine the overall effectiveness of the program, surveys were used to measure best practices implemented on-site, perceptions towards pollution prevention, and overall satisfaction with the industry-specific trainings. This paper demonstrates that promotoras can promote the implementation of pollution prevention best practices by Hispanic small and home-based businesses considered “hard-to-reach” by government-led programs.

  9. Effects of psychosocial stimulation on improving home environment and child-rearing practices: results from a community-based trial among severely malnourished children in Bangladesh.

    Science.gov (United States)

    Nahar, Baitun; Hossain, Md Iqbal; Hamadani, Jena D; Ahmed, Tahmeed; Grantham-McGregor, Sally; Persson, Lars-Ake

    2012-08-07

    Parenting programmes are effective in enhancing parenting practices and child development. This study evaluated the effects of a intervention with psychosocial stimulation (PS) on the quality of the home environment and mothers' child-rearing practices in a community-based trial with severely malnourished Bangladeshi children. Severely underweight children (n = 507), 6-24 months of age, were randomly assigned to five groups: PS; food supplementation (FS); PS + FS; clinic-control (CC); and, hospital-control (CH). PS included fortnightly follow-up visits for six months at community clinics where a play leader demonstrated play activities and gave education on child development and child rearing practices. FS comprised cereal-based supplements (150-300 kcal/day) for three months. All groups received medical care, micronutrient supplements and growth monitoring. Mothers were given the Home Observation for Measurement of the Environment (HOME) inventory and a questionnaire on parenting at baseline and after six months to assess the outcome. 322 children completed the study. After six months of intervention the PS + FS and PS groups benefitted in the total HOME score (depending on the comparison group, effect sizes varied from 0.66 to 0.33 SD) The PS + FS and PS groups also benefitted in two HOME subscales: maternal involvement (effect sizes: 0.8 to 0.55 SD) and play materials, (effect sizes: 0.46 to 0.6 SD), and child-rearing practices scores (effect size: 1.5 to 1.1 SD). The PS + FS group benefitted 4.0 points in total HOME score compared with CH, 4.8 points compared with CC and 4.5 points compared with FS (p Child-rearing practice scores of the PS + FS group improved 7.7, 6.4 and 6.6 points and the PS group improved 8.5, 7.2 and 7.4 points more than CH, CC and FS, respectively (p Child-rearing practices of mothers of severely malnourished children and the quality of their home environment can be improved through community-based

  10. Effects of psychosocial stimulation on improving home environment and child-rearing practices: results from a community-based trial among severely malnourished children in Bangladesh

    Directory of Open Access Journals (Sweden)

    Nahar Baitun

    2012-08-01

    Full Text Available Abstract Background Parenting programmes are effective in enhancing parenting practices and child development. This study evaluated the effects of a intervention with psychosocial stimulation (PS on the quality of the home environment and mothers’ child-rearing practices in a community-based trial with severely malnourished Bangladeshi children. Method Severely underweight children (n = 507, 6–24 months of age, were randomly assigned to five groups: PS; food supplementation (FS; PS + FS; clinic-control (CC; and, hospital-control (CH. PS included fortnightly follow-up visits for six months at community clinics where a play leader demonstrated play activities and gave education on child development and child rearing practices. FS comprised cereal-based supplements (150–300 kcal/day for three months. All groups received medical care, micronutrient supplements and growth monitoring. Mothers were given the Home Observation for Measurement of the Environment (HOME inventory and a questionnaire on parenting at baseline and after six months to assess the outcome. Results 322 children completed the study. After six months of intervention the PS + FS and PS groups benefitted in the total HOME score (depending on the comparison group, effect sizes varied from 0.66 to 0.33 SD The PS + FS and PS groups also benefitted in two HOME subscales: maternal involvement (effect sizes: 0.8 to 0.55 SD and play materials, (effect sizes: 0.46 to 0.6 SD, and child-rearing practices scores (effect size: 1.5 to 1.1 SD. The PS + FS group benefitted 4.0 points in total HOME score compared with CH, 4.8 points compared with CC and 4.5 points compared with FS (p  Conclusions Child-rearing practices of mothers of severely malnourished children and the quality of their home environment can be improved through community-based psychosocial stimulation with or without food supplementation. This may be of importance to promote child development.

  11. 29 CFR 785.39 - Travel away from home community.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Travel away from home community. 785.39 Section 785.39... Principles Traveltime § 785.39 Travel away from home community. Travel that keeps an employee away from home overnight is travel away from home. Travel away from home is clearly worktime when it cuts across the...

  12. Facility and home based HIV Counseling and Testing: a comparative analysis of uptake of services by rural communities in southwestern Uganda

    Directory of Open Access Journals (Sweden)

    Guerra Ranieri

    2011-03-01

    with both facility and home based VCT options within a given setting. The clients are then able to select a model for VCT that best fits their characteristics. This is likely to have positive implications for both service coverage and uptake by different sub-groups within particular communities.

  13. The Impact of a Home-Based Computerized Cognitive Training Intervention on Fall Risk Measure Performance in Community Dwelling Older Adults, a Pilot Study.

    Science.gov (United States)

    Blackwood, J; Shubert, T; Fogarty, K; Chase, C

    2016-02-01

    Cognitive intervention studies have reported improvements in various domains of cognition as well as a transfer effect of improved function post training. Despite the availability of web based cognitive training programs, most intervention studies have been performed under the supervision of researchers. Therefore, the purpose of this study was to first, examine the feasibility of a six week home based computerized cognitive training (CCT) program in a group of community dwelling older adults and, second, to determine if a CCT program which focused on set shifting, attention, and visual spatial ability impacted fall risk measure performance. This pilot study used a pretest/posttest experimental design with randomization by testing site to an intervention or control group. Community dwelling older adults (mean age = 74.6 years) participated in either the control (N=25) or the intervention group (N=19). Intervention group subjects participated in 6 weeks of home based CCT 3x/week for an average of 23 minutes/session, using an online CCT program. Comparisons of mean scores on three measures of physical function (usual gait speed, five times sit to stand, timed up and go) were completed at baseline and week 7. Following the completion of an average of 18 sessions of CCT at home with good adherence (86%) and retention (92%) rates, a statistically significant difference in gait speed was found between groups with an average improvement of 0.14 m/s in the intervention group. A home based CCT program is a feasible approach to targeting cognitive impairments known to influence fall risk and changes in gait in older adults.

  14. Needs-based Funding for Home Care and Community Support Services in Ontario: A New Approach Based on Linked Survey and Administrative Data

    OpenAIRE

    Jeremiah Hurley; Brian Hutchison; Gioia Buckley; Christel Woodward

    2003-01-01

    1.0 Background Since 1994, the Ontario Ministry of Health and Long-term Care (MOHLTC) has used an equity funding formula to allocate new funding for the delivery of long-term care (LTC) community services, which includes home care services and community support services in the province.[Ontario Ministry of Health 2000] The objective of the formula is to reduce historical disparities in funding among Community Care Access Centre (CCAC) regions by allocating new funds on the basis of the relati...

  15. Infants delivered in maternity homes run by traditional birth attendants in urban Nigeria: a community-based study.

    Science.gov (United States)

    Olusanya, Bolajoko O; Inem, Victor A; Abosede, Olayinka A

    2011-06-01

    We explored factors associated with traditional maternity/herbal homes (TMHs) run by traditional birth attendants (TBAs) compared with hospital or home delivery in Lagos, Nigeria, and found that infants delivered at TMHs were less likely to have severe hyperbilirubinemia compared with infants delivered in hospitals or residential homes. These infants were also less likely to be preterm compared with those delivered in hospitals or undernourished compared with infants delivered in residential homes. We concluded that infants delivered at TMHs who survive are unlikely to be at greater risks of some adverse perinatal outcomes than those delivered in hospitals or family homes.

  16. 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......Sustaining daily, unsupervised healthcare activities in non-clinical settings such as the private home can challenge, among others, older adults. To support such unsupervised care activities, an increasingly number of reminders and monitoring systems are being designed. However, most...

  17. Home hospitalization in the spectrum of community geriatric care.

    Science.gov (United States)

    Stessman, J; Hammerman-Rozenberg, R; Cohen, A

    1997-04-01

    The Home Hospitalization Programme was initiated in Jerusalem in 1991 to provide intensive medical care at home in order to prevent or shorten hospitalizations. The programme was based upon regular home visits by physicians, and nursing assessment to determine the need for regular nursing care. Primary-care physicians and nurses were renumerated by a global monthly fee, and were on 24-h call in addition to their periodic visits. Patients were recruited by senior geriatric physicians from acute hospital wards, as well as from the community, at the family doctor's request. Ancillary services available to the home hospitalization team included laboratory and electrocardiographic testing, specialty consultations, physical occupational or speech therapy, social work and home help up to 3 h daily. Monthly visits by a senior physician provided oversight and further consultation. Home hospitalization grew out of the continuing care division of the Clalit Sick Fund, a health maintenance organization providing umbrella medical insurance and ambulatory care. The programme grew synergistically with the other facilities of continuing care to encompass a network of comprehensive services to acute, subacute and chronic patients both at home and in institutional settings. In 4 years this network succeeded in establishing the focus of subacute intensive care in the community, achieving high levels of patient and family satisfaction, as well as striking economic advantages. In its first 2 years of operation home hospitalization saved S4 million due to reduced hospital utilization, and preliminary data for the subsequent 2 years indicated that this trend continued. Home hospitalization became the hub of a far-reaching system of supportive, intensive and humane care in the community.

  18. Creating Work Opportunities for the Poor through Home Community ...

    African Journals Online (AJOL)

    This article seeks to investigate how Home Community Based Care (HCBC) is used as a strategy to create work opportunities for the poor. Quantitative and qualitative data from 65 HCBC organisations with three years of active involvement in HCBC that are funded by the Department of Health was collected. This was done ...

  19. Understanding the agency of home-based care volunteers ...

    African Journals Online (AJOL)

    In traditional Zulu communities, caregiving is rooted in compassionate and hardworking personal identity precepts and the traditional identity expectations of women. Home-based-care volunteerism in the community represents the performance of this identity. Data from a series of interviews with 15 home-based care ...

  20. A home-based, carer-enhanced exercise program improves balance and falls efficacy in community-dwelling older people with dementia.

    Science.gov (United States)

    Taylor, Morag E; Lord, Stephen R; Brodaty, Henry; Kurrle, Susan E; Hamilton, Sarah; Ramsay, Elisabeth; Webster, Lyndell; Payne, Narelle L; Close, Jacqueline C T

    2017-01-01

    Older people with dementia are at increased risk of physical decline and falls. Balance and mood are significant predictors of falls in this population. The aim of this study was to determine the effect of a tailored home-based exercise program in community-dwelling older people with dementia. Forty-two participants with mild to moderate dementia were recruited from routine health services. All participants were offered a six-month home-based, carer-enhanced, progressive, and individually tailored exercise program. Physical activity, quality of life, physical, and psychological assessments were administered at the beginning and end of the trial. Of 33 participants (78.6%) who completed the six-month reassessment ten (30%) reported falls and six (18%) multiple falls during the follow-up period. At reassessment, participants had better balance (sway on floor and foam), reduced concern about falls, increased planned physical activity, but worse knee extension strength and no change in depression scores. The average adherence to the prescribed exercise sessions was 45% and 22 participants (52%) were still exercising at trial completion. Those who adhered to ≥70% of prescribed sessions had significantly better balance at reassessment compared with those who adhered to balance, concern about falls, and planned physical activity in community-dwelling older people with dementia. Future research should determine whether exercise interventions are effective in reducing falls and elucidate strategies for enhancing uptake and adherence in this population.

  1. Community-Wide Zero Energy Ready Home Standard

    Energy Technology Data Exchange (ETDEWEB)

    Herk, A. [IBACOS, Inc., Pittsburght, PA (United States); Beggs, T. [IBACOS, Inc., Pittsburght, PA (United States)

    2016-02-05

    This report outlines the steps a developer can use when looking to create and implement higher performance standards such as the U.S. Department of Energy (DOE) Zero Energy Ready Home (ZERH) standards in a community. The report also describes the specific examples of how this process was followed by a developer, Forest City, in the Stapleton community in Denver, Colorado. IBACOS described the steps used to begin to bring the DOE ZERH standard to the Forest City Stapleton community based on 15 years of community-scale development work done by IBACOS. As a result of this prior IBACOS work, the team gained an understanding of the various components that a master developer needs to consider and created strategies for incorporating those components in the initial phases of development to achieve higher performance buildings in the community. An automated scoring system can be used to perform an internal audit that provides a detailed and consistent evaluation of how several homes under construction or builders' floor plans compare with the requirements of the DOE Zero Energy Ready Home program. This audit can be performed multiple times at specific milestones during construction to allow the builder to make changes as needed throughout construction for the project to meet Zero Energy Ready Home standards. This scoring system also can be used to analyze a builder's current construction practices and design.

  2. Pregnancy and Village Outreach Tibet: a descriptive report of a community- and home-based maternal-newborn outreach program in rural Tibet.

    Science.gov (United States)

    Dickerson, Ty; Crookston, Benjamin; Simonsen, Sara E; Sheng, Xiaoming; Samen, Arlene; Nkoy, Flory

    2010-01-01

    The Pregnancy and Village Outreach Tibet (PAVOT) program, a model for community- and home-based maternal-newborn outreach in rural Tibet, is presented. This article describes PAVOT, including the history, structure, content, and activities of the program, as well as selected program outcome measures and demographic characteristics, health behaviors, and pregnancy outcomes of women who recently participated in the program. The PAVOT program was developed to provide health-related services to pregnant rural Tibetan women at risk of having an unattended home birth. The program involves training local healthcare workers and laypersons to outreach pregnant women and family members. Outreach includes basic maternal-newborn health education and simple obstetric and neonatal life-saving skills training. In addition, the program distributes safe and clean birth kits, newborn hats, blankets, and maternal micronutrient supplements (eg, prenatal vitamins and minerals). More than 980 pregnant women received outreach during the study period. More than 92% of outreach recipients reported receiving safe pregnancy and birth education, clean birthing and uterine massage skills instruction, and clean umbilical cord care training. Nearly 80% reported basic newborn resuscitation skills training. Finally, nearly 100% of outreach recipients received maternal micronutrient supplements and safe and clean birth kits. The PAVOT program is a model program that has been proven to successfully provide outreach to rural-living Tibetans by delivering maternal-newborn health education, skills training, and resources to the home.

  3. A randomized controlled trial of a community-based dementia care coordination intervention: effects of MIND at Home on caregiver outcomes.

    Science.gov (United States)

    Tanner, Jeremy A; Black, Betty S; Johnston, Deirdre; Hess, Edward; Leoutsakos, Jeannie-Marie; Gitlin, Laura N; Rabins, Peter V; Lyketsos, Constantine G; Samus, Quincy M

    2015-04-01

    To assess whether MIND at Home, a community-based, multicomponent, care coordination intervention, reduces unmet caregiving needs and burden in informal caregivers of persons with memory disorders. An 18-month randomized controlled trial of 289 community-living care recipient (CR)-caregiver (informal caregivers, i.e., unpaid individuals who regularly assisted the CR) dyads from 28 postal code areas of Baltimore, Maryland was conducted. All dyads and the CR's primary care physician received the written needs assessment results and intervention recommendations. Intervention dyads then received an 18-month care coordination intervention delivered by nonclinical community workers to address unmet care needs through individualized care planning, referral and linkage to dementia services, provision of caregiver dementia education and skill-building strategies, and care progress monitoring by an interdisciplinary team. Primary outcome was total percent of unmet caregiver needs at 18 months. Secondary outcomes included objective and subjective caregiver burden measures, quality of life (QOL), and depression. Total percent of unmet caregiver needs declined in both groups from baseline to 18 months, with no statistically significant between-group difference. No significant group differences occurred in most caregiver burden measures, depression, or QOL. There was a potentially clinically relevant reduction in self-reported number of hours caregivers spent with the CR for MIND participants compared with control subjects. No statistically significant impacts on caregiver outcomes were found after multiple comparison adjustments. However, MIND at Home appeared to have had a modest and clinically meaningful impact on informal caregiver time spent with CRs. Copyright © 2015 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. From end of life to chronic care: the provision of community home-based care for HIV and the adaptation to new health care demands in Zambia.

    Science.gov (United States)

    Aantjes, Carolien J; Simbaya, Joseph; Quinlan, Tim K C; Bunders, Joske F G

    2016-11-01

    Aim We present the evolution of primary-level HIV and AIDS services, shifting from end of life to chronic care, and draw attention to the opportunities and threats for the future of Zambia's nascent chronic care system. Although African governments struggled to provide primary health care services in the context of a global economic crisis, civil society organisations (CSO) started mobilising settlement residents to respond to another crisis: the HIV and AIDS pandemic. These initiatives actively engaged patients, families and settlement residents to provide home-based care to HIV-infected patients. After 30 years, CHBC programmes continue to be appropriate in the context of changing health care needs in the population. The study took place in 2011 and 2012 and was part of a multi-country study. It used a mixed method approach involving semi-structured interviews, focus group discussions, structured interviews, service observations and a questionnaire survey. Findings Our research revealed long-standing presence of extensive mutual support amongst residents in many settlements, the invocation of cultural values that emphasise social relationships and organisation of people by CSO in care and support programmes. This laid the foundation for a locally conceived model of chronic care capable of addressing the new care demands arising from the country's changing burden of disease. However, this capacity has come under threat as the reduction in donor funding to community home-based care programmes and donor and government interventions, which have changed the nature of these programmes in the country. Zambia's health system risks losing valuable capacity for fulfilling its vision 'to bring health care as close to the family as possible' if government strategies do not acknowledge the need for transformational approaches to community participation and continuation of the brokering role by CSO in primary health care.

  5. Complications and co-morbidities in radiographs of patients in traditional bone setters’ homes in Ogwa, Edo State, Nigeria: a community-based study

    International Nuclear Information System (INIS)

    Eze, Kenneth C.

    2012-01-01

    Background: Musculoskeletal injuries are common in developing countries, but access to high quality orthopedic care is not. Traditional bone setters (TBS) serve to fill the gap, but the nature and quality of their treatment are largely understudied. Traditional bone setting in Idunmunkpaghan clan of Ogwa community, Edo State, Nigeria, was founded by Odion Ekhimere between about 1680 and 1705. The TBS practice in this community is studied to find out the complications and co-morbidities associated with it. Methods: A prospective community-based study of the patients admitted in the traditional bone setters’ homes was done at Ogwa over a -2-year period by studying the admission and discharge radiographs of patients treated in the community and by interviewing the TBS and patients. Result: Ninety patients with radiographs of the lesion sites were followed up from admission to discharge at the TBS homes, comprising 53 males (53.89%) and 37 females (41.11%) with a male to female ratio of 1.4:1. Sixty five patients (72.2%) had fracture or dislocation. Forty four of the 65 patients (67.7%) with fracture/dislocation had complications including mal-union 31(70.4%), secondary osteoarthritis 8 (18.2%), non-reduction of dislocation 7 (11.9%), non-union 8 (18.2%), and others 12 (27.2%). Co-morbidities were identified in 15 patients (16.7%) and included severe osteoarthritis 7 (46.7%), diabetic foot ulcer 4 (26.7%), severe hypertension with cardiomegaly 4 (26.7%), metastatic carcinoma of the prostate 3 (20.0%), septic arthritis 2 (13.3%), pulmonary tuberculosis 1 (6.7%) and others 3 (20.0%). Conclusion: The practice of traditional bone setting is well established in Idunmunkpaghan clan in Ukpogo quarter of Ogwa. Education and training of the TBS is the key to reduction of complications and co-morbidities seen in their practices as they have high patronage and the patients have high regards for them and will continue to patronize them

  6. Complications and co-morbidities in radiographs of patients in traditional bone setters’ homes in Ogwa, Edo State, Nigeria: a community-based study

    Energy Technology Data Exchange (ETDEWEB)

    Eze, Kenneth C., E-mail: ezechallenge@yahoo.co.uk [Department of Radiology, Faculty of Medicine, College of Health Sciences, Nnamdi Azikiwe University, Nnewi Campus, Anambra State (Nigeria)

    2012-09-15

    Background: Musculoskeletal injuries are common in developing countries, but access to high quality orthopedic care is not. Traditional bone setters (TBS) serve to fill the gap, but the nature and quality of their treatment are largely understudied. Traditional bone setting in Idunmunkpaghan clan of Ogwa community, Edo State, Nigeria, was founded by Odion Ekhimere between about 1680 and 1705. The TBS practice in this community is studied to find out the complications and co-morbidities associated with it. Methods: A prospective community-based study of the patients admitted in the traditional bone setters’ homes was done at Ogwa over a -2-year period by studying the admission and discharge radiographs of patients treated in the community and by interviewing the TBS and patients. Result: Ninety patients with radiographs of the lesion sites were followed up from admission to discharge at the TBS homes, comprising 53 males (53.89%) and 37 females (41.11%) with a male to female ratio of 1.4:1. Sixty five patients (72.2%) had fracture or dislocation. Forty four of the 65 patients (67.7%) with fracture/dislocation had complications including mal-union 31(70.4%), secondary osteoarthritis 8 (18.2%), non-reduction of dislocation 7 (11.9%), non-union 8 (18.2%), and others 12 (27.2%). Co-morbidities were identified in 15 patients (16.7%) and included severe osteoarthritis 7 (46.7%), diabetic foot ulcer 4 (26.7%), severe hypertension with cardiomegaly 4 (26.7%), metastatic carcinoma of the prostate 3 (20.0%), septic arthritis 2 (13.3%), pulmonary tuberculosis 1 (6.7%) and others 3 (20.0%). Conclusion: The practice of traditional bone setting is well established in Idunmunkpaghan clan in Ukpogo quarter of Ogwa. Education and training of the TBS is the key to reduction of complications and co-morbidities seen in their practices as they have high patronage and the patients have high regards for them and will continue to patronize them.

  7. Evaluation of home lead remediation in an Australian mining community.

    Science.gov (United States)

    Boreland, F; Lesjak, M; Lyle, D

    2009-12-20

    In 1994 a comprehensive program was established to reduce children's blood lead levels in Broken Hill, NSW, Australia. Home remediation (abatement of lead hazards in a child's home) was included as part of a case management strategy for children with blood lead levels >or=15 microg/dL. Children with blood lead levels >or=30 microg/dL were offered immediate home remediation. Children with blood lead levels of 15-29 microg/dL were allocated to 'immediate' or 'delayed' home remediation; a subset of these participated in a randomized controlled trial (RCT) to evaluate the effectiveness of home remediation for reducing blood lead levels. One hundred and seventeen children received home remediation. One hundred and thirteen returned for follow-up blood tests, 88 of whom participated in the RCT. On average children's blood lead levels decreased by 1.7 microg/dL (10%) in the 6 months after remediation and by 2.2 microg/dL (13%) in the 6-12 months after remediation. However, remediation did not significantly change the rate of decline in blood lead levels (P=0.609). There was no evidence of association between change in children's blood lead levels and changes in lead loading in their homes. The results are consistent with the published literature, which suggests that home remediation does not reduce children's exposure to lead sufficiently to cause a moderate or greater decrease in their blood lead level. In communities where lead is widely dispersed, the study suggests that it is important to assess potential sources and pathways by which children are exposed to lead when developing an intervention plan, and the need for multiple interventions to effectively reduce blood lead levels. The findings reinforce the ongoing need for rigorous epidemiological evaluation of lead management programs to improve the evidence base, and for effective primary prevention to avoid children being exposed to lead in the first place.

  8. Home-based COPD psychoeducation

    DEFF Research Database (Denmark)

    Bove, D G; Midtgaard, J; Kaldan, G

    2017-01-01

    in reducing symptoms of anxiety and increasing mastery of dyspnoea in patients with advanced chronic obstructive pulmonary disease (COPD). However, we do not know if the intervention is perceived as meaningful and applicable in the everyday life of patients with advanced COPD. METHODS: We conducted a nested......OBJECTIVE: To explore the patients' experiences of a minimal home-based psychoeducative intervention aimed at reducing symptoms of anxiety. BACKGROUND: In a randomised controlled trial (RCT) we have shown that a minimal home-based and nurse-led psychoeducative intervention has a significant effect...... post-trial qualitative study. The study methodology was Interpretive Description as described by Thorne. The study was based on semi-structured interviews with twenty patients from the RCT intervention group i.g. home-living people with a diagnosis of advanced COPD and symptoms of anxiety. RESULTS...

  9. Home-based video exercise intervention for community-dwelling frail older women: a randomized controlled trial

    DEFF Research Database (Denmark)

    Vestergaard, Sonja; Kronborg, Christian; Puggaard, Lis

    2008-01-01

    and health-related quality of life. METHODS: Communitydwelling frail women >/=75 yrs, receiving public home care, were randomized into a training group (n=30) and a control group (n=31). Participants exercised for 26 minutes, three times per week for five months. Both groups received a bi-weekly telephone...... call. The effect of intervention was evaluated by the physical performance test, mobility-tiredness score, maximal isometric handgrip and biceps strength, lower limb explosive power, repeated chair rise (5 times), 10-m maximal walking-speed, semi-tandem balance, and health-related quality of life......, handgrip, biceps strength, chair rise, and 10-m maximal walking-speed in the training group, and for walking-speed and self-rated health in the control group. CONCLUSIONS: These results suggest that homebased training for frail older women using an exercise video induces lasting health-related quality...

  10. Preventing deaths from rising opioid overdose in the US – the promise of naloxone antidote in community-based naloxone take-home programs

    Directory of Open Access Journals (Sweden)

    Straus MM

    2013-09-01

    Full Text Available Michele M Straus, Udi E Ghitza, Betty Tai Center for the Clinical Trials Network, National Institute on Drug Abuse, National Institutes of Health, United States Department of Health and Human Services, Bethesda, MD, USA Abstract: The opioid overdose epidemic is an alarming and serious public health problem in the United States (US that has been escalating for 11 years. The 2011 National Survey on Drug Use and Health (NSDUH demonstrated that 1 in 20 persons in the US aged 12 or older reported nonmedical use of prescription painkillers in the past year. Prescription drug overdose is now the leading cause of accidental death in the United States – surpassing motor vehicle accidents. Great efforts have been initiated to curb the overdose crisis. Notable examples of these efforts are (1 the Drug Enforcement Administration’s (DEA National Take-Back Initiative instituted in 2010; (2 the Prescription Drug Monitoring Programs (PDMPs implemented in most US states to provide practitioners with point-of-care information regarding a patient's controlled substance use; (3 the naloxone rescue programs initiated in the community to avert mortality resulting from overdose. The use of naloxone rescue strategies has gained traction as an effective measure to prevent fatal opioid overdose. Many US federal-government agencies are working to make these strategies more accessible to first responders and community participants. This new approach faces many challenges, such as accessibility to naloxone and the equipment and training needed to administer it, but none is more challenging than the fear of legal repercussions. US federal-government agencies, local governments, health care institutions, and community-based organizations have begun to tackle these barriers, and naloxone take-home programs have gained recognition as a feasible and sensible preventive strategy to avoid a fatal result from opioid overdose. Although many challenges still need to be overcome

  11. Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services

    Directory of Open Access Journals (Sweden)

    Margaret K Danilovich

    2015-11-01

    Full Text Available Objectives: This study used validated physical performance measures to examine function, risk of adverse health outcomes, and the relationship with allocated hours of weekly caregiving assistance among older adults receiving home and community-based services through a Medicaid waiver program. Methods: Older adults (n = 42 completed physical performance measures including grip strength, 30-s chair rise, Timed Up and Go, and gait speed. Demographic information including age, gender, and allocated hours of weekly caregiving assistance were also collected. Results: A majority, 72% of females and 86% of males, had weak grip strength, 57% met criteria for fall risk based on their Timed Up and Go score, 83% had lower extremity strength impairments, and 98% were unable to ambulate more than 1.0 m/s. Frailty was prevalent in the sample with 72% of clients meeting Fried’s frailty criteria. The most significant predictors of allocated hours of weekly caregiving assistance approved for clients were race and gait speed. Conclusion: Based on scores on physical performance measures, clients are at risk of falls, hospitalization, and mortality, and scores indicate an urgent need to assess performance in addition to self-reported activities of daily living limitations for this population. Performance measures associated with quantifiable risk of adverse outcomes can be critical indicators for referrals and services needed to enhance the safety and improve care outcomes for homebound older adults.

  12. "I like talking to people on the computer": Outcomes of a home-based intervention to develop social media skills in youth with disabilities living in rural communities.

    Science.gov (United States)

    Raghavendra, Parimala; Hutchinson, Claire; Grace, Emma; Wood, Denise; Newman, Lareen

    2018-05-01

    To investigate the effectiveness of a home-based social media use intervention to enhance the social networks of rural youth with disabilities. Participants were nine youth (mean age = 17.0 years) with disabilities from two rural Australian communities. The intervention consisted of providing appropriate assistive technology and social media training on individualised goals. Using mixed methods, quantitative (a single group pre-post) and qualitative (interviews with participants and their carers) measures were used to examine outcomes of training, individual experiences of the intervention, and changes to online social networks. Participants increased their performance and satisfaction with performance on social media problem areas post-intervention; paired t-tests showed statistical significance at p social participation, independence and improvements to literacy. Ongoing parental concerns regarding cyber safety and inappropriate online content were noted. The findings suggest that social media training is a feasible method for increasing social networks among rural-based youth with disabilities. To sustain ongoing benefits, parents need knowledge and training in integrating assistive technology and social media. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Factors Affecting the Presence of Adequately Iodized Salt at Home in Wolaita, Southern Ethiopia: Community Based Study.

    Science.gov (United States)

    Kumma, Wondimagegn Paulos; Haji, Yusuf; Abdurahmen, Junayde; Mehretie Adinew, Yohannes

    2018-01-01

    Universal use of iodized salt is a simple and inexpensive method to prevent and eliminate iodine deficiency disorders like mental retardation. However, little is known about the level of adequately iodized salt consumption in the study area. Therefore, the study was aimed at assessing the proportion of households having adequately iodized salt and associated factors in Wolaita Sodo town and its peripheries, Southern Ethiopia. A cross-sectional study was conducted from May 10 to 20, 2016, in 441 households in Sodo town and its peripheries. Samples were selected using the systematic sampling technique. An iodometric titration method (AOAC, 2000) was used to analyze the iodine content of the salt samples. Data entry and analysis were done using Epi Info version 3.5.1 and SPSS version 16, respectively. The female to male ratio of the respondents was 219. The mean age of the respondents was 30.2 (±7.3 SD). The proportion of households having adequately iodized salt was 37.7%, with 95% CI of 33.2% to 42.2%. Not exposing salt to sunlight with [OR: 3.75; 95% CI: 2.14, 6.57], higher monthly income [OR: 3.71; 95% CI: 1.97-7.01], and formal education of respondents with [OR: 1.75; 95% CI: 1.14, 2.70] were found associated with the presence of adequately iodized salt at home. This study revealed low levels of households having adequately iodized salt in Wolaita Sodo town and its peripheries. The evidence here shows that there is a need to increase the supply of adequately iodized salt to meet the goal for monitoring progress towards sustainable elimination of IDD.

  14. Factors Affecting the Presence of Adequately Iodized Salt at Home in Wolaita, Southern Ethiopia: Community Based Study

    Directory of Open Access Journals (Sweden)

    Wondimagegn Paulos Kumma

    2018-01-01

    Full Text Available Background. Universal use of iodized salt is a simple and inexpensive method to prevent and eliminate iodine deficiency disorders like mental retardation. However, little is known about the level of adequately iodized salt consumption in the study area. Therefore, the study was aimed at assessing the proportion of households having adequately iodized salt and associated factors in Wolaita Sodo town and its peripheries, Southern Ethiopia. Methods. A cross-sectional study was conducted from May 10 to 20, 2016, in 441 households in Sodo town and its peripheries. Samples were selected using the systematic sampling technique. An iodometric titration method (AOAC, 2000 was used to analyze the iodine content of the salt samples. Data entry and analysis were done using Epi Info version 3.5.1 and SPSS version 16, respectively. Result. The female to male ratio of the respondents was 219. The mean age of the respondents was 30.2 (±7.3 SD. The proportion of households having adequately iodized salt was 37.7%, with 95% CI of 33.2% to 42.2%. Not exposing salt to sunlight with [OR: 3.75; 95% CI: 2.14, 6.57], higher monthly income [OR: 3.71; 95% CI: 1.97–7.01], and formal education of respondents with [OR: 1.75; 95% CI: 1.14, 2.70] were found associated with the presence of adequately iodized salt at home. Conclusion. This study revealed low levels of households having adequately iodized salt in Wolaita Sodo town and its peripheries. The evidence here shows that there is a need to increase the supply of adequately iodized salt to meet the goal for monitoring progress towards sustainable elimination of IDD.

  15. A longitudinal study of risk factors for community-based home help services in Alzheimer’s disease: the influence of cholinesterase inhibitor therapy

    Directory of Open Access Journals (Sweden)

    Wattmo C

    2013-03-01

    Full Text Available Carina Wattmo, Elisabeth Paulsson, Lennart Minthon, Elisabet LondosClinical Memory Research Unit, Department of Clinical Sciences, Malmö, Lund University, Malmö, SwedenBackground: To investigate the long-term effects of cholinesterase inhibitor (ChEI therapy and the influence of sociodemographic and clinical factors on the use of community-based home help services (HHS by patients with Alzheimer’s disease (AD.Methods: This 3-year, prospective, multicenter study included 880 AD patients treated with donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every 6 months, the patients were assessed with several rating scales, including the Mini-Mental State Examination, Instrumental Activities of Daily Living (IADL, and Physical Self-Maintenance Scale. Doses of ChEI and amounts of HHS per week were recorded. Cox regression models were used to predict the time to HHS, and multiple linear regression was used to predict the volume of HHS used.Results: During the study, 332 patients (38% used HHS. Factors that both postponed HHS use and predicted lower amounts of HHS were higher doses of ChEIs, better IADL ability, and living with family. Men, younger individuals, and those with a slower IADL decline showed a longer time to HHS, whereas female sex, a lower cognitive status, or more medications at baseline predicted fewer hours of HHS.Conclusions: Higher doses of ChEI might reduce the use of HHS, possibly reducing the costs of community-based care. Female spouses provide more informal care than do male spouses, so the likelihood of using HHS is greater among women with AD. The "silent group" of more cognitively impaired and frail elderly AD patients receives less HHS, which might precipitate institutionalization.Keywords: cognition, activities of daily living, treatment effect, gender, predictors

  16. A community-based study of early childhood sensory stimulation in home environment associated with growth and psychomotor development in Pakistan.

    Science.gov (United States)

    Avan, Bilal Iqbal; Raza, Syed Ahsan; Kirkwood, Betty R

    2014-10-01

    Sensory stimulation (SS) is a non-nutritional modifiable risk factor for early childhood development. We assessed SS in home environment and examined its influence on physical growth and psychomotor development (PD). A cross-sectional study was conducted in 26 communities in Pakistan among children aged development. There is a need to corroborate these results by additional research for integration in health policy initiatives.

  17. Effectiveness of home- and community-based rehabilitation in a large cohort of patients disabled by cerebrovascular accident: evidence of a dose-response relationship.

    Science.gov (United States)

    Altman, Irwin M; Swick, Shannon; Malec, James F

    2013-09-01

    To (1) assess the effectiveness of home- and community-based rehabilitation (HCBR) in a large cohort of individuals with disabilities secondary to cerebrovascular accident (CVA); and (2) evaluate the responsiveness to treatment of the Mayo-Portland Adaptability Inventory (MPAI-4) to changes resulting from HCBR in this patient group. Retrospective analysis of program evaluation data for treatment completers and noncompleters. HCBR conducted in 7 geographically distinct U.S. cities. Individuals with CVA (n=738) who completed the prescribed course of rehabilitation (completed course of treatment [CCT]) compared with 150 individuals who were precipitously discharged (PD) before program completion. HCBR delivered by certified professional staff on an individualized basis. Mayo-Portland Adaptability Inventory (MPAI-4) completed by professional consensus on admission and at discharge. With the use of analysis of covariance, MPAI-4 total scores at discharge for CCT participants were compared with those of PD participants, with admission MPAI-4, age, length of stay, and time since event as covariates. CCT participants showed greater improvement than PD participants (F=99.48, PMPAI-4 indexes than those in the PD group who were discharged before completing the prescribed program. This dose-response relationship provides evidence of a causal relationship between treatment and outcome. Copyright © 2013 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  18. 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.

  19. 77 FR 26361 - Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers...

    Science.gov (United States)

    2012-05-03

    ... outdated, and that ``intellectual disability'' is the appropriate way to discuss this type of disability..., and that ``intellectual disability'' is the appropriate way to discuss this type of disability, the... the benefit, and may not limit or target any service based on age, nature or type of disability...

  20. Facility and market factors affecting transitions from nursing home to community.

    Science.gov (United States)

    Arling, Greg; Abrahamson, Kathleen A; Cooke, Valerie; Kane, Robert L; Lewis, Teresa

    2011-09-01

    Research into nursing home transitions has given limited attention to the facility or community contexts. To identify facility and market factors affecting transitions of nursing home residents back to the community. Multilevel models were used to estimate effects of facility and market factors on facility-level community discharge rates after controlling for resident demographic, health, and functional conditions. Facility discharge rates were adjusted using Empirical Bayes estimation. Annual cohort of first-time admissions (N=24,648) to 378 Minnesota nursing facilities in 75 nursing home markets from July 2005 to June 2006. Community discharge within 90 days of admission; facility occupancy, payer mix, ownership, case-mix acuity, size, admissions from hospitals, nurse staffing level, and proportion of admissions preferring or having support to return to the community; and nursing market population size, average occupancy, market concentration, and availability of home and community-based services. Rates of community discharge (Empirical Bayes residual) were highest in facilities with more residents preferring community discharge, more Medicare days, higher nurse staffing levels, and higher occupancy. In addition, facilities had higher community discharge rates if they were located in markets with a greater ratio of home and community-based services recipients to nursing home residents and with larger populations. State Medicaid programs should undertake system-level interventions that encourage nursing facilities to reduce unused bed capacity, balance the mix of payers, invest in nurse staffing, and take other steps to promote community discharges. In addition, states should increase home and community-based services, particularly in markets with low community discharge rates.

  1. HOME Plus: Program design and implementation of a family-focused, community-based intervention to promote the frequency and healthfulness of family meals, reduce children's sedentary behavior, and prevent obesity.

    Science.gov (United States)

    Flattum, Colleen; Draxten, Michelle; Horning, Melissa; Fulkerson, Jayne A; Neumark-Sztainer, Dianne; Garwick, Ann; Kubik, Martha Y; Story, Mary

    2015-04-29

    Involvement in meal preparation and eating meals with one's family are associated with better dietary quality and healthy body weight for youth. Given the poor dietary quality of many youth, potential benefits of family meals for better nutritional intake and great variation in family meals, development and evaluation of interventions aimed at improving and increasing family meals are needed. This paper presents the design of key intervention components and process evaluation of a community-based program (Healthy Home Offerings via the Mealtime Environment (HOME) Plus) to prevent obesity. The HOME Plus intervention was part of a two-arm (intervention versus attention-only control) randomized-controlled trial. Ten monthly, two-hour sessions and five motivational/goal-setting telephone calls to promote healthy eating and increasing family meals were delivered in community-based settings in the Minneapolis/St. Paul, MN metropolitan area. The present study included 81 families (8-12 year old children and their parents) in the intervention condition. Process surveys were administered at the end of each intervention session and at a home visit after the intervention period. Chi-squares and t-tests were used for process survey analysis. The HOME Plus program was successfully implemented and families were highly satisfied. Parents and children reported that the most enjoyable component was cooking with their families, learning how to eat more healthfully, and trying new recipes/foods and cooking tips. Average session attendance across the ten months was high for families (68%) and more than half completed their home activities. Findings support the value of a community-based, family-focused intervention program to promote family meals, limit screen time, and prevent obesity. NCT01538615.

  2. Factors associated with intended use of a maternity waiting home in Southern Ethiopia: a community-based cross-sectional study.

    Science.gov (United States)

    Vermeiden, Tienke; Braat, Floris; Medhin, Girmay; Gaym, Asheber; van den Akker, Thomas; Stekelenburg, Jelle

    2018-01-19

    Although Ethiopia is scaling up Maternity Waiting Homes (MWHs) to reduce maternal and perinatal mortality, women's use of MWHs varies markedly between facilities. To maximize MWH utilization, it is essential that policymakers are aware of supportive and inhibitory factors. This study had the objective to describe factors and perceived barriers associated with potential utilization of an MWH among recently delivered and pregnant women in Southern Ethiopia. A community-based cross-sectional study was conducted between March and November 2014 among 428 recently delivered and pregnant women in the Eastern Gurage Zone, Southern Ethiopia, where an MWH was established for high-risk pregnant women to await onset of labour. The structured questionnaire contained questions regarding possible determinants and barriers. Logistic regression with 95% Confidence Intervals (CI) was used to examine association of selected variables with potential MWH use. While only thirty women (7.0%) had heard of MWHs prior to the study, 236 (55.1%), after being explained the concept, indicated that they intended to stay at such a structure in the future. The most important factors associated with intended MWH use in the bivariate analysis were a woman's education (secondary school or higher vs. no schooling: odds ratio [OR] 6.3 [95% CI 3.46 to 11.37]), her husband's education (secondary school or higher vs. no schooling: OR 5.4 [95% CI 3.21 to 9.06]) and envisioning relatively few barriers to MWH use (OR 0.32 [95% CI 0.25 to 0.39]). After adjusting for possible confounders, potential users had more frequently suffered complications in previous childbirths (adjusted odds ratio [aOR] 4.0 [95% CI 1.13 to 13.99]) and envisioned fewer barriers to MWH use (aOR 0.3 [95% CI 0.23 to 0.38]). Barriers to utilization included being away from the household (aOR 18.1 [95% CI 5.62 to 58.46]) and having children in the household cared for by the community during a woman's absence (aOR 9.3 [95% CI 2.67 to 32

  3. Knowledge and Skills of Mothers/Care Givers of Children Under Five Years in Communities with Home Based Management of Malaria in Tamale, Northern Region, Ghana, 2013

    Directory of Open Access Journals (Sweden)

    Mukaila Z. Mumuni

    2016-11-01

    Full Text Available Background: Malaria is still one of the major public health problems. More than 400 million cases of malaria are reported each year worldwide, Sub-Saharan Africa is the most affected region where about 90% of all malaria deaths in the world occur especially in children under five years of age. Home based management of Malaria showed a tremendous effect on reducing mortalities among children in Ghana. Objectives: to determine the current level of knowledge and skills of mothers in Tamale Metropolitan Area in the northern region of Ghana in terms of disease identification, management and transmission of malaria. Methodology: A cross sectional study conducted in 2013 involved 400 families and mothers/care givers with children less than five years were selected randomly and represented urban, peri-urbanand rural settings. Results: More than 90% of respondents identified malaria by presence of fever while 57.5% used fever as a cardinal sign. 91% of participants sought early treatment in urban and peri-urban settings while 85% did so in rural sites. 55% of participants administered the correct doses daily but only 17% of them knew the side effects of Antimalarial medications used. Almost all participants were aware about transmission of malaria, when to repeat the drug dose and usage of paracetamol as a medicine to reduce body temperature. Conclusion: The overall knowledge and skills demonstrated are encouraging, there is no much difference between urban and rural settings. Community based initiatives should be strengthened and promoted to provide homemade solutions to saving lives and resources.

  4. Pharmacist home visits: A 1-year experience from a community pharmacy.

    Science.gov (United States)

    Monte, Scott V; Passafiume, Sarah N; Kufel, Wesley D; Comerford, Patrick; Trzewieczynski, Dean P; Andrus, Kenneth; Brody, Peter M

    2016-01-01

    To provide experience on the methods and costs for delivering a large-scale community pharmacist home visit service. Independent urban community pharmacy, Buffalo, NY. Mobile Pharmacy Solutions provides traditional community pharmacy walk-in service and a suite of clinically oriented services, including outbound adherence calls linked to home delivery, payment planning, medication refill synchronization, adherence packaging, and pharmacist home visits. Pharmacist daily staffing included three dispensing pharmacists, one residency-trained pharmacist, and two postgraduate year 1 community pharmacy residents. A large-scale community pharmacy home visit service delivered over a 1-year period. Pharmacist time and cost to administer the home visit service as well as home visit request sources and description of patient demographics. A total of 172 visits were conducted (137 initial, 35 follow-up). Patients who received a home visit averaged 9.8 ± 5.2 medications and 3.0 ± 1.6 chronic disease states. On average, a home visit required 2.0 ± 0.8 hours, which included travel time. The percentages of visits completed by pharmacists and residents were 60% and 40%, respectively. The amounts of time to complete a visit were similar. Average home visit cost including pharmacist time and travel was $119 ($147 for a pharmacist, $77 for a resident). In this community pharmacy-based home visit service, costs are an important factor, with each pharmacist visit requiring 2 hours to complete. This experience provides a blueprint and real-world perspective for community pharmacies endeavoring to implement a home visit service and sets a foundation for future prospective trials to evaluate the impact of the service on important indicators of health and cost. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  5. The influence of home and community attachment on firewise behavior

    Science.gov (United States)

    Gerard T. Kyle; Gene L. Theodori; James D. Absher; Jinhee. Jun

    2010-01-01

    The purpose of this investigation was to examine the influence of residents’ attachment to their homes and community on their willingness to adopt Firewise recommendations. Our sample was drawn from a population residing in the wildland–urban interface where the threat of wildfire is acute. The Firewise recommendations concerned 13 activities affecting home design,...

  6. Lower mortality is observed among low birth weight young infants who have received home-based care by female community health volunteers in rural Nepal

    DEFF Research Database (Denmark)

    Neupane, Dinesh; Dawson, Penny; Houston, Robin

    2017-01-01

    and in many other developing countries. This is a cohort study to evaluate the risk of deaths among LBW infants who received FCHV follow up visit for home-based care compared to those who did not receive in Rural Nepal. Methods A cohort study design was used with data from the Morang Innovative Neonatal...

  7. A home-based nutrition intervention to increase consumption of fruits, vegetables, and calcium-rich foods in community dwelling elders.

    Science.gov (United States)

    Bernstein, A; Nelson, Miriam E; Tucker, Katherine L; Layne, Jennifer; Johnson, Elizabeth; Nuernberger, Andrea; Castaneda, Carmen; Judge, James O; Buchner, David; Singh, Maria Fiatarone

    2002-10-01

    To increase fruit, vegetable, and calcium-rich food consumption in community-dwelling, functionally impaired elderly. Six-month, home-based nutrition intervention study. Seventy men and women older than age 69 years were randomized to either a nutrition education intervention (n = 38) or a control group that received an exercise intervention (n = 32). Nutrition education was designed to increase fruit, vegetable, and calcium-rich food consumption. Food intake was assessed by a food frequency questionnaire. Fasting blood measures of nutrients and carotenoids were performed. Statistical Analysis Two-group randomized controlled trial with pre-test and post-test design and intention-to-treat analysis. Analysis of covariance to was used to assess differences between the two groups. Baseline and change partial correlation coefficients were performed between intake and blood nutrient levels. Paired t tests were conducted to test within-group changes. Compared with the exercise group, subjects in nutrition group increased their self-reported intake of fruits by 1.1 +/- 0.2 (mean +/- SEM) servings per day (2.8 to 3.9, P = .01), vegetables 1.1 +/- 0.2 servings per day (2.3 to 3.4, P = .001), and milk/dairy 0.9 +/- 0.2 servings per day (3.0 to 3.9, P = .001). There was an increase in the dietary intake of alpha-carotene and beta-carotene in the nutrition group and this correlated with the increase in blood concentrations of alpha-carotene and beta-carotene (P foods. Recommendations for increasing consumption of fruits, vegetables, and calcium-rich foods should be specific and individualized to meet the dietary pattern and lifestyle of the individual. Compliance should be encouraged with record keeping as well as through continuous monitoring and positive reinforcement.

  8. Needs assessment for home-based care and the strengthening of social support networks: the role of community care workers in rural South Africa

    Directory of Open Access Journals (Sweden)

    Mosa Moshabela

    2015-12-01

    Full Text Available Background: Community care workers (CCWs in rural South Africa provide medical, personal, household, educational, and social care services to their clients. However, little understanding exists on how provision of services is approached within a household, taking into account available social support networks. Objective: The aim of this study was to generate an understanding of the processes that underpin the provision of care by CCWs in rural households and their engagement with clients, primary caregivers (PCGs, and other members of the social support network. Design: We analysed in-depth interviews conducted in a triad of participants involved in a home-based care (HBC encounter – 32 clients, 32 PCGs, and 17 CCWs. For each triad, a purposefully selected CCW was linked with a purposefully selected client and the corresponding PCG using maximum variation sampling. Three coders used an inductive content analysis method to describe participants’ references to the nuances of processes followed by CCWs in servicing HBC clients. Written informed consent was obtained from all participants. Findings: The results suggest that, by intuition and prior knowledge, CCWs treated each household uniquely, depending on the clients’ care needs, cooperation, availability of a social network, and the reliability and resilience of the social support system for the client. Four distinct processes took place in rural households: needs assessment for care, rationing of care, appraisal of care, and reinforcement of a social support system. However, there was no particular order or sequence established for these processes, and caregivers followed no prescribed or shared standards. Conclusions: CCWs bring a basket of services to a household, but engage in a constant, dynamic, and cyclical process of weighing needs against services provided. The service package is uniquely crafted and tailored for each household, depending on the absorptive capacity of the social

  9. Early home-based recognition of anaemia via general danger signs, in young children, in a malaria endemic community in north-east Tanzania

    DEFF Research Database (Denmark)

    Ringsted, Frank M; Bygbjerg, Ib C; Samuelsen, Helle

    2006-01-01

    BACKGROUND: Ethnographic studies from East Africa suggest that cerebral malaria and anaemia are not classified in local knowledge as malaria complications, but as illnesses in their own right. Cerebral malaria 'degedege' has been most researched, in spite of anaemia being a much more frequent...... complication in infants, and not much is known on how this is interpreted by caretakers. Anaemia is difficult to recognize clinically, even by health workers. METHODS: Ethnographic longitudinal cohort field study for 14 months, with monthly home-visits in families of 63 newborn babies, identified by community...

  10. Midwives' experiences of referring obese women to either a community or home-based antenatal weight management service: Implications for service providers and midwifery practice.

    Science.gov (United States)

    Atkinson, Lou; French, David P; Ménage, Diane; Olander, Ellinor K

    2017-06-01

    a variety of services to support women to undertake weight management behaviours during pregnancy have recently been implemented as a means to reduce the risks to mother and infant. In the UK, midwives lead the care of the majority of pregnant women and are seen as the ideal source of referral into antenatal services. However, midwives have reported concerns regarding raising the topic of weight with obese women and negative referral experiences have been cited as a reason not to engage with a service. This study explored midwives' experiences of referring women to one of two antenatal weight management services. qualitative, cross-sectional interview and focus group study, with data analysed thematically. midwifery teams in the West Midlands, England. midwives responsible for referring to either a home-based, one to one service (N=12), or a community-based, group service (N=11). four themes emerged from the data. Participants generally had a positive View of the service, but their Information needs were not fully met, as they wanted more detail about the service and feedback regarding the women they had referred. Approaches to referral differed, with some participants referring all women who met the eligibility criteria, and some offering women a choice to be referred or not. Occasionally the topic was not raised at all when a negative reception was anticipated. Reasons for poor uptake of the services included pragmatic barriers, and their perception of women's lack of interest in weight management. midwives' differing views on choice and gaining agreement to refer means referral practices vary, which could increase the risk that obese women have inequitable access to weight management services. However, midwives' confidence in the services on offer may be increased with more detailed information about the service and feedback on referrals, which would additionally act as prompts to refer. weight management services need to improve communication with their

  11. Pet Problems at Home: Pet Problems in the Community.

    Science.gov (United States)

    Soltow, Willow

    1984-01-01

    Discusses problems of pets in the community, examining the community's role related to disruptive pets and pet overpopulation. Also discusses pet problems at home, offering advice on selecting a pet, meeting a pet's needs, and disciplining pets. Includes a list of books, films/filmstrips, teaching materials, and various instructional strategies.…

  12. Home-School Links: Networking the Learning Community.

    Science.gov (United States)

    1996

    The topic of networking the learning community with home-school links is addressed in four papers: "Internet Access via School: Expectations of Students and Parents" (Roy Crotty); "The School Library as Community Information Gateway" (Megan Perry); "Rural Access to the Internet" (Ken Eustace); and "NetDay '96:…

  13. Nurse-led home visitation programme to improve health-related quality of life and reduce disability among potentially frail community-dwelling older people in general practice: a theory-based process evaluation.

    Science.gov (United States)

    Stijnen, Mandy M N; Jansen, Maria W J; Duimel-Peeters, Inge G P; Vrijhoef, Hubertus J M

    2014-10-25

    Population ageing fosters new models of care delivery for older people that are increasingly integrated into existing care systems. In the Netherlands, a primary-care based preventive home visitation programme has been developed for potentially frail community-dwelling older people (aged ≥75 years), consisting of a comprehensive geriatric assessment during a home visit by a practice nurse followed by targeted interdisciplinary care and follow-up over time. A theory-based process evaluation was designed to examine (1) the extent to which the home visitation programme was implemented as planned and (2) the extent to which general practices successfully redesigned their care delivery. Using a mixed-methods approach, the focus was on fidelity (quality of implementation), dose delivered (completeness), dose received (exposure and satisfaction), reach (participation rate), recruitment, and context. Twenty-four general practices participated, of which 13 implemented the home visitation programme and 11 delivered usual care to older people. Data collection consisted of semi-structured interviews with practice nurses (PNs), general practitioners (GPs), and older people; feedback meetings with PNs; structured registration forms filled-out by PNs; and narrative descriptions of the recruitment procedures and registration of inclusion and drop-outs by members of the research team. Fidelity of implementation was acceptable, but time constraints and inadequate reach (i.e., the relatively healthy older people participated) negatively influenced complete delivery of protocol elements, such as interdisciplinary cooperation and follow-up of older people over time. The home visitation programme was judged positively by PNs, GPs, and older people. Useful tools were offered to general practices for organising proactive geriatric care. The home visitation programme did not have major shortcomings in itself, but the delivery offered room for improvement. General practices received

  14. Pig Farmers' Homes Harbor More Diverse Airborne Bacterial Communities Than Pig Stables or Suburban Homes.

    Science.gov (United States)

    Vestergaard, Ditte V; Holst, Gitte J; Basinas, Ioannis; Elholm, Grethe; Schlünssen, Vivi; Linneberg, Allan; Šantl-Temkiv, Tina; Finster, Kai; Sigsgaard, Torben; Marshall, Ian P G

    2018-01-01

    Airborne bacterial communities are subject to conditions ill-suited to microbial activity and growth. In spite of this, air is an important transfer medium for bacteria, with the bacteria in indoor air having potentially major consequences for the health of a building's occupants. A major example is the decreased diversity and altered composition of indoor airborne microbial communities as a proposed explanation for the increasing prevalence of asthma and allergies worldwide. Previous research has shown that living on a farm confers protection against development of asthma and allergies, with airborne bacteria suggested as playing a role in this protective effect. However, the composition of this beneficial microbial community has still not been identified. We sampled settled airborne dust using a passive dust sampler from Danish pig stables, associated farmers' homes, and from suburban homes (267 samples in total) and carried out quantitative PCR measurements of bacterial abundance and MiSeq sequencing of the V3-V4 region of bacterial 16S rRNA genes found in these samples. Airborne bacteria had a greater diversity and were significantly more abundant in pig stables and farmers' homes than suburban homes (Wilcoxon rank sum test P < 0.05). Moreover, bacterial taxa previously suggested to contribute to a protective effect had significantly higher relative and absolute abundance in pig stables and farmers' homes than in suburban homes (ALDEx2 with P < 0.05), including Firmicutes, Peptostreptococcaceae, Prevotellaceae, Lachnospiraceae, Ruminococcaceae, Ruminiclostridium , and Lactobacillus . Pig stables had significantly lower airborne bacterial diversity than farmers' homes, and there was no discernable direct transfer of airborne bacteria from stable to home. This study identifies differences in indoor airborne bacterial communities that may be an important component of this putative protective effect, while showing that pig stables themselves do not appear to

  15. Care of newborn in the community and at home.

    Science.gov (United States)

    Neogi, S B; Sharma, J; Chauhan, M; Khanna, R; Chokshi, M; Srivastava, R; Prabhakar, P K; Khera, A; Kumar, R; Zodpey, S; Paul, V K

    2016-12-01

    India has contributed immensely toward generating evidence on two key domains of newborn care: Home Based Newborn Care (HBNC) and community mobilization. In a model developed in Gadchiroli (Maharashtra) in the 1990s, a package of Interventions delivered by community health workers during home visits led to a marked decline in neonatal deaths. On the basis of this experience, the national HBNC program centered around Accredited Social Health Activists (ASHAs) was introduced in 2011, and is now the main community-level program in newborn health. Earlier in 2004, the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) program was rolled out with inclusion of home visits by Anganwadi Worker as an integral component. IMNCI has been implemented in 505 districts in 27 states and 4 union territories. A mix of Anganwadi Workers, ASHAs, auxiliary nursing midwives (ANMs) was trained. The rapid roll out of IMNCI program resulted in improving quality of newborn care at the ground field. However, since 2012 the Ministry of Health and Family Welfare decided to limit the IMNCI program to ANMs only and leaving the Anganwadi component to the stewardship of the Integrated Child Development Services. ASHAs, the frontline workers for HBNC, receive four rounds of training using two modules. There are a total of over 900 000 ASHAs per link workers in the country, out of which, only 14% have completed the fourth round of training. The pace of uptake of the HBNC program has been slow. Of the annual rural birth cohort of over 17 million, about 4 million newborns have been visited by ASHA during the financial year 2013-2014 and out of this 120 000 neonates have been identified as sick and referred to health facilities for higher level of neonatal care. Supportive supervision remains a challenge, the role of ANMs in supervision needs more clarity and there are issues surrounding quality of training and the supply of HBNC kits. The program has low visibility in many states

  16. Student, Home, and School Socio-Demographic Factors: Links to School, Home, and Community Arts Participation

    Science.gov (United States)

    Mansour, Marianne; Martin, Andrew J.; Anderson, Michael; Gibson, Robyn; Liem, Gregory Arief D.; Sudmalis, David

    2016-01-01

    This study explored the role of student (e.g., age, language background, gender), home (e.g., parent/caregiver education), and school (e.g., school type, size) socio-demographic factors in students' school (e.g., in-school arts tuition, arts engagement), home (e.g., parent/caregiver-child arts interaction), and community (e.g., arts attendance,…

  17. The Home as Workplace: Investigating Home Based Enterprises in ...

    African Journals Online (AJOL)

    The research revealed the importance of home based enterprises as a major source of income generation and socialization in urban areas. Recommendations include the adoption of case-specific planning models, consideration of cultural contexts in planning and the adoption of local economic development strategies in ...

  18. Community-Wide Zero Energy Ready Home Standard

    Energy Technology Data Exchange (ETDEWEB)

    Herk, A. [IBACOS, Inc., Pittsburgh, PA (United States); Beggs, T. [IBACOS, Inc., Pittsburgh, PA (United States)

    2016-02-05

    This report outlines the steps a developer can take when creating and implementing high performance standards such as the U.S. Department of Energy’s (DOE’s) Zero Energy Ready Home (ZERH) standards on a community-wide scale. The report also describes the specific examples of how this process is underway in the Stapleton community in Denver, Colorado, by the developer Forest City.

  19. Community Based Health Insurance Knowledge and Willingness to ...

    African Journals Online (AJOL)

    Community Based Health Insurance Knowledge and Willingness to Pay; A Survey of a Rural Community in ... Journal Home > Vol 6, No 1 (2012) > ... and is the most appropriate insurance model for rural areas where incomes are unstable.

  20. Landscaping Habitat for Humanity Homes: A Community Outreach Project

    Science.gov (United States)

    Ramsay, Jodie L.

    2008-01-01

    The purpose of this project is to incorporate a community service component into a Biology course at Northern State University (NSU) in Aberdeen, SD. Students in an upper-level botany course (Plant Structure and Function) provide landscaping services to homeowners who have purchased homes through Habitat for Humanity. Homeowner satisfaction with…

  1. Ciprofloxacin : Use and resistance in Community, Nursing Home and Hospital

    NARCIS (Netherlands)

    van Hees, B.C.

    2011-01-01

    The aim of the studies described in this thesis was to analyze some aspects of ciprofloxacin use and clinical and (molecular) epidemiology of ciprofloxacin resistance in different settings, both within hospitals (chapter 3,4 and 6), community and nursing homes (chapter 2 and 5). With its broad

  2. Home-based Neurologic Music Therapy for Upper Limb Rehabilitation with Stroke Patients at Community Rehabilitation Stage - a Feasibility Study Protocol.

    Directory of Open Access Journals (Sweden)

    Alex J Street

    2015-09-01

    Full Text Available Background: Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. Methods: For this feasibility study a small sample size of 14 participants (3 – 60 months post stroke has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n=7 or wait list control (n=7 group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Discussion: Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

  3. Home-based neurologic music therapy for upper limb rehabilitation with stroke patients at community rehabilitation stage-a feasibility study protocol.

    Science.gov (United States)

    Street, Alexander J; Magee, Wendy L; Odell-Miller, Helen; Bateman, Andrew; Fachner, Jorg C

    2015-01-01

    Impairment of upper limb function following stroke is more common than lower limb impairment and is also more resistant to treatment. Several lab-based studies with stroke patients have produced statistically significant gains in upper limb function when using musical instrument playing and techniques where rhythm acts as an external time-keeper for the priming and timing of upper limb movements. For this feasibility study a small sample size of 14 participants (3-60 months post stroke) has been determined through clinical discussion between the researcher and study host in order to test for management, feasibility and effects, before planning a larger trial determined through power analysis. A cross-over design with five repeated measures will be used, whereby participants will be randomized into either a treatment (n = 7) or wait list control (n = 7) group. Intervention will take place twice weekly over 6 weeks. The ARAT and 9HPT will be used to measure for quantitative gains in arm function and finger dexterity, pre/post treatment interviews will serve to investigate treatment compliance and tolerance. A lab based EEG case comparison study will be undertaken to explore audio-motor coupling, brain connectivity and neural reorganization with this intervention, as evidenced in similar studies. Before evaluating the effectiveness of a home-based intervention in a larger scale study, it is important to assess whether implementation of the trial methodology is feasible. This study investigates the feasibility, efficacy and patient experience of a music therapy treatment protocol comprising a chart of 12 different instrumental exercises and variations, which aims at promoting measurable changes in upper limb function in hemiparetic stroke patients. The study proposes to examine several new aspects including home-based treatment and dosage, and will provide data on recruitment, adherence and variability of outcomes.

  4. Pig Farmers’ Homes Harbor More Diverse Airborne Bacterial Communities Than Pig Stables or Suburban Homes

    Directory of Open Access Journals (Sweden)

    Ditte V. Vestergaard

    2018-05-01

    Full Text Available Airborne bacterial communities are subject to conditions ill-suited to microbial activity and growth. In spite of this, air is an important transfer medium for bacteria, with the bacteria in indoor air having potentially major consequences for the health of a building’s occupants. A major example is the decreased diversity and altered composition of indoor airborne microbial communities as a proposed explanation for the increasing prevalence of asthma and allergies worldwide. Previous research has shown that living on a farm confers protection against development of asthma and allergies, with airborne bacteria suggested as playing a role in this protective effect. However, the composition of this beneficial microbial community has still not been identified. We sampled settled airborne dust using a passive dust sampler from Danish pig stables, associated farmers’ homes, and from suburban homes (267 samples in total and carried out quantitative PCR measurements of bacterial abundance and MiSeq sequencing of the V3–V4 region of bacterial 16S rRNA genes found in these samples. Airborne bacteria had a greater diversity and were significantly more abundant in pig stables and farmers’ homes than suburban homes (Wilcoxon rank sum test P < 0.05. Moreover, bacterial taxa previously suggested to contribute to a protective effect had significantly higher relative and absolute abundance in pig stables and farmers’ homes than in suburban homes (ALDEx2 with P < 0.05, including Firmicutes, Peptostreptococcaceae, Prevotellaceae, Lachnospiraceae, Ruminococcaceae, Ruminiclostridium, and Lactobacillus. Pig stables had significantly lower airborne bacterial diversity than farmers’ homes, and there was no discernable direct transfer of airborne bacteria from stable to home. This study identifies differences in indoor airborne bacterial communities that may be an important component of this putative protective effect, while showing that pig stables

  5. Pig Farmers’ Homes Harbor More Diverse Airborne Bacterial Communities Than Pig Stables or Suburban Homes

    Science.gov (United States)

    Vestergaard, Ditte V.; Holst, Gitte J.; Basinas, Ioannis; Elholm, Grethe; Schlünssen, Vivi; Linneberg, Allan; Šantl-Temkiv, Tina; Finster, Kai; Sigsgaard, Torben; Marshall, Ian P. G.

    2018-01-01

    Airborne bacterial communities are subject to conditions ill-suited to microbial activity and growth. In spite of this, air is an important transfer medium for bacteria, with the bacteria in indoor air having potentially major consequences for the health of a building’s occupants. A major example is the decreased diversity and altered composition of indoor airborne microbial communities as a proposed explanation for the increasing prevalence of asthma and allergies worldwide. Previous research has shown that living on a farm confers protection against development of asthma and allergies, with airborne bacteria suggested as playing a role in this protective effect. However, the composition of this beneficial microbial community has still not been identified. We sampled settled airborne dust using a passive dust sampler from Danish pig stables, associated farmers’ homes, and from suburban homes (267 samples in total) and carried out quantitative PCR measurements of bacterial abundance and MiSeq sequencing of the V3–V4 region of bacterial 16S rRNA genes found in these samples. Airborne bacteria had a greater diversity and were significantly more abundant in pig stables and farmers’ homes than suburban homes (Wilcoxon rank sum test P < 0.05). Moreover, bacterial taxa previously suggested to contribute to a protective effect had significantly higher relative and absolute abundance in pig stables and farmers’ homes than in suburban homes (ALDEx2 with P < 0.05), including Firmicutes, Peptostreptococcaceae, Prevotellaceae, Lachnospiraceae, Ruminococcaceae, Ruminiclostridium, and Lactobacillus. Pig stables had significantly lower airborne bacterial diversity than farmers’ homes, and there was no discernable direct transfer of airborne bacteria from stable to home. This study identifies differences in indoor airborne bacterial communities that may be an important component of this putative protective effect, while showing that pig stables themselves do not appear

  6. Cognitive Radio-based Home Area Networks

    NARCIS (Netherlands)

    Sarijari, M.A.B.

    2016-01-01

    A future home area network (HAN) is envisaged to consist of a large number of devices that support various applications such as smart grid, security and safety systems, voice call, and video streaming. Most of these home devices are communicating based on various wireless networking technologies

  7. Abundance of introduced species at home predicts abundance away in herbaceous communities

    Science.gov (United States)

    Firn, Jennifer; Moore, Joslin L.; MacDougall, Andrew S.; Borer, Elizabeth T.; Seabloom, Eric W.; HilleRisLambers, Janneke; Harpole, W. Stanley; Cleland, Elsa E.; Brown, Cynthia S.; Knops, Johannes M.H.; Prober, Suzanne M.; Pyke, David A.; Farrell, Kelly A.; Bakker, John D.; O'Halloran, Lydia R.; Adler, Peter B.; Collins, Scott L.; D'Antonio, Carla M.; Crawley, Michael J.; Wolkovich, Elizabeth M.; La Pierre, Kimberly J.; Melbourne, Brett A.; Hautier, Yann; Morgan, John W.; Leakey, Andrew D.B.; Kay, Adam; McCulley, Rebecca; Davies, Kendi F.; Stevens, Carly J.; Chu, Cheng-Jin; Holl, Karen D.; Klein, Julia A.; Fay, Phillip A.; Hagenah, Nicole; Kirkman, Kevin P.; Buckley, Yvonne M.

    2011-01-01

    Many ecosystems worldwide are dominated by introduced plant species, leading to loss of biodiversity and ecosystem function. A common but rarely tested assumption is that these plants are more abundant in introduced vs. native communities, because ecological or evolutionary-based shifts in populations underlie invasion success. Here, data for 26 herbaceous species at 39 sites, within eight countries, revealed that species abundances were similar at native (home) and introduced (away) sites - grass species were generally abundant home and away, while forbs were low in abundance, but more abundant at home. Sites with six or more of these species had similar community abundance hierarchies, suggesting that suites of introduced species are assembling similarly on different continents. Overall, we found that substantial changes to populations are not necessarily a pre-condition for invasion success and that increases in species abundance are unusual. Instead, abundance at home predicts abundance away, a potentially useful additional criterion for biosecurity programmes.

  8. Effects of home-based tele-exercise on sarcopenia among community-dwelling elderly adults: Body composition and functional fitness.

    Science.gov (United States)

    Hong, Jeeyoung; Kim, Jeongeun; Kim, Suk Wha; Kong, Hyoun-Joong

    2017-01-01

    This study aims to develop a form of tele-exercise that would enable real-time interactions between exercise instructors and community-dwelling elderly people and to investigate its effects on improvement of sarcopenia-related factors of body composition and functional fitness among the elderly. Randomized, controlled trial, with a 12-week intervention period. Community-dwelling senior citizens in Gangseo-gu, Seoul, South Korea. The participants were 23 elderly individuals (tele-exercise group: 11, control group: 12), aged 69 to 93years. The tele-exercise program was developed utilizing a 15-in. all-in-one PC and video conferencing software (Skype™), with broadband Internet connectivity. The tele-exercise group performed supervised resistance exercise at home for 20-40min a day three times per week for 12weeks. The remote instructor provided one-on-one instruction to each participant during the intervention. The control group maintained their lifestyles without any special intervention. The sarcopenia-related factors of body composition and functional fitness were examined prior to, as well as following, a 12-week intervention period. The data were analyzed with a two-way repeated measures ANOVA. There were significant improvements in lower limb muscle mass (p=0.017), appendicular lean soft tissue (p=0.032), total muscle mass (p=0.033), and chair sit-and-reach length (p=0.019) for the tele-exercise group compared to the control group. No group×time interaction effects were detected for the 2-min step, chair stand, and time effects (psarcopenia-related factors such as total-body skeletal muscle mass, appendicular lean soft tissue, lower limb muscle mass, and the chair sit-and-reach scores among community-dwelling elderly adults. These results imply that tele-exercise can be a new and effective intervention method for increasing skeletal muscle mass and the physical functioning of the lower limbs from the perspective of sarcopenia improvement among the elderly

  9. Perceived mHealth barriers and benefits for home-based HIV testing and counseling and other care: Qualitative findings from health officials, community health workers, and persons living with HIV in South Africa.

    Science.gov (United States)

    van Heerden, Alastair; Harris, Danielle M; van Rooyen, Heidi; Barnabas, Ruanne V; Ramanathan, Nithya; Ngcobo, Nkosinathi; Mpiyakhe, Zukiswa; Comulada, W Scott

    2017-06-01

    mHealth has been proposed to address inefficiencies in the current South African healthcare system, including home-based HIV testing and counseling (HTC) programs. Yet wide-scale adoption of mHealth has not occurred. Even as infrastructure barriers decrease, a need to better understand perceived adoption barriers by stakeholders remains. We conducted focus group discussions (FGD) in South Africa in 2016 with 10 home-based HTC field staff, 12 community health workers (CHWs) and 10 persons living with HIV (PLH). Key informant (KI) interviews were conducted with five health officials. Perceptions about current home-based HTC practices, future mHealth systems and the use of biometrics for patient identification were discussed, recorded and transcribed for qualitative analysis. Themes were based on a conceptual model for perceived mHealth service quality. Stakeholders brought up a lack of communication in sharing patient health information between clinics, between clinics and CHWs, and between clinics and patients as major barriers to care that mHealth can address. CHWs need better patient information from clinics in terms of physical location and health status to plan visitation routes and address patient needs. CHWs perceive that communication barriers create distrust towards them by clinic staff. PLH want automated appointment and medication reminders. KI see mHealth as a way to improve health information transfer to government officials to better allocate healthcare resources. Stakeholders are also optimistic about the ability for biometrics to improve patient identification but disagreed as to which biometrics would be acceptable, especially in older patients. All stakeholders provided useful information towards the development of mHealth systems. Hospitals are adopting patient-centered approaches that solicit feedback from patients and incorporate them into decision-making processes. A similar approach is needed in the development of mHealth systems. Further, such

  10. A qualitative study of in-home robotic telepresence for home care of community-living elderly subjects.

    Science.gov (United States)

    Boissy, Patrick; Corriveau, Hélène; Michaud, François; Labonté, Daniel; Royer, Marie-Pier

    2007-01-01

    We examined the requirements for robots in home telecare using two focus groups. The first comprised six healthcare professionals involved in geriatric care and the second comprised six elderly people with disabilities living in the community. The concept of an in-home telepresence robot was illustrated using a photograph of a mobile robot, and participants were then asked to suggest potential health care applications. Interview data derived from the transcript of each group discussion were analyzed using qualitative induction based on content analysis. The analyses yielded statements that were categorized under three themes: potential applications, usability issues and user requirements. Teleoperated mobile robotic systems in the home were thought to be useful in assisting multidisciplinary patient care through improved communication between patients and healthcare professionals, and offering respite and support to caregivers under certain conditions. The shift from a traditional hospital-centred model of care in geriatrics to a home-based model creates opportunities for using telepresence with mobile robotic systems in home telecare.

  11. Building a design community for sustainable homes through configuration and open innovation

    DEFF Research Database (Denmark)

    Thuesen, Christian Langhoff; Jespersen, Kristina Risom

    2009-01-01

    . Furthermore will an idea space collect and rate ideas from the users. Through a combination of technical and user driven innovation the design community will act as a learning tool for the users and producers and thereby facilitate the development of a market for sustainable homes.......This paper presents a development project which aims to create a market place for sustainable homes – around a design community where the uses and producers collectively can develop new energy efficient solutions and thereby reduce the emmisson of CO2. The core functionality of the design community...... is a configurator where the users based on the produceres templates can design their own home at a selected address visualizing and estimating the energy consumption, total cost, CO2 emission etc. All the designs will be collected and rated in a design space creating transparency over the market and technologies...

  12. Naloxone and the Inner City Youth Experience (NICYE): a community-based participatory research study examining young people's perceptions of the BC take home naloxone program.

    Science.gov (United States)

    Mitchell, Keren; Durante, S Elise; Pellatt, Katrina; Richardson, Chris G; Mathias, Steve; Buxton, Jane A

    2017-06-07

    Take home naloxone (THN) programs reduce mortality by training bystanders to respond to opioid overdoses. Clinical observation by the health care team at the Inner City Youth (ICY) program indicated that young adults appeared to enthusiastically participate in the THN program and developed improved relationships with staff after THN training. However, we found a dearth of literature exploring the experiences of young adults with THN programs. This study set out to address this gap and identify suggestions from the young adults for program improvement. The primary research question was "How do street-involved young people experience the THN Program in Vancouver, BC?" The study was undertaken at the ICY Program. Two peer researchers with lived experience of THN were recruited from ICY and were involved in all phases of the study. The peer researchers and a graduate student facilitated two focus groups and five individual interviews with ICY program participants using a semi-structured interview guide. Audio recordings were transcribed verbatim. The cut-up-and-put-in-folders approach was used to identify emerging themes. The themes that emerged were perceptions of risk, altruism, strengthening relationship with staff, access to training, empowerment, and confidence in ability to respond, and suggestions for youth-friendly training. These themes were then situated within the framework of the health belief model to provide additional context. Participants viewed themselves as vulnerable to overdose and spoke of the importance of expanding access to THN training. Following training, participants reported an increase in internal locus of control, an improved sense of safety among the community of people who use drugs, improved self-esteem, and strengthened relationships with ICY staff. Overall, participants found THN training engaging, which appeared to enhance participation in other ICY programming. Young people perceived THN training as a positive experience that

  13. What is next after transfer of care from hospital to home for stroke patients? Evaluation of a community stroke care service based in a primary care clinic

    Science.gov (United States)

    Aziz, Aznida Firzah Abdul; Aziz, Noor Azah Abd; Nordin, Nor Azlin Mohd; Ali, Mohd Fairuz; Sulong, Saperi; Aljunid, Syed Mohamed

    2013-01-01

    Context: Poststroke care in developing countries is inundated with poor concordance and scarce specialist stroke care providers. A primary care-driven health service is an option to ensure optimal care to poststroke patients residing at home in the community. Aims: We assessed outcomes of a pilot long-term stroke care clinic which combined secondary prevention and rehabilitation at community level. Settings and Design: A prospective observational study of stroke patients treated between 2008 and 2010 at a primary care teaching facility. Subjects and Methods: Analysis of patients was done at initial contact and at 1-year post treatment. Clinical outcomes included stroke risk factor(s) control, depression according to Patient Health Questionnaire (PHQ9), and level of independence using Barthel Index (BI). Statistical Analysis Used: Differences in means between baseline and post treatment were compared using paired t-tests or Wilcoxon-signed rank test. Significance level was set at 0.05. Results: Ninety-one patients were analyzed. Their mean age was 62.9 [standard deviation (SD) 10.9] years, mean stroke episodes were 1.30 (SD 0.5). The median interval between acute stroke and first contact with the clinic 4.0 (interquartile range 9.0) months. Mean systolic blood pressure decreased by 9.7 mmHg (t = 2.79, P = 0.007), while mean diastolic blood pressure remained unchanged at 80mmHg (z = 1.87, P = 0.06). Neurorehabilitation treatment was given to 84.6% of the patients. Median BI increased from 81 (range: 2−100) to 90.5 (range: 27−100) (Z = 2.34, P = 0.01). Median PHQ9 scores decreased from 4.0 (range: 0−22) to 3.0 (range: 0−19) though the change was not significant (Z= −0.744, P = 0.457). Conclusions: Primary care-driven long-term stroke care services yield favorable outcomes for blood pressure control and functional level. PMID:24347948

  14. What is next after transfer of care from hospital to home for stroke patients? Evaluation of a community stroke care service based in a primary care clinic

    Directory of Open Access Journals (Sweden)

    Aznida Firzah Abdul Aziz

    2013-01-01

    Full Text Available Context: Poststroke care in developing countries is inundated with poor concordance and scarce specialist stroke care providers. A primary care-driven health service is an option to ensure optimal care to poststroke patients residing at home in the community. Aims: We assessed outcomes of a pilot long-term stroke care clinic which combined secondary prevention and rehabilitation at community level. Settings and Design: A prospective observational study of stroke patients treated between 2008 and 2010 at a primary care teaching facility. Subjects and Methods: Analysis of patients was done at initial contact and at 1-year post treatment. Clinical outcomes included stroke risk factor(s control, depression according to Patient Health Questionnaire (PHQ9, and level of independence using Barthel Index (BI. Statistical Analysis Used: Differences in means between baseline and post treatment were compared using paired t-tests or Wilcoxon-signed rank test. Significance level was set at 0.05. Results: Ninety-one patients were analyzed. Their mean age was 62.9 [standard deviation (SD 10.9] years, mean stroke episodes were 1.30 (SD 0.5. The median interval between acute stroke and first contact with the clinic 4.0 (interquartile range 9.0 months. Mean systolic blood pressure decreased by 9.7 mmHg (t = 2.79, P = 0.007, while mean diastolic blood pressure remained unchanged at 80mmHg (z = 1.87, P = 0.06. Neurorehabilitation treatment was given to 84.6% of the patients. Median BI increased from 81 (range: 2−100 to 90.5 (range: 27−100 (Z = 2.34, P = 0.01. Median PHQ9 scores decreased from 4.0 (range: 0−22 to 3.0 (range: 0−19 though the change was not significant (Z= −0.744, P = 0.457. Conclusions: Primary care-driven long-term stroke care services yield favorable outcomes for blood pressure control and functional level.

  15. Characteristics of Older Georgians Receiving Older Americans Act Nutrition Program Services and Other Home- and Community-Based Services: Findings from the Georgia Aging Information Management System (GA AIMS).

    Science.gov (United States)

    Lee, Jung Sun; Shannon, Jerry; Brown, Arvine

    2015-01-01

    This descriptive study examined characteristics of older Georgians receiving Older Americans Act Nutrition Program Services and other home- and community-based services (HCBS) using state aging administrative data (N = 31,341, mean age: 76.6 ± 9.2 y, 71.2% female, 52.3% White). Home-delivered meals (HDM) was used most frequently. The characteristics of older Georgian HCBS participants varied by the type and number of HCBS received. Those receiving HDM and other in-home and caregiving services were more likely to show poorer sociodemographic, economic, and functional characteristics, and food insecurity. Those receiving multiple HCBS were most vulnerable, but showed lower level of food insecurity than those receiving single HCBS, suggesting potential combined benefits of receiving multiple programs. This study underscores the importance of documenting dynamic needs for HCBS, especially HDM, among vulnerable older adults as part of standard administrative process to identify those at high risk of institutionalization, optimize HCBS delivery and coordination, and maximize HCBS benefits.

  16. Community-Based Care

    Science.gov (United States)

    ... our e-newsletter! Aging & Health A to Z Community-Based Care Basic Facts & Information A variety of healthcare options ... day care centers are either in churches or community centers. Adult day care is commonly used to care for people who ...

  17. Impact on postpartum hemorrhage of prophylactic administration of oxytocin 10 IU via UnijectTM by peripheral health care providers at home births: design of a community-based cluster-randomized trial

    Directory of Open Access Journals (Sweden)

    Stanton Cynthia K

    2012-06-01

    Full Text Available Abstract Background Hemorrhage is the leading direct cause of maternal death globally. While oxytocin is the drug of choice for postpartum hemorrhage prevention, its use has generally been limited to health facilities. This trial assesses the effectiveness, safety, and feasibility of expanding the use of prophylactic intramuscular oxytocin to peripheral health care providers at home births in four predominantly rural districts in central Ghana. Methods This study is designed as a community-based cluster-randomized trial in which Community Health Officers are randomized to provide (or not provide an injection of oxytocin 10 IU via the UnijectTM injection system within one minute of delivery of the baby to women who request their presence at home at the onset of labor. The primary aim is to determine if administration of prophylactic oxytocin via Uniject™ by this cadre will reduce the risk of postpartum hemorrhage by 50 % relative to deliveries which do not receive the prophylactic intervention. Postpartum hemorrhage is examined under three sequential definitions: 1 blood loss ≥500 ml (BL; 2 treatment for bleeding (TX and/or BL; 3 hospital referral for bleeding and/or TX and/or BL. Secondary outcomes address safety and feasibility of the intervention and include adverse maternal and fetal outcomes and logistical concerns regarding assistance at home births and the storage and handling of oxytocin, respectively. Discussion Results from this trial will build evidence for the effectiveness of expanding the delivery of this established prophylactic intervention to peripheral settings. Complementary data on safety and logistical issues related to this intervention will assist policymakers in low-income countries in selecting both the best uterotonic and service delivery strategy for postpartum hemorrhage prevention. Results of this trial are expected in mid-2013. The trial is registered at ClinicalTrials.gov: NCT01108289.

  18. Impact on postpartum hemorrhage of prophylactic administration of oxytocin 10 IU via Uniject™ by peripheral health care providers at home births: design of a community-based cluster-randomized trial.

    Science.gov (United States)

    Stanton, Cynthia K; Newton, Samuel; Mullany, Luke C; Cofie, Patience; Agyemang, Charlotte Tawiah; Adiibokah, Edward; Darcy, Niamh; Khan, Sadaf; Levisay, Alice; Gyapong, John; Armbruster, Deborah; Owusu-Agyei, Seth

    2012-06-07

    Hemorrhage is the leading direct cause of maternal death globally. While oxytocin is the drug of choice for postpartum hemorrhage prevention, its use has generally been limited to health facilities. This trial assesses the effectiveness, safety, and feasibility of expanding the use of prophylactic intramuscular oxytocin to peripheral health care providers at home births in four predominantly rural districts in central Ghana. This study is designed as a community-based cluster-randomized trial in which Community Health Officers are randomized to provide (or not provide) an injection of oxytocin 10 IU via the Uniject™ injection system within one minute of delivery of the baby to women who request their presence at home at the onset of labor. The primary aim is to determine if administration of prophylactic oxytocin via Uniject™ by this cadre will reduce the risk of postpartum hemorrhage by 50 % relative to deliveries which do not receive the prophylactic intervention. Postpartum hemorrhage is examined under three sequential definitions: 1) blood loss ≥500 ml (BL); 2) treatment for bleeding (TX) and/or BL; 3) hospital referral for bleeding and/or TX and/or BL. Secondary outcomes address safety and feasibility of the intervention and include adverse maternal and fetal outcomes and logistical concerns regarding assistance at home births and the storage and handling of oxytocin, respectively. Results from this trial will build evidence for the effectiveness of expanding the delivery of this established prophylactic intervention to peripheral settings. Complementary data on safety and logistical issues related to this intervention will assist policymakers in low-income countries in selecting both the best uterotonic and service delivery strategy for postpartum hemorrhage prevention. Results of this trial are expected in mid-2013. The trial is registered at ClinicalTrials.gov: NCT01108289.

  19. Effectiveness of the Home Based Life Saving Skills training by community health workers on knowledge of danger signs, birth preparedness, complication readiness and facility delivery, among women in Rural Tanzania.

    Science.gov (United States)

    August, Furaha; Pembe, Andrea B; Mpembeni, Rose; Axemo, Pia; Darj, Elisabeth

    2016-06-02

    In spite of government efforts, maternal mortality in Tanzania is currently at more than 400 per 100,000 live births. Community-based interventions that encourage safe motherhood and improved health-seeking behaviour through acquiring knowledge on the danger signs and improving birth preparedness, and, ultimately, reduce maternal mortality, have been initiated in different parts of low-income countries. Our aim was to evaluate if the Home Based Life Saving Skills education by community health workers would improve knowledge of danger signs, birth preparedness and complication readiness and facility-based deliveries in a rural community in Tanzania. A quasi-experimental study design was used to evaluate the effectiveness of Home Based Life Saving Skills education to pregnant women and their families through a community intervention. An intervention district received training with routine care. A comparison district continued to receive routine antenatal care. A structured household questionnaire was used in order to gather information from women who had delivered a child within the last two years before the intervention. This questionnaire was used in both the intervention and comparison districts before and after the intervention. The net intervention effect was estimated using the difference between the differences in the intervention and control districts at baseline and endline. A total of 1,584 and 1,486 women were interviewed at pre-intervention and post intervention, respectively. We observed significant improvement of knowledge of three or more danger signs during pregnancy (15.2 % vs. 48.1 %) with a net intervention effect of 29.0 % (95 % CI: 12.8-36.2; p effect on the knowledge of three or more danger signs during childbirth (15.3 % vs. 43.1 %) with a net intervention effect of 18.3 % (95 % CI: 11.4-25.2; p effect of 9.4 % (95 % CI: 6.4-15.7; p effect of 10.3 % (95 % CI: 10.3-20.3; p effect of 25.3 % (95 % CI: 16.9-33.2; p

  20. Developing and promoting hygiene in the home and community.

    Science.gov (United States)

    Bloomfield, S F; Signorelli, C; Fara, G

    2010-01-01

    The last two decades have seen infectious diseases (IDs) moving back up the health agenda. If the burden of ID is to be contained, the responsibility must be shared by the public. The International Scientific Forum on Home Hygiene (IFH) is working to raise awareness of the role of home hygiene, and promote understanding of hygiene practice. To develop a strategy for home hygiene, IFH has used the available scientific data to formulate a risk-based approach. This "targeted hygiene" approach maximises protection against infection, whilst minimising any impact on the environment from cleaning and disinfection products, minimising any risks associated antimicrobial resistance, and sustaining interaction with the microbial flora of the environment. IFH has developed a comprehensive range of materials which are being promoted through the IFH website and other channels. Analysis of website traffic indicates significant demand for home hygiene information including scientific material and information in "plain language".

  1. Android based security and home automation system

    OpenAIRE

    Khan, Sadeque Reza; Dristy, Farzana Sultana

    2015-01-01

    The smart mobile terminal operator platform Android is getting popular all over the world with its wide variety of applications and enormous use in numerous spheres of our daily life. Considering the fact of increasing demand of home security and automation, an Android based control system is presented in this paper where the proposed system can maintain the security of home main entrance and also the car door lock. Another important feature of the designed system is that it can control the o...

  2. Home-based intermediate care program vs hospitalization

    Science.gov (United States)

    Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

    2008-01-01

    OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

  3. A case of community-based fall prevention: Survey of organization and content of minor home help services in Swedish municipalities.

    Science.gov (United States)

    Bernfort, Lars; Eckard, Nathalie; Husberg, Magnus; Alwin, Jenny

    2014-11-01

    The aim of this study was to survey minor home help services provided by Swedish municipalities with the main purpose to prevent fall injuries. If minor home help services were presented on the homepage of a municipality, an initial telephone contact was taken. Thereafter a questionnaire was administered, including questions about target groups, aim with the services, tasks included, costs and restrictions for users, budget, and experienced gains with the services. Municipalities not providing minor home help services were asked about the reason therefore and if the municipality had previously provided the services Results: The questionnaire response rate was 92%. In 191 of Sweden's 290 municipalities services were provided by, or in cooperation with, the municipality. Reasons for not providing the services were mainly financial and lack of demand. Services were more often provided in larger cities and in municipalities located in populous regions. In some municipalities services were performed by persons with functional disabilities or unemployed persons. Both providers and users expressed satisfaction with the services aspects expressed were that services lead to greater sense of safety and social gains the effect of the services in terms of fall prevention is yet to be proved with only a small fall-preventive effect services are probably cost-effective improved quality of life, sense of safety, and being able to offer meaningful work to otherwise unemployed persons are important aspects that might in themselves motivate the provision of minor home help services. © 2014 the Nordic Societies of Public Health.

  4. Factors associated with intended use of a maternity waiting home in Southern Ethiopia : a community-based cross-sectional study

    NARCIS (Netherlands)

    Vermeiden, Tienke; Braat, Floris; Medhin, Girmay; Gaym, Asheber; van den Akker, Thomas; Stekelenburg, Jelle

    2018-01-01

    BACKGROUND: Although Ethiopia is scaling up Maternity Waiting Homes (MWHs) to reduce maternal and perinatal mortality, women's use of MWHs varies markedly between facilities. To maximize MWH utilization, it is essential that policymakers are aware of supportive and inhibitory factors. This study had

  5. WIRELESS HOME AUTOMATION SYSTEM BASED ON MICROCONTROLLER

    Directory of Open Access Journals (Sweden)

    MUNA H. SALEH

    2017-11-01

    Full Text Available This paper presents the development of Global System Mobile (GSM-based control home air-conditioner for home automation system. The main aim of the prototype development is to reduce electricity wastage. GSM module was used for receiving Short Message Service (SMS from the user’s mobile phone that automatically enable the controller to take any further action such as to switch ON and OFF the home air-conditioner. The system controls the air-conditioner based on the temperature reading through the sensor. Every period temperature sensor sends the degree to Micro Controller Unit (MCU through ZigBee. Based on temperature degree MCU send ON or OFF signal to switch. Additionally, system allows user to operate or shut down the airconditioner remotely through SMS.

  6. 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.

  7. Improving household air, drinking water and hygiene in rural Peru: a community-randomized–controlled trial of an integrated environmental home-based intervention package to improve child health

    Science.gov (United States)

    Hartinger, SM; Lanata, CF; Hattendorf, J; Verastegui, H; Gil, AI; Wolf, J; Mäusezahl, D

    2016-01-01

    Abstract Background: Diarrhoea and acute lower respiratory infections are leading causes of childhood morbidity and mortality, which can be prevented by simple low-cost interventions. Integrated strategies can provide additional benefits by addressing multiple health burdens simultaneously. Methods: We conducted a community-randomized–controlled trial in 51 rural communities in Peru to evaluate whether an environmental home-based intervention package, consisting of improved solid-fuel stoves, kitchen sinks, solar disinfection of drinking water and hygiene promotion, reduces lower respiratory infections, diarrhoeal disease and improves growth in children younger than 36 months. The attention control group received an early child stimulation programme. Results: We recorded 24 647 child-days of observation from 250 households in the intervention and 253 in the attention control group during 12-month follow-up. Mean diarrhoea incidence was 2.8 episodes per child-year in the intervention compared with 3.1 episodes in the control arm. This corresponds to a relative rate of 0.78 [95% confidence interval (CI): 0.58–1.05] for diarrhoea incidence and an odds ratio of 0.71 (95% CI: 0.47–1.06) for diarrhoea prevalence. No effects on acute lower respiratory infections or children’s growth rates were observed. Conclusions: Combined home-based environmental interventions slightly reduced childhood diarrhoea, but the confidence interval included unity. Effects on growth and respiratory outcomes were not observed, despite high user compliance of the interventions. The absent effect on respiratory health might be due to insufficient household air quality improvements of the improved stoves and additional time needed to achieve attitudinal and behaviour change when providing composite interventions. PMID:27818376

  8. Improving household air, drinking water and hygiene in rural Peru: a community-randomized-controlled trial of an integrated environmental home-based intervention package to improve child health.

    Science.gov (United States)

    Hartinger, S M; Lanata, C F; Hattendorf, J; Verastegui, H; Gil, A I; Wolf, J; Mäusezahl, D

    2016-12-01

    Diarrhoea and acute lower respiratory infections are leading causes of childhood morbidity and mortality, which can be prevented by simple low-cost interventions. Integrated strategies can provide additional benefits by addressing multiple health burdens simultaneously. We conducted a community-randomized-controlled trial in 51 rural communities in Peru to evaluate whether an environmental home-based intervention package, consisting of improved solid-fuel stoves, kitchen sinks, solar disinfection of drinking water and hygiene promotion, reduces lower respiratory infections, diarrhoeal disease and improves growth in children younger than 36 months. The attention control group received an early child stimulation programme. We recorded 24 647 child-days of observation from 250 households in the intervention and 253 in the attention control group during 12-month follow-up. Mean diarrhoea incidence was 2.8 episodes per child-year in the intervention compared with 3.1 episodes in the control arm. This corresponds to a relative rate of 0.78 [95% confidence interval (CI): 0.58-1.05] for diarrhoea incidence and an odds ratio of 0.71 (95% CI: 0.47-1.06) for diarrhoea prevalence. No effects on acute lower respiratory infections or children's growth rates were observed. Combined home-based environmental interventions slightly reduced childhood diarrhoea, but the confidence interval included unity. Effects on growth and respiratory outcomes were not observed, despite high user compliance of the interventions. The absent effect on respiratory health might be due to insufficient household air quality improvements of the improved stoves and additional time needed to achieve attitudinal and behaviour change when providing composite interventions. © The Author 2016. Published by Oxford University Press on behalf of the International Epidemiological Association

  9. 38 CFR 17.60 - Extensions of community nursing home care beyond six months.

    Science.gov (United States)

    2010-07-01

    ... nursing home care beyond six months. 17.60 Section 17.60 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS MEDICAL Use of Community Nursing Home Care Facilities § 17.60 Extensions of community nursing home care beyond six months. Directors of health care facilities may authorize, for any...

  10. Home Features and Assistive Technology for the Home-Bound Elderly in a Thai Suburban Community by Applying the International Classification of Functioning, Disability, and Health

    Directory of Open Access Journals (Sweden)

    Supawadee Putthinoi

    2017-01-01

    Full Text Available The ageing population is having an impact worldwide and has created a serious challenge in Thailand’s healthcare systems, whereby healthcare practitioners play a major role in promoting independent interaction of their client’s abilities, as well as environmental factors. The purpose of this study was to survey features of the home and assistive technology (AT for the home-bound elderly in the community of Chiang Mai, Thailand. Home evaluation included features inside and outside the home, and AT was based on the International Classification of Functioning, Disability, and Health (ICF concept. Methods included observation and an interview that were used by the researcher for evaluation. The study found that every home had at least one hazardous home feature such as inappropriate width of the door, high door threshold, tall stair steps, no bedside rail, and inappropriate height of the toilet pan. AT was found in houses as general products and technology for personal use in daily living and for personal indoor and outdoor mobility as well as transportation. Therefore, home features and AT can afford the home-bound elderly independent living within the community. Perspective AT according to the ICF concept could provide a common language for ageing in place benefits.

  11. 45 CFR 1306.33 - Home-based program option.

    Science.gov (United States)

    2010-10-01

    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Home-based program option. 1306.33 Section 1306.33... PROGRAM HEAD START STAFFING REQUIREMENTS AND PROGRAM OPTIONS Head Start Program Options § 1306.33 Home-based program option. (a) Grantees implementing a home-based program option must: (1) Provide one home...

  12. Article Commentary: The interRAI Pediatric Home Care (PEDS HC Assessment: Evaluating the Long-term Community-Based Service and Support Needs of Children Facing Special Healthcare Challenges

    Directory of Open Access Journals (Sweden)

    Charles D. Phillips

    2015-01-01

    Full Text Available The vast majority of assessment instruments developed to assess children facing special healthcare challenges were constructed to assess children within a limited age range or children who face specific conditions or impairments. In contrast, the interRAI Pediatric Home Care (PEDS HC Assessment Form was specifically designed to assess the long-term community-based service and support needs of children and youth aged from four to 20 years who face a wide range of chronic physical or behavioral health challenges. Initial research indicates that PEDS HC items exhibit good predictive validity–-explaining significant proportions of the variance in parents’ perceptions of needs, case managers’ service authorizations, and Medicaid program expenditures for long-term community-based services and supports. In addition, PEDS HC items have been used to construct scales that summarize the strengths and needs of children facing special healthcare challenges. Versions of the PEDS HC are now being used in Medicaid programs in three states in the United States.

  13. Home

    Science.gov (United States)

    intersect as Attack Wing leaders change roles The 112th COS postured as cyber shield for Pa. infrastructure 111th Attack Wing 111th Attack Wing 21st Century Guard Airmen Home News Photos Art Video Resources - The Balance Search 111th Attack Wing: COMMUNITY/ENVIRO May 16, 2018; Pa. Department of Health update

  14. A community randomised controlled trial evaluating a home-based environmental intervention package of improved stoves, solar water disinfection and kitchen sinks in rural Peru: rationale, trial design and baseline findings.

    Science.gov (United States)

    Hartinger, S M; Lanata, C F; Hattendorf, J; Gil, A I; Verastegui, H; Ochoa, T; Mäusezahl, D

    2011-11-01

    Pneumonia and diarrhoea are leading causes of death in children. There is a need to develop effective interventions. We present the design and baseline findings of a community-randomised controlled trial in rural Peru to evaluate the health impact of an Integrated Home-based Intervention Package in children aged 6 to 35 months. We randomised 51 communities. The intervention was developed through a community-participatory approach prior to the trial. They comprised the construction of improved stoves and kitchen sinks, the promotion of hand washing, and solar drinking water disinfection (SODIS). To reduce the potential impact of non-blinding bias, a psychomotor stimulation intervention was implemented in the control arm. The baseline survey included anthropometric and socio-economic characteristics. In a sub-sample we determined the level of faecal contamination of drinking water, hands and kitchen utensils and the prevalence of diarrhoegenic Escherichia coli in stool specimen. We enrolled 534 children. At baseline all households used open fires and 77% had access to piped water supplies. E. coli was found in drinking water in 68% and 64% of the intervention and control households. Diarrhoegenic E. coli strains were isolated from 45/139 stool samples. The proportion of stunted children was 54%. Randomization resulted in comparable study arms. Recently, several critical reviews raised major concerns on the reliability of open health intervention trials, because of uncertain sustainability and non-blinding bias. In this regard, the presented trial featuring objective outcome measures, a simultaneous intervention in the control communities and a 12-month follow up period will provide valuable evidence. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Smart Home System Based on GSM Network

    Directory of Open Access Journals (Sweden)

    Bakhtiar Ali Karim

    2018-04-01

    Full Text Available Due to increasing robbery and intrusion, establishing home-security system has become a correlated part of the modern houses, buildings, and offices. As the family members are not at home all the time, the traditional home security system, which makes alarm sound only, may not be efficient enough. Alternatively, Global System for Mobile communications (GSM based security system can provide higher level of security and convenience compared to the traditionally used systems. The main objective of the current paper is to design and implement cost-efficient and reliable security, safety and home automation system for protection and occupants’ convenience. If any undesired events, such as intrusion, gas leakage and fire occurs in the house, our system warns the homeowner in real-time using Short Message Service (SMS. With the proposed system home appliances can also be controlled in three ways, namely sending SMS from the authorized numbers to the system through GSM network, smartphone app using Bluetooth module and infrared (IR control using IR module

  16. Interagency partnership to deliver Veteran-Directed Home and Community-Based Services: Interviews with Aging and Disability Network agency personnel regarding their experience with partner Department of Veterans Affairs medical centers.

    Science.gov (United States)

    Thomas, Kali S; Allen, Susan M

    2016-01-01

    Veteran-Directed Home and Community-Based Services (VD-HCBS) is a consumer-directed program that began in 2009 and is jointly administered in a partnership between the Veterans Health Administration and the Administration for Community Living. The objective of this article is to describe the Aging and Disability Network agency (ADNA) personnel's perceptions of the implementation of the VD-HCBS program with partner Department of Veterans Affairs medical centers (VAMCs). Qualitative interviews with 26 ADNA VD-HCBS personnel across the country were transcribed, coded, and analyzed. Results suggest that the majority of ADNA personnel interviewed perceive the collaboration experience to be positive. Interviewees reported several key mechanisms for facilitating a successful partnership, including frequent communication, training in VAMC billing procedures, having a designated VAMC staff person for the program, and active involvement of the VAMC from the onset of VD-HCBS program development. Findings have implications for other interagency partnerships formed to deliver services to vulnerable Veterans.

  17. Needing smart home technologies: the perspectives of older adults in continuing care retirement communities.

    Science.gov (United States)

    Courtney, Karen L; Demiris, George; Rantz, Marilyn; Skubic, Marjorie

    2008-01-01

    At present, the vast majority of older adults reside in the community. Though many older adults live in their own homes, increasing numbers are choosing continuing care retirement communities (CCRCs), which range from independent apartments to assisted living and skilled-nursing facilities. With predictions of a large increase in the segment of the population aged 65 and older, a subsequent increase in demand on CCRCs can be anticipated. With these expectations, researchers have begun exploring the use of smart home information-based technologies in these care facilities to enhance resident quality of life and safety, but little evaluation research exists on older adults' acceptance and use of these technologies. This study investigated the factors that influence the willingness of older adults living in independent and assisted living CCRCs to adopt smart home technology. Participants (n = 14) were recruited from community-dwelling older adults, aged 65 or older, living in one of two mid-western US CCRC facilities (independent living and assisted living type facilities). This study used a qualitative, descriptive approach, guided by principles of grounded theory research. Data saturation (or when no new themes or issues emerged from group sessions) occurred after four focus groups (n = 11 unique respondents) and was confirmed through additional individual interviews (n = 3). The findings from this study indicate that although privacy can be a barrier for older adults' adoption of smart home technology their own perception of their need for the technology can override their privacy concerns. Factors influencing self-perception of need for smart home technology, including the influence of primary care providers, are presented. Further exploration of the factors influencing older adults' perceptions of smart home technology need and the development of appropriate interventions is necessary.

  18. A community-integrated home based depression intervention for older African Americans: descripton of the Beat the Blues randomized trial and intervention costs

    Directory of Open Access Journals (Sweden)

    Gitlin Laura N

    2012-02-01

    Full Text Available Abstract Background Primary care is the principle setting for depression treatment; yet many older African Americans in the United States fail to report depressive symptoms or receive the recommended standard of care. Older African Americans are at high risk for depression due to elevated rates of chronic illness, disability and socioeconomic distress. There is an urgent need to develop and test new depression treatments that resonate with minority populations that are hard-to-reach and underserved and to evaluate their cost and cost-effectiveness. Methods/Design Beat the Blues (BTB is a single-blind parallel randomized trial to assess efficacy of a non-pharmacological intervention to reduce depressive symptoms and improve quality of life in 208 African Americans 55+ years old. It involves a collaboration with a senior center whose care management staff screen for depressive symptoms (telephone or in-person using the Patient Health Questionnaire (PHQ-9. Individuals screened positive (PHQ-9 ≥ 5 on two separate occasions over 2 weeks are referred to local mental health resources and BTB. Interested and eligible participants who consent receive a baseline home interview and then are randomly assigned to receive BTB immediately or 4 months later (wait-list control. All participants are interviewed at 4 (main study endpoint and 8 months at home by assessors masked to study assignment. Licensed senior center social workers trained in BTB meet with participants at home for up to 10 sessions over 4 months to assess care needs, make referrals/linkages, provide depression education, instruct in stress reduction techniques, and use behavioral activation to identify goals and steps to achieve them. Key outcomes include reduced depressive symptoms (primary, reduced anxiety and functional disability, improved quality of life, and enhanced depression knowledge and behavioral activation (secondary. Fidelity is enhanced through procedure manuals and staff

  19. Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses.

    Science.gov (United States)

    Lim, Mei Ling; Yong, Bei Yi Paulynn; Mar, Mei Qi Maggie; Ang, Shin Yuh; Chan, Mei Mei; Lam, Madeleine; Chong, Ngian Choo Janet; Lopez, Violeta

    2018-07-01

    To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Ninety-nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed-bound (90%) and required full assistance with their feeding (99%). Most were not on follow-up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition. © 2018 John Wiley & Sons Ltd.

  20. 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

  1. Water, sanitation and hygiene in community based care ...

    African Journals Online (AJOL)

    Majority of the HIV/AIDS patients in South Africa receive health care services at home. However, limited studies have been conducted to examine the water, sanitation and hygiene (WASH) situation in the homes of the care receivers and its impact on community-based care. The main objective of this study was to explore ...

  2. Democratic candidates call for change in the health care system: wider use of home and community-based care, chronic disease management, universal coverage, and greater use of telehealth.

    Science.gov (United States)

    Marsh, Aaron G

    2008-10-01

    Senator Barack Obama, the Democratic candidate for president, and Senator Joe Biden, the party's candidate for vice president, have made health care reform a central pillar of their campaign. The Democrats want to target the 12 percent of Americans who are responsible for 69 percent of health care costs. Such individuals generally have multiple and complex health care problems, which if left untreated, require them to seek care in hospital emergency rooms which are vastly overcrowded. In order to solve the problem, they believe first that universal coverage along the lines of the Federal Government Employees' health plan is necessary, followed by a shift away from institutionally-based care, making home and community-based care, which integrates telehealth and other technologies, the norm. The party's platform includes this committment to help solve the problem of long-term care, which affects not only the nation's 35 million elderly, but increasingly will affect the 78 million baby boomers who are entering their retirement years.

  3. Comparison of home- and gymnasium-based resistance training on ...

    African Journals Online (AJOL)

    Comparison of home- and gymnasium-based resistance training on flexibility in the ... which is especially essential in the maintenance of functional abilities of the ... the effects of a home- and gymnasium-based resistance training programme ...

  4. The Use of Emergency Medication Kits in Community Palliative Care: An Exploratory Survey of Views of Current Practice in Australian Home-Based Palliative Care Services.

    Science.gov (United States)

    Bullen, Tracey; Rosenberg, John P; Smith, Bradley; Maher, Kate

    2015-09-01

    Improving symptom management for palliative care patients has obvious benefits for patients and advantages for the clinicians, as workload demands and work-related stress can be reduced when the emergent symptoms of patients are managed in a timely manner. The use of emergency medication kits (EMKs) can provide such timely symptom relief. The purpose of this study was to conduct a survey of a local service to examine views on medication management before and after the implementation of an EMK and to conduct a nationwide prevalence survey examining the use of EMKs in Australia. Most respondents from community palliative care services indicated that EMKs were not being supplied to palliative care patients but believed such an intervention could improve patient care. © The Author(s) 2014.

  5. Uptake of Home-Based HIV Testing, Linkage to Care, and Community Attitudes about ART in Rural KwaZulu-Natal, South Africa: Descriptive Results from the First Phase of the ANRS 12249 TasP Cluster-Randomised Trial.

    Directory of Open Access Journals (Sweden)

    Collins C Iwuji

    2016-08-01

    Full Text Available The 2015 WHO recommendation of antiretroviral therapy (ART for all immediately following HIV diagnosis is partially based on the anticipated impact on HIV incidence in the surrounding population. We investigated this approach in a cluster-randomised trial in a high HIV prevalence setting in rural KwaZulu-Natal. We present findings from the first phase of the trial and report on uptake of home-based HIV testing, linkage to care, uptake of ART, and community attitudes about ART.Between 9 March 2012 and 22 May 2014, five clusters in the intervention arm (immediate ART offered to all HIV-positive adults and five clusters in the control arm (ART offered according to national guidelines, i.e., CD4 count ≤ 350 cells/μl contributed to the first phase of the trial. Households were visited every 6 mo. Following informed consent and administration of a study questionnaire, each resident adult (≥16 y was asked for a finger-prick blood sample, which was used to estimate HIV prevalence, and offered a rapid HIV test using a serial HIV testing algorithm. All HIV-positive adults were referred to the trial clinic in their cluster. Those not linked to care 3 mo after identification were contacted by a linkage-to-care team. Study procedures were not blinded. In all, 12,894 adults were registered as eligible for participation (5,790 in intervention arm; 7,104 in control arm, of whom 9,927 (77.0% were contacted at least once during household visits. HIV status was ever ascertained for a total of 8,233/9,927 (82.9%, including 2,569 ascertained as HIV-positive (942 tested HIV-positive and 1,627 reported a known HIV-positive status. Of the 1,177 HIV-positive individuals not previously in care and followed for at least 6 mo in the trial, 559 (47.5% visited their cluster trial clinic within 6 mo. In the intervention arm, 89% (194/218 initiated ART within 3 mo of their first clinic visit. In the control arm, 42.3% (83/196 had a CD4 count ≤ 350 cells/μl at first

  6. Kinect based physiotherapy system for home use

    Directory of Open Access Journals (Sweden)

    Haas Dominik

    2015-09-01

    Full Text Available In physiotherapy, rehabilitation outcome is majorly dependent on the patient continuing exercises at home. To support a continuous and correct execution of exercises composed by the physiotherapist it is important that the patient stays motivated. With the emergence of game consoles such as Nintendo Wii, Sony PlayStation or Microsoft Xbox360 that employ special controllers or camera based motion recognition as means of user input those technologies have also been found to be interesting for other real-life applications. We present a concept to employ the Microsoft Kinect system as means to support patients during physiotherapy exercises at home. The system is intended to allow a physiotherapist to compose an individual set of exercises and to control the correct execution of those exercises through tracking the patient’s motions.

  7. Integrated and Optimized Energy-Efficient Construction Package for a Community of Production Homes in the Mixed-Humid Climate

    Energy Technology Data Exchange (ETDEWEB)

    Mallay, D. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Wiehagen, J. [Partnership for Home Innovation, Upper Marlboro, MD (United States); Del Bianco, M. [Partnership for Home Innovation, Upper Marlboro, MD (United States)

    2014-10-01

    This research high performance home analyzes how a set of advanced technologies can be integrated into a durable and energy-efficient house in the mixed-humid climate while remaining affordable to homeowners. The technical solutions documented in this report are the cornerstone of the builder's entire business model based on delivering high-performance homes on a production basis as a standard product offering to all price segments of the residential market. Home Innovation Research Labs partnered with production builder Nexus EnergyHomes (CZ 4) and they plan to adopt the successful components of the energy solution package for all 55 homes in the community. The research objective was to optimize the builder's energy solution package based on energy performance and construction costs. All of the major construction features, including envelope upgrades, space conditioning system, hot water system, and solar electric system were analyzed.

  8. The Role of Arts Participation in Students' Academic and Nonacademic Outcomes: A Longitudinal Study of School, Home, and Community Factors

    Science.gov (United States)

    Martin, Andrew J.; Mansour, Marianne; Anderson, Michael; Gibson, Robyn; Liem, Gregory A. D.; Sudmalis, David

    2013-01-01

    This longitudinal study draws on positive youth development frameworks and ecological models to examine the role of school-, home- and community-based arts participation in students' academic (e.g., motivation, engagement) and nonacademic (e.g., self-esteem, life satisfaction) outcomes. The study is based on 643 elementary and high school students…

  9. Smart Demand Response Based on Smart Homes

    Directory of Open Access Journals (Sweden)

    Jingang Lai

    2015-01-01

    Full Text Available Smart homes (SHs are crucial parts for demand response management (DRM of smart grid (SG. The aim of SHs based demand response (DR is to provide a flexible two-way energy feedback whilst (or shortly after the consumption occurs. It can potentially persuade end-users to achieve energy saving and cooperate with the electricity producer or supplier to maintain balance between the electricity supply and demand through the method of peak shaving and valley filling. However, existing solutions are challenged by the lack of consideration between the wide application of fiber power cable to the home (FPCTTH and related users’ behaviors. Based on the new network infrastructure, the design and development of smart DR systems based on SHs are related with not only functionalities as security, convenience, and comfort, but also energy savings. A new multirouting protocol based on Kruskal’s algorithm is designed for the reliability and safety of the SHs distribution network. The benefits of FPCTTH-based SHs are summarized at the end of the paper.

  10. Use of the Home Safety Self-Assessment Tool (HSSAT) within Community Health Education to Improve Home Safety.

    Science.gov (United States)

    Horowitz, Beverly P; Almonte, Tiffany; Vasil, Andrea

    2016-10-01

    This exploratory research examined the benefits of a health education program utilizing the Home Safety Self-Assessment Tool (HSSAT) to increase perceived knowledge of home safety, recognition of unsafe activities, ability to safely perform activities, and develop home safety plans of 47 older adults. Focus groups in two senior centers explored social workers' perspectives on use of the HSSAT in community practice. Results for the health education program found significant differences between reported knowledge of home safety (p = .02), ability to recognize unsafe activities (p = .01), safely perform activities (p = .04), and develop a safety plan (p = .002). Social workers identified home safety as a major concern and the HSSAT a promising assessment tool. Research has implications for reducing environmental fall risks.

  11. Active home-based cancer treatment

    Directory of Open Access Journals (Sweden)

    Bordonaro S

    2012-06-01

    Full Text Available Sebastiano Bordonaro Fabio Raiti, Annamaria Di Mari, Calogera Lopiano, Fabrizio Romano, Vitalinda Pumo, Sebastiano Rametta Giuliano, Margherita Iacono, Eleonora Lanteri, Elena Puzzo, Sebastiano Spada, Paolo TralongoUOC Medical Oncology, RAO, ASP 8 Siracusa, ItalyBackground: Active home-based treatment represents a new model of health care. Chronic treatment requires continuous access to facilities that provide cancer care, with considerable effort, particularly economic, on the part of patients and caregivers. Oral chemotherapy could be limited as a consequence of poor compliance and adherence, especially by elderly patients.Methods: We selected 30 cancer patients referred to our department and treated with oral therapy (capecitabine, vinorelbine, imatinib, sunitinib, sorafenib, temozolomide, ibandronate. This pilot study of oral therapy in the patient’s home was undertaken by a doctor and two nurses with experience in clinical oncology. The instruments used were clinical diaries recording home visits, hospital visits, need for caregiver support, and a questionnaire specially developed by the European Organization for Research and Treatment of Cancer (EORTC, known as the QLQ-C30 version 2.0, concerning the acceptability of oral treatment from the patient’s perspective.Results: This program decreased the need to access cancer facilities by 98.1%, promoted better quality of life for patients, as reflected in increased EORTC QLQ-C30 scores over time, allowing for greater adherence to oral treatment as a result of control of drug administration outside the hospital. This model has allowed treatment of patients with difficult access to care (elderly, disabled or otherwise needed caregivers that in the project represent the majority (78% of these.Conclusions: This model of active home care improves quality of life and adherence with oral therapy, reduces the need to visit the hospital, and consequently decreases the number of lost hours of work on

  12. Engaging the Community Cultural Wealth of Latino Immigrant Families in a Community-Based Program

    Science.gov (United States)

    Gil, Elizabeth

    2017-01-01

    The purpose of this qualitative case study utilizing ethnographic methods was to understand how family members' participation in Digital Home, a community-based technology program in an urban mid-sized Midwestern city, built on and fostered Latino immigrant families' community cultural wealth (Yosso, 2005) in order to increase their abilities to…

  13. 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 ...

  14. Family Connections: Building Connections among Home, School, and Community

    Science.gov (United States)

    Dikkers, Amy Garrett

    2013-01-01

    Recent research on parental involvement has explored connections between parental involvement in school and children's academic achievement. While many schools have active parent organizations and a base of parents who offer additional support, others struggle to make connections with their parents or community members. Even in places with active…

  15. Extended architecture for home base stations with multimedia services

    NARCIS (Netherlands)

    Voicu, A.; Jarnikov, D.S.

    2011-01-01

    This paper describes the use of mobile access points (home node base stations, femtocells) for providing TV streaming to mobile devices inside the home. The research is focused on finding commonalities between architectures of the home node base station for different technologies. The result is a

  16. Challenges for sustainability of home based economic activities in ...

    African Journals Online (AJOL)

    Factors accountable for successful and sustainable home based economic activities were determined. Impacts of home based economic activities were found to be significant in the education of the children, income security and social welfare of families. The study emphasized home economic entrepreneurial education, ...

  17. Is socially integrated community day care for people with dementia associated with higher user satisfaction and a higher job satisfaction of staff compared to nursing home-based day care?

    Science.gov (United States)

    Marijke van Haeften-van Dijk, A; Hattink, Bart J J; Meiland, Franka J M; Bakker, Ton J E M; Dröes, Rose-Marie

    2017-06-01

    To investigate whether community-based (CO) day care with carer support according to the proven effective Meeting Centres Support Programme model is associated with higher satisfaction of people with dementia (PwD) and their informal caregivers (CG) and with a higher job satisfaction among care staff compared to traditional nursing home-based (NH) day care. Data were collected in 11 NH day care centres and 11 CO day care centres. User satisfaction of PwD and CG was evaluated in the 11 NH day care centres (n PwD = 41, n CG = 39) and 11 CO day care centres (n PwD = 28, n CG = 36) with a survey after six months of participation. Job satisfaction was measured only in the six NH day care centres that recently transformed to CO day care, with two standard questionnaires before (n STAFF = 35), and six months after the transition (n STAFF = 35). PwD were more positive about the communication and listening skills of staff and the atmosphere and activities at the CO day care centre. Also, CG valued the communication with, and expertise of, staff in CO day care higher, and were more satisfied with the received emotional, social and practical support. After the transition, satisfaction of staff with the work pace increased, but satisfaction with learning opportunities decreased. PwD and CG were more satisfied about the communication with the staff and the received support in CO day care than in NH day care. Overall job satisfaction was not higher, except satisfaction about work pace.

  18. 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...

  19. Smart GSM Based Home Automation System

    OpenAIRE

    Teymourzadeh, Rozita

    2013-01-01

    This research work investigates the potential of ‘Full Home Control’, which is the aim of the Home Automation Systems in near future. The analysis and implementation of the home automation technology using Global System for Mobile Communication (GSM) modem to control home appliances such as light, conditional system, and security system via Short Message Service (SMS) text messages is presented in this paper. The proposed research work is focused on the functionality of the GSM protocol, whic...

  20. Associations between nursing home performance and hospital 30-day readmissions for acute myocardial infarction, heart failure and pneumonia at the healthcare community level in the United States.

    Science.gov (United States)

    Pandolfi, Michelle M; Wang, Yun; Spenard, Ann; Johnson, Florence; Bonner, Alice; Ho, Shih-Yieh; Elwell, Timothy; Bakullari, Anila; Galusha, Deron; Leifheit-Limson, Erica; Lichtman, Judith H; Krumholz, Harlan M

    2017-12-01

    readmission rates for Medicare fee-for-service patients for acute myocardial infarction, heart failure or pneumonia. Coordinated care between hospitals and nursing homes is essential to reduce readmissions. Nursing homes can improve performance and reduce readmissions by increasing registered nursing homes. Further, communities can work together to create cross-continuum care teams comprised of hospitals, nursing homes, patients and their families, and other community-based service providers to reduce unplanned readmissions. © 2017 John Wiley & Sons Ltd.

  1. Preventive home visits to elderly people by community nurses in The Netherlands.

    NARCIS (Netherlands)

    Kerkstra, A.; Castelein, E.; Philipsen, H.

    1991-01-01

    This study aims at a description of the current position of preventive home visits to the elderly by community nurses in The Netherlands. Over a period of 8 weeks, a representative sample of 108 community nurses and 49 community nursing auxiliaries at 47 different locations paid a total number of

  2. Effectiveness of a San Francisco Bay area community education program on reducing home energy use

    Science.gov (United States)

    Wilkinson, Ellen M.

    In order to promote the adoption of home energy reduction practices and mitigate the climate impact of the collective greenhouse gas emissions generated by consumers, it is critical to identify an effective educational approach. A community-based educational intervention model that employs norms, information, commitment, feedback, and face-to-face communication strategies was examined for its ability to motivate changes in everyday energy-use behavior in two communities compared to a control group. A follow up study was also conducted to evaluate whether behaviors adopted as a result of the intervention were long lasting, and whether the community-focused features of the intervention were motivating to participants. Results showed that a greater number of individuals participated in the intervention over its five-month duration, reported significantly higher numbers of adopted behaviors, and maintained more adopted behaviors post-intervention than did people in the control group. In addition, intervention participants reported that some of the community-based features of the intervention motivated their behavior changes. These findings lend support to a number of social and community psychology theories about how to design effective interventions by leveraging social awareness and support.

  3. 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 ...

  4. Wireless Android Based Home Automation System

    Directory of Open Access Journals (Sweden)

    Muhammad Tanveer Riaz

    2017-01-01

    Full Text Available This manuscript presents a prototype and design implementation of an advance home automation system that uses Wi-Fi technology as a network infrastructure connecting its parts. The proposed system consists of two main components; the first part is the server, which presents system core that manages and controls user’s home. Users and system administrator can locally (Local Area Network or remotely (internet manage and control the system. Second part is the hardware interface module, which provides appropriate interface to sensors and actuator of home automation system. Unlike most of the available home automation system in the market, the proposed system is scalable that one server can manage many hardware interface modules as long as it exists within network coverage. System supports a wide range of home automation devices like appliances, power management components, and security components. The proposed system is better in terms of the flexibility and scalability than the commercially available home automation systems

  5. Personal computer based home automation system

    OpenAIRE

    Hellmuth, George F.

    1993-01-01

    The systems engineering process is applied in the development of the preliminary design of a home automation communication protocol. The objective of the communication protocol is to provide a means for a personal computer to communicate with adapted appliances in the home. A needs analysis is used to ascertain that a need exist for a home automation system. Numerous design alternatives are suggested and evaluated to determine the best possible protocol design. Coaxial cable...

  6. Community Food Environment, Home Food Environment, and Fruit and Vegetable Intake of Children and Adolescents

    Science.gov (United States)

    Ding, Ding; Sallis, James F.; Norman, Gregory J.; Saelens, Brian E.; Harris, Sion Kim; Kerr, Jacqueline; Rosenberg, Dori; Durant, Nefertiti; Glanz, Karen

    2012-01-01

    Objectives: To determine (1) reliability of new food environment measures; (2) association between home food environment and fruit and vegetable (FV) intake; and (3) association between community and home food environment. Methods: In 2005, a cross-sectional survey was conducted with readministration to assess test-retest reliability. Adolescents,…

  7. Home-based versus centre-based cardiac rehabilitation.

    Science.gov (United States)

    Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

    2010-01-20

    The burden of cardiovascular disease world-wide is one of great concern to patients and health care agencies alike. Traditionally centre-based cardiac rehabilitation (CR) programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. To determine the effectiveness of home-based cardiac rehabilitation programmes compared with supervised centre-based cardiac rehabilitation on mortality and morbidity, health-related quality of life and modifiable cardiac risk factors in patients with coronary heart disease. We updated the search of a previous review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2007, Issue 4), MEDLINE, EMBASE and CINAHL from 2001 to January 2008. We checked reference lists and sought advice from experts. No language restrictions were applied. Randomised controlled trials (RCTs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes, in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Studies were selected independently by two reviewers, and data extracted by a single reviewer and checked by a second one. Authors were contacted where possible to obtain missing information. Twelve studies (1,938 participants) met the inclusion criteria. The majority of studies recruited a lower risk patient following an acute myocardial infarction (MI) and revascularisation. There was no difference in outcomes of home- versus centre-based cardiac rehabilitation in mortality risk ratio (RR) was1.31 (95% confidence interval (C) 0.65 to 2.66), cardiac events, exercise capacity standardised mean difference (SMD) -0.11 (95% CI -0.35 to 0.13), as well as in modifiable risk factors (systolic blood pressure; diastolic blood pressure; total cholesterol

  8. Community and home gardens increase vegetable intake and food security of residents in San Jose, California

    Directory of Open Access Journals (Sweden)

    Susan Algert

    2016-04-01

    Full Text Available As of 2013, 42 million American households were involved in growing their own food either at home or in a community garden plot. The purpose of this pilot study was to document the extent to which gardeners, particularly less affluent ones, increase their vegetable intake when eating from either home or community garden spaces. Eighty-five community gardeners and 50 home gardeners from San Jose, California, completed a survey providing information on demographic background, self-rated health, vegetable intake and the benefits of gardening. The gardeners surveyed were generally low income and came from a variety of ethnic and educational backgrounds. Participants in this study reported doubling their vegetable intake to a level that met the number of daily servings recommended by the U.S. Dietary Guidelines. Growing food in community and home gardens can contribute to food security by helping provide access to fresh vegetables and increasing consumption of vegetables by gardeners and their families.

  9. National Survey of Emergency Physicians Concerning Home-Based Care Options as Alternatives to Emergency Department-Based Hospital Admissions.

    Science.gov (United States)

    Stuck, Amy R; Crowley, Christopher; Killeen, James; Castillo, Edward M

    2017-11-01

    Emergency departments (EDs) in the United States play a prominent role in hospital admissions, especially for the growing population of older adults. Home-based care, rather than hospital admission from the ED, provides an important alternative, especially for older adults who have a greater risk of adverse events, such as hospital-acquired infections, falls, and delirium. The objective of the survey was to understand emergency physicians' (EPs) perspectives on home-based care alternatives to hospitalization from the ED. Specific goals included determining how often EPs ordered home-based care, what they perceive as the barriers and motivators for more extensive ordering of home-based care, and the specific conditions and response times most appropriate for such care. A group of 1200 EPs nationwide were e-mailed a six-question survey. Participant response was 57%. Of these, 55% reported ordering home-based care from the ED within the past year as an alternative to hospital admission or observation, with most doing so less than once per month. The most common barrier was an "unsafe or unstable home environment" (73%). Home-based care as a "better setting to care for low-acuity chronic or acute disease exacerbation" was the top motivator (79%). Medical conditions EPs most commonly considered for home-based care were cellulitis, urinary tract infection, diabetes, and community-acquired pneumonia. Results suggest that EPs recognize there is a benefit to providing home-based care as an alternative to hospitalization, provided they felt the home was safe and a process was in place for dispositioning the patient to this setting. Better understanding of when and why EPs use home-based care pathways from the ED may provide suggestions for ways to promote wider adoption. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

  10. The emotional context facing nursing home residents' families: a call for role reinforcement strategies from nursing homes and the community.

    Science.gov (United States)

    Bern-Klug, Mercedes

    2008-01-01

    Identify useful concepts related to the emotional context facing family members of nursing home residents. These concepts can be used in future studies to design and test interventions that benefit family caregivers. Secondary data analyses of qualitative ethnographic data. Two nursing homes in a large Midwestern city; 8 months of data collection in each. 44 family members of nursing home residents whose health was considered, "declining." Role theory was used to design and help interpret the findings. Data included transcripts of conversations between family members and researchers and were analyzed using a coding scheme developed for the secondary analysis. Comments about emotions related to the social role of family member were grouped into three categories: relief related to admission, stress, and decision making support/stress. Subcategories of stress include the role strain associated with "competing concerns" and the psychological pressures of 1) witnessing the decline of a loved one in a nursing home, and 2) guilt about placement. Decision-making was discussed as a challenge which family members did not want to face alone; support from the resident, health care professionals, and other family members was appreciated. Family members may benefit from role reinforcement activities provided by nursing home staff and community members. All nursing home staff members (in particular social workers) and physicians are called upon to provide educationa and support regarding nursing home admissions, during the decline of the resident, and especially regarding medical decision-making. Community groups are asked to support the family member by offering assistance with concrete tasks (driving, visiting, etc.) and social support.

  11. Nursing staff competence, work strain, stress and satisfaction in elderly care: a comparison of home-based care and nursing homes.

    Science.gov (United States)

    Hasson, Henna; Arnetz, Judith E

    2008-02-01

    The aims of this study were to: (1) compare older people care nursing staff's perceptions of their competence, work strain and work satisfaction in nursing homes and home-based care; and (2) to examine determinants of work satisfaction in both care settings. The shift in older people care from hospitals to community-based facilities and home care has had implications for nursing practice. Lack of competence development, high levels of work strain and low levels of work satisfaction among nursing staff in both care settings have been associated with high turnover. Few studies have compared staff perceptions of their competence and work in nursing homes as opposed to home-based care. A cross-sectional questionnaire survey. Nursing staff perceptions of their competence, work strain, stress and satisfaction were measured by questionnaire in 2003 in two older people care organizations in Sweden. Comparisons of all outcome variables were made between care settings both within and between the two organizations. Multiple regression analysis was used to determine predictors of work satisfaction in home care and nursing homes respectively. In general, staff in home-based care reported significantly less sufficient knowledge compared with staff in nursing homes. However, home care staff experienced significantly less physical and emotional strain compared with staff in nursing homes. Ratings of work-related exhaustion, mental energy and overall work satisfaction did not differ significantly between care settings. In both care settings, work-related exhaustion was the strongest (inverse) predictor of work satisfaction. Future interventions should focus on counteracting work-related exhaustion and improving competence development to improve work satisfaction among older people care nursing staff in both care settings. Relevance to clinical practice. Work-related exhaustion and lack of competence development may have significant negative implications for work satisfaction among

  12. Introducing priority setting and resource allocation in home and community care programs.

    Science.gov (United States)

    Urquhart, Bonnie; Mitton, Craig; Peacock, Stuart

    2008-01-01

    To use evidence from research to identify and implement priority setting and resource allocation that incorporates both ethical practices and economic principles. Program budgeting and marginal analysis (PBMA) is based on two key economic principles: opportunity cost (i.e. doing one thing instead of another) and the margin (i.e. resource allocation should result in maximum benefit for available resources). An ethical framework for priority setting and resource allocation known as Accountability for Reasonableness (A4R) focuses on making sure that resource allocations are based on a fair decision-making process. It includes the following four conditions: publicity; relevance; appeals; and enforcement. More recent literature on the topic suggests that a fifth condition, that of empowerment, should be added to the Framework. The 2007-08 operating budget for Home and Community Care, excluding the residential sector, was developed using PBMA and incorporating the A4R conditions. Recommendations developed using PBMA were forwarded to the Executive Committee, approved and implemented for the 2007-08 fiscal year operating budget. In addition there were two projects approved for approximately $200,000. PBMA is an improvement over previous practice. Managers of Home and Community Care are committed to using the process for the 2008-09 fiscal year operating budget and expanding its use to include mental health and addictions services. In addition, managers of public health prevention and promotion services are considering using the process.

  13. The impact of dementia on influenza vaccination uptake in community and care home residents.

    Science.gov (United States)

    Shah, Sunil M; Carey, Iain M; Harris, Tess; DeWilde, Stephen; Cook, Derek G

    2012-01-01

    Influenza vaccination is recommended for older people irrespective of cognitive decline or residential setting. To examine the effect of dementia diagnosis on flu vaccination uptake in community and care home residents in England and Wales. Retrospective analysis of a primary care database with 378,462 community and 9,106 care (nursing and residential) home residents aged 65-104 in 2008-09. Predictors of vaccine uptake were examined adjusted for age, sex, area deprivation and major chronic diseases. Age and sex standardised uptake of influenza vaccine was 74.7% (95% CI: 73.7-75.8%) in community patients without dementia, 71.4% (69.3-73.5%) in community patients with dementia, 80.5% (78.9-82.2%) in care home patients without dementia and 83.3% (81.4-85.3%) in care home patients with dementia. In a fully adjusted model, compared with community patients without dementia, patients with dementia in the community were less likely to receive vaccination (RR: 0.96, 95% CI: 0.94-0.97) while care home patients with (RR: 1.06, 1.03-1.09) and without (RR: 1.03, 1.01-1.05) dementia were more likely to receive vaccination. Area deprivation and chronic diseases were, respectively, negative and positive predictors of uptake. Lower influenza vaccine uptake among community patients with dementia, compared with care home residents, suggests organisational barriers to community uptake but high uptake among patients with dementia in care homes does not suggest concern over informed consent acts as a barrier. Primary care for community patients with dementia needs to ensure that they receive all appropriate preventive interventions.

  14. Boom clay pore water, home of a diverse microbial community

    International Nuclear Information System (INIS)

    Wouters, Katinka; Moors, Hugo; Leys, Natalie

    2012-01-01

    Document available in extended abstract form only. Boom Clay pore water (BCPW) has been studied in the framework of geological disposal of nuclear waste for over two decades, thereby mainly addressing its geochemical properties. A reference composition for synthetic clay water has been derived earlier by modelling and spatial calibration efforts, mainly based on interstitial water sampled from different layers within the Boom clay. However, since microbial activity is found in a range of extreme circumstances, the possibility of microbes interacting with future radioactive waste in a host formation like Boom Clay, cannot be ignored. In this respect, BCPW was sampled from different Boom Clay layers using the Morpheus piezometer and subsequently analysed by a complementary set of microbiological and molecular techniques, in search for overall shared and abundant microorganisms. Similar to the previous characterization of the 'average' BCPW chemical composition, the primary aim of this microbiological study is to determine a representative BCPW microbial community which can be used in laboratory studies. Secondly, the in situ activity and the metabolic properties of members of this community were addressed, aiming to assess their survival and proliferation chances in repository conditions. In a first approach, total microbial DNA of the community was extracted from the BCPW samples. This molecular approach allows a broad insight in the total microbial ecology of the BCPW samples. By polymerase chain reaction (PCR) on the highly conserved 16S rRNA genes in this DNA pool and subsequent sequencing and bio-informatics analysis, operational taxonomic units (OTUs) could be assigned to the microbial community. The bacterial community was found to be quite diverse, with OTUs belonging to 8 different phyla (Proteobacteria, Actinobacteria, Firmicutes, Bacteroidetes, Chlorobi, Spirochetes, Chloroflexi and Deinococcus-Thermus). These results provide an overall view of the

  15. Boom clay pore water, home of a diverse microbial community

    Energy Technology Data Exchange (ETDEWEB)

    Wouters, Katinka; Moors, Hugo; Leys, Natalie [SCK.CEN, Environment, Health and Safety Institute, B-2400 Mol (Belgium)

    2012-10-15

    Document available in extended abstract form only. Boom Clay pore water (BCPW) has been studied in the framework of geological disposal of nuclear waste for over two decades, thereby mainly addressing its geochemical properties. A reference composition for synthetic clay water has been derived earlier by modelling and spatial calibration efforts, mainly based on interstitial water sampled from different layers within the Boom clay. However, since microbial activity is found in a range of extreme circumstances, the possibility of microbes interacting with future radioactive waste in a host formation like Boom Clay, cannot be ignored. In this respect, BCPW was sampled from different Boom Clay layers using the Morpheus piezometer and subsequently analysed by a complementary set of microbiological and molecular techniques, in search for overall shared and abundant microorganisms. Similar to the previous characterization of the 'average' BCPW chemical composition, the primary aim of this microbiological study is to determine a representative BCPW microbial community which can be used in laboratory studies. Secondly, the in situ activity and the metabolic properties of members of this community were addressed, aiming to assess their survival and proliferation chances in repository conditions. In a first approach, total microbial DNA of the community was extracted from the BCPW samples. This molecular approach allows a broad insight in the total microbial ecology of the BCPW samples. By polymerase chain reaction (PCR) on the highly conserved 16S rRNA genes in this DNA pool and subsequent sequencing and bio-informatics analysis, operational taxonomic units (OTUs) could be assigned to the microbial community. The bacterial community was found to be quite diverse, with OTUs belonging to 8 different phyla (Proteobacteria, Actinobacteria, Firmicutes, Bacteroidetes, Chlorobi, Spirochetes, Chloroflexi and Deinococcus-Thermus). These results provide an overall view of the

  16. Home-based Constraint Induced Movement Therapy Poststroke

    OpenAIRE

    Stephen Isbel HScD; Christine Chapparo PhD; David McConnell PhD; Judy Ranka PhD

    2014-01-01

    Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors. Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity L...

  17. The functions of hospital-based home care for people with severe mental illness in Taiwan.

    Science.gov (United States)

    Huang, Xuan-Yi; Lin, Mei-Jue; Yang, Tuz-Ching; Hsu, Yuan-Shan

    2010-02-01

    The purposes of this study were to understand the functions of hospital-based home care for people with severe mental illness in Taiwan, and the factors that affect functions of professionals who provide hospital-based home care. Hospital-based home care is a service which provides those people with serious mental illnesses who are in crisis and who are candidates for admission to hospital. Home care has been shown to have several advantages over inpatient treatment. However, there is a lack of knowledge about the functions of hospital-based home care for people with severe mental illness in Taiwan. This qualitative study was based on the grounded theory method of Strauss and Corbin. The study was conducted in six different hospital areas in central Taiwan in 2007-2008. Data were collected using semi-structured face-to-face interviews. Constant comparative analysis continued during the open, axial and selective coding processes until data saturation occurred. Participants were selected by theoretical sampling. When theoretical saturation was achieved, 21 clients with mental illness, 19 carers and 25 professionals were interviewed. Several functions were found when these professionals provided hospital-based home care services for people with severe mental illness in Taiwan, including stabilising the clients illness, supplying emergency care services, improving life-coping abilities, employment and welfare assistance, emotional support for both clients and carers, assistance with future and long-term arrangements and assistance with communication between carers and clients. Hospital-based home care provides several important services for helping clients and their families to live in the community. The recommendations based on the findings of this study can be used as a guide to improve the delivery of hospital-based home care services to community-dwelling clients with severe mental illness and their carers.

  18. Does smart home technology prevent falls in community-dwelling older adults: a literature review.

    Science.gov (United States)

    Pietrzak, Eva; Cotea, Cristina; Pullman, Stephen

    2014-01-01

    Falls in older Australians are an increasingly costly public health issue, driving the development of novel modes of intervention, especially those that rely on computer-driven technologies. The aim of this paper was to gain an understanding of the state of the art of research on smart homes and computer-based monitoring technologies to prevent and detect falls in the community-dwelling elderly. Cochrane, Medline, Embase and Google databases were searched for articles on fall prevention in the elderly using pre-specified search terms. Additional papers were searched for in the reference lists of relevant reviews and by the process of 'snowballing'. Only studies that investigated outcomes related to falling such as fall prevention and detection, change in participants' fear of falling and attitudes towards monitoring technology were included. Nine papers fulfilled the inclusion criteria. The following outcomes were observed: (1) older adults' attitudes towards fall detectors and smart home technology are generally positive; (2) privacy concerns and intrusiveness of technology were perceived as less important to participants than their perception of health needs and (3) unfriendly and age-inappropriate design of the interface may be one of the deciding factors in not using the technology. So far, there is little evidence that using smart home technology may assist in fall prevention or detection, but there are some indications that it may increase older adults' confidence and sense of security, thus possibly enabling aging in place.

  19. A tailored counseling and home-based rehabilitation program to increase physical activity and improve mobility among community-dwelling older people after hospitalization: protocol of a randomized controlled trial.

    Science.gov (United States)

    Turunen, K; Aaltonen, L; Kumpumäki, J; Portegijs, E; Keikkala, S; Kinnunen, M-L; Finni, T; Sipilä, S; Nikander, R

    2017-11-21

    Physical activity (PA) decreases during hospitalization. In particular, the amount of PA engaged in by older people who are hospitalized following musculoskeletal injury is likely to be limited for months after discharge home. Given the importance of an active lifestyle for their recovery and the prevention of future adverse outcomes, there is clearly a need for interventions to increase PA. This article describes the protocol of a randomized controlled trial set up to investigate the effects of a physical activity oriented home rehabilitation program (ProPA) on PA and the restoration of mobility in community-dwelling older people. Men and women aged 60 years or older hospitalized due to a musculoskeletal injury or disorder in the back or lower limbs are recruited. After discharge from hospital to home, participants are randomized into a six-month ProPA program or a standard care (control) group. The ProPA program consists of a motivational interview, goal attainment process, guidance for safe walking, a progressive home exercise program and physical activity counseling. In addition, frail participants who are not able to go outdoors alone receive support from volunteers. Primary outcomes are PA measured using a 3-dimentional accelerometer, and mobility assessed by the Short Physical Performance Battery and self-reports. Secondary outcomes are life space mobility, participation restriction, fear of falling, pain, mood, and grip strength. Information on barriers to and enablers of PA participation are also collected. Data on mortality and use of health services are collected from the national register. In this 6-month intervention, all participants are assessed in their homes at baseline and after three and six months, and at 12 months after randomization they will receive a follow-up questionnaire. This study investigates the effects of a rehabilitation program on PA and mobility among older people at risk for increased sedentary time and mobility problems. If

  20. Reconsidering Community-based Retailing

    OpenAIRE

    Maughan, Rebecca; O'Driscoll, Aidan

    2012-01-01

    One of the areas with great potential for economic, social and environmental benefit is community-based retailing. The concept of community based retailing can incorporate a number of different tenets. We suggest that it is retailing that is based close to the community it serves, usually within the town or village centre rather than out-of-town locations, and which is composed of a diverse range of small and medium sized business that are often independently or co-operatively owned. These co...

  1. Internationalisation at Home: Exploiting the Potential of the Non-nationals' and Expatriates' Community

    Directory of Open Access Journals (Sweden)

    Andreja Jaklič

    2016-02-01

    Full Text Available Objective: The paper explores the first-time internationalisation strategy and discusses whether firms could actually begin internationalisation at home without crossing the border by approaching the international expatriates’ community in the home city/market. Research Design & Methods: The concept of internationalisation at home is studied through the case study method. An example of a public company from the creative industry in the capital city from the Central and Eastern European region is studied. Findings: The expatriates’ community, so far often neglected market segment, has a rising potential in several European cites. The results highlight a positive impact on performance after approaching the expatriates’ community. Organisational learning effects result in improved and stabilised sales and strengthened firm-specific advantages. Implications & Recommendations: Internationalisation at home is disruptive innovation, especially appropriate for enterprises under high resource constraints. It is fast, cost efficient and has positive externalities. The international expatriates’ community in the home city/market offers fast organisational learning and a testing area for enterprises. Contribution & Value Added: Internationalisation at home adds to the existing understanding of internationalisation. The findings that firms could begin the organisational learning process of internationalisation before or even without the first foreign entry and proposals for the integrating expatriates’ community into the marketing strategy may influence future internationalisation paths.

  2. Treating Emotionally Disturbed Youth: Home-Based Family Focused Intervention.

    Science.gov (United States)

    Anders-Cibik, Pamela; And Others

    Home-based intervention services for emotionally disturbed youth are also commonly known as in-home services, family-centered services, family-based services, intensive family services, or family preservation services. They have developed as a way to deal with serious family problems that often result in the removal of a child or adolescent from…

  3. International Journal of Web Based Communities

    DEFF Research Database (Denmark)

    2006-01-01

    Special Issue on Knowledge Communication, culture and communities of practice in web based communities. ......Special Issue on Knowledge Communication, culture and communities of practice in web based communities. ...

  4. Home-based carers’ perceptions of health promotion on sexual health communication in Vhembe District

    Directory of Open Access Journals (Sweden)

    Dorah U. Ramathuba

    2015-05-01

    Full Text Available Background: The introduction of home-based care in rural communities in the 1980s contributed immensely toward the upliftment of the personal and environmental health of communities. Women’s groups provided health promotion skills and health education to communities and made a difference in health-related behaviour change. Objective: The purpose of the study was to explore and describe the home-based carers’ perception regarding health promotion concerning sexual health communication in Vhembe district, in the context of HIV, amongst communities still rooted in their culture. Method: A qualitative, explorative and descriptive design was used in order to understand home-based carers’ perceptions regarding health promotion on sexual health communication amongst rural communities which may adversely impact on health promotion practices. The population were home-based organisations in Vhembe. The sample was purposive and randomly selected and data were gathered through semi-structured face-to-face interviews and focus groups which determined data saturation. Open coding was used for analysis of data. Results: The results indicated that sexual communication was absent in most relationships and was not seen as necessary amongst married couples. Socioeconomic conditions, power inequity and emotional dependence had a negative impact on decision making and sexual communication. Conclusion: This study, therefore, recommends that educational and outreach efforts should focus on motivating change by improving the knowledge base of home-based carers. Since they are health promoters, they should be able to change the perceptions of the communities toward sexually-transmitted infections and HIV by promoting sexual health communication.

  5. The Calibration Home Base for Imaging Spectrometers

    Directory of Open Access Journals (Sweden)

    Johannes Felix Simon Brachmann

    2016-08-01

    Full Text Available The Calibration Home Base (CHB is an optical laboratory designed for the calibration of imaging spectrometers for the VNIR/SWIR wavelength range. Radiometric, spectral and geometric calibration as well as the characterization of sensor signal dependency on polarization are realized in a precise and highly automated fashion. This allows to carry out a wide range of time consuming measurements in an ecient way. The implementation of ISO 9001 standards in all procedures ensures a traceable quality of results. Spectral measurements in the wavelength range 380–1000 nm are performed to a wavelength uncertainty of +- 0.1 nm, while an uncertainty of +-0.2 nm is reached in the wavelength range 1000 – 2500 nm. Geometric measurements are performed at increments of 1.7 µrad across track and 7.6 µrad along track. Radiometric measurements reach an absolute uncertainty of +-3% (k=1. Sensor artifacts, such as caused by stray light will be characterizable and correctable in the near future. For now, the CHB is suitable for the characterization of pushbroom sensors, spectrometers and cameras. However, it is planned to extend the CHBs capabilities in the near future such that snapshot hyperspectral imagers can be characterized as well. The calibration services of the CHB are open to third party customers from research institutes as well as industry.

  6. Home-based virtual reality balance training and conventional balance training in Parkinson's disease: A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Wen-Chieh Yang

    2016-09-01

    Conclusion: This study did not find any difference between the effects of the home-based virtual reality balance training and conventional home balance training. The two training options were equally effective in improving balance, walking, and quality of life among community-dwelling patients with PD.

  7. Wireless Android Based Home Automation System

    OpenAIRE

    Muhammad Tanveer Riaz; Eman Manzoor Ahmed; Fariha Durrani; Muhammad Asim Mond

    2017-01-01

    This manuscript presents a prototype and design implementation of an advance home automation system that uses Wi-Fi technology as a network infrastructure connecting its parts. The proposed system consists of two main components; the first part is the server, which presents system core that manages and controls user’s home. Users and system administrator can locally (Local Area Network) or remotely (internet) manage and control the system. Second part is the hardware interface module, which p...

  8. An Ontological Perspective on the Development of Home-School Partnership Relationships with Indigenous Communities

    Science.gov (United States)

    Hindle, Rawiri; Hynds, Anne; Averill, Robin; Meyer, Luanna; Faircloth, Susan

    2017-01-01

    We propose the use of an ontological perspective to shift current thinking about the phenomenon of home/school partnerships, particularly through an examination of school leaders (leadership team)--community relationships that seek to better serve Indigenous students and their communities. We reanalysed focus group interviews of indigenous Maori…

  9. Home-based care for people living with AIDS in Zimbabwe ...

    African Journals Online (AJOL)

    Similar to the healthcare systems of other resource-constrained countries with a high prevalence of HIV and AIDS, Zimbabwe's healthcare system encourages communities and non-governmental organisations (NGOs) to support the public healthcare sector by initiating home-based care activities and training volunteers to ...

  10. A Role Model Mother/caregiver Programme to Expand Home-based ...

    African Journals Online (AJOL)

    In Nigeria, a Role Model Mother/Caregiver (RMM/C) programme was initiated by the National Malaria Control Programme (NMCP) to provide home-based management of malaria. Criteria for RMM/C selection were developed centrally by the Nigerian NMCP for community use. RMM/Cs were identified and recruited by the ...

  11. Named data networking-based smart home

    Directory of Open Access Journals (Sweden)

    Syed Hassan Ahmed

    2016-09-01

    Full Text Available Named data networking (NDN treats content/data as a “first class citizen” of the network by giving it a “name”. This content “name” is used to retrieve any information, unlike in device-centric networks (i.e., the current Internet, which depend on physical IP addresses. Meanwhile, the smart home concept has been gaining attention in academia and industries; various low-cost embedded devices are considered that can sense, process, store, and communicate data autonomously. In this paper, we study NDN in the context of smart-home communications, discuss the preliminary evaluations, and describe the future challenges of applying NDN in smart-home applications.

  12. Exploring home visits in a faith community as a service-learning opportunity.

    Science.gov (United States)

    du Plessis, Emmerentia; Koen, Magdalene P; Bester, Petra

    2013-08-01

    Within South Africa the Psychiatric Nursing Science curriculum in undergraduate Baccalaureate nursing education utilizes home visits as a service-learning opportunity. In this context faith communities are currently unexplored with regards to service-learning opportunities. With limited literature available on this topic, the question was raised as to what are these students' and family members' experience of home visits within a faith community. To explore and describe nursing students' and family members' experiences of home visits within a faith community. A qualitative approach was used that was phenomenological, explorative and descriptive and contextual in nature. The research was conducted within a faith community as service learning opportunity for Baccalaureate degree nursing students. This community was situated in a semi-urban area in the North-West Province, South Africa. Eighteen (n=18) final year nursing students from different cultural representations, grouped into seven groups conducted home visits at seven (n=7) families. Comprehensive reflective reporting after the visits, namely that the students participated in a World Café data collection technique and interviews were conducted with family members. Three main themes emerged: students' initial experiences of feeling overwhelmed but later felt more competent; students' awareness of religious and cultural factors; and students' perception of their role. Two main themes from the family members emerged: experiencing caring and growth. There is mutual benefit for nursing students and family members. Students' experiences progress during home visits from feeling overwhelmed and incompetent towards a trusting relationship. Home visits in a faith community seems to be a valuable service learning opportunity, and the emotional competence, as well as spiritual and cultural awareness of nursing students should be facilitated in preparation for such home visits. Copyright © 2012 Elsevier Ltd. All rights

  13. Effects of Nursing Home Residency on Diabetes Care in Individuals with Dementia: An Explorative Analysis Based on German Claims Data

    Directory of Open Access Journals (Sweden)

    Larissa Schwarzkopf

    2017-02-01

    Full Text Available Aims: This claims data-based study compares the intensity of diabetes care in community dwellers and nursing home residents with dementia. Methods: Delivery of diabetes-related medical examinations (DRMEs was compared via logistic regression in 1,604 community dwellers and 1,010 nursing home residents with dementia. The intra-individual effect of nursing home transfer was evaluated within mixed models. Results: Delivery of DRMEs decreases with increasing care dependency, with more community-living individuals receiving DRMEs. Moreover, DRME provision decreases after nursing home transfer. Conclusion: Dementia patients receive fewer DRMEs than recommended, especially in cases of higher care dependency and particularly in nursing homes. This suggests lacking awareness regarding the specific challenges of combined diabetes and dementia care.

  14. A Systematic Review of Home-Based Childhood Obesity Prevention Studies

    Science.gov (United States)

    Fawole, Oluwakemi; Segal, Jodi; Wilson, Renee F.; Cheskin, Lawrence J.; Bleich, Sara N.; Wu, Yang; Lau, Brandyn; Wang, Youfa

    2013-01-01

    BACKGROUND AND OBJECTIVES: Childhood obesity is a global epidemic. Despite emerging research about the role of the family and home on obesity risk behaviors, the evidence base for the effectiveness of home-based interventions on obesity prevention remains uncertain. The objective was to systematically review the effectiveness of home-based interventions on weight, intermediate (eg, diet and physical activity [PA]), and clinical outcomes. METHODS: We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library from inception through August 11, 2012. We included experimental and natural experimental studies with ≥1-year follow-up reporting weight-related outcomes and targeting children at home. Two independent reviewers screened studies and extracted data. We graded the strength of the evidence supporting interventions targeting diet, PA, or both for obesity prevention. RESULTS: We identified 6 studies; 3 tested combined interventions (diet and PA), 1 used diet intervention, 1 combined intervention with primary care and consumer health informatics components, and 1 combined intervention with school and community components. Select combined interventions had beneficial effects on fruit/vegetable intake and sedentary behaviors. However, none of the 6 studies reported a significant effect on weight outcomes. Overall, the strength of evidence is low that combined home-based interventions effectively prevent obesity. The evidence is insufficient for conclusions about home-based diet interventions or interventions implemented at home in association with other settings. CONCLUSIONS: The strength of evidence is low to support the effectiveness of home-based child obesity prevention programs. Additional research is needed to test interventions in the home setting, particularly those incorporating parenting strategies and addressing environmental influences. PMID:23753095

  15. Home

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  16. [Community coordination of dental care needs in a home medical care support ward and at home].

    Science.gov (United States)

    Sumi, Yasunori; Ozawa, Nobuyoshi; Miura, Hiroko; Miura, Hisayuki; Toba, Kenji

    2011-01-01

    The purpose of this study was to ascertain the current statuses and problems of dental home care patients by surveying the oral care status and needs of patients in the home medical care support ward at the National Center for Geriatrics and Gerontology. Patients that required continuous oral management even after discharge from the hospital were referred to local dental clinics to receive home dental care. We investigated the suitability and problems associated with such care, and identified the dental care needs of home patients and the status of local care coordination, including those in hospitals. The subjects were 82 patients. We ascertained their general condition and oral status, and also investigated the problems associated with patients judged to need specialized oral care by a dentist during oral treatment. Patients who required continuous specialized oral care after discharge from hospital were referred to dental clinics that could provide regular care, and the problems at the time of referral were identified. Dry mouth was reported by many patients. A large number of patients also needed specialized dental treatment such as the removal of dental calculus or tooth extraction. Problems were seen in oral function, with 38 of the patients (46%) unable to gargle and 23 (28%) unable to hold their mouths open. About half of the patients also had dementia, and communication with these patients was difficult. Of the 43 patients who were judged to need continuing oral care after discharge from hospital, their referral to a dental clinic for regular care was successful for 22 (51%) patients and unsuccessful for 21 (49%) patients. The reasons for unsuccessful referrals included the fact that the family, patient, nurse, or caregiver did not understand the need for specialized oral care. The present results suggest the need for specialized oral treatment in home medical care. These findings also suggest that coordinating seamless dental care among primary physicians

  17. Work characteristics and pesticide exposures among migrant agricultural families: a community-based research approach.

    Science.gov (United States)

    McCauley, L A; Lasarev, M R; Higgins, G; Rothlein, J; Muniz, J; Ebbert, C; Phillips, J

    2001-05-01

    There are few data on pesticide exposures of migrant Latino farmworker children, and access to this vulnerable population is often difficult. In this paper we describe a community-based approach to implement culturally appropriate research methods with a migrant Latino farmworker community in Oregon. Assessments were conducted in 96 farmworker homes and 24 grower homes in two agricultural communities in Oregon. Measurements included surveys of pesticide use and work protection practices and analyses of home-dust samples for pesticide residues of major organophosphates used in area crops. Results indicate that migrant farmworker housing is diverse, and the amounts and types of pesticide residues found in homes differ. Azinphos-methyl (AZM) was the pesticide residue found most often in both farmworker and grower homes. The median level of AZM in farmworker homes was 1.45 ppm compared to 1.64 ppm in the entry area of grower homes. The median level of AZM in the play areas of grower homes was 0.71 ppm. The levels of AZM in migrant farmworker homes were most associated with the distance from fields and the number of agricultural workers in the home. Although the levels of AZM in growers and farmworker homes were comparable in certain areas, potential for disproportionate exposures occur in areas of the homes where children are most likely to play. The relationship between home resident density, levels of pesticide residues, and play behaviors of children merit further attention.

  18. Experiences with and expectations of maternity waiting homes in Luapula Province, Zambia: a mixed-methods, cross-sectional study with women, community groups and stakeholders.

    Science.gov (United States)

    Chibuye, Peggy S; Bazant, Eva S; Wallon, Michelle; Rao, Namratha; Fruhauf, Timothee

    2018-01-25

    Luapula Province has the highest maternal mortality and one of the lowest facility-based births in Zambia. The distance to facilities limits facility-based births for women in rural areas. In 2013, the government incorporated maternity homes into the health system at the community level to increase facility-based births and reduce maternal mortality. To examine the experiences with maternity homes, formative research was undertaken in four districts of Luapula Province to assess women's and community's needs, use patterns, collaboration between maternity homes, facilities and communities, and promising practices and models in Central and Lusaka Provinces. A cross-sectional, mixed-methods design was used. In Luapula Province, qualitative data were collected through 21 focus group discussions with 210 pregnant women, mothers, elderly women, and Safe Motherhood Action Groups (SMAGs) and 79 interviews with health workers, traditional leaders, couples and partner agency staff. Health facility assessment tools, service abstraction forms and registers from 17 facilities supplied quantitative data. Additional qualitative data were collected from 26 SMAGs and 10 health workers in Central and Lusaka Provinces to contextualise findings. Qualitative transcripts were analysed thematically using Atlas-ti. Quantitative data were analysed descriptively using Stata. Women who used maternity homes recognized the advantages of facility-based births. However, women and community groups requested better infrastructure, services, food, security, privacy, and transportation. SMAGs led the construction of maternity homes and advocated the benefits to women and communities in collaboration with health workers, but management responsibilities of the homes remained unassigned to SMAGs or staff. Community norms often influenced women's decisions to use maternity homes. Successful maternity homes in Central Province also relied on SMAGs for financial support, but the sustainability of these

  19. Using Medicaid To Increase Funding for Home- and Community-Based Mental Health Services for Children and Youth with Severe Emotional Disturbances. A Report on a CASSP Workshop (Bethesda, Maryland, September 14-15, 1988).

    Science.gov (United States)

    Williams, Sarah

    This report highlights the major issues discussed during a 2-day workshop on Medicaid funding for community-based mental health services for children and youth with severe emotional disturbances. The report opens with a brief description of the service needs of children and youth with severe emotional disturbances and the system of care that can…

  20. An Ontology-based Context-aware System for Smart Homes: E-care@home

    Directory of Open Access Journals (Sweden)

    Marjan Alirezaie

    2017-07-01

    Full Text Available Smart home environments have a significant potential to provide for long-term monitoring of users with special needs in order to promote the possibility to age at home. Such environments are typically equipped with a number of heterogeneous sensors that monitor both health and environmental parameters. This paper presents a framework called E-care@home, consisting of an IoT infrastructure, which provides information with an unambiguous, shared meaning across IoT devices, end-users, relatives, health and care professionals and organizations. We focus on integrating measurements gathered from heterogeneous sources by using ontologies in order to enable semantic interpretation of events and context awareness. Activities are deduced using an incremental answer set solver for stream reasoning. The paper demonstrates the proposed framework using an instantiation of a smart environment that is able to perform context recognition based on the activities and the events occurring in the home.

  1. An Ontology-based Context-aware System for Smart Homes: E-care@home.

    Science.gov (United States)

    Alirezaie, Marjan; Renoux, Jennifer; Köckemann, Uwe; Kristoffersson, Annica; Karlsson, Lars; Blomqvist, Eva; Tsiftes, Nicolas; Voigt, Thiemo; Loutfi, Amy

    2017-07-06

    Smart home environments have a significant potential to provide for long-term monitoring of users with special needs in order to promote the possibility to age at home. Such environments are typically equipped with a number of heterogeneous sensors that monitor both health and environmental parameters. This paper presents a framework called E-care@home, consisting of an IoT infrastructure, which provides information with an unambiguous, shared meaning across IoT devices, end-users, relatives, health and care professionals and organizations. We focus on integrating measurements gathered from heterogeneous sources by using ontologies in order to enable semantic interpretation of events and context awareness. Activities are deduced using an incremental answer set solver for stream reasoning. The paper demonstrates the proposed framework using an instantiation of a smart environment that is able to perform context recognition based on the activities and the events occurring in the home.

  2. An Exploratory Examination of Social Ties and Crime in Mobile Home Communities

    Directory of Open Access Journals (Sweden)

    William P. McCarty

    2013-11-01

    Full Text Available Guided by the systemic model of social disorganization, the purpose of this study was to explore the nature of social ties in mobile home communities and examine how that relates to rates of violent and property crime. Interviews with a small sample of mobile home residents, owners, and managers in Omaha, Nebraska, indicate a wide spectrum of communities, from those characterized by an atomized population to those with strong social ties. Fear of crime, ethnically heterogeneous populations, and lax management were cited by respondents as factors that undermined relationships. Proactive management and a desire to help neighbors were cited by respondents as factors that helped strengthen relationships. Violent and property crime rates for the mobile home communities were largely consistent with the interview data, providing support for the importance of social networks and a systemic model of social disorganization. The implications of these findings for research and policy are also explored.

  3. Gendered home-based care in South Africa: more trouble for the troubled.

    Science.gov (United States)

    Akintola, Olagoke

    2006-11-01

    This study investigates the experiences of informal caregivers of people living with HIV in two semi-rural communities in South Africa. Ethnographic methods were used to collect and analyse data on the gendered nature and consequences of home-based care from 21 primary caregivers and 20 volunteer caregivers as well as 10 key informants. It was generally women who were poor, unemployed and unmarried who combined the care-giving role with their traditional role as homemaker and that of being the household head and breadwinner. The caregivers experienced physical strains and emotional problems, and were at elevated risk of being infected with HIV and TB. Men were largely absent in HIV/AIDS-affected homes and usually did not assist because of rigid gendered divisions of labour. Home-based care, by creating a disproportionate burden on women, is exacerbating existing gender inequities. It is argued that a thorough understanding of how home-based care undermines the physical health and psychological wellbeing of already vulnerable women is crucial for informing policies on home-based care. Thus, there is a need to incorporate gender perspectives when planning and implementing home-based care programmes.

  4. The European Community ITER Home Team Organization: January 1993

    International Nuclear Information System (INIS)

    Spears, W.R.

    1994-01-01

    The European Community (EC) Fusion Programme embraces all work carried out in the field of thermonuclear fusion by magnetic confinement in the 12 Member States and in two extra-Community countries, Sweden and Switzerland (which are fully associated with this Programme). The long-term objective of the EC Fusion Programme is the joint creation of safe, environmentally sound prototype reactors. This Programme presents itself as a single body in its relation with other Fusion Programmes in the world

  5. Automated Clinical Assessment from Smart home-based Behavior Data

    Science.gov (United States)

    Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

    2016-01-01

    Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behaviour in the home and predicting standard clinical assessment scores of the residents. To accomplish this goal, we propose a Clinical Assessment using Activity Behavior (CAAB) approach to model a smart home resident’s daily behavior and predict the corresponding standard clinical assessment scores. CAAB uses statistical features that describe characteristics of a resident’s daily activity performance to train machine learning algorithms that predict the clinical assessment scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years using prediction and classification-based experiments. In the prediction-based experiments, we obtain a statistically significant correlation (r = 0.72) between CAAB-predicted and clinician-provided cognitive assessment scores and a statistically significant correlation (r = 0.45) between CAAB-predicted and clinician-provided mobility scores. Similarly, for the classification-based experiments, we find CAAB has a classification accuracy of 72% while classifying cognitive assessment scores and 76% while classifying mobility scores. These prediction and classification results suggest that it is feasible to predict standard clinical scores using smart home sensor data and learning-based data analysis. PMID:26292348

  6. [Current status of costs and utilizations of hospital based home health nursing care in Korea].

    Science.gov (United States)

    Ryu, Hosihn

    2006-12-01

    The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequela of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won ( approximately 48 $, 1 $=960 Won). The costs ranged from 74,523 Won ( approximately 78 $, loss of chronic kidney function, N18) to 32,270 Won ( approximately 34 $, other cerebrovascular diseases, I67). Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

  7. Community-based recreational football

    DEFF Research Database (Denmark)

    Bruun, Ditte Marie; Bjerre, Eik; Krustrup, Peter

    2014-01-01

    is limited and the majority of prostate cancer survivors remain sedentary. Hence, novel approaches to evaluate and promote physical activity are warranted. This paper presents the rationale behind the delivery and evaluation of community-based recreational football offered in existing football clubs under...... the Danish Football Association to promote quality of life and physical activity adherence in prostate cancer survivors. The RE-AIM framework will be applied to evaluate the impact of the intervention including outcomes both at the individual and organizational level. By introducing community-based sport...

  8. Work characteristics and pesticide exposures among migrant agricultural families: a community-based research approach.

    OpenAIRE

    McCauley, L A; Lasarev, M R; Higgins, G; Rothlein, J; Muniz, J; Ebbert, C; Phillips, J

    2001-01-01

    There are few data on pesticide exposures of migrant Latino farmworker children, and access to this vulnerable population is often difficult. In this paper we describe a community-based approach to implement culturally appropriate research methods with a migrant Latino farmworker community in Oregon. Assessments were conducted in 96 farmworker homes and 24 grower homes in two agricultural communities in Oregon. Measurements included surveys of pesticide use and work protection practices and a...

  9. Cost effectiveness of facility and home based HIV voluntary ...

    African Journals Online (AJOL)

    Cost effectiveness of facility and home based HIV voluntary counseling and ... Background: In Uganda, the main stay for provision of human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) ... AJOL African Journals Online.

  10. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K

    2012-01-01

    , as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory......The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university...... hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment...

  11. Assessment of Home-Based Nigerian Engineers on Risk ...

    African Journals Online (AJOL)

    Assessment of Home-Based Nigerian Engineers on Risk Management Approach ... Journal of Applied Sciences and Environmental Management ... The Analysis of Variance (ANOVA) and Correlation methods were adopted for statistical ...

  12. A Home-Based Palliative Care Consult Service for Veterans.

    Science.gov (United States)

    Golden, Adam G; Antoni, Charles; Gammonley, Denise

    2016-11-01

    We describe the development and implementation of a home-based palliative care consult service for Veterans with advanced illness. A retrospective chart review was performed on 73 Veterans who received a home-based palliative care consult. Nearly one-third were 80 years of age or older, and nearly one-third had a palliative diagnosis of cancer. The most common interventions of the consult team included discussion of advance directives, completion of a "do not resuscitate" form, reduction/stoppage of at least 1 medication, explanation of diagnosis, referral to home-based primary care program, referral to hospice, and assessment/support for caregiver stress. The home-based consult service was therefore able to address clinical and psychosocial issues that can demonstrate a direct benefit to Veterans, families, and referring clinicians. © The Author(s) 2015.

  13. Inculcating home economics based life skills in rural women in ...

    African Journals Online (AJOL)

    Inculcating home economics based life skills in rural women in Anambra state ... Poverty among rural women in Nigeria hinders the economic and social ... could be inculcated among the rural women using a range of networking approaches.

  14. Does smart home technology prevent falls in community-dwelling older adults: a literature review

    Directory of Open Access Journals (Sweden)

    Eva Pietrzak

    2014-04-01

    Full Text Available Background: Falls in older Australians are an increasingly costly public health issue, driving the development of novel modes of intervention, especially those that rely on computer-driven technologies. Objective: The aim of this paper was to gain an understanding of the state of the art of research on smart homes and computer-based monitoring technologies to prevent and detect falls in the community-dwelling elderly. Method: Cochrane, Medline, Embase and Google databases were searched for articles on fall prevention in the elderly using pre-specified search terms. Additional papers were searched for in the reference lists of relevant reviews and by the process of ‘snowballing’. Only studies that investigated outcomes related to falling such as fall prevention and detection, change in participants’ fear of falling and attitudes towards monitoring technology were included. Results: Nine papers fulfilled the inclusion criteria. The following outcomes were observed: (1 older adults’ attitudes towards fall detectors and smart home technology are generally positive; (2 privacy concerns and intrusiveness of technology were perceived as less important to participants than their perception of health needs and (3 unfriendly and age-inappropriate design of the interface may be one of the deciding factors in not using the technology. Conclusion: So far, there is little evidence that using smart home technology may assist in fall prevention or detection, but there are some indications that it may increase older adults’ confidence and sense of security, thus possibly enabling aging in place.

  15. Integrated and Optimized Energy-Efficient Construction Package for a Community of Production Homes in the Mixed-Humid Climate

    Energy Technology Data Exchange (ETDEWEB)

    Mallay, D.; Wiehagen, J.; Del Bianco, M.

    2014-10-01

    Selection and integration of high performance home features are two sides of the same coin in energy efficient sustainable construction. Many advanced technologies are available for selection, but it is in the integration of these technologies into an affordable set of features that can be used on a production basis by builders, that ensures whole-house performance meets expectations. This research high performance home analyzes how a set of advanced technologies can be integrated into a durable and energy efficient house in the mixed-humid climate while remaining affordable to homeowners. The technical solutions documented in this report are the cornerstone of the builder's entire business model based on delivering high-performance homes on a production basis as a standard product offering to all price segments of the residential market. Home Innovation Research Labs partnered with production builder Nexus EnergyHomes (CZ 4). The builder plans to adopt the successful components of the energy solution package for all 55 homes in the community. The research objective was to optimize the builder's energy solution package based on energy performance and construction costs. All of the major construction features, including envelope upgrades, space conditioning system, hot water system, and solar electric system were analyzed. The information in this report can be used by builders and designers to evaluate options, and the integration of options, for increasing the efficiency of home designs in climate zone 4. The data also provide a point of reference for evaluating estimates of energy savings and costs for specific features.

  16. Synthetic socioeconomic based domestic wastewater hydrographs for small arid communities

    KAUST Repository

    Elnakar, H.

    2012-06-04

    A model was developed to predict synthetic socioeconomic based domestic wastewater hydrographs for the small arid communities. The model predicts the flow hydrograph for random weekdays and weekends based on the specific socioeconomic characteristics of the community. The main socioeconomic characteristics are the composition of the community, the different user behaviours in using water appliances, and the unit discharges of such appliances. Use patterns of water appliances are assumed to vary for the various members of the community and the type of day. Each community is composed of several social categories such as the employee, working woman, stay home woman, stay home child, students etc. The use patterns account for the stochastic nature of use in terms of number of uses, duration of the use and times of use in the day. Randomly generated hydrographs are generated for weekdays and weekends along with synthetic hydrographs of non-exceedance. The model was verified for a small residential compound in Sharm El Shiekh - Egypt using 11 days of flow measurements performed in summer. The synthetic hydrographs based on assumed water use patterns of the various members of the community compared reasonably with the measured hydrographs. Synthetic hydrographs can be derived for a community under consideration to reflect its socioeconomic conditions and thus can be used to generate probability based peaking factors to be used in the design of sewerage systems pumping facilities, and treatment plants. © 201 WIT Press.

  17. Synthetic socioeconomic based domestic wastewater hydrographs for small arid communities

    KAUST Repository

    Elnakar, H.; Imam, E.; Nassar, K.

    2012-01-01

    A model was developed to predict synthetic socioeconomic based domestic wastewater hydrographs for the small arid communities. The model predicts the flow hydrograph for random weekdays and weekends based on the specific socioeconomic characteristics of the community. The main socioeconomic characteristics are the composition of the community, the different user behaviours in using water appliances, and the unit discharges of such appliances. Use patterns of water appliances are assumed to vary for the various members of the community and the type of day. Each community is composed of several social categories such as the employee, working woman, stay home woman, stay home child, students etc. The use patterns account for the stochastic nature of use in terms of number of uses, duration of the use and times of use in the day. Randomly generated hydrographs are generated for weekdays and weekends along with synthetic hydrographs of non-exceedance. The model was verified for a small residential compound in Sharm El Shiekh - Egypt using 11 days of flow measurements performed in summer. The synthetic hydrographs based on assumed water use patterns of the various members of the community compared reasonably with the measured hydrographs. Synthetic hydrographs can be derived for a community under consideration to reflect its socioeconomic conditions and thus can be used to generate probability based peaking factors to be used in the design of sewerage systems pumping facilities, and treatment plants. © 201 WIT Press.

  18. Community Based Nutrition Rehabilitation in Tanzania: Challenges and Lessons Learned

    International Nuclear Information System (INIS)

    Urio, Elisaphinate Moses; Jeje, Benedict; Ndossi, Godwin

    2014-01-01

    Full text: Malnutrition among children under the age of five continues to be a significant public health problem in Tanzania. Despite numerous nutritional interventions that have been implemented, the country still experiences high rates of malnutrition. According to Tanzania Demographic and Health Survey of 2010 the prevalence of underweight was estimated to be 16%, wasting 5% and stunting 42 %. Factors contributing to causes of malnutrition include immediate, underlying and basic causes. All these factors are interlinked and operate synergistically and not independently. Approaches for managing malnourished children in Tanzania evolved from facility based Nutrition Rehabilitation Units (NURU) in the late 1960s to Community Based Nutrition Rehabilitation (CBNR) in late 1980s. In the latter approach, malnourished children are rehabilitated in the same environment (village, home) that precipitated the condition, using resources and infrastructures available in the community. Mothers are taught about child feeding using family foods to make good food mixtures and of the importance of feeding frequency for the young child. Limitations for this approach include inadequate advocacy to leaders from districts down to the community level, few trained health providers and community health workers on knowledge and skills on community based nutrition rehabilitation, inadequate equipment and supplies for identification and categorization of malnutrition, low awareness of parents, care givers and community leaders on home rehabilitation of malnourished children. Nonetheless, Community Based Nutrition Rehabilitation approach has the potential to address malnutrition in children given political will and resources. (author)

  19. 76 FR 70069 - Federal Home Loan Bank Community Support Amendments

    Science.gov (United States)

    2011-11-10

    ..., First Floor, on business days between 9 a.m. and 5 p.m. U.S. Mail, United Parcel Service, Federal Express, or Other Mail Service: The mailing address for comments is: Alfred M. Pollard, General Counsel...), requires FHFA to adopt regulations establishing standards of community investment or service for members of...

  20. Community-based gang desistance

    DEFF Research Database (Denmark)

    Højgaard Dichmann, Kirstine; Jensen, Tobias Bo; Mørck, Line Lerche

    2018-01-01

    of belonging to the communities in Homeboy Industries also facilitates self-reflection and identity transformation. Homeboy Industries is furthermore an important life changing resource because it offers former gang members a legal source of income. This provides them with a new and secure base, a way...

  1. Named data networking-based smart home

    OpenAIRE

    Syed Hassan Ahmed; Dongkyun Kim

    2016-01-01

    Named data networking (NDN) treats content/data as a “first class citizen” of the network by giving it a “name”. This content “name” is used to retrieve any information, unlike in device-centric networks (i.e., the current Internet), which depend on physical IP addresses. Meanwhile, the smart home concept has been gaining attention in academia and industries; various low-cost embedded devices are considered that can sense, process, store, and communicate data autonomously. In this paper, we s...

  2. Community knowledge, attitudes and behaviours about environmental tobacco smoke in homes and cars.

    Science.gov (United States)

    Dunn, Jeff; Greenbank, Susan; McDowell, Michelle; Mahoney, Catherine; Mazerolle, Paul; Occhipinti, Stefano; Steginga, Suzanne

    2008-08-01

    to assess knowledge, attitudes and behaviours about environmental tobacco smoke (ETS) in cars and homes in Queensland. 1,026 randomly selected Queensland residents (84% response) participated in a computer assisted telephone survey to assess knowledge, attitudes and behaviours about ETS in cars and homes; and attitudes towards restrictions on smoking in a range of contexts. Most respondents are aware of the negative health effects of ETS and have smoking bans in their cars (75.8%) and homes (76.8%), however bans are less prevalent for smokers (cars: 37.9%; homes: 51%; p=0.000). For cars/homes, most smokers who did not have smoking bans would not smoke at all around pregnant women (67.7%/53.7%); fewer would refrain for childrennon-smoking adults (31.3%/17.9%); and children 13-17 years (30.9%/21.2%). Parent smokers are less likely to not smoke at all around children>or=2 years (p=0.000) compared to non-parent smokers. Most respondents support car/ home smoking bans for childrencommunity support for legislation targeting ETS in cars and homes, however this varies by context, smoking and parental status.

  3. 77 FR 14787 - Federal Home Loan Bank Members Selected for Community Support Review

    Science.gov (United States)

    2012-03-13

    ... 2010 fifth round community support review cycle: Federal Home Loan Bank of Boston--District 1 People's... Association Canton Georgia. Bank of Chickamauga Chickamauga Georgia. The Peoples Bank Eatonton Georgia. The........... Kentucky. Peoples Bank of Kentucky, Inc Flemingsburg......... Kentucky. The Farmers Bank Hardinsburg...

  4. Play Therapy for Bereaved Children: Adapting Strategies to Community, School, and Home Settings

    Science.gov (United States)

    Webb, Nancy Boyd

    2011-01-01

    Play therapy is a highly adaptable treatment method that can be modified according to children's ages, circumstances, and settings in which counseling occurs. Play therapy may be used in schools, community settings, and homes to help children following the death of a significant other. After reviewing basic developmental factors that affect…

  5. 29 CFR 785.40 - When private automobile is used in travel away from home community.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false When private automobile is used in travel away from home community. 785.40 Section 785.40 Labor Regulations Relating to Labor (Continued) WAGE AND HOUR DIVISION... WORKED Application of Principles Traveltime § 785.40 When private automobile is used in travel away from...

  6. How Homophobia Hurts Children: Nurturing Diversity at Home, at School, and in the Community.

    Science.gov (United States)

    Baker, Jean M.

    This book examines the challenges facing gay, lesbian, bisexual, and transsexual youth, suggesting ways to bring about significant and positive differences in homes, schools, and communities. It presents the experiences of such children, in their own words, as they gradually discover they are different from most other children in their sexual…

  7. Population Health and Tailored Medical Care in the Home: the Roles of Home-Based Primary Care and Home-Based Palliative Care.

    Science.gov (United States)

    Ritchie, Christine S; Leff, Bruce

    2018-03-01

    With the growth of value-based care, payers and health systems have begun to appreciate the need to provide enhanced services to homebound adults. Recent studies have shown that home-based medical services for this high-cost, high-need population reduce costs and improve outcomes. Home-based medical care services have two flavors that are related to historical context and specialty background-home-based primary care (HBPC) and home-based palliative care (HBPalC). Although the type of services provided by HBPC and HBPalC (together termed "home-based medical care") overlap, HBPC tends to encompass longitudinal and preventive care, while HBPalC often provides services for shorter durations focused more on distress management and goals of care clarification. Given workforce constraints and growing demand, both HBPC and HBPalC will benefit from working together within a population health framework-where HBPC provides care to all patients who have trouble accessing traditional office practices and where HBPalC offers adjunctive care to patients with high symptom burden and those who need assistance with goals clarification. Policy changes that support provision of medical care in the home, population health strategies that tailor home-based medical care to the specific needs of the patients and their caregivers, and educational initiatives to assure basic palliative care competence for all home-based medical providers will improve access and reduce illness burden to this important and underrecognized population. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  8. Privatizing community animal health worker based veterinary ...

    African Journals Online (AJOL)

    Privatizing community animal health worker based veterinary services delivery system in West Kordofan, Southern Sudan; The needed roles of community animal health assistant (CAHA) and Pastoral unions.

  9. Prenatal and infancy home visiting by nurses: from randomized trials to community replication.

    Science.gov (United States)

    Olds, David L

    2002-09-01

    This paper summarizes a 25-year program of research that has attempted to improve the early health and development of low-income mothers and children and their future life trajectories with prenatal and infancy home visiting by nurses. The program has been tested in two separate large-scale randomized controlled trials with different populations living in different contexts. The program has been successful in improving parental care of the child as reflected in fewer injuries and ingestions that may be associated with child abuse and neglect; and maternal life-course, reflected in fewer subsequent pregnancies, greater work force participation, and reduced use of public assistance and food stamps. In the first trial, the program also produced long-term effects on the number of arrests, convictions, emergent substance use, and promiscuous sexual activity of 15-year-old children whose nurse-visited mothers were low-income and unmarried when they registered in the study during pregnancy. Since 1996, the program has been offered for public investment outside of research contexts. Careful attention has been given to ensuring that the program is replicated with fidelity to the model tested in the scientifically controlled studies by working with community leaders to ensure that organization and community contexts are favorable for the program; by providing the nurses with excellent training and technical assistance and detailed visit-by-visit guidelines; and by providing organizations with a web-based clinical information system that creates a basis for monitoring program performance and continuous quality improvement.

  10. 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.

  11. Renewal strategy and community based organisations in community ...

    African Journals Online (AJOL)

    Renewal strategy and community based organisations in community ... the local population and resources to do that which the governments had failed to do. ... country with a view to reducing poverty and developmental imbalance in Nigeria.

  12. ALWAYS COMING HOME: METIS LEGAL UNDERSTANDINGS OF COMMUNITY AND TERRITORY

    Directory of Open Access Journals (Sweden)

    Kerry Sloan

    2017-01-01

    Full Text Available Metis ideas of territory are complex, varied and often not well understood.  Metis perspectives on intersections of territory and community are likewise not appreciated by Canadian courts.  This is evident in the difficulties of Metis rights claimants in British Columbia, where misconceptions about Metis history and traditional use areas have resulted in courts questioning the existence of historic Metis communities in the province.  The leading case on Metis rights in Canada, R v Powley, requires claimants to prove there is a historic Metis community in an area where claimed rights are exercised.  In BC, courts following Powley in three cases – R v Howse, R v Nunn and R v Willison – have held there are no historic Metis communities in the Kootenays, the south Okanagan, or the Kamloops/Shuswap area.  Although these regions comprise only a portion of lands within provincial boundaries, the BC government takes the position there are no Metis communities in the province capable of meeting the Powley test, and thus asserts there can be no Metis Aboriginal rights holders in BC.      To challenge this position, and in order to illustrate the multiplicity and richness of Metis legal understandings of territory and community, the author braids family history, narrative, legal analysis and the perspectives of 23 Metis people from the southern BC interior who were involved in or affected by the Howse, Nunn and Willison cases.  The author suggests that expansive and nuanced Metis understandings of communities and territories cannot be encompassed by the Powley/Willison definition of a Metis community as “... a group of Métis with a distinctive collective identity, living together in the same geographic area and sharing a common way of life”.  While the court’s definition posits history, territory and community as separable, Metis views suggest these concepts are interlinked and mutually constitutive.    Les idées des Métis au

  13. Cost-effectiveness implications based on a comparison of nursing home and home health case mix.

    OpenAIRE

    Kramer, A M; Shaughnessy, P W; Pettigrew, M L

    1985-01-01

    Case-mix differences between 653 home health care patients and 650 nursing home patients, and between 455 Medicare home health patients and 447 Medicare nursing home patients were assessed using random samples selected from 20 home health agencies and 46 nursing homes in 12 states in 1982 and 1983. Home health patients were younger, had shorter lengths of stay, and were less functionally disabled than nursing home patients. Traditional long-term care problems requiring personal care were more...

  14. First Steps towards Evidence-Based Preventive Home Visits: Experiences Gathered in a Swedish Municipality

    Directory of Open Access Journals (Sweden)

    Charlotte Löfqvist

    2012-01-01

    Full Text Available The purpose of preventive home visits is to promote overall health and wellbeing in old age. The aim of this paper was to describe the process of the development of evidence-based preventive home visits, targeting independent community-living older persons. The evidence base was generated from published studies and practical experiences. The results demonstrate that preventive home visits should be directed to persons 80 years old and older and involve various professional competences. The visits should be personalized, lead to concrete interventions, and be followed up. The health areas assessed should derive from a broad perspective and include social, psychological, and medical aspects. Core components in the protocol developed in this study captured physical, medical, psychosocial, and environmental aspects. Results of a pilot study showed that the protocol validly identified health risks among older people with different levels of ADL dependence.

  15. Designing an Elderly Assistance Program Based-on Home Care

    Science.gov (United States)

    Umusya'adah, L.; Juwaedah, A.; Jubaedah, Y.; Ratnasusanti, H.; Puspita, R. H.

    2018-02-01

    PKH (Program Keluarga Harapan) is a program of Indonesia’s Government through the ministry of social directorate to accelerate the poverty reduction and the achievement of Millennium Development Goals (MDGs) target as well as the policies development in social protection and social welfare domain or commonly referred to as Indonesian Conditional Cash Transfer (CCT) Program. This research is motivated that existing participants of the family expectation program (PKH) that already exist in Sumedang, Indoensia, especially in the South Sumedang on the social welfare components is only limited to the health checking, while for assisting the elderly based Home Care program there has been no structured and systematic, where as the elderly still need assistance, especially from the family and community environment. This study uses a method of Research and Development with Model Addie which include analysis, design, development, implementation and evaluation. Participants in this study using purposive sampling, where selected families of PKH who provide active assistance to the elderly with 82 participants. The program is designed consists of program components: objectives, goals, forms of assistance, organizing institutions and implementing the program, besides, program modules include assisting the elderly. Form of assistance the elderly cover physical, social, mental and spiritual. Recommended for families and companions PKH, the program can be implemented to meet the various needs of the elderly. For the elderly should introspect, especially in the health and follow the advice recommended by related parties

  16. Comparison of home and away-from-home physical activity using accelerometers and cellular network-based tracking devices.

    Science.gov (United States)

    Ramulu, Pradeep Y; Chan, Emilie S; Loyd, Tara L; Ferrucci, Luigi; Friedman, David S

    2012-08-01

    Measuring physical at home and away from home is essential for assessing health and well-being, and could help design interventions to increase physical activity. Here, we describe how physical activity at home and away from home can be quantified by combining information from cellular network-based tracking devices and accelerometers. Thirty-five working adults wore a cellular network-based tracking device and an accelerometer for 6 consecutive days and logged their travel away from home. Performance of the tracking device was determined using the travel log for reference. Tracking device and accelerometer data were merged to compare physical activity at home and away from home. The tracking device detected 98.6% of all away-from-home excursions, accurately measured time away from home and demonstrated few prolonged signal drop-out periods. Most physical activity took place away from home on weekdays, but not on weekends. Subjects were more physically active per unit of time while away from home, particularly on weekends. Cellular network-based tracking devices represent an alternative to global positioning systems for tracking location, and provide information easily integrated with accelerometers to determine where physical activity takes place. Promoting greater time spent away from home may increase physical activity.

  17. A community-wide school health project for the promotion of smoke-free homes.

    Science.gov (United States)

    Loke, Alice Yuen; Mak, Y W

    2015-11-26

    A community-wide school health project for the promotion of smoke-free homes was launched in June 2010 with the aim of promoting the benefits of smoke-free homes to all school-aged children (aged 6-18), and indirectly to their parents and family members. The 1-year project included health talks on a smoke-free life; the distribution of educational leaflets; slogan and visual art competitions; and a health fair held in June 2011. Two sets of questionnaires were developed to solicit a resolution and action from the participants regarding the establishment of a smoke-free home, and their decision to stay smoke-free. This is a paper to report on the activities of this project, the attempts to reach out to school-aged children, and their indications of agreement with, support for, and commitment to promoting smoke-free homes. The project reached an estimated 12,800 school-aged children in Hong Kong. A large proportion of those received educational leaflets (69.6-88.2 %). Of those who participated in the health fair, 69.7-87.6 % agreed to promote the concept of smoke-free homes to friends and family. More primary than secondary students pledged to not take up smoking (90.8 vs 85.8 %). About 82 % of those who had experimented with smoking pledged to stop. A small proportion of them reported already having established a smoke-free policy at home (14.9 %), placed a 'No Smoking' sign at home (16.4 %), informed visitors of their smoke-free policy at home (12.9 %), and asked visitors to dispose of lit cigarettes before entering their home (15.9 %). This community-wide school health project on the benefits of smoke-free homes reached a large number of students, and indirectly to family members, and home visitors. Public health efforts of this kind should be continued to reach younger generations and the general public.

  18. A qualitative study of in-home robotic telepresence for home care of community-living elderly subjects

    DEFF Research Database (Denmark)

    Boissy, Patrice; Corriveau, Hélène; Michaud, François

    2007-01-01

    was illustrated using a photograph of a mobile robot, and participants were then asked to suggest potential health care applications. Interview data derived from the transcript of each group discussion were analyzed using qualitative induction based on content analysis. The analyses yielded statements that were...... categorized under three themes: potential applications, usability issues and user requirements. Teleoperated mobile robotic systems in the home were thought to be useful in assisting multidisciplinary patient care through improved communication between patients and healthcare professionals, and offering...

  19. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Eva Helena; Kjaergaard, Hanne; Johansen, Christoffer

    2013-01-01

    BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety...... children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care. RESULTS: All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age......, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P = 0.04; 95% confidence interval (CI): -0.2-19.5) and worry (P = 0.04; 95% CI: -0.4-20.6) in the home-care group indicating better physical health and less worry for children...

  20. On participatory design of home-based healthcare

    DEFF Research Database (Denmark)

    Grönvall, Erik; Kyng, Morten

    2013-01-01

    Participatory design (PD) activities in private homes challenge how we relate to the PD process, compared to PD in professional settings. Grounded in a project related to chronic dizziness among older people, we identified four challenges when performing PD with ill, weak users in their private...... homes. The challenges are (1) designing for, and negotiating knowledge about, the home, (2) ill, weak users and their participation in PD, (3) divergent interests of participants and (4) usable and sustainable post-project solutions. These challenges have to be carefully addressed, and we use them...... to reflect upon differences between a home-based PD process with non-workers, such as ours, and work-place projects, such as Utopia. Through this reflection, the paper contributes to a more general discussion on PD in non-work settings with weak users. Indeed, differences do exist between traditional PD...

  1. Needs of Community Nursing-based Continuing Home Care in Old Patients with Chronic Diseases:A Qualitative Study%老年慢性病患者对以社区护士为主导的居家延续护理需求的质性研究

    Institute of Scientific and Technical Information of China (English)

    徐九霞; 韩琤琤; 赵洁; 马春红; 张金声; 黄永禧

    2017-01-01

    目的 调查老年慢性病患者对以社区护士为主导的居家延续护理的需求.方法 2016年6月至8月,采用立意取样法选取社区内14名慢性病患者进行半结构式访谈,用质性研究的现象学分析法收集整理资料、分析提炼主题.结果 慢性病患者对居家延续护理均表现出积极、急迫的态度.主要需求包括疾病和康复相关知识、心理慰籍关怀服务、疾病康复护理、日常安全帮助、医保政策支持.结论 应支持老年慢性病患者居家延续护理,加强以社区护士为主导的专业化居家延续护理团队建设.%Objective To investigate the needs of nursing-based continuing home care in old patients with chronic diseases in communi-ty. Methods From June to August, 2016, 14 old patients with chronic diseases were purposively sampled, and interviewed with semi-struc-ture. The data were collected and refined with phenomenological analysis. Results The patients were very positive in nursing-based continu-ing home care. The main requirements included the knowledge about chronic diseases, psychological comforts, rehabilitation nursing, daily security help and medical insurance support. Conclusion It is necessary to support the continuing home care for old patients with chronic diseases, and strengthen the profesional nursing team building in community.

  2. Home-based care, technology, and the maintenance of selves.

    Science.gov (United States)

    Parks, Jennifer A

    2015-06-01

    In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons (especially older persons) to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann's notion of "holding" persons' identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this "holding" work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be "held" in place.

  3. Experiences of HIV/AIDS home-based caregivers in Vhembe district of the Limpopo Province

    Directory of Open Access Journals (Sweden)

    N.S. Mashau

    2009-09-01

    Full Text Available The purpose of this study was to explore and describe the experiences of HIV and AIDS home-based caregivers in the Vhembe district of Limpopo Province. A qualitative research design which was exploratory, descriptive and contextual was executed with a sample of purposively selected participants who provided home-based care to people living with HIV and AIDS in the Vhembe district of Limpopo Province. Data saturation occurred after in-depth interviews with fifteen participants. In-depth individual interviews and field notes were also used during data collection. The findings reveal that HIV/AIDS home-based caregivers express pain and despair when caring for HIV/AIDS patients. The theme was supported by the following categories and subcategories: problems related to stigma when caring for patients at their homes; stress, burnout, frustration and feelings of helplessness when caring for patients. Recommendations that are described focus on building a working relationship between the home-based caregivers, community and the family.

  4. Feasibility of pulse oximetry for assessment of infants born in community based midwifery care

    NARCIS (Netherlands)

    Smit, M.; Ganzeboom, A.; Dawson, J.A.; Walther, F.J.; Bustraan, J.; van Roosmalen, Jos; te Pas, A.B.

    2014-01-01

    To evaluate the feasibility of using pulse oximetry (PO) for evaluating infants born in community-based midwifery care. Design: a prospective, observational study of infants born after midwifery supervised (home) births. Setting: 27 midwives from seven practices providing primary care in (home)

  5. Home Water Treatment Habits and Effectiveness in a Rural Arizona Community.

    Science.gov (United States)

    Lothrop, Nathan; Wilkinson, Sarah T; Verhougstraete, Marc; Sugeng, Anastasia; Loh, Miranda M; Klimecki, Walter; Beamer, Paloma I

    Drinking water quality in the United States (US) is among the safest in the world. However, many residents, often in rural areas, rely on unregulated private wells or small municipal utilities for water needs. These utilities may violate the Safe Drinking Water Act contaminant guidelines, often because they lack the required financial resources. Residents may use alternative water sources or install a home water treatment system. Despite increased home water treatment adoption, few studies have examined their use and effectiveness in the US. Our study addresses this knowledge gap by examining home water treatment in a rural Arizona community. Water samples were analyzed for metal(loid)s, and home treatment and demographic data were recorded in 31 homes. Approximately 42% of homes treated their water. Independent of source water quality, residents with higher income (OR = 1.25; 95%CI (1.00 - 1.64)) and education levels (OR = 1.49; 95%CI (1.12 - 2.12)) were more likely to treat their water. Some contaminant concentrations were effectively reduced with treatment, while some were not. We conclude that increased educational outreach on contaminant testing and treatment, especially to rural areas with endemic water contamination, would result in a greater public health impact while reducing rural health disparities.

  6. Home-based cardiac rehabilitation for people with heart failure

    DEFF Research Database (Denmark)

    Zwisler, Ann Dorthe Olsen; Norten, RJ; Dean, SG

    2016-01-01

    AIMS: To assess the effectiveness of home-based cardiac rehabilitation (CR) for heart failure compared to either usual medical care (i.e. no CR) or centre-based CR on mortality, morbidity, exercise capacity, health-related quality of life, drop out, adherence rates, and costs. METHODS: Randomised...

  7. Exploration of digital entrepreneurship – online home based businesses through empirical analysis

    OpenAIRE

    Anwar, Naveed

    2015-01-01

    Digital entrepreneurship is a broad domain and includes businesses predominantly operating online, such as online retailers, portals, community sites and also businesses providing services to enable other businesses to operate online, such as web designers, platform providers and operators. This research focused online home based businesses on any stage of business development, for example start-up or grown, and focus on any aspect, such as raising finance, establishing networks or developing...

  8. Impact of long term care and mortality risk in community care and nursing homes populations.

    Science.gov (United States)

    Lopes, Hugo; Mateus, Céu; Rosati, Nicoletta

    To identify the survival time, the mortality risk factors and the individuals' characteristics associated with cognitive and physical status at discharge, among the Portuguese long-term care (LTC) populations. Home-and-Community-Based Services (HCBS) and three types of Nursing Homes (NH). 20,984 individuals admitted and discharged in 2015. The Kaplan-Meier survival analysis and the Cox Proportional Hazards Models were used to study the mortality risk; the Wilcoxon signed-rank test to identify the number of individuals with cognitive and physical changes between admission and discharge; two cumulative odds ordinal logistic regressions to predict the cognitive and physical dependence levels at discharge RESULTS: The mortality rate at HCBS was 30%, and 17% at the NH, with a median survival time of 173 and 200 days, respectively. The main factors associated with higher mortality were older age, male gender, family/neighbour support, neoplasms and cognitive/physical dependence at admission. In NH/HCBS, 26%/18% of individuals improve their cognitive status, while in physical status the proportion was 38%/27%, respectively. Finally, older age, being illiterate and being classified at the lowest cognitive and physical status at admission decrease the likelihood of achieving a higher level of cognitive and physical independence at discharge. The adoption of a robust and complete assessment tool, the definition of guidelines to enable a periodical assessment of individuals' autonomy and the adoption of benchmark metrics allowing the comparison of results between similar units are some of the main goals to be taken into account for future developments of this care in Portugal. Copyright © 2018 Elsevier B.V. All rights reserved.

  9. Enabling affordable and efficiently deployed location based smart home systems.

    Science.gov (United States)

    Kelly, Damian; McLoone, Sean; Dishongh, Terry

    2009-01-01

    With the obvious eldercare capabilities of smart environments it is a question of "when", rather than "if", these technologies will be routinely integrated into the design of future houses. In the meantime, health monitoring applications must be integrated into already complete home environments. However, there is significant effort involved in installing the hardware necessary to monitor the movements of an elder throughout an environment. Our work seeks to address the high infrastructure requirements of traditional location-based smart home systems by developing an extremely low infrastructure localisation technique. A study of the most efficient method of obtaining calibration data for an environment is conducted and different mobile devices are compared for localisation accuracy and cost trade-off. It is believed that these developments will contribute towards more efficiently deployed location-based smart home systems.

  10. Intelligent Home Control System Based on Single Chip Microcomputer

    Science.gov (United States)

    Yang, Libo

    2017-12-01

    Intelligent home as a way to achieve the realization of the family information has become an important part of the development of social information, Internet of Things because of its huge application prospects, will be smart home industry in the development process of a more realistic breakthrough in the smart home industry development has great significance. This article is based on easy to implement, easy to operate, close to the use of the design concept, the use of STC89C52 microcontroller as the control core for the control terminal, and including infrared remote control, buttons, Web interface, including multiple control sources to control household appliances. The second chapter of this paper describes the design of the hardware and software part of the specific implementation, the fifth chapter is based on the design of a good function to build a specific example of the environment.

  11. Community-Based Child-Rearing Support for Families : Based on an Investigation in Sapporo, Japan

    OpenAIRE

    Kudo, Haruka

    2017-01-01

    Against the backdrop of a high proportion of mothers who take care of their children at home and the problem of child-rearing anxiety and social isolation among them, the Japanese government has currently expanded child-rearing support via the Community-based Child-rearing Support Centers (CCSCs). They are open spaces for infants and parents in the community, where they can gather freely, communicate with each other, and share their anxieties and worries related to child rearing. ...

  12. A learning-based agent for home neurorehabilitation.

    Science.gov (United States)

    Lydakis, Andreas; Meng, Yuanliang; Munroe, Christopher; Wu, Yi-Ning; Begum, Momotaz

    2017-07-01

    This paper presents the iterative development of an artificially intelligent system to promote home-based neurorehabilitation. Although proper, structured practice of rehabilitation exercises at home is the key to successful recovery of motor functions, there is no home-program out there which can monitor a patient's exercise-related activities and provide corrective feedback in real time. To this end, we designed a Learning from Demonstration (LfD) based home-rehabilitation framework that combines advanced robot learning algorithms with commercially available wearable technologies. The proposed system uses exercise-related motion information and electromyography signals (EMG) of a patient to train a Markov Decision Process (MDP). The trained MDP model can enable an agent to serve as a coach for a patient. On a system level, this is the first initiative, to the best of our knowledge, to employ LfD in an health-care application to enable lay users to program an intelligent system. From a rehabilitation research perspective, this is a completely novel initiative to employ machine learning to provide interactive corrective feedback to a patient in home settings.

  13. Risk and protective factors associated with intentional self-harm among older community-residing home care clients in Ontario, Canada.

    Science.gov (United States)

    Neufeld, Eva; Hirdes, John P; Perlman, Christopher M; Rabinowitz, Terry

    2015-10-01

    We aim to concurrently examine risk and protective factors associated with intentional self-harm among community-residing older adults receiving home care services in Ontario, Canada. Administrative health data from the home care sector were linked to hospital administrative data to carry out the analyses. Home care data are collected in Ontario using the Resident Assessment Instrument-Home Care (RAI-HC), an assessment tool that identifies strengths, preferences and needs of long-stay home care clients. The sample included Ontario home care clients aged 60 years or older assessed with the RAI-HC between 2007 and 2010 (N = 222,149). Multivariable analyses were performed using SAS. Hospital records of intentional self-harm (ISH) were present in 9.3 cases per 1000 home care clients. Risks of ISH included younger age (60-74 years; OR = 3.14, CI: 2.75-3.59), psychiatric diagnosis (OR = 2.29, CI: 2.06-2.54), alcohol use and dependence (OR = 1.69, CI: 1.34-2.14), psychotropic medication (OR = 1.94, CI: 1.75-2.15) and depressive symptoms (OR = 1.58, CI: 1.40-1.78). Protective effects were found for marital status and positive social relationships, yet these effects were more pronounced for men. Cognitive performance measures showed the odds of ISH 1.86 times higher for older adults with moderate to severe cognitive impairment. This study based on provincial data points to tangible areas for preventative assessment by frontline home care professionals. Of interest were the risk and protective factors that differed by sex. As demand for home care in Canada is expected to increase, these findings may inform home care professionals' appraisal and approach to suicide prevention among community-residing older adults. Copyright © 2015 John Wiley & Sons, Ltd.

  14. Association between stairs in the home and instrumental activities of daily living among community-dwelling older adults.

    Science.gov (United States)

    Tomioka, Kimiko; Kurumatani, Norio; Hosoi, Hiroshi

    2018-06-04

    There is insufficient evidence regarding the relationship of home environment with functional capacity among community-dwelling older people without disabilities. We conducted a population-based longitudinal cohort study and examined whether stairs in the home were associated with capability to perform instrumental activities of daily living (IADL) in community-dwelling high-functioning older adults. The target population was individuals aged 65 years or older living in two municipalities in Nara Prefecture in Japan. At the baseline survey, residents who were independent in IADL (n = 6722) were included as survey subjects. Subjects were divided into three groups according to their home type; one-storey residences, walk-up residences, or residences with an elevator. IADL was evaluated using the Tokyo Metropolitan Institute of Gerontology Index of Competence. Multiple logistic regression analyses stratified by gender were used to calculate the odds ratio (OR) and a 95% confidence interval (CI) for a decline in IADL, with one-storey residences as a reference. Age, studied area, marital status, working status, self-perceived economic status, body mass index, chronic diseases, smoking, drinking, eating habits, basic activities of daily living, cognitive functioning, depression, self-rated health, and social participation were used as covariates. During the 3-year follow-up, 11.6% of the subjects showed a decline in IADL. After adjusting for covariates, women who lived in walk-up residences had a lower risk for IADL decline (adjusted OR = 0.72, 95% CI = 0.52-0.99), while living in a home with an elevator was not associated with IADL decline (adjusted OR = 0.94, 95% CI = 0.49-1.77). In contrast, there was no association between home type and IADL decline in men (walk-up residences, adjusted OR = 0.90, 95% CI = 0.71-1.14; residences with an elevator, adjusted OR = 0.82, 95% CI = 0.39-1.72). The presence of stairs in the home was

  15. Stem cell homing-based tissue engineering using bioactive materials

    Science.gov (United States)

    Yu, Yinxian; Sun, Binbin; Yi, Chengqing; Mo, Xiumei

    2017-06-01

    Tissue engineering focuses on repairing tissue and restoring tissue functions by employing three elements: scaffolds, cells and biochemical signals. In tissue engineering, bioactive material scaffolds have been used to cure tissue and organ defects with stem cell-based therapies being one of the best documented approaches. In the review, different biomaterials which are used in several methods to fabricate tissue engineering scaffolds were explained and show good properties (biocompatibility, biodegradability, and mechanical properties etc.) for cell migration and infiltration. Stem cell homing is a recruitment process for inducing the migration of the systemically transplanted cells, or host cells, to defect sites. The mechanisms and modes of stem cell homing-based tissue engineering can be divided into two types depending on the source of the stem cells: endogenous and exogenous. Exogenous stem cell-based bioactive scaffolds have the challenge of long-term culturing in vitro and for endogenous stem cells the biochemical signal homing recruitment mechanism is not clear yet. Although the stem cell homing-based bioactive scaffolds are attractive candidates for tissue defect therapies, based on in vitro studies and animal tests, there is still a long way before clinical application.

  16. Home Quick – Occupational Therapy Home Visits Using mHealth, to Facilitate Discharge from Acute Admission Back to the Community

    Directory of Open Access Journals (Sweden)

    Jacqueline Nix

    2017-06-01

    Full Text Available This article reports upon an initiative to improve the timeliness of occupational therapy home visits for discharge planning by implementing technology solutions while maintaining patient safety. A community hospital in Queensland, Australia, hosted a process evaluation that examined which aspects of home visiting could be replaced or augmented by alternative technologies. Strategies were trialled, implemented and assessed using the number of home visits completed and the time from referral to completion as outcomes. A technology-enhanced solution called “Home Quick” was developed using technology to facilitate pre-discharge home visits. The implementation of Home Quick resulted in an increase in the number of home visits conducted prior to discharge (50% increase from 145 to 223 and significantly increased the number of patients seen earlier following referral (X2=69.3; p<0.001. The substitution of direct home visits with technology-enabled remote visits is suitable for a variety of home visiting scenarios traditionally performed by occupational therapists.

  17. Home

    Science.gov (United States)

    AF Branding & Trademark Licensing Join the Air Force Home About Us The Air Force Symbol Display Resources Document Library TM Connect Search AF Branding and Trademark Licensing Program: important links Legal Documents 10 U.S.C. § 2260 15 U.S.C. § 167;167; 1114-1125 DODI 5535.12, DoD Branding and

  18. Can specially trained community care workers effectively support patients and their families in the home setting at the end of life?

    Science.gov (United States)

    Poulos, Roslyn G; Harkin, Damian; Poulos, Christopher J; Cole, Andrew; MacLeod, Rod

    2018-03-01

    Surveys indicate that many Australians would prefer to die at home, but relatively few do. Recognising that patients and their families may not have the support they need to enable end-of-life care at home, a consortium of care providers developed, and received funding to trial, the Palliative Care Home Support Program (PCHSP) across seven health districts in New South Wales, Australia. The programme aimed to supplement end-of-life care in the home provided by existing multidisciplinary community palliative care teams, with specialist supportive community care workers (CCWs). An evaluation of the service was undertaken, focussing on the self-reported impact of the service on family carers (FCs), with triangulation of findings from community palliative care teams and CCWs. Service evaluation data were obtained through postal surveys and/or qualitative interviews with FCs, community palliative care teams and CCWs. FCs also reported the experience of their loved one based on 10 items drawn from the Quality of Death and Dying Questionnaire (QODD). Thematic analysis of surveys and interviews found that the support provided by CCWs was valued by FCs for: enabling choice (i.e. to realise end-of-life care in the home); providing practical assistance ("hands-on"); and for emotional support and reassurance. This was corroborated by community palliative care teams and CCWs. Responses by FCs on the QODD items indicated that in the last week of life, effective control of symptoms was occurring and quality of life was being maintained. This study suggests that satisfactory outcomes for patients and their families who wish to have end-of-life care in the home can be enabled with the additional support of specially trained CCWs. A notable benefit of the PCHSP model, which provided specific palliative care vocational training to an existing community care workforce, was a relatively rapid increase in the palliative care workforce across the state. © 2017 John Wiley & Sons Ltd.

  19. 'Catching up': The significance of occupational communities for the delivery of high quality home care by community nurses.

    Science.gov (United States)

    Adams, Mary; Robert, Glenn; Maben, Jill

    2013-07-01

    This article examines the importance of some informal work practices among community nurses during a period of significant organizational change. Ethnographic fieldwork in two purposively selected adult community nursing services in England comprised 79 hours of observation of routine practice, 21 interviews with staff and 23 interviews with patients. We identified the informal work practice of 'catching up', informal work conversations between immediate colleagues, as an important but often invisible aspect of satisfying work relationships and of the relational care of patients. Drawing on anthropological literatures on 'communities of practice' the article examines two central issues concerning the practices of 'catching up': (1) how informal learning processes shape community nursing work; (2) how this informal learning is shaped both in relation to the ideals of community nursing work and the wider political and organizational contexts of community nursing practice. Our findings highlight the distinctive value of informal workplace 'catch ups' for nurses to manage the inherent challenges of good home care for patients and to develop a shared ethic of care and professional identity. Our findings also indicate the decline of 'catching up' between nurses along with diminishing time and opportunity for staff to care holistically for patients in present service climates.

  20. Home-based HIV counselling and testing in Western Kenya ...

    African Journals Online (AJOL)

    Home-based HIV counselling and testing was feasible among this rural population in western Kenya, with a majority of the population accepting to get tested. These data suggest that scaling-up of HBCT is possible and may enable large numbers of individuals to know their HIV serostatus in sub-Saharan Africa.

  1. Effectiveness of a home-based pulmonary rehabilitation programme ...

    African Journals Online (AJOL)

    week home-based pulmonary rehabilitation programme (PRP) improved the baseline measurements of lung function, exercise tolerance and health-related quality of life (HRQoL) in patients receiving out-patient treatment for PTB. Method: A single ...

  2. Who are good home-based care volunteers? | Marincowitz | South ...

    African Journals Online (AJOL)

    Aim: The aim of the study was to describe the characteristics of volunteers who remained active in the home-based care project located in Tzaneen (Limpopo Province) and thereby assist the project leaders to improve the recruitment and quality of the service in the future. Methodology: Structured questionnaires were ...

  3. Effectiveness of a home-based pulmonary rehabilitation programme ...

    African Journals Online (AJOL)

    AZ-505), exercise tolerance using the 6-min-walk test (6MWT), the Borg exercise exertion scale and ... determine whether a six week home-based Pulmonary. Rehabilitation ..... the study was consistent with the scenario relating to the historical ...

  4. A HOME-BASED MASSED PRACTICE SYSTEM FOR PEDIATRIC NEUROREHABILITATION

    Directory of Open Access Journals (Sweden)

    Yi-Ning Wu

    2013-11-01

    Full Text Available The objective of this paper is to introduce a novel low-cost human-computer interface (HCI system for home-based massed practice for children with upper limb impairment due to brain injury. Successful massed practice, a type of neurorehabilitation, may be of value for children with brain injury because it facilitates impaired limb use. Use of automated, home-based systems could provide a practical means for massed practice. However, the optimal strategy to deliver and monitor home-based massed practice is still unclear. We integrated motion sensor, video game, and HCI software technologies to create a useful home-based massed practice at targeted joints. The system records joint angle and number of movements using a low-cost custom hand-held sensor. The sensor acts as an input device to play video games. We demonstrated the system’s functionality and provided preliminary observations on usage by children with brain injury, including joint motion and muscle activation.

  5. Resource allocation in smart homes based on Banker's algorithm

    NARCIS (Netherlands)

    Virag, A.; Bogdan, S.

    2011-01-01

    This paper proposes a method for improved energy management in smart homes by means of resource allocation. For this purpose, a Banker's algorithm based strategy has been developed. It is used to control the system and decide which of the given processes should be provided with resources at the

  6. Hospital-based home care for children with cancer

    DEFF Research Database (Denmark)

    Hansson, Helena; Hallström, Inger; Kjaergaard, Hanne

    2011-01-01

    Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL...

  7. Quality in home-based childcare : Impact and improvement

    NARCIS (Netherlands)

    Groeneveld, Marilene Gerarda

    2010-01-01

    The thesis ‘Quality in home-based childcare: Impact and improvement’ consists of two studies. The general aim of the first study is to examine children’s stress levels and wellbeing, and the role of caregiver stress and childcare quality. This first study is described in chapters 2, 3, and 4.

  8. Smart-Home Architecture Based on Bluetooth mesh Technology

    Science.gov (United States)

    Wan, Qing; Liu, Jianghua

    2018-03-01

    This paper describes the smart home network system based on Nordic nrf52832 device. Nrf52832 is new generation RF SOC device focus on sensor monitor and low power Bluetooth connection applications. In this smart home system, we set up a self-organizing network system which consists of one control node and a lot of monitor nodes. The control node manages the whole network works; the monitor nodes collect the sensor information such as light intensity, temperature, humidity, PM2.5, etc. Then update to the control node by Bluetooth mesh network. The design results show that the Bluetooth mesh wireless network system is flexible and construction cost is low, which is suitable for the communication characteristics of a smart home network. We believe it will be wildly used in the future.

  9. Home-based voluntary HIV counselling and testing found highly acceptable and to reduce inequalities

    Directory of Open Access Journals (Sweden)

    Michelo Charles

    2010-06-01

    Full Text Available Abstract Background Low uptake of voluntary HIV counselling and testing (VCT in sub-Saharan Africa is raising acceptability concerns which might be associated with ways by which it is offered. We investigated the acceptability of home-based delivery of counselling and HIV testing in urban and rural populations in Zambia where VCT has been offered mostly from local clinics. Methods A population-based HIV survey was conducted in selected communities in 2003 (n = 5035. All participants stating willingness to be HIV tested were offered VCT at home and all counselling was conducted in the participants' homes. In the urban area post-test counselling and giving of results were done the following day whereas in rural areas this could take 1-3 weeks. Results Of those who indicated willingness to be HIV tested, 76.1% (95%CI 74.9-77.2 were counselled and received the test result. Overall, there was an increase in the proportion ever HIV tested from 18% before provision of home-based VCT to 38% after. The highest increase was in rural areas; among young rural men aged 15-24 years up from 14% to 42% vs. for urban men from 17% to 37%. Test rates by educational attainment changed from being positively associated to be evenly distributed after home-based VCT. Conclusions A high uptake was achieved by delivering HIV counselling and testing at home. The highest uptakes were seen in rural areas, in young people and groups with low educational attainment, resulting in substantial reductions in existing inequalities in accessing VCT services.

  10. Home exercise programmes supported by video and automated reminders compared with standard paper-based home exercise programmes in patients with stroke: a randomized controlled trial.

    Science.gov (United States)

    Emmerson, Kellie B; Harding, Katherine E; Taylor, Nicholas F

    2017-08-01

    To determine whether patients with stroke receiving rehabilitation for upper limb deficits using smart technology (video and reminder functions) demonstrate greater adherence to prescribed home exercise programmes and better functional outcomes when compared with traditional paper-based exercise prescription. Randomized controlled trial comparing upper limb home exercise programmes supported by video and automated reminders on smart technology, with standard paper-based home exercise programmes. A community rehabilitation programme within a large metropolitan health service. Patients with stroke with upper limb deficits, referred for outpatient rehabilitation. Participants were randomly assigned to the control (paper-based home exercise programme) or intervention group (home exercise programme filmed on an electronic tablet, with an automated reminder). Both groups completed their prescribed home exercise programme for four weeks. The primary outcome was adherence using a self-reported log book. Secondary outcomes were change in upper limb function and patient satisfaction. A total of 62 participants were allocated to the intervention ( n = 30) and control groups ( n = 32). There were no differences between the groups for measures of adherence (mean difference 2%, 95% CI -12 to 17) or change in the Wolf Motor Function Test log transformed time (mean difference 0.02 seconds, 95% CI -0.1 to 0.1). There were no between-group differences in how participants found instructions ( p = 0.452), whether they remembered to do their exercises ( p = 0.485), or whether they enjoyed doing their exercises ( p = 0.864). The use of smart technology was not superior to standard paper-based home exercise programmes for patients recovering from stroke. This trial design was registered prospectively with the Australian and New Zealand Clinical Trials Register, ID: ACTRN 12613000786796. http://www.anzctr.org.au/trialSearch.aspx.

  11. Designing of smart home automation system based on Raspberry Pi

    Energy Technology Data Exchange (ETDEWEB)

    Saini, Ravi Prakash; Singh, Bhanu Pratap [B K Birla Institute of Engineering & Technology, Pilani, Rajasthan (India); Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn, E-mail: Dr.N.L@ieee.org [Thammasat University, Rangsit Campus, Pathum Thani (Thailand)

    2016-03-09

    Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning “on” and “off” of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

  12. Designing of smart home automation system based on Raspberry Pi

    Science.gov (United States)

    Saini, Ravi Prakash; Singh, Bhanu Pratap; Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn

    2016-03-01

    Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning "on" and "off" of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

  13. Designing of smart home automation system based on Raspberry Pi

    International Nuclear Information System (INIS)

    Saini, Ravi Prakash; Singh, Bhanu Pratap; Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn

    2016-01-01

    Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning “on” and “off” of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

  14. Home-based Constraint Induced Movement Therapy Poststroke

    Directory of Open Access Journals (Sweden)

    Stephen Isbel HScD

    2014-10-01

    Full Text Available Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy protocol with eight poststroke survivors. Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT and the Motor Activity Log (MAL. Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]: Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 – 10.18, p = 0.000; WMFT (Functional Ability: z = -4.63, p = 0.000. Seven out of the eight participants exceeded the minimal detectable change on both subscales of the MAL. Conclusion: This study offers positive preliminary data regarding the feasibility of a home-based CI Therapy protocol. This requires further study through an appropriately powered control trial.

  15. The critical role of social workers in home-based primary care.

    Science.gov (United States)

    Reckrey, Jennifer M; Gettenberg, Gabrielle; Ross, Helena; Kopke, Victoria; Soriano, Theresa; Ornstein, Katherine

    2014-01-01

    The growing homebound population has many complex biomedical and psychosocial needs and requires a team-based approach to care (Smith, Ornstein, Soriano, Muller, & Boal, 2006). The Mount Sinai Visiting Doctors Program (MSVD), a large interdisciplinary home-based primary care program in New York City, has a vibrant social work program that is integrated into the routine care of homebound patients. We describe the assessment process used by MSVD social workers, highlight examples of successful social work care, and discuss why social workers' individualized care plans are essential for keeping patients with chronic illness living safely in the community. Despite barriers to widespread implementation, such social work involvement within similar home-based clinical programs is essential in the interdisciplinary care of our most needy patients.

  16. Appliance based control for Home Power Management Systems

    International Nuclear Information System (INIS)

    Özkan, Hanife Apaydın

    2016-01-01

    This study scrutinizes energy-friendly smart home appliances (hereafter ‘smart appliances’), control of these appliances and their effects on the efficient use of energy. To accomplish this, smart appliances and their operation principles are introduced and their energy savings compared to conventional appliances are analyzed using precise measurements. Then, a real-time Appliance-based Home Power Management System (Ab-HPMS) which manages power consumption of smart appliances and that of the house as a whole is proposed. For Ab-HPMS, an appliance control algorithm, called Appliance-based Rolling Wave Planning (Ab-RWP), is developed with the aim of reducing electricity cost and improving energy efficiency while maintaining user comfort. Ab-RWP algorithm interacts with appliances in a priority order based on user comfort which is determined by utilizing their smart operational characteristics. Operations of smart appliances and their integrations with Ab-HPMS are modeled with Petri nets to verify that they meet the requirements expressed in the specifications. Simulation results demonstrate that proposed Ab-HPMS provides improvements in terms of the energy consumption reduction of about 5%–16%, cost reduction of about 10%–24% and peak reduction at high demand period of about 38%–53% compared to conventional appliances usage. - Highlights: • The effects of smart home appliances on energy saving are investigated. • Petri nets models of smart appliances are developed to simulate their operations in smart home. • A real-time appliance-based home power management system (Ab-HPMS) is proposed. • Power density function is evaluated to interrupt the operation of smart washing machine.

  17. HEP@Home - A distributed computing system based on BOINC

    CERN Document Server

    Amorim, A; Andrade, P; Amorim, Antonio; Villate, Jaime; Andrade, Pedro

    2005-01-01

    Project SETI@HOME has proven to be one of the biggest successes of distributed computing during the last years. With a quite simple approach SETI manages to process large volumes of data using a vast amount of distributed computer power. To extend the generic usage of this kind of distributed computing tools, BOINC is being developed. In this paper we propose HEP@HOME, a BOINC version tailored to the specific requirements of the High Energy Physics (HEP) community. The HEP@HOME will be able to process large amounts of data using virtually unlimited computing power, as BOINC does, and it should be able to work according to HEP specifications. In HEP the amounts of data to be analyzed or reconstructed are of central importance. Therefore, one of the design principles of this tool is to avoid data transfer. This will allow scientists to run their analysis applications and taking advantage of a large number of CPUs. This tool also satisfies other important requirements in HEP, namely, security, fault-tolerance an...

  18. MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES.

    Science.gov (United States)

    Whitesell, Nancy Rumbaugh; Bolan, Marc; Chomos, Julianna C; Heath, Debra; Miles, Jon; Salvador, Melina; Whitmore, Corrie; Barlow, Allison

    2018-05-04

    In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts. © 2018 Michigan Association for Infant Mental Health.

  19. From Campuses to Communities: Community-Based Cultism and ...

    African Journals Online (AJOL)

    Due to the criminal activities of the cult groups in the NDR and ineptitude of the police, communities have responded by creating vigilante groups but this has only promoted cycle of violence. The paper recommended that government should tackle community-based cultism and also strengthen the Nigeria Police Force to be ...

  20. Renewal Strategy and Community Based Organisations in Community

    African Journals Online (AJOL)

    FBL

    organisations in the study areas and Community-Based Poverty Reduction. Programme ... regions or areas. In Nigeria, for ... industries in the growing and developing urban areas. ..... Security network is also provided by the community. To ..... Development Efforts in Nigeria: Case Study of Anambra and Oyo State, NISER.

  1. 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

  2. Region based Brain Computer Interface for a home control application.

    Science.gov (United States)

    Akman Aydin, Eda; Bay, Omer Faruk; Guler, Inan

    2015-08-01

    Environment control is one of the important challenges for disabled people who suffer from neuromuscular diseases. Brain Computer Interface (BCI) provides a communication channel between the human brain and the environment without requiring any muscular activation. The most important expectation for a home control application is high accuracy and reliable control. Region-based paradigm is a stimulus paradigm based on oddball principle and requires selection of a target at two levels. This paper presents an application of region based paradigm for a smart home control application for people with neuromuscular diseases. In this study, a region based stimulus interface containing 49 commands was designed. Five non-disabled subjects were attended to the experiments. Offline analysis results of the experiments yielded 95% accuracy for five flashes. This result showed that region based paradigm can be used to select commands of a smart home control application with high accuracy in the low number of repetitions successfully. Furthermore, a statistically significant difference was not observed between the level accuracies.

  3. Web-based home rehabilitation gaming system for balance training

    Directory of Open Access Journals (Sweden)

    Oleh Kachmar

    2014-06-01

    Full Text Available Currently, most systems for virtual rehabilitation and motor training require quite complex and expensive hardware and can be used only in clinical settings. Now, a low-cost rehabilitation game training system has been developed for patients with movement disorders; it is suitable for home use under the distant supervision of a therapist. It consists of a patient-side application installed on a home computer and the virtual rehabilitation Game Server in the Internet. System can work with different input gaming devices connected through USB or Bluetooth, such as a Nintendo Wii balance board, a Nintendo Wii remote, a MS Kinect sensor, and custom made rehabilitation gaming devices based on a joystick. The same games can be used with all training devices. Assessment of the Home Rehabilitation Gaming System for balance training was performed on six patients with Cerebral Palsy, who went through daily training sessions for two weeks. Preliminary results showed balance improvement in patients with Cerebral Palsy after they had completed home training courses. Further studies are needed to establish medical requirements and evidence length.

  4. The home-based maternal record: a tool for family involvement in health care.

    Science.gov (United States)

    Shah, P M; Shah, K P; Belsey, M A

    1988-04-01

    The home-based maternal record offers an opportunity for family involvement in health care. Home-based records of maternal health have been used in several developing countries, and have led to increased detection and monitoring of women at high risk for complications during pregnancy. Home-based cards that include menstrual information remind health workers to educate and motivate women for family planning, and serve as a source of health statistics. Records that use pictures and symbols have been used by illiterate traditional birth attendants, and had an accurate completion rate of over 90%. The WHO has prepared a prototype record and guidelines for local adaptation. The objectives were to provide continuity of care throughout pregnancy, ensure recognition of at-risk women, encourage family participation in health care, an provide data on maternal health, breastfeeding, and family planning. The guidelines have been evaluated and results show that the records have improved the coverage, acceptability, and quality of MCH/FP care. The records have also led to an increase in diagnosis and referral of at-risk women and newborns, and the use of family planning and tetanus toxoid immunization has increased in the 13 centers where the reports are being used. Focus group discussions have shown that mothers, community members, primary health workers, and doctors and nurses liked the records. It is important to adapt criteria for high-risk conditions to the local areas where the records will be used to ensure the relevance of risk diagnosis. The evidence shows that home-based maternal and child records can be an important tool in the promotion of self-reliance and family participation in health care. In addition, home-based records can be used for the implementation of primary health care at the local level, and serve as a resource for data collection.

  5. An IBeacon-Based Location System for Smart Home Control.

    Science.gov (United States)

    Liu, Qinghe; Yang, Xinshuang; Deng, Lizhen

    2018-06-11

    Indoor location and intelligent control system can bring convenience to people’s daily life. In this paper, an indoor control system is designed to achieve equipment remote control by using low-energy Bluetooth (BLE) beacon and Internet of Things (IoT) technology. The proposed system consists of five parts: web server, home gateway, smart terminal, smartphone app and BLE beacons. In the web server, fingerprint matching based on RSSI stochastic characteristic and posture recognition model based on geomagnetic sensing are used to establish a more efficient equipment control system, combined with Pedestrian Dead Reckoning (PDR) technology to improve the accuracy of location. A personalized menu of remote “one-click” control is finally offered to users in a smartphone app. This smart home control system has been implemented by hardware, and precision and stability tests have been conducted, which proved the practicability and good user experience of this solution.

  6. Home-based telework in France: Characteristics, barriers and perspectives

    OpenAIRE

    AGUILERA, Anne; LETHIAIS, Virginie; RALLET, Alain; PROULHAC, Laurent

    2016-01-01

    The aim of this article is to explain the gap between high social expectations, particularly in terms of reducing commuting frequency, increasing productivity and improving work-life balance, and the reality of home-based telework. We use three French databases which give information about employers but also employees. We highlight that telework is not only a fairly restricted phenomenon but also one that lacks impetus; it is mainly an informal working arrangement. The main reasons raised by ...

  7. Adding value while saving dollars: unleashing the potential of a national, integrated approach to home and community care.

    Science.gov (United States)

    Petch, Teresa; Shamian, Judith

    2009-01-01

    This commentary by Victorian Order of Nurses Canada, written in response to "Getting What We Pay For? The Value-for-Money Challenge," by McGrail, Zierler and Ip, answers four key questions about Canada's home and community care sector: (1) What are our objectives? (2) Where do we achieve good value now? (3) Where and why are we failing? and (4) What will help us do better? We conclude that although the home and community care sector offers great promise in meeting the evolving health and social needs of Canadians, it is not living up to its potential. We propose the development of a national, integrated approach to home and community care to help Canadians remain healthy and independent in their homes. This would represent a wise financial investment for governments and would contribute to the long-term health of Canadians.

  8. Home-based radiology transcription and a productivity pay plan.

    Science.gov (United States)

    Kerr, K

    1997-01-01

    Shands Hospital in Gainesville, Fla., decided to evaluate the way it provided transcription services in its radiology department. It identified four goals: increased productivity, decreased operating expense, finding much needed space in the radiology department and increasing employee morale. The department performs 165,000 procedures annually, with 66 radiologists, 29 faculty, and 37 residents and fellows on staff. Six FTEs comprised the transcription pool in the radiology department, with transcription their only duty. Transcriptionists were paid an hourly rate based on their years of service, not their productivity. Evaluation and measurement studies were undertaken by the hospital's management systems engineering department. The transcriptionists' hours were then changed to provide coverage during the periods of heaviest dictation. The productivity level of the transcription staff was also measured and various methods of measurement reviewed. The goal was a pure incentive pay plan that would reward employees for every increase in productivity. The incentive pay plan was phased in over a three-month period. Transcriptionists were paid for work performed, with no base pay beyond minimum wage. The move to home-based transcription was planned. The necessary equipment was identified and various issues specific to working at home were addressed. Approximately six months later, the transcriptionists were set up to work at home. The astounding results achieved are presented: 28% increase in productivity, operational cost savings exceeding $25,000 and a space savings of 238 square feet.

  9. Home Camera-Based Fall Detection System for the Elderly

    Directory of Open Access Journals (Sweden)

    Koldo de Miguel

    2017-12-01

    Full Text Available Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

  10. Home Camera-Based Fall Detection System for the Elderly.

    Science.gov (United States)

    de Miguel, Koldo; Brunete, Alberto; Hernando, Miguel; Gambao, Ernesto

    2017-12-09

    Falls are the leading cause of injury and death in elderly individuals. Unfortunately, fall detectors are typically based on wearable devices, and the elderly often forget to wear them. In addition, fall detectors based on artificial vision are not yet available on the market. In this paper, we present a new low-cost fall detector for smart homes based on artificial vision algorithms. Our detector combines several algorithms (background subtraction, Kalman filtering and optical flow) as input to a machine learning algorithm with high detection accuracy. Tests conducted on over 50 different fall videos have shown a detection ratio of greater than 96%.

  11. A Novel Web Service Based Home Energy Management System

    DEFF Research Database (Denmark)

    Rossello Busquet, Ana; Soler, José

    2011-01-01

    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....

  12. The work-home interface : The role of home-based predictors of burnout among mothers

    NARCIS (Netherlands)

    Missler, M.A.; Stroebe, M.S.; van der Laan, G.

    2014-01-01

    Research into the work–home interface has mainly focused on work-related variables, leaving aspects associated with the home domain relatively understudied. This investigation examined both facilitation and conflict between home and work in a sample of 260 working mothers with children up to four

  13. Developing Home-Based Virtual Reality Therapy Interventions.

    Science.gov (United States)

    Lin, Janice; Kelleher, Caitlin L; Engsberg, Jack R

    2013-02-01

    Stroke is one of the leading causes of serious long-term disability. However, home exercise programs given at rehabilitation often lack in motivational aspects. The purposes of this pilot study were (1) create individualized virtual reality (VR) games and (2) determine the effectiveness of VR games for improving movement in upper extremities in a 6-week home therapy intervention for persons with stroke. Participants were two individuals with upper extremity hemiparesis following a stroke. VR games were created using the Looking Glass programming language and modified based on personal interests, goals, and abilities. Participants were asked to play 1 hour each day for 6 weeks. Assessments measured upper extremity movement (range of motion and Action Research Arm Test [ARAT]) and performance in functional skills (Canadian Occupational Performance Measure [COPM] and Motor Activity Log [MAL]). Three VR games were created by a supervised occupational therapist student. The participants played approximately four to six times a week and performed over 100 repetitions of movements each day. Participants showed improvement in upper extremity movement and participation in functional tasks based on results from the COPM, ARAT, and MAL. Further development in the programming environment is needed to be plausible in a rehabilitation setting. Suggestions include graded-level support and continuation of creating a natural programming language, which will increase the ability to use the program in a rehabilitation setting. However, the VR games were shown to be effective as a home therapy intervention for persons with stroke. VR has the potential to advance therapy services by creating a more motivating home-based therapy service.

  14. Embracing a competency-based specialty curriculum for community-based nursing roles.

    Science.gov (United States)

    Levin, Pamela F; Swider, Susan M; Breakwell, Susan; Cowell, Julia M; Reising, Virginia

    2013-01-01

    The Quad Council competencies for public health nursing (PHN) provide guidance in developing curricula at both the generalist and specialist level. However, these competencies are based on nursing roles in traditional public health agencies and community/public health is defined more broadly than official agency practice. The question arises as to whether community-based specialties require largely the same knowledge and skill set as PHN. The purpose of the competency cross-mapping project reported here was to (a) assess the intersection of the Quad Council competencies with four community-based specialties and (b) ensure the appropriateness of a Quad Council-based curriculum to prepare graduates across these four specialties (home health, occupational health, environmental health, and school nursing). This article details the multistep cross-mapping process, including validation with practice leaders. Results indicate strong alignment of community-based specialty competencies with Quad Council competencies. Community-based specialty-specific content that did not align well is identified, along with examples of didactic and clinical strategies to address gaps. This work indicates that a Quad Council-based curriculum is appropriate to prepare graduates in community-based specialties when attention to the specialty-specific competencies in the clinical setting is included. This work guides the development of a doctorate of nursing practice curriculum in PHN, encompassing the four additional community-based specialties. © 2013 Wiley Periodicals, Inc.

  15. IMPLEMENTING AN ATTACHMENT-BASED PARENTING INTERVENTION WITHIN HOME-BASED EARLY HEAD START: HOME-VISITORS' PERCEPTIONS AND EXPERIENCES.

    Science.gov (United States)

    West, Allison L; Aparicio, Elizabeth M; Berlin, Lisa J; Jones Harden, Brenda

    2017-07-01

    Implementation of evidence-based interventions in "real-world" settings is enhanced when front-line staff view the intervention as acceptable, appropriate, and feasible. This qualitative study addresses Early Head Start (EHS) home visitors' perceptions and experiences of an evidence-based parenting intervention, the Attachment and Biobehavioral Catch-up program (M. Dozier, O. Lindhiem, & J. Ackerman, 2005), when added to EHS services as usual within the context of a research-practice partnership. Thematic analysis of in-depth, qualitative interviews indicates that home visitors experienced the intervention as positive and helpful for EHS families. Some challenges included scheduling and uncertainty regarding the goals of the intervention. Concerns over participation in the research centered on information exchange, confidentiality, and time limitations. © 2017 Michigan Association for Infant Mental Health.

  16. Home Automation System Based on Intelligent Transducer Enablers

    Science.gov (United States)

    Suárez-Albela, Manuel; Fraga-Lamas, Paula; Fernández-Caramés, Tiago M.; Dapena, Adriana; González-López, Miguel

    2016-01-01

    This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers), which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet. PMID:27690031

  17. Home Automation System Based on Intelligent Transducer Enablers.

    Science.gov (United States)

    Suárez-Albela, Manuel; Fraga-Lamas, Paula; Fernández-Caramés, Tiago M; Dapena, Adriana; González-López, Miguel

    2016-09-28

    This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers), which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet.

  18. Home Automation System Based on Intelligent Transducer Enablers

    Directory of Open Access Journals (Sweden)

    Manuel Suárez-Albela

    2016-09-01

    Full Text Available This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers, which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet.

  19. Upon a Home Assistant Solution Based on Raspberry Pi Platform

    Directory of Open Access Journals (Sweden)

    Alexandru Florentin IFTIMIE

    2017-01-01

    Full Text Available Our ongoing research on Internet of Things (IoT has been focused on a project aiming to creating a proof of concept for a distributed system capable of controlling common devices found in a house such as TVs, air conditioning units, and other electrical devices. In order to automate these devices, the system integrates various sensors and actuators and, depending of user’s needs and creativity in conceiving and implementing new commands, the system is able to take care and execute the respective commands in a safe and secure manner. This paper presents our current research results upon a personal home assistant solution designed and built around Raspberry Pi V3 platform. The distributed, client-server approach enables users to control home electric and electronic devices from an Android based mobile application.

  20. Home-Based Telepsychiatry in US Urban Area

    Directory of Open Access Journals (Sweden)

    Alireza Amirsadri

    2017-01-01

    Full Text Available Telepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if the patient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized for schizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practice with social worker traveling to the home with electronic tablet for connection with psychiatrist. The intervention resulted in detecting unrecognized depression and complex trauma. The treatment plan included adding an antidepressant and therapy plan, eliminating one psychiatric medication, and reducing dosage of pain medication. The outcomes were improved function and quality of life. The patient and caregiver were both highly satisfied with the services. This hybrid telepsychiatry is a reasonable option for homebound elderly patients living in urban areas and less expensive than nursing home admission.

  1. The uniqueness of elderly care: registered nurses' experience as preceptors during clinical practice in nursing homes and home-based care.

    Science.gov (United States)

    Carlson, Elisabeth; Bengtsson, Mariette

    2014-04-01

    The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses' experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments. © 2013.

  2. Home and Community Language Proficiency in Spanish-English Early Bilingual University Students.

    Science.gov (United States)

    Schmidtke, Jens

    2017-10-17

    This study assessed home and community language proficiency in Spanish-English bilingual university students to investigate whether the vocabulary gap reported in studies of bilingual children persists into adulthood. Sixty-five early bilinguals (mean age = 21 years) were assessed in English and Spanish vocabulary and verbal reasoning ability using subtests of the Woodcock-Muñoz Language Survey-Revised (Schrank & Woodcock, 2009). Their English scores were compared to 74 monolinguals matched in age and level of education. Participants also completed a background questionnaire. Bilinguals scored below the monolingual control group on both subtests, and the difference was larger for vocabulary compared to verbal reasoning. However, bilinguals were close to the population mean for verbal reasoning. Spanish scores were on average lower than English scores, but participants differed widely in their degree of balance. Participants with an earlier age of acquisition of English and more current exposure to English tended to be more dominant in English. Vocabulary tests in the home or community language may underestimate bilingual university students' true verbal ability and should be interpreted with caution in high-stakes situations. Verbal reasoning ability may be more indicative of a bilingual's verbal ability.

  3. Microcontroller Based Home Security and Load Controlling Using Gsm Technology

    OpenAIRE

    Mustafijur Rahman; A.H.M Zadidul Karim; Sultanur Nyeem; Faisal Khan; Golam Matin

    2015-01-01

    "Home automation" referred to as 'Intelligent home' or 'automated home', indicates the automation of daily tasks with electrical devices used in homes. This could be the control of lights or more complex chores such as remote viewing of the house interiors for surveillance purposes. The emerging concept of smart homes offers a comfortable, convenient and safe and secure environment for occupants. These include automatic load controlling, fire detection, temperature sensing, and motion detecti...

  4. The Agreement between the MMSE and IQCODE Tests in a Community-Based Sample of Subjects Aged 70 Years or Older Receiving In-Home Nursing: An Explorative Study

    Directory of Open Access Journals (Sweden)

    Øyvind Kirkevold

    2015-02-01

    Full Text Available Aim: It was the aim of this study to compare the Mini-Mental State Examination (MMSE with the Informant Questionnaire for Cognitive Decline in the Elderly (IQCODE and to explore the characteristics of subjects with possible dementia with only one of the two tools. Methods: We used a random sample of patients aged 70+ receiving social service or in-home nursing. The patients were tested with the MMSE, and the next of kin was interviewed using the following: the IQCODE, the Cornell Scale for Depression in Dementia (CSDD, the Neuropsychiatric Inventory (NPI, instrumental activities of daily living (IADL, personal ADL (PADL and the General Medical Health Rating (GMHR. Results: Subjects with dementia defined only according to the MMSE showed a pattern of scores on IADL, PADL, CSDD, NPI-10 and GMHR similar to the no-dementia group according to both the MMSE and the IQCODE. Those with dementia defined only according to the IQCODE showed a pattern of scores similar to the possible dementia group according to both the MMSE and the IQCODE.

  5. The role of social relationships among elderly community-dwelling and nursing-home residents: findings from a quality of life study.

    Science.gov (United States)

    Scocco, Paolo; Nassuato, Mario

    2017-07-01

    In Western countries, older adults' needs are often managed through institutionalization. Based on the assumption that quality of life, particularly social relationships, may be perceived differently according to residential setting, the aims of this study were to compare World Health Organization Quality of Life brief version (WHOQOL-BREF) scores of elderly community-dwelling residents and nursing home residents. A sample of 207 older adults (135 community-dwelling residents, 72 nursing home residents) was evaluated with Mini-Mental State Examination (MMSE), WHOQOL-BREF, and Geriatric Depression Scale (GDS). Nursing home residents achieved lower WHOQOL-BREF scores on the physical health scale only (P = 0.002). In a linear regression model, physical score correlated negatively with GDS score (P = 0.0001) and Mini-Mental State Examination score (P = 0.04), but positively with male gender (P = 0.02) and community-dwelling residence (P = 0.001); psychological score correlated negatively with GDS score (P = 0.0001) and being married (P = 0.03), but positively with male gender (P = 0.009) and being unmarried (P = 0.03). The social relationships score correlated negatively with the GDS score (P = 0.0001) and male gender (P = 0.02), but positively with high education level (P = 0.04). The environment score negatively correlated with GDS score (P = 0.0001). In a logistic regression model, living in a nursing home correlated with female gender (P = 0.001), age (P = 0.0001), a lower physical score (P = 0.0001), and a higher social relationships score (P = 0.02). Depressive symptoms correlated with low scores in all WHOQOL-BREF domains. The variables that correlated with living conditions in a nursing home were older age, male gender, lower physical domain scores, and higher social relationship scores. Opportunities for socialization in nursing homes may thus improve perception of quality of life in this domain. © 2017 Japanese Psychogeriatric Society.

  6. Integrating Community into the Classroom: Community Gardening, Community Involvement, and Project-Based Learning.

    Science.gov (United States)

    Langhout, Regina Day; Rappaport, Julian; Simmons, Doretha

    2002-01-01

    Culturally relevant, ongoing project-based learning was facilitated in a predominantly African American urban elementary school via a community garden project. The project involved teachers, students, university members, and community members. This article evaluates the project through two classroom-community collaboration models, noting common…

  7. Design of smart home gateway based on Wi-Fi and ZigBee

    Science.gov (United States)

    Li, Yang

    2018-04-01

    With the increasing demand for home lifestyle, the traditional smart home products have been unable to meet the needs of users. Aim at the complex wiring, high cost and difficult operation problems of traditional smart home system, this paper designs a home gateway for smart home system based on Wi-Fi and ZigBee. This paper first gives a smart home system architecture base on cloud server, Wi-Fi and ZigBee. This architecture enables users to access the smart home system remotely from Internet through the cloud server or through Wi-Fi at home. It also offers the flexibility and low cost of ZigBee wireless networking for home equipment. This paper analyzes the functional requirements of the home gateway, and designs a modular hardware architecture based on the RT5350 wireless gateway module and the CC2530 ZigBee coordinator module. Also designs the software of the home gateway, including the gateway master program and the ZigBee coordinator program. Finally, the smart home system and home gateway are tested in two kinds of network environments, internal network and external network. The test results show that the designed home gateway can meet the requirements, support remote and local access, support multi-user, support information security technology, and can timely report equipment status information.

  8. Exploring pharmacy and home-based sexually transmissible infection testing.

    Science.gov (United States)

    Habel, Melissa A; Scheinmann, Roberta; Verdesoto, Elizabeth; Gaydos, Charlotte; Bertisch, Maggie; Chiasson, Mary Ann

    2015-11-01

    Background This study assessed the feasibility and acceptability of pharmacy and home-based sexually transmissible infection (STI) screening as alternate testing venues among emergency contraception (EC) users. The study included two phases in February 2011-July 2012. In Phase I, customers purchasing EC from eight pharmacies in Manhattan received vouchers for free STI testing at onsite medical clinics. In Phase II, three Facebook ads targeted EC users to connect them with free home-based STI test kits ordered online. Participants completed a self-administered survey. Only 38 participants enrolled in Phase I: 90% female, ≤29 years (74%), 45% White non-Hispanic and 75% college graduates; 71% were not tested for STIs in the past year and 68% reported a new partner in the past 3 months. None tested positive for STIs. In Phase II, ads led to >45000 click-throughs, 382 completed the survey and 290 requested kits; 28% were returned. Phase II participants were younger and less educated than Phase I participants; six tested positive for STIs. Challenges included recruitment, pharmacy staff participation, advertising with discretion and cost. This study found low uptake of pharmacy and home-based testing among EC users; however, STI testing in these settings is feasible and the acceptability findings indicate an appeal among younger women for testing in non-traditional settings. Collaborating with and training pharmacy and medical staff are key elements of service provision. Future research should explore how different permutations of expanding screening in non-traditional settings could improve testing uptake and detect additional STI cases.

  9. Health economic evaluation of home and hospital-based care in ...

    African Journals Online (AJOL)

    ... diabetes treatment satisfaction, diabetes knowledge and costs during three months ... Results: The cost of home-based care in insulin therapy diabetes was 61% ... Conclusions: The care at home approach for type 2 diabetic patients can be ...

  10. A home-based clothing manufacturing: the owner and the business

    African Journals Online (AJOL)

    S Blignaut

    home life. Women in home-based businesses are more flexible in managing ... and balancing their work and families (Alderman & .... business are important in determining its overall .... purpose of the study, to inspire a trusting relationship,.

  11. Efficacy and acceptability of a home-based, family-inclusive intervention for veterans with TBI: A randomized controlled trial.

    Science.gov (United States)

    Winter, Laraine; Moriarty, Helene J; Robinson, Keith; Piersol, Catherine V; Vause-Earland, Tracey; Newhart, Brian; Iacovone, Delores Blazer; Hodgson, Nancy; Gitlin, Laura N

    2016-01-01

    Traumatic brain injury (TBI) often undermines community re-integration, impairs functioning and produces other symptoms. This study tested an innovative programme for veterans with TBI, the Veterans' In-home Programme (VIP), delivered in veterans' homes, involving a family member and targeting the environment (social and physical) to promote community re-integration, mitigate difficulty with the most troubling TBI symptoms and facilitate daily functioning. Interviews and intervention sessions were conducted in homes or by telephone. Eighty-one veterans with TBI at a VA polytrauma programme and a key family member. This was a 2-group randomized controlled trial. Control-group participants received usual-care enhanced by two attention-control telephone calls. Follow-up interviews occurred up to 4 months after baseline interview. VIP's efficacy was evaluated using measures of community re-integration, target outcomes reflecting veterans' self-identified problems and self-rated functional competence. At follow-up, VIP participants had significantly higher community re-integration scores and less difficulty managing targeted outcomes, compared to controls. Self-rated functional competence did not differ between groups. In addition, VIP's acceptability was high. A home-based, family-inclusive service for veterans with TBI shows promise for improving meaningful outcomes and warrants further research and clinical application.

  12. Community acquired infections in older patients admitted to hospital from care homes versus the community: cohort study of microbiology and outcomes.

    Science.gov (United States)

    Marwick, Charis; Santiago, Virginia Hernandez; McCowan, Colin; Broomhall, Janice; Davey, Peter

    2013-02-06

    Residents of care homes are at risk of colonisation and infection with antibiotic resistant bacteria, but there is little evidence that antibiotic resistance among such patients is associated with worse outcomes than among older people living in their own homes. Our aim was to compare the prevalence of antibiotic resistant bacteria and clinical outcomes in older patients admitted to hospital with acute infections from care homes versus their own homes. We enrolled patients admitted to Ninewells Hospital in 2005 who were older than 64 years with onset of acute community acquired respiratory tract, urinary tract or skin and soft tissue infections, and with at least one sample sent for culture. The primary outcome was 30 day mortality, adjusted for age, sex, Charlson Index of co-morbidity, sepsis severity, presence of resistant isolates and resistance to initial therapy. 161 patients were identified, 60 from care homes and 101 from the community. Care home patients were older, had more co-morbidities, and higher rates of resistant bacteria, including MRSA and Gram negative organisms resistant to co-amoxiclav, cefuroxime and/or ciprofloxacin, overall (70% versus 36%, p = 0.026). 30 day mortality was high in both groups (30% in care home patients and 24% in comparators). In multivariate logistic regression we found that place of residence did not predict 30 day mortality (adjusted odds ratio (OR) for own home versus care home 1.01, 95% CI 0.40-2.52, p = 0.984). Only having severe sepsis predicted 30 day mortality (OR 10.09, 95% CI 3.37-30.19, p care homes were more likely to have resistant organisms but high levels of antimicrobial resistance were found in both groups. Thus, we recommend that antibiotic therapies active against resistant organisms, guided by local resistance patterns, should be considered for all older patients admitted with severe sepsis regardless of their place of residence.

  13. The Community Intervention Team as a means of Improving the transition from hospital to home for patients

    OpenAIRE

    Kearns, Michelle; Curran, Margaret; Collier, Dorcas; Burke, Mary; Lawler, Michelle

    2017-01-01

    Introduction: Too frequently patients are discharged from hospital to their home without local support from healthcare professionals. Without this support patients are often readmitted to hospital unnecessarily.Short description of practice change implemented: Networked Community intervention team (CIT) services make a unique contribution in facilitating the transition between hospital and home.Aim and theory of change: The aim is to facilitate early discharge from an acute setting, providing...

  14. 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.

  15. Home-Based Primary Care: Beyond Extension of the Independence at Home Demonstration.

    Science.gov (United States)

    Rotenberg, James; Kinosian, Bruce; Boling, Peter; Taler, George

    2018-04-01

    The Independence at Home (IAH) Demonstration Year 2 results confirmed that the first-year savings were 10 times as great as those of the pioneer accountable care organizations during their initial 2 years. We update projected savings from nationwide conversion of the IAH demonstration, incorporating Year 2 results and improving attribution of IAH-qualified (IAH-Q) Medicare beneficiaries to home-based primary care (HBPC) practices. Applying IAH qualifying criteria to beneficiaries in the Medicare 5% claims file, the effect of expanding HBPC to the 2.4 million IAH-Q beneficiaries is projected using various growth rates. Total 10-year system-wide savings (accounting for IAH implementation but before excluding shared savings) range from $2.6 billion to $27.8 billion, depending on how many beneficiaries receive HBPC on conversion to a Medicare benefit, mix of clinical practice success, and growth rate of IAH practices. Net projected savings to the Centers for Medicare and Medicaid Services (CMS) after routine billing for IAH services and distribution of shared savings ranges from $1.8 billion to $10.9 billion. If aligning IAH with other advanced alternative payment models achieved at least 35% penetration of the eligible population in 10 years, CMS savings would exceed savings with the current IAH design and HBPC growth rate. If the demonstration were simply extended 2 years with a beneficiary cap of 50,000 instead of 15,000 (as currently proposed), CMS would save an additional $46 million. The recent extension of IAH, a promising person-centered CMS program for managing medically complex and frail elderly adults, offers the chance to evaluate modifications to promote more rapid HBPC growth. © 2018, Copyright the Authors Journal compilation © 2018, The American Geriatrics Society.

  16. Poststroke Rehabilitation and Restorative Care Utilization: A Comparison Between VA Community Living Centers and VA-contracted Community Nursing Homes.

    Science.gov (United States)

    Jia, Huanguang; Pei, Qinglin; Sullivan, Charles T; Cowper Ripley, Diane C; Wu, Samuel S; Bates, Barbara E; Vogel, W Bruce; Bidelspach, Douglas E; Wang, Xinping; Hoffman, Nannette

    2016-03-01

    Effective poststroke rehabilitation care can speed patient recovery and minimize patient functional disabilities. Veterans affairs (VA) community living centers (CLCs) and VA-contracted community nursing homes (CNHs) are the 2 major sources of institutional long-term care for Veterans with stroke receiving care under VA auspices. This study compares rehabilitation therapy and restorative nursing care among Veterans residing in VA CLCs versus those Veterans in VA-contracted CNHs. Retrospective observational. All Veterans diagnosed with stroke, newly admitted to the CLCs or CNHs during the study period who completed at least 2 Minimum Data Set assessments postadmission. The outcomes were numbers of days for rehabilitation therapy and restorative nursing care received by the Veterans during their stays in CLCs or CNHs as documented in the Minimum Data Set databases. For rehabilitation therapy, the CLC Veterans had lower user rates (75.2% vs. 76.4%, P=0.078) and fewer observed therapy days (4.9 vs. 6.4, Pcare, CLC Veterans had higher user rates (33.5% vs. 30.6%, Pcare days (9.4 vs. 5.9, Pcare (coefficient=5.48±0.37, Pcare both before and after risk adjustment.

  17. An Agent-Based Model of Evolving Community Flood Risk.

    Science.gov (United States)

    Tonn, Gina L; Guikema, Seth D

    2017-11-17

    Although individual behavior plays a major role in community flood risk, traditional flood risk models generally do not capture information on how community policies and individual decisions impact the evolution of flood risk over time. The purpose of this study is to improve the understanding of the temporal aspects of flood risk through a combined analysis of the behavioral, engineering, and physical hazard aspects of flood risk. Additionally, the study aims to develop a new modeling approach for integrating behavior, policy, flood hazards, and engineering interventions. An agent-based model (ABM) is used to analyze the influence of flood protection measures, individual behavior, and the occurrence of floods and near-miss flood events on community flood risk. The ABM focuses on the following decisions and behaviors: dissemination of flood management information, installation of community flood protection, elevation of household mechanical equipment, and elevation of homes. The approach is place based, with a case study area in Fargo, North Dakota, but is focused on generalizable insights. Generally, community mitigation results in reduced future damage, and individual action, including mitigation and movement into and out of high-risk areas, can have a significant influence on community flood risk. The results of this study provide useful insights into the interplay between individual and community actions and how it affects the evolution of flood risk. This study lends insight into priorities for future work, including the development of more in-depth behavioral and decision rules at the individual and community level. © 2017 Society for Risk Analysis.

  18. Systematic Review of Community-Based Childhood Obesity Prevention Studies

    Science.gov (United States)

    Segal, Jodi; Wu, Yang; Wilson, Renee; Wang, Youfa

    2013-01-01

    OBJECTIVE: This study systematically reviewed community-based childhood obesity prevention programs in the United States and high-income countries. METHODS: We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library for relevant English-language studies. Studies were eligible if the intervention was primarily implemented in the community setting; had at least 1 year of follow-up after baseline; and compared results from an intervention to a comparison group. Two independent reviewers conducted title scans and abstract reviews and reviewed the full articles to assess eligibility. Each article received a double review for data abstraction. The second reviewer confirmed the first reviewer’s data abstraction for completeness and accuracy. RESULTS: Nine community-based studies were included; 5 randomized controlled trials and 4 non–randomized controlled trials. One study was conducted only in the community setting, 3 were conducted in the community and school setting, and 5 were conducted in the community setting in combination with at least 1 other setting such as the home. Desirable changes in BMI or BMI z-score were found in 4 of the 9 studies. Two studies reported significant improvements in behavioral outcomes (1 in physical activity and 1 in vegetable intake). CONCLUSIONS: The strength of evidence is moderate that a combined diet and physical activity intervention conducted in the community with a school component is more effective at preventing obesity or overweight. More research and consistent methods are needed to understand the comparative effectiveness of childhood obesity prevention programs in the community setting. PMID:23753099

  19. A comparison of arsenic exposure in young children and home water arsenic in two rural West Texas communities

    Directory of Open Access Journals (Sweden)

    Michelle Del Rio

    2017-10-01

    Full Text Available Abstract Background In a previously conducted Health Impact Assessment of a well-water dependent southwest community, arsenic (As levels greater than the EPA Maximum Contaminant Level (10 μg/L were identified in home water samples. The goals of this study were to test whether children from the previously studied well-water dependent community (Community 1 had higher blood As levels than children from a demographically similar and geographically nearby community dependent on a municipal water supply (Community 2; to test whether home water As levels predicted child As blood levels; and to examine how child As blood levels changed over time. Methods This was an observational study of 252 children aged 4 to 12 years from two communities. Children were recruited through elementary schools and tested during the school day; 204 children participated in follow-up testing. Home water samples were collected according to U.S. Environmental Protection agency recommended procedures. Child heavy metal blood levels and home water sample heavy metal levels were analyzed using inductively coupled plasma mass spectrometry. General linear regression analysis was used to test the influence of community on child As levels, and to examine the contribution of home water As levels to child blood As levels. Results Arsenic was detectable in all children tested. Blood levels ranged from 0.09–2.61 μg/dL; approximately 31% of children tested at Time I (79/252 had blood As values above the current acceptable limit (1.2 μg/dL. Approximately 8% of household water samples (6/76 had As levels higher than 10 μg/L. Community did not predict child blood As levels; seasonal effects differed by Community. At Time II, child blood As levels were higher in Community 2 than in Community 1. Conclusion A large proportion of children in the communities tested had As exposure. Home water As levels did not predict child blood As levels. Fluctuating child blood As levels by season

  20. A web based tool for storing and visualising data generated within a smart home.

    Science.gov (United States)

    McDonald, H A; Nugent, C D; Moore, G; Finlay, D D; Hallberg, J

    2011-01-01

    There is a growing need to re-assess the current approaches available to researchers for storing and managing heterogeneous data generated within a smart home environment. In our current work we have developed the homeML Application; a web based tool to support researchers engaged in the area of smart home research as they perform experiments. Within this paper the homeML Application is presented which includes the fundamental components of the homeML Repository and the homeML Toolkit. Results from a usability study conducted by 10 computer science researchers are presented; the initial results of which have been positive.

  1. National Structural Survey of Veterans Affairs Home-Based Primary Care Programs.

    Science.gov (United States)

    Karuza, Jurgis; Gillespie, Suzanne M; Olsan, Tobie; Cai, Xeuya; Dang, Stuti; Intrator, Orna; Li, Jiejin; Gao, Shan; Kinosian, Bruce; Edes, Thomas

    2017-12-01

    To describe the current structural and practice characteristics of the Department of Veterans Affairs (VA) Home-Based Primary Care (HBPC) program. We designed a national survey and surveyed HBPC program directors on-line using REDCap. We received 236 surveys from 394 identified HBPC sites (60% response rate). HBPC site characteristics were quantified using closed-ended formats. HBPC program directors were most often registered nurses, and HBPC programs primarily served veterans with complex chronic illnesses that were at high risk of hospitalization and nursing home care. Primary care was delivered using interdisciplinary teams, with nurses, social workers, and registered dietitians as team members in more than 90% of the sites. Most often, nurse practitioners were the principal primary care providers (PCPs), typically working with nurse case managers. Nearly 60% of the sites reported dual PCPs involving VA and community-based physicians. Nearly all sites provided access to a core set of comprehensive services and programs (e.g., case management, supportive home health care). At the same time, there were variations according to site (e.g., size, location (urban, rural), use of non-VA hospitals, primary care models used). HBPC sites reflected the rationale and mission of HBPC by focusing on complex chronic illness of home-based veterans and providing comprehensive primary care using interdisciplinary teams. Our next series of studies will examine how HBPC site structural characteristics and care models are related to the processes and outcomes of care to determine whether there are best practice standards that define an optimal HBPC structure and care model or whether multiple approaches to HBPC better serve the needs of veterans. Published 2017. This article is a U.S. Government work and is in the public domain in the USA.

  2. Enabling Composition-Based Video-Conferencing for the Home

    NARCIS (Netherlands)

    A.J. Jansen (Jack); P.S. Cesar Garcia (Pablo Santiago); T. Stevens; I. Kegel; J. Issing

    2011-01-01

    htmlabstractThis paper describes a videoconferencing system that meets performance constraints and functional requirements for use in consumer homes. Our system improves existing home technologies (such as video chat) by providing high-quality audiovisual communication, efficient encoding

  3. GPs' adherence to guidelines for structured assessments of stroke survivors in the community and care homes.

    Science.gov (United States)

    Gonçalves-Bradley, Daniela C; Boylan, Anne-Marie; Koshiaris, Constantinos; Vazquez Montes, Maria; Ford, Gary A; Lasserson, Daniel S

    2015-12-01

    Clinical practice guidelines recommend that stroke survivors' needs be assessed at regular intervals after stroke. The extent to which GPs comply with national guidance particularly for patients in care homes who have greatest clinical complexity is unknown. This study aimed to establish the current clinical practice in the UK of needs assessment by GPs for stroke survivors after hospital discharge for acute stroke. Cross-sectional online survey of current practice of GPs, using the national doctors.net network. The survey was completed by 300 GPs who had on average been working for 14 years. The structured assessment of stroke survivors' needs was not offered by 31% of GPs, with no significant difference for level of provision in community or care home settings. The outputs of reviews were added to patients' notes by 89% of GPs and used to change management by 57%. Only half the GPs reported integrating the information obtained into care plans and only a quarter of GPs had a protocol for follow-up of identified needs. Analysis of free-text comments indicated that patients in some care homes may receive more regular and structured reviews. This survey suggests that at least one-third of GPs provide no formal review of the needs of stroke patients and that in only a minority are identified needs addressed in a structured way. Standardization is required for what is included in reviews and how needs are being identified and met. © The Author 2015. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Mobile and Home-based Vendors’ Contributions to the Retail Food Environment in Rural South Texas Mexican-origin Settlements

    Science.gov (United States)

    Valdez, Zulema; Dean, Wesley R; Sharkey, Joseph R

    2012-01-01

    A growing concern with high rates of obesity and overweight among immigrant minority populations in the U.S. has focused attention on the availability and accessibility to healthy foods in such communities. Small-scale vending in rural, impoverished and underserved areas, however, is generally overlooked; yet, this type of informal activity and source for food is particularly important in such environs, or “food desserts,” where traditional forms of work and mainstream food outlets are limited or even absent. This exploratory study investigates two types of small-scale food vending that take place in rural colonias, or Mexican-origin settlements along the South Texas border with Mexico: mobile and home-based. Using a convenience sample of 23 vendors who live and work in Texas colonias, this study identifies the characteristics associated with mobile and home-based food vendors and their businesses and its contributions to the rural food environment. Findings reveal that mobile and home-based vending provides a variety of food and beverage options to colonia residents, and suggests that home-based vendors contribute a greater assortment of food options, including some healthier food items, than mobile food vendors, which offer and sell a limited range of products. Findings may contribute to the development of innovative policy solutions and interventions aimed at increasing healthy food options or reducing health disparities in immigrant communities. PMID:22531289

  5. Chapter 11. Community analysis-based methods

    Energy Technology Data Exchange (ETDEWEB)

    Cao, Y.; Wu, C.H.; Andersen, G.L.; Holden, P.A.

    2010-05-01

    Microbial communities are each a composite of populations whose presence and relative abundance in water or other environmental samples are a direct manifestation of environmental conditions, including the introduction of microbe-rich fecal material and factors promoting persistence of the microbes therein. As shown by culture-independent methods, different animal-host fecal microbial communities appear distinctive, suggesting that their community profiles can be used to differentiate fecal samples and to potentially reveal the presence of host fecal material in environmental waters. Cross-comparisons of microbial communities from different hosts also reveal relative abundances of genetic groups that can be used to distinguish sources. In increasing order of their information richness, several community analysis methods hold promise for MST applications: phospholipid fatty acid (PLFA) analysis, denaturing gradient gel electrophoresis (DGGE), terminal restriction fragment length polymorphism (TRFLP), cloning/sequencing, and PhyloChip. Specific case studies involving TRFLP and PhyloChip approaches demonstrate the ability of community-based analyses of contaminated waters to confirm a diagnosis of water quality based on host-specific marker(s). The success of community-based MST for comprehensively confirming fecal sources relies extensively upon using appropriate multivariate statistical approaches. While community-based MST is still under evaluation and development as a primary diagnostic tool, results presented herein demonstrate its promise. Coupled with its inherently comprehensive ability to capture an unprecedented amount of microbiological data that is relevant to water quality, the tools for microbial community analysis are increasingly accessible, and community-based approaches have unparalleled potential for translation into rapid, perhaps real-time, monitoring platforms.

  6. Medicare and Medicaid Programs; CY 2017 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2016-11-03

    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, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-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 CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

  7. A Web-Based Model for Diabetes Education and Decision Support for the Home Care Nurse

    OpenAIRE

    Hill, Michelle; Kirby, Judy

    1998-01-01

    Diabetes education for the home care population requires expert knowledge to be available at the point-of-care, the patient's home. This poster displays a model for Web-based diabetes education and decision support for the home care nurse. The system utilizes the line of reasoning (LOR) model to organize and represent expert decision-making thought processes.

  8. Home Care Quality Indicators (HCQIS) Based on the MDS-HC

    Science.gov (United States)

    Hirdes, John P.; Fries, Brant E.; Morris, John N.; Ikegami, Naoki; Zimmerman, David; Dalby, Dawn M.; Aliaga, Pablo; Hammer, Suzanne; Jones, Richard

    2004-01-01

    Purpose: This study aimed to develop home care quality indicators (HCQIs) to be used by a variety of audiences including consumers, agencies, regulators, and policy makers to support evidence-based decision making related to the quality of home care services. Design and Methods: Data from 3,041 Canadian and 11,252 U.S. home care clients assessed…

  9. Cohort study of smoke-free homes in economically disadvantaged communities in the Dominican Republic

    Directory of Open Access Journals (Sweden)

    Ann M. Dozier

    2014-01-01

    Full Text Available OBJECTIVE: To analyze household smoking-ban prevalence over time and predictors among communities in the Dominican Republic, historically a significant tobacco-growing country with few tobacco control regulations. METHODS: Baseline (2004 and follow-up surveillance surveys (2006, 2007 (each n > 1 000 randomly selected households conducted in six economically disadvantaged communities (three tobacco-growing and two each urban, peri-urban, and rural assessed household members’ demographics, health status, and household characteristics, including smoking restrictions. RESULTS: Between 2004 and 2007, household smoking-ban prevalence increased in all communities, with overall rates increasing from 23.9% (2004 to 45.3% (2007. Households with smokers adopted smoking bans at lower rates (6%-17% versus those without smokers (which had an adoption rate of 35%-58%. Logistic regression models demonstrated that the associations between allowing smoking in households with no members who smoked and being located in a tobacco-growing community, being a Catholic household, and having a member with a cardiovascular problem were statistically significant. The association between having a child under age 5 or a member with a respiratory condition and prohibiting smoking in the home was not statistically significant. CONCLUSIONS: Prevalence of households banning smoking increased in all communities but remained well below rates in industrialized countries. For low- and middle-income countries or those in early stages of tobacco control, basic awareness-raising measures (including surveillance activities may lead to statistically significant increases in household smoking-ban adoption, particularly among households with no smokers. An increase in household smoking-ban prevalence may result in changes in community norms that can lead to a further increase in the adoption of smoking bans. Having household members who smoke and being in a tobacco-growing community may

  10. Strategy community development based on local resources

    Science.gov (United States)

    Meirinawati; Prabawati, I.; Pradana, G. W.

    2018-01-01

    The problem of progressing regions is not far from economic problems and is often caused by the inability of the regions in response to changes in economic conditions that occur, so the need for community development programs implemented to solve various problems. Improved community effort required with the real conditions and needs of each region. Community development based on local resources process is very important, because it is an increase in human resource capability in the optimal utilization of local resource potential. In this case a strategy is needed in community development based on local resources. The community development strategy are as follows:(1) “Eight Line Equalization Plus” which explains the urgency of rural industrialization, (2) the construction of the village will be more successful when combining strategies are tailored to regional conditions, (3) the escort are positioning themselves as the Planner, supervisor, information giver, motivator, facilitator, connecting at once evaluators.

  11. Gender Responsive Community Based Planning and Budgeting ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    ... Responsive Community Based Planning and Budgeting Tool for Local Governance ... in data collection, and another module that facilitates gender responsive and ... In partnership with UNESCO's Organization for Women in Science for the ...

  12. WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings

    OpenAIRE

    Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

    2015-01-01

    Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home...

  13. A Study on Home Based Enterprises in Kampoeng Pandean as Supporting Sustainable Architecture

    Directory of Open Access Journals (Sweden)

    Safeyah Muchlisiniyati

    2016-01-01

    Full Text Available Home Based Enterprises (HBEs provide an enormous impact on the lives of the citizens and the environment. The impacts include: increase income and welfare of the family, provide job opportunities, improve the quality of homes and the environment, and ensure life sustainability. The existence of the business leads changes to the house. Those changes that made to the house are often ignore the comfort of home space and the environment as living space. This study aims to look at the development of HBEs performed by community in Kampoeng Pandean. The measurement items used are architectural sustainability factors, ie economical sustainability, social sustainability, and enviromental sustainability. The study is located in Kampoeng Pandean Sidoarjo. The method used is a combination of qualitative and quantitative method. The results show that HBEs in Kampoeng Pandean have not fully supported the sustainable architecture. Environmental sustainability has not been met, due to the density of the environment, the high percentage of building area to land area, and the construction of business space does not consider the comfort factor.

  14. Home-based mobile cardio-pulmonary rehabilitation consultant system.

    Science.gov (United States)

    Lee, Hsu-En; Wang, Wen-Chih; Lu, Shao-Wei; Wu, Bo-Yuan; Ko, Li-Wei

    2011-01-01

    Cardiovascular diseases are the most popular cause of death in the world recently. For postoperatives, cardiac rehabilitation is still asked to maintain at home (phase II) to improve cardiac function. However, only one third of outpatients do the exercise regularly, reflecting the difficulty for home-based healthcare: lacking of monitoring and motivation. Hence, a cardio-pulmonary rehabilitation system was proposed in this research to improve rehabilitation efficiency for better prognosis. The proposed system was built on mobile phone and receiving electrocardiograph (ECG) signal from a wireless ECG holter via Bluetooth connection. Apart from heart rate (HR) monitor, an ECG derived respiration (EDR) technique is also included to provide respiration rate (RR). Both HR and RR are the most important vital signs during exercise but only used one physiological signal recorder in this system. In clinical test, there were 15 subjects affording Bruce Task (treadmill) to simulate rehabilitation procedure. Correlation between this system and commercial product (Custo-Med) was up to 98% in HR and 81% in RR. Considering the prevention of sudden heart attack, an arrhythmia detection expert system and healthcare server at the backend were also integrated to this system for comprehensive cardio-pulmonary monitoring whenever and wherever doing the exercise.

  15. Comparative characteristics of the home care nursing services used by community-dwelling older people from urban and rural environments.

    Science.gov (United States)

    Borowiak, Ewa; Kostka, Tomasz

    2013-06-01

    To compare home care nursing services use by community-dwelling older people from urban and rural environments in Poland. In the current literature, there is a lack of data based on multidimensional geriatric assessment concerning the provision of care delivered by nurses for older people from urban and rural environments. Cross-sectional random survey. Between 2006-2010, a random sample of 935 older people (over 65 years of age) from an urban environment and 812 from a neighbouring rural environment were interviewed in a cross-sectional survey. The rural dwellers (82·8%) nominated their family members as care providers more often than the city inhabitants (51·2%). Home nursing care was provided to 4·1% of people in the city and 6·5% in the county. Poststroke condition, poor nutritional status, and low physical activity level, as well as low scores for activities of daily living, instrumental activities of daily living, and Mini-Mental State Examination values, were all determinants of nursing care, both in urban and rural areas. In the urban environment, additional predictors of nursing care use were age, presence of ischaemic heart disease, diabetes and respiratory disorders, number of medications taken, and a high depression score. Poor functional status is the most important determinant of nursing care use in both environments. In the urban environment, a considerable proportion of community-dwelling elders live alone. In the rural environment, older people usually have someone available for potential care services. The main problem seems to be seeking nursing care only in advanced deterioration of functional status. © 2012 Blackwell Publishing Ltd.

  16. The conjoint influence of home enriched environment and lead exposure on children's cognition and behaviour in a Mexican lead smelter community.

    Science.gov (United States)

    Moodie, Sue; Ialongo, Nick; López, Patricia; Rosado, Jorge; García-Vargas, Gonzalo; Ronquillo, Dolores; Kordas, Katarzyna

    2013-01-01

    A range of studies has been conducted on the detrimental effects of lead in mining and smelting communities. The neurocognitive and behavioural health effects of lead on children are well known. This research characterized the conjoint influence of lead exposure and home enriched environment on neurocognitive function and behaviour for first-grade children living in a Mexican lead smelter community. Structural equation models were used for this analysis with latent outcome variables, Cognition and Behaviour, constructed based on a battery of assessments administered to the first-grade children, their parents, and teachers. Structural equation modelling was used to describe complex relationships of exposure and health outcomes in a manner that permitted partition of both direct and indirect effects of the factors being measured. Home Environment (a latent variable constructed from information on mother's education and support of school work and extracurricular activities), and child blood lead concentration each had a main significant effect on cognition and behaviour. However, there were no statistically significant moderation relationships between lead and Home Environment on these latent outcomes. Home Environment had a significant indirect mediation effect between lead and both Cognition and Behaviour (p-valueEnvironment has a moderate mediation effect with respect to lead effects on Behaviour (β=0.305) and a lower mediation effect on Cognition (β=0.184). The extent of home enrichment in this study was most highly related to the mother's support of schoolwork and slightly less by the mother's support of extracurricular activities or mother's education. Further research may be able to develop approaches to support families to make changes within their home and child rearing practices, or advocate for different approaches to support their child's behaviour to reduce the impact of lead exposure on children's cognitive and behavioural outcomes. Copyright © 2012

  17. Home and community care services: a major opportunity for preventive health care

    Directory of Open Access Journals (Sweden)

    Lujic Sanja

    2010-05-01

    Full Text Available Abstract Background In Australia, the Home and Community Care (HACC program provides services in the community to frail elderly living at home and their carers. Surprisingly little is known about the health of people who use these services. In this study we sought to describe health-related factors associated with use of HACC services, and to identify potential opportunities for targeting preventive services to those at high risk. Methods We obtained questionnaire data from the 45 and Up Study for 103,041 men and women aged 45 years and over, sampled from the general population of New South Wales, Australia in 2006-2007, and linked this with administrative data about HACC service use. We compared the characteristics of HACC clients and non-clients according to a range of variables from the 45 and Up Study questionnaire, and estimated crude and adjusted relative risks for HACC use with generalized linear models. Results 4,978 (4.8% participants used HACC services in the year prior to completing the questionnaire. Increasing age, female sex, lower pre-tax household income, not having a partner, not being in paid work, Indigenous background and living in a regional or remote location were strongly associated with HACC use. Overseas-born people and those speaking languages other than English at home were significantly less likely to use HACC services. People who were underweight, obese, sedentary, who reported falling in the past year, who were current smokers, or who ate little fruit or vegetables were significantly more likely to use HACC services. HACC service use increased with decreasing levels of physical functioning, higher levels of psychological distress, and poorer self-ratings of health, eyesight and memory. HACC clients were more likely to report chronic health conditions, in particular diabetes, stroke, Parkinson's disease, anxiety and depression, cancer, heart attack or angina, blood clotting problems, asthma and osteoarthritis

  18. Community-based knowledge translation: unexplored opportunities

    Directory of Open Access Journals (Sweden)

    Armstrong Rebecca

    2011-06-01

    Full Text Available Abstract Background Knowledge translation is an interactive process of knowledge exchange between health researchers and knowledge users. Given that the health system is broad in scope, it is important to reflect on how definitions and applications of knowledge translation might differ by setting and focus. Community-based organizations and their practitioners share common characteristics related to their setting, the evidence used in this setting, and anticipated outcomes that are not, in our experience, satisfactorily reflected in current knowledge translation approaches, frameworks, or tools. Discussion Community-based organizations face a distinctive set of challenges and concerns related to engaging in the knowledge translation process, suggesting a unique perspective on knowledge translation in these settings. Specifically, community-based organizations tend to value the process of working in collaboration with multi-sector stakeholders in order to achieve an outcome. A feature of such community-based collaborations is the way in which 'evidence' is conceptualized or defined by these partners, which may in turn influence the degree to which generalizable research evidence in particular is relevant and useful when balanced against more contextually-informed knowledge, such as tacit knowledge. Related to the issues of evidence and context is the desire for local information. For knowledge translation researchers, developing processes to assist community-based organizations to adapt research findings to local circumstances may be the most helpful way to advance decision making in this area. A final characteristic shared by community-based organizations is involvement in advocacy activities, a function that has been virtually ignored in traditional knowledge translation approaches. Summary This commentary is intended to stimulate further discussion in the area of community-based knowledge translation. Knowledge translation, and exchange

  19. Employees' views on home-based, after-hours telephone triage by Dutch GP cooperatives.

    Science.gov (United States)

    Backhaus, Ramona; van Exel, Job; de Bont, Antoinette

    2013-11-04

    Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage.

  20. Community-Scale Attic Retrofit and Home Energy Upgrade Data Mining

    Energy Technology Data Exchange (ETDEWEB)

    Berman, M. [Alliance for Residential Building Innovation, Davis, CA (United States); Smith, P. [Alliance for Residential Building Innovation, Davis, CA (United States); Jackson, J. [Alliance for Residential Building Innovation, Davis, CA (United States)

    2015-05-07

    The U.S. Department of Energy’s Building America research team, Alliance for Residential Building Innovation (ARBI), implemented a project to increase residential retrofits in Davis, California. The project used a neighborhood-focused strategy for implementation and a low-cost retrofit program that focused on upgraded attic insulation and duct sealing. ARBI worked with a community partner, the not-for-profit Cool Davis Initiative, as well as selected area contractors to implement a strategy that sought to capitalize on the strong local expertise of partners and the unique aspects of the Davis, California, community. Working with community partners also allowed ARBI to collect and analyze data about effective messaging tactics for community-based retrofit programs.

  1. Factors related to the provision of home-based end-of-life care among home-care nursing, home help, and care management agencies in Japan.

    Science.gov (United States)

    Igarashi, Ayumi; Kurinobu, Takeshi; Ko, Ayako; Okamoto, Yuko; Matsuura, Shino; Feng, Mei; Yamamoto-Mitani, Noriko

    2015-09-12

    To promote home death, it is necessary to clarify the institutional barriers to conducting end-of-life (EOL) care and consider strategies to deal with this process. This study aims to clarify institution-related factors associated with the provision of home-based EOL care cases, and to compare them among three different types of home-care agencies. We administered a cross-sectional survey throughout Japan to investigate the number and characteristics of EOL cases of home-care nursing (HN), home-help (HH) and care management (CM) agencies. Bivariate and multivariate analyses were performed for each type of agency to examine factors related to the provision of EOL care. 378 HN agencies, 274 HH agencies, and 452 CM agencies responded to the distributed questionnaire. HN agencies had on average 2.1 (SD = 4.0; range 0-60) home-based EOL cases in the last 3 months, while HH agencies had 0.9 (SD = 1.3; range 0-7) and CM agencies had 1.5 (SD = 2.2; range 0-18) in the last 6 months. In a multivariable analysis of HN agencies, a large number of staff (OR: 1.52; p EOL care; in HH agencies, accepting EOL clients in the agency (OR: 3.29; p EOL care; in CM agencies, the number of staff (OR: 1.21; p = 0.037), the number of collaborating HH agencies (OR: 1.07; p = 0.032), and whether home-care nurses and home helpers visit clients together (OR: 1.89; p = 0.007) were positively associated with the provision of EOL care. The agency's size and the inter-agency collaborative system seemed most important among HN agencies and CM agencies, while institutional preparedness for EOL was most important for HH agencies. These findings represent important new information for targeting different effective strategies in the promotion of home-based EOL care, depending on the agency type.

  2. Give Water a Hand. Home Site Action Guide. Organizing Water Conservation and Pollution Prevention Service Projects in Your Community.

    Science.gov (United States)

    Wisconsin Univ., Madison. Coll. of Agricultural and Life Sciences.

    Students grades 4-8 can use this guide to explore the topics of water and water conservation within the home while conducting an environmental community service project. Youth groups, led by a group leader, work with local experts from business, government, or environmental organizations to complete the project. Nine activity sections involve…

  3. Conservation implications for the Himalayan wolf Canis (lupus) himalayensis based on observations of packs and home sites in Nepal

    OpenAIRE

    Werhahn, G; Kusi, N; Sillero-Zubiri, C; Macdonald, DW

    2017-01-01

    We provide insights into pack composition and den site parameters of the Himalayan wolf Canis (lupus) himalayensis based on observations of free-ranging wolves in three study areas in Nepal. We combine this with a social survey of the local Buddhist communities regarding human–carnivore conflict, to draw inferences for conservation practice in the Nepalese Himalayas. We recorded eight wolf packs (with an average composition of two adults and three pups), and found five home sites in high-alti...

  4. Research on the cultivation path of smart home-based care service mode in Internet+ vision

    Directory of Open Access Journals (Sweden)

    Peng Qingchao

    2016-01-01

    Full Text Available Home-based care for the aged is an effective method to solve the problem of caring the aged in China. This thesis analyzes some problems existing in the development of current home-based care service for the aged in our country and the positive effects brought by Internet+ in home-based care service. It proposes a new service mode of care for the aged--Internet+ home-based care service, and explains the establishment of this system and the responsibilities of the participants. Also, it explores the path to realize the establishment of Internet+ home-based care service mode so as to promote the healthy development of home-based care service in China.

  5. Community-Based Ecotourism: The Transformation of Local Community

    Directory of Open Access Journals (Sweden)

    Pookhao Nantira

    2014-01-01

    Full Text Available Community-based ecotourism (CBET is considered a sustainable form of tourism that improves the quality of life of hosts at the tourist destination. Scholars have yet to explore the long-term operation of CBET in relation to its effects on the local way of life. Consequently, the purpose of this paper is to examine the transformation of a local community due to the operation of CBET in relation to sociocultural, economic and environmental aspects. The findings reveal that the community encounters both positive and negative impacts of transformation. However, unintended impacts of the CBET operation lay embedded in the transformation of relationships among the community members. The study identifies that close relationships among the villagers has been initially transformed to loose relationships due to forgotten communal goals; CBET has transformed from being a conservation tool to being a business-oriented goal which causes conflicts of interest among local people and alters traditional social structure. The study also agrees with the notion of social exchange theory for villagers to enhance environmental sustainability, and proposes that slight inequalities of benefits received from CBET causes social transformation at the local level.

  6. Performance Improvement Strategic Home Based Manufacturer Tahu And Tempe Groups Based In The District Of Jember

    Directory of Open Access Journals (Sweden)

    Istatuk Budi Yuswanto

    2017-04-01

    Full Text Available Tahu dan tempe is a product of the soybean meal that has been known since long in Indonesia. Tahu is a Chinese food products in contrast to tempe an authentic Indonesian food . As tempe tahu also favored by the people of Indonesia because it has a taste that delicious nutritious and affordable price.Industries that produce tahu dan tempe are generally small-scale home-based businesses with the number of workers a little less than 2-6 people and investments that are not too large. The use of technology in small business home-based producer of tahu dan tempe quite simple and easy to learn so it can be run by anyone. The success of small business home-based manufacturers to survive and evolve toward more advanced by knowing their strengths weaknesses opportunities that can be taken by small business home-based and threat or better known as the SWOT Strength Weakness Opportunity Threath that can be retrieved strategies that affect the success and development of small business home-based manufacturer of tahu dan tempe.Constraints faced by small businesses and home-based manufacturers know that the soybean Tepe that include budget constraints limited access to banking limited human resources marketing only the scope of Jember and lack of good management. No group or cooperative does not have a good recording making it difficult to make financial reports manufacturing planning and operational supervision and finances into this industry employers group lemah.Pembentukan help solve problems and maximize its potential.

  7. Cost Effectiveness of a Home-Based Intervention That Helps Functionally Vulnerable Older Adults Age in Place at Home

    Directory of Open Access Journals (Sweden)

    Eric Jutkowitz

    2012-01-01

    Full Text Available Evaluating cost effectiveness of interventions for aging in place is essential for adoption in service settings. We present the cost effectiveness of Advancing Better Living for Elders (ABLE, previously shown in a randomized trial to reduce functional difficulties and mortality in 319 community-dwelling elders. ABLE involved occupational and physical therapy sessions and home modifications to address client-identified functional difficulties, performance goals, and home safety. Incremental cost-effectiveness ratio (ICER, expressed as additional cost to bring about one additional year of life, was calculated. Two models were then developed to account for potential cost differences in implementing ABLE. Probabilistic sensitivity analyses were conducted to account for variations in model parameters. By two years, there were 30 deaths (9: ABLE; 21: control. Additional costs for 1 additional year of life was $13,179 for Model 1 and $14,800 for Model 2. Investment in ABLE may be worthwhile depending on society's willingness to pay.

  8. Listening to the community: Using formative research to strengthen maternity waiting homes in Zambia.

    Science.gov (United States)

    Scott, Nancy A; Vian, Taryn; Kaiser, Jeanette L; Ngoma, Thandiwe; Mataka, Kaluba; Henry, Elizabeth G; Biemba, Godfrey; Nambao, Mary; Hamer, Davidson H

    2018-01-01

    The WHO recommends maternity waiting homes (MWH) as one intervention to improve maternal and newborn health. However, persistent structural, cultural and financial barriers in their design and implementation have resulted in mixed success in both their uptake and utilization. Guidance is needed on how to design a MWH intervention that is acceptable and sustainable. Using formative research and guided by a sustainability framework for health programs, we systematically collected data from key stakeholders and potential users in order to design a MWH intervention in Zambia that could overcome multi-dimensional barriers to accessing facility delivery, be acceptable to the community and be financially and operationally sustainable. We used a concurrent triangulation study design and mixed methods. We used free listing to gather input from a total of 167 randomly sampled women who were pregnant or had a child under the age of two (n = 59), men with a child under the age of two (n = 53), and community elders (n = 55) living in the catchment areas of four rural health facilities in Zambia. We conducted 17 focus group discussions (n = 135) among a purposive sample of pregnant women (n = 33), mothers-in-law (n = 32), traditional birth attendants or community maternal health promoters (n = 38), and men with a child under two (n = 32). We administered 38 semi-structured interviews with key informants who were identified by free list respondents as having a stake in the condition and use of MWHs. Lastly, we projected fixed and variable recurrent costs for operating a MWH. Respondents most frequently mentioned distance, roads, transport, and the quality of MWHs and health facilities as the major problems facing pregnant women in their communities. They also cited inadequate advanced planning for delivery and the lack of access to delivery supplies and baby clothes as other problems. Respondents identified the main problems of MWHs specifically as over-crowding, poor

  9. Research on the cultivation path of smart home-based care service mode in Internet+ vision

    OpenAIRE

    Peng Qingchao

    2016-01-01

    Home-based care for the aged is an effective method to solve the problem of caring the aged in China. This thesis analyzes some problems existing in the development of current home-based care service for the aged in our country and the positive effects brought by Internet+ in home-based care service. It proposes a new service mode of care for the aged--Internet+ home-based care service, and explains the establishment of this system and the responsibilities of the participants. Also, it explor...

  10. Accessories modifying based on plastic waste of shampoo bottle as home economic product

    Science.gov (United States)

    Setyowati, Erna; Sukesi, Siti

    2018-03-01

    Plastic is a waste that can not decompose by the soil and if its left without a good handling can pollute the environment. Plastic waste needs processing by the recycle bottles principle. Shampoo bottle is one of plastic waste with high density polyethylene type (HDPE). One of the innovation to recycling shampoo bottles waste into the new products whichbeneficially and aestheticallyform by engineered the buns accesories. Accessories are one of the tools used by most women, in the form of trinkets or ornaments which ajusted to the trend to beautify the look. Accessories from shampoo bottle waste can be obtained from household waste, beauty salon and the beauty program study by inculcating human beings' behavior by transforming waste into blessing while also increasing family income. Technique of making its by compiling through improvement of panelist team. The goal of this research is to engineering theaccessories based on shampoo bottle waste as home economics. The method are using experiment, observation and documentation, analysis using descriptive. The results obtained from the overall sensory test averaged at 93%, while the favored test averaged at 85.5%. The product can be ordered according to the desired design, but it takes a long time. Therefore accessories engineering from shampoo bottles waste-based can be used as home economics. The production of shampoo bottles waste-based accessories should improved its quality and quantity, to be marketed through the community, by the cooperation with accessories and bun craftsmen.

  11. Montessori-based training makes a difference for home health workers & their clients.

    Science.gov (United States)

    Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J

    2003-01-01

    Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training.

  12. A model based message passing approach for flexible and scalable home automation controllers

    Energy Technology Data Exchange (ETDEWEB)

    Bienhaus, D. [INNIAS GmbH und Co. KG, Frankenberg (Germany); David, K.; Klein, N.; Kroll, D. [ComTec Kassel Univ., SE Kassel Univ. (Germany); Heerdegen, F.; Jubeh, R.; Zuendorf, A. [Kassel Univ. (Germany). FG Software Engineering; Hofmann, J. [BSC Computer GmbH, Allendorf (Germany)

    2012-07-01

    There is a large variety of home automation systems that are largely proprietary systems from different vendors. In addition, the configuration and administration of home automation systems is frequently a very complex task especially, if more complex functionality shall be achieved. Therefore, an open model for home automation was developed that is especially designed for easy integration of various home automation systems. This solution also provides a simple modeling approach that is inspired by typical home automation components like switches, timers, etc. In addition, a model based technology to achieve rich functionality and usability was implemented. (orig.)

  13. Community-Based Intrusion Detection

    OpenAIRE

    Weigert, Stefan

    2017-01-01

    Today, virtually every company world-wide is connected to the Internet. This wide-spread connectivity has given rise to sophisticated, targeted, Internet-based attacks. For example, between 2012 and 2013 security researchers counted an average of about 74 targeted attacks per day. These attacks are motivated by economical, financial, or political interests and commonly referred to as “Advanced Persistent Threat (APT)” attacks. Unfortunately, many of these attacks are successful and the advers...

  14. Abundance of introduced species at home predicts abundance away in herbaceous communities

    Science.gov (United States)

    J. Firn; J.L. Moore; A.S. MacDougall; E.T. Borer; E.W. Seabloom; J. HilleRisLambers; S. Harpole; E.E. Cleland; C.S. Brown; J.M.H. Knops; S.M. Prober; D.A. Pyke; K.A. Farrell; J.D. Bakker; L.R. O’Halloran; P.B. Adler; S.L. Collins; C.M. D’Antonio; M.J. Crawley; E.M. Wolkovich; K.J. La Pierre; B.A. Melbourne; Y. Hautier; J.W. Morgan; A.D.B. Leakey; A.D. Kay; R.L. McCulley; K.F. Davies; C.J. Stevens; C.J. Chu

    2011-01-01

    Many ecosystems worldwide are dominated by introduced plant species, leading to loss of biodiversity and ecosystem function. A common but rarely tested assumption is that these plants are more abundant in introduced vs. native communities, because ecological or evolutionary-based shifts in populations underlie invasion success. Here, data for 26 herbaceous species at...

  15. A community based study of failure to thrive in Israel.

    Science.gov (United States)

    Wilensky, D S; Ginsberg, G; Altman, M; Tulchinsky, T H; Ben Yishay, F; Auerbach, J

    1996-01-01

    OBJECTIVE: To examine the characteristics of infants suffering from failure to thrive in a community based cohort in Israel and to ascertain the effect of failure to thrive on their cognitive development. METHODS: By review of records maintained at maternal and child health clinics in Jerusalem and the two of Beit Shemesh, epidemiological data were obtained at age 15 months on a cohort of all babies born in 1991. For each case of failure to thrive, a matched control was selected from the same maternal and child health clinic. At age 20 months, cognitive development was measured, and at 25 months a home visit was carried out to assess maternal psychiatric status by questionnaire, and the HOME assessment was performed to assess the home environment. RESULTS: 3.9% of infants were found to have fallen below the third centile in weight for at least three months during the first year of life. Infants with failure to thrive did not differ from the general population in terms of obstetric or neonatal complications, birth order, or parents' ethnic origin, age, or years of education. The infants with failure to thrive did have lower birthweights and marginally smaller head circumferences at birth. Developmental assessment at 20 months of age showed a DQ of 99.7 v 107.2 in the matched controls, with 11.5% having a DQ below 80, as opposed to only 4.6% of the controls. No differences were found in maternal psychiatric problems as measured by a self report questionnaire. There were, however, significant differences in subscales of the HOME scale. CONCLUSIONS: (1) Infants who suffered from failure to thrive had some physiological predispositions that put them at risk; (2) failure to thrive may be an early marker of families providing suboptimal developmental stimulation. PMID:8869197

  16. Entrepreneurial Checklist Tool for Beginning Farm and Home-Based Businesses

    Science.gov (United States)

    Rafie, A. R.; Nartea, Theresa

    2012-01-01

    Extension educators entertain frequent questions on beginning a farm or starting a home-based business. Retired, unemployed, and displaced workers consider starting a small farm or home-based business. Determining educational needs or individual business aptitude is time consuming. Lengthy and comprehensive skill-based checklists exist for…

  17. Immigrant Identities in the Digital Age: Portraits of Spanish-Speaking Young Men Learning in a Community-Based Setting

    Science.gov (United States)

    Creel-Erickson, Gwen Rene

    2013-01-01

    Currently the United States is home to a large and increasing immigrant population. Many of these immigrant students use community-based programs for their educational needs. Despite the large number of immigrant students who currently use alternate resources, such as churches and community centers, for education, adult language learners in…

  18. Persona-based Adaptation in a Smart Green Home

    NARCIS (Netherlands)

    Havinga, P. (Paul); Leeuwen, van H. (Henk); Salomons, E. (Etto); Teeuw, W. (Wouter)

    2012-01-01

    In this paper Etto Salomons presents his vision of the GoGreen project on a smart home that is capable of decreasing energy consumption while at the same time increasing user comfort. To identify the main challenges he introduces a general model for intelligent homes that describes the current

  19. Performing Home in Barcelona: A Practice-Based Photo Essay

    Science.gov (United States)

    Pons, Esther Belvis

    2018-01-01

    During the winter of 2016, I carried out an artistic project in Barcelona entitled 'Performing Home' that aimed to explore the affective and social challenges that artists in political asylum or refuge cope with. The project began with a simple question: "where in public spaces do artists in asylum feel 'at home'?" It explored how public…

  20. Home-based Self-care: Understanding and Designing Pervasive Technology to Support Care Management Work at Home

    DEFF Research Database (Denmark)

    Verdezoto, Nervo

    the self-care management work at home. People need to know which care activities to perform, when to perform them, how to proceed and why these are important. While at home, an active lifestyle and comorbidity not only challenge self-care activities but also the use of self-care technologies in non...... 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...... practices are investigated to (a) further understand the self-care management work in nonclinical settings, and (b) inform future design of pervasive healthcare technology that accounts for people’s perspectives on self-care and everyday life. First, we explore two selfcare practices of medication...

  1. Home Away from Home: International Students and Their Identity-Based Social Networks in Australia

    Science.gov (United States)

    Gomes, Catherine; Berry, Marsha; Alzougool, Basil; Chang, Shanton

    2014-01-01

    This paper explores the role of identity in helping international students form social networks at an Australian institution and how these networks contribute to creating a sense of home away. The findings suggest that international students form distinct social networks that are not necessarily solely made up of fellow students from their home…

  2. Future Directions of Applying Healthcare Cloud for Home-based Chronic Disease Care

    OpenAIRE

    Hu, Yan; Eriksén, Sara; Lundberg, Jenny

    2017-01-01

    The care of chronic disease has become the main challenge for healthcare institutions around the world. To meet the growing needs of patients, moving the front desk of healthcare from hospital to home is essential. Recently, cloud computing has been applied to healthcare domain; however, adapting to and using this technology effectively for home-based care is still in its initial phase. We have proposed a conceptual hybrid cloud model for home-based chronic disease care, and have evaluated it...

  3. Community-based natural resource management

    DEFF Research Database (Denmark)

    Treue, Thorsten; Nathan, Iben

    that deliver credible and easily accessible information. Checks and balances can be supported through civil society as well as the media. Finally, the private sector plays a key and potentially beneficial role in the harvest, transport and marketing of CBNRM products. Thus, dialogue partners should include......This technical note is the product of a long process of consultation with a wide range of resource persons who have over the years been involved in the Danish support to Community Based Natural Resource Management. It gives a brief introduction to community-based natural resource management (CBNRM...... from CBNRM will be useful when designing community-based climate adaptation strategies. Thus, this note is a contribution to an ongoing debate as well as a product of the long-standing experiences of Danida's environmental portfolio. CBNRM is not a stand-alone solution to secure poverty reduction...

  4. The application of autostereoscopic display in smart home system based on mobile devices

    Science.gov (United States)

    Zhang, Yongjun; Ling, Zhi

    2015-03-01

    Smart home is a system to control home devices which are more and more popular in our daily life. Mobile intelligent terminals based on smart homes have been developed, make remote controlling and monitoring possible with smartphones or tablets. On the other hand, 3D stereo display technology developed rapidly in recent years. Therefore, a iPad-based smart home system adopts autostereoscopic display as the control interface is proposed to improve the userfriendliness of using experiences. In consideration of iPad's limited hardware capabilities, we introduced a 3D image synthesizing method based on parallel processing with Graphic Processing Unit (GPU) implemented it with OpenGL ES Application Programming Interface (API) library on IOS platforms for real-time autostereoscopic displaying. Compared to the traditional smart home system, the proposed system applied autostereoscopic display into smart home system's control interface enhanced the reality, user-friendliness and visual comfort of interface.

  5. Community Based Networks and 5G

    DEFF Research Database (Denmark)

    Williams, Idongesit

    2016-01-01

    The deployment of previous wireless standards has provided more benefits for urban dwellers than rural dwellers. 5G deployment may not be different. This paper identifies that Community Based Networks as carriers that deserve recognition as potential 5G providers may change this. The argument....... The findings indicate that 5G connectivity can be extended to rural areas by these networks, via heterogenous networks. Hence the delivery of 5G data rates delivery via Wireless WAN in rural areas can be achieved by utilizing the causal factors of the identified models for Community Based Networks....

  6. Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes.

    Science.gov (United States)

    Ali, Bako; Awad, Ali Ismail

    2018-03-08

    The Internet of Things (IoT) is an emerging paradigm focusing on the connection of devices, objects, or "things" to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE) methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes.

  7. Community-Based Programming: An Opportunity and Imperative for the Community College.

    Science.gov (United States)

    Boone, Edgar J.

    1992-01-01

    Defines community-based programing as a cooperative process in which the community college serves as leader and catalyst in effecting collaboration among community members, leaders, and groups. Recommends 15 tasks for community college leaders involved in community-based programing, including environmental scanning and coalition building. (DMM)

  8. Driving forces for home-based reablement; a qualitative study of older adults' experiences.

    Science.gov (United States)

    Hjelle, Kari Margrete; Tuntland, Hanne; Førland, Oddvar; Alvsvåg, Herdis

    2017-09-01

    As a result of the ageing population worldwide, there has been a growing international interest in a new intervention termed 'reablement'. Reablement is an early and time-limited home-based intervention with emphasis on intensive, goal-oriented and interdisciplinary rehabilitation for older adults in need of rehabilitation or at risk of functional decline. The aim of this qualitative study was to describe how older adults experienced participation in reablement. Eight older adults participated in semi-structured interviews. A qualitative content analysis was used as the analysis strategy. Four main themes emerged from the participants' experiences of participating in reablement: 'My willpower is needed', 'Being with my stuff and my people', 'The home-trainers are essential', and 'Training is physical exercises, not everyday activities'. The first three themes in particular reflected the participants' driving forces in the reablement process. Driving forces are intrinsic motivation in interaction with extrinsic motivation. Intrinsic motivation was based on the person's willpower and responsibility, and extrinsic motivation was expressed to be strengthened by being in one's home environment with 'own' people, as well as by the co-operation with the reablement team. The reablement team encouraged and supported the older adults to regain confidence in performing everyday activities as well as participating in the society. Our findings have practical significance for politicians, healthcare providers and healthcare professionals by contributing to an understanding of how intrinsic and extrinsic motivation influence reablement. Some persons need apparently more extrinsic motivational support also after the time-limited reablement period is completed. The municipal health and care services need to consider individualised follow-up programmes after the intensive reablement period in order to maintain the achieved skills to perform everyday activities and participate in

  9. Risk adjustment methods for Home Care Quality Indicators (HCQIs based on the minimum data set for home care

    Directory of Open Access Journals (Sweden)

    Hirdes John P

    2005-01-01

    Full Text Available Abstract Background There has been increasing interest in enhancing accountability in health care. As such, several methods have been developed to compare the quality of home care services. These comparisons can be problematic if client populations vary across providers and no adjustment is made to account for these differences. The current paper explores the effects of risk adjustment for a set of home care quality indicators (HCQIs based on the Minimum Data Set for Home Care (MDS-HC. Methods A total of 22 home care providers in Ontario and the Winnipeg Regional Health Authority (WRHA in Manitoba, Canada, gathered data on their clients using the MDS-HC. These assessment data were used to generate HCQIs for each agency and for the two regions. Three types of risk adjustment methods were contrasted: a client covariates only; b client covariates plus an "Agency Intake Profile" (AIP to adjust for ascertainment and selection bias by the agency; and c client covariates plus the intake Case Mix Index (CMI. Results The mean age and gender distribution in the two populations was very similar. Across the 19 risk-adjusted HCQIs, Ontario CCACs had a significantly higher AIP adjustment value for eight HCQIs, indicating a greater propensity to trigger on these quality issues on admission. On average, Ontario had unadjusted rates that were 0.3% higher than the WRHA. Following risk adjustment with the AIP covariate, Ontario rates were, on average, 1.5% lower than the WRHA. In the WRHA, individual agencies were likely to experience a decline in their standing, whereby they were more likely to be ranked among the worst performers following risk adjustment. The opposite was true for sites in Ontario. Conclusions Risk adjustment is essential when comparing quality of care across providers when home care agencies provide services to populations with different characteristics. While such adjustment had a relatively small effect for the two regions, it did

  10. Risk adjustment methods for Home Care Quality Indicators (HCQIs) based on the minimum data set for home care

    Science.gov (United States)

    Dalby, Dawn M; Hirdes, John P; Fries, Brant E

    2005-01-01

    Background There has been increasing interest in enhancing accountability in health care. As such, several methods have been developed to compare the quality of home care services. These comparisons can be problematic if client populations vary across providers and no adjustment is made to account for these differences. The current paper explores the effects of risk adjustment for a set of home care quality indicators (HCQIs) based on the Minimum Data Set for Home Care (MDS-HC). Methods A total of 22 home care providers in Ontario and the Winnipeg Regional Health Authority (WRHA) in Manitoba, Canada, gathered data on their clients using the MDS-HC. These assessment data were used to generate HCQIs for each agency and for the two regions. Three types of risk adjustment methods were contrasted: a) client covariates only; b) client covariates plus an "Agency Intake Profile" (AIP) to adjust for ascertainment and selection bias by the agency; and c) client covariates plus the intake Case Mix Index (CMI). Results The mean age and gender distribution in the two populations was very similar. Across the 19 risk-adjusted HCQIs, Ontario CCACs had a significantly higher AIP adjustment value for eight HCQIs, indicating a greater propensity to trigger on these quality issues on admission. On average, Ontario had unadjusted rates that were 0.3% higher than the WRHA. Following risk adjustment with the AIP covariate, Ontario rates were, on average, 1.5% lower than the WRHA. In the WRHA, individual agencies were likely to experience a decline in their standing, whereby they were more likely to be ranked among the worst performers following risk adjustment. The opposite was true for sites in Ontario. Conclusions Risk adjustment is essential when comparing quality of care across providers when home care agencies provide services to populations with different characteristics. While such adjustment had a relatively small effect for the two regions, it did substantially affect the

  11. Twenty weeks of home-based interactive training of children with cerebral palsy improves functional abilities

    DEFF Research Database (Denmark)

    Lorentzen, Jakob; Greve, Line Z; Kliim-Due, Mette

    2015-01-01

    BACKGROUND: Home-based training is becoming ever more important with increasing demands on the public health systems. We investigated whether individualized and supervised interactive home-based training delivered through the internet improves functional abilities in children with cerebral palsy...

  12. English Language Learners' Strategies for Reading Computer-Based Texts at Home and in School

    Science.gov (United States)

    Park, Ho-Ryong; Kim, Deoksoon

    2016-01-01

    This study investigated four elementary-level English language learners' (ELLs') use of strategies for reading computer-based texts at home and in school. The ELLs in this study were in the fourth and fifth grades in a public elementary school. We identify the ELLs' strategies for reading computer-based texts in home and school environments. We…

  13. Caring for home-based care workers | de Saxe Zerden | Southern ...

    African Journals Online (AJOL)

    care workers provide critical services, which include physical, psychosocial, and palliative care activities.1 A quantitative and qualitative study of home-based care workers in South Africa was conducted in 2005 to better understand the needs, fears and motivations of front-line care workers at Thembalethu Home Based ...

  14. Latino Parent Home-Based Practices that Bolster Student Academic Persistence

    Science.gov (United States)

    Mena, Jasmine A.

    2011-01-01

    Home-based parental involvement practices (i.e., educational encouragement, monitoring, and support) and their impact on students' academic persistence were investigated with a sample of 137, ninth-grade Latino students in a northeast high school. Structural Equation Modeling results indicate that the relationship between home-based parental…

  15. 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.

  16. Scientists and Faith Communities in Dialogue - Finding Common Ground to Care for our Common Home

    Science.gov (United States)

    Jablonski, L. M.

    2017-12-01

    World-wide, faith communities are a key place for education and outreach to the general adult population. The sacred responsibility to care for the earth, living sustainability and concern for the poor are nearly universal priorities across faith communities. Scientists and people of faith share in common experiences of awe and wonder and ethical roles as citizens. The majority of faith communities have statements on climate changes, environmental justice, and stewardship, and respond with education, action plans and advocacy. People of faith are increasingly seeking science expertise to better understand the science and best solutions to implement. Transformation of point of view often requires heart-felt motivation (domain of religion) as well as knowledge (science). Scientists can participate in alleviating environmental justice by providing data and education to communities. Expert testimony is a critical service. Pope Francis' environmental encyclical Laudato si, engaged diverse scientists in its writing and outreach. Francis invites our continued dialogue with people of faith and goodwill of all societal sectors and fields to achieve an integral ecology that integrates science, economics, and impacts on the poor. For scientists to be most effective in sharing expertise, and building understanding and trust in scientific findings, skill- building is needed in: communication, finding common ground, intercultural competency, working with diverse populations and religious literacy. Educational initiatives bridging scientists and faith-communities will be highlighted including within: the Ecological Society of America, American Assn for Advancement of Sustainability in Higher Education, faith-based & Environmental Justice networks, Nature centers, Higher Education (including Seminary) Initiatives and the Hanley Sustainability Institute, and interfaith religious organizations engaged with scientists. Bridge-building and ongoing partnerships of scientists, EJ

  17. Context-Based Energy Disaggregation in Smart Homes

    Directory of Open Access Journals (Sweden)

    Francesca Paradiso

    2016-01-01

    Full Text Available In this paper, we address the problem of energy conservation and optimization in residential environments by providing users with useful information to solicit a change in consumption behavior. Taking care to highly limit the costs of installation and management, our work proposes a Non-Intrusive Load Monitoring (NILM approach, which consists of disaggregating the whole-house power consumption into the individual portions associated to each device. State of the art NILM algorithms need monitoring data sampled at high frequency, thus requiring high costs for data collection and management. In this paper, we propose an NILM approach that relaxes the requirements on monitoring data since it uses total active power measurements gathered at low frequency (about 1 Hz. The proposed approach is based on the use of Factorial Hidden Markov Models (FHMM in conjunction with context information related to the user presence in the house and the hourly utilization of appliances. Through a set of tests, we investigated how the use of these additional context-awareness features could improve disaggregation results with respect to the basic FHMM algorithm. The tests have been performed by using Tracebase, an open dataset made of data gathered from real home environments.

  18. Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

    Science.gov (United States)

    Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

    2015-01-01

    The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

  19. A Smart Home Center Platform Solution Based on Smart Mirror

    Directory of Open Access Journals (Sweden)

    Deng Xibo

    2017-01-01

    Full Text Available With the popularization of the concept of smart home, people have raised requirements on the experience of smart living. A smart home platform center solution is put forward in order to solve the intelligent interoperability and information integration of smart home, which enable people to have a more intelligent and convenient life experience. This platform center is achieved through the Smart Mirror. The Smart Mirror refers to a smart furniture, on the basis of the traditional concept of mirror, combining Raspberry Pi, the application of one-way mirror imaging principle, the touch-enabled design, voice and video interaction. Smart Mirror can provide a series of intelligent experience for the residents, such as controlling all the intelligent furniture through Smart Mirror; accessing and displaying the weather, time, news and other life information; monitoring the home environment; remote interconnection operation.

  20. Community care for the Elderly: Needs and Service Use Study (CENSUS): Who receives home care packages and what are the outcomes?

    Science.gov (United States)

    Low, Lee-Fay; Fletcher, Jennifer; Gresham, Meredith; Brodaty, Henry

    2015-09-01

    Investigate factors associated with waiting times for home care packages and outcomes for care recipients and carers. Analyses of data collected every four months for 12 months from 55 community-dwelling older adults eligible for government-subsidised packaged care and their carers. Thirty of fifty-five participants were offered a package; they waited from one to 237 days. Baseline quality of life was higher for those offered a package than those not. Baseline care needs and unmet needs, neuropsychiatric symptoms, and cognitive decline did not predict offers. Package receipt compared to non-package receipt was associated with decreased carer burden over time but did not affect levels of unmet care needs, care needs or quality of life. Being offered a home care package was not based on waiting time or unmet care needs. Reforms should include a transparent system of wait listing and prioritisation. © 2014 ACOTA.

  1. Community-Scale Attic Retrofit and Home Energy Upgrade Data Mining

    Energy Technology Data Exchange (ETDEWEB)

    Berman, M. [Alliance for Residential Building Innovation, Davis, CA (United States); Smith, P. [Alliance for Residential Building Innovation, Davis, CA (United States); Jackson, J. [Alliance for Residential Building Innovation, Davis, CA (United States)

    2015-05-01

    Residential retrofit is an essential element of any comprehensive strategy for improving residential energy efficiency, yet remains a challenging proposition to sell to homeowners due to low levels of awareness and lack of financial incentive. The Alliance for Residential Building Innovation (ARBI) implemented a project to increase residential retrofits in Davis, CA called Retrofit Your Attic developed and appropriate data sets were uploaded to the Building America Field Data Repository (BAFDR). Two key conclusions are a broad based public awareness campaign is needed to increase understanding of the makeup and benefits of residential retrofits and a dramatic shift is needed so that efficient homes are appraised and valued at higher levels. The SAVE Act, proposed bipartisan federal legislation [S.1106], offers one way to accomplish this.

  2. Community-based health insurance knowledge, concern ...

    African Journals Online (AJOL)

    Community-based health insurance knowledge, concern, preferences, and financial planning for health care among informal sector workers in a health district of Douala, Cameroon. ... This is mainly due to the lack of awareness and limited knowledge on the basic concepts of a CBHI by this target population. Solidarity ...

  3. Facilitating community-based interprofessional education and ...

    African Journals Online (AJOL)

    Facilitating community-based interprofessional education and collaborative practice in a health sciences faculty: Student perceptions and experiences. ... It became apparent that students need to be prepared to work in interprofessional groups. The overall intervention was perceived positively, allowing students to become ...

  4. Participation in community based natural resource management ...

    African Journals Online (AJOL)

    The study was on participation in Community Based Natural Resource Management Programme (CBNRMP) and its socio-economic effect on rural families in Ikwerre Area, Rivers State Nigeria. A structured questionnaire was administered to 60 beneficiaries of the programme. Data collected were subjected to descriptive ...

  5. Intelligent Home Control System Based on ARM10

    Science.gov (United States)

    Chen, G. X.; Jiang, J.; Zhong, L. H.

    2017-10-01

    Intelligent home is becoming the hot spot of social attention in the 21st century. When it is in China, it is a really new industry. However, there is no doubt that Intelligent home will become a new economic growth point of social development; it will change the life-style of human being. To develop the intelligent home, we should keep up with the development trend of technology. This is the reason why I talk about the intelligent home control system here. In this paper, intelligent home control system is designed for alarm and remote control on gas- leaking, fire disaster, earthquake prediction, etc., by examining environmental changes around house. When the Intelligent home control system has detected an accident occurs, the processor will communicate with the GSM module, informing the house keeper the occurrence of accident. User can receive and send the message to the system to cut the power by mobile phone. The system can get access to DCCthrough ARM10 JTAG interface, using DCC to send and receive messages. At the same time, the debugger on the host is mainly used to receive the user’s command and send it to the debug component in the target system. The data that returned from the target system is received and displayed to the user in a certain format.

  6. American Academy of Home Care Medicine

    Science.gov (United States)

    ... articles Community Paramedicine Is at the Forefront of Home Care Medicine By Linda DeCherrie, MD Learn how community ... You can still learn from the leaders in home-based primary care. All of the stand-out sessions will be ...

  7. Literature Review of the Evidence Base for a Hospice at Home Service

    OpenAIRE

    Stosz, Laura

    2008-01-01

    This literature review aimed to identify the evidence base for a hospice at home service at the end of life for facilitating death at home to narrow the gap between preference and reality. This study defines ‘hospice at home’ as hospice style care provided in the home environment; this means specialist palliative care, equipment and medication is available 24/7. However, services operating under this term are not uniform across the literature. Terms encountered in the literature that are used...

  8. The Utility of Home-Practice in Mindfulness-Based Group Interventions: A Systematic Review.

    Science.gov (United States)

    Lloyd, Annette; White, Ross; Eames, Catrin; Crane, Rebecca

    2018-01-01

    A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.

  9. A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway

    OpenAIRE

    Guan, Kai; Shao, Minggang; Wu, Shuicai

    2017-01-01

    This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) ...

  10. SMART HOME SECURITY SOLUTIONS BASED ON INTERNET OF THINGS (IOT) USING WIFI INTERFACE

    OpenAIRE

    Bhavna1, Dr. Neetu Sharma2

    2018-01-01

    Smart home system is very popular in modern days that give many kind of application that make everything is simple and easy to control. In modern day, home appliances are using wireless technology and can be accessed by internet that will make residents life easier and organized. IoT-based Home Automation System is designed to assist the people with physical disabilities and elderly to provide support as well as to control the electrical appliances and monitor the room temperature using mobil...

  11. Identifying participation needs of people with acquired brain injury in the development of a collective community smart home.

    Science.gov (United States)

    Levasseur, Mélanie; Pigot, Hélène; Couture, Mélanie; Bier, Nathalie; Swaine, Bonnie; Therriault, Pierre-Yves; Giroux, Sylvain

    2016-11-01

    This study explored the personalized and collective participation needs of people with acquired brain injury (ABI) living in a future shared community smart home. An action research study was conducted with 16 persons, seven with ABI, four caregivers and five rehabilitation or smart home healthcare providers. Twelve interviews and two focus groups were conducted, audiotaped, transcribed and analyzed for content. Seventy personalized and 18 collective participation needs were reported related to daily and social activities. Personalized needs concerned interpersonal relationships, general organization of activities, leisure, housing, fitness and nutrition. Collective needs related mainly to housing, general organization of activities and nutrition. Personalized and collective participation needs of people with ABI planning to live in a community smart home are diverse and concern daily as well as social activities. Implications for Rehabilitation To meet participation needs of people with ABI, the design of smart homes must consider all categories of daily and social activities. Considering personalized and collective needs allowed identifying exclusive examples of each. As some persons with ABI had difficulty identifying their needs as well as accepting their limitations and the assistance required, rehabilitation professionals must be involved in needs identification.

  12. Integrated community-based dementia care: the Geriant model

    Directory of Open Access Journals (Sweden)

    Ludo Glimmerveen

    2015-09-01

    Full Text Available This article gives an in-depth description of the service delivery model of Geriant, a Dutch organization providing community-based care services for people suffering from dementia. Core to its model is the provision of clinical case management, embedded in multidisciplinary dementia care teams. As Geriant's client group includes people from the first presumption of dementia until they can no longer live at home, its care model provides valuable lessons about how different mechanisms of integration are flexibly put to use if the complexity of clients” care needs increases. It showcases how the integration of services for a specific sub-population is combined with alignment of these services with generalist network partners. After a detailed description of the programme and its results, this article builds on the work of Walter Leutz for a conceptual discussion of Geriant's approach to care integration. 

  13. THE HIDDEN POWER IN GAPS: COMMUNITY HOME CARE VOLUNTEER GROUP PARTICIPANT OF A CATHOLIC CHURCH IN CARIACICA – ES - BRAZIL

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    Clésio de Oliveira Venâncio

    2012-12-01

    Full Text Available Objective: To examine the voluntary community home care mode while a network of affective work in the region of Porto Santana in Cariacica – one of the municipalities of the Metropolitan Area of Greater Vitória – ES – Brazil. Method: an exploratory study, qualitative approach, held together with a group that develops community home care in the territory in which they live in the period April to October 2010. To obtain data group visits were made, targeted interviews and follow-up on their routines, if configuring a cartographic process. Results: the reports of the group's members and of the observations made during the trail pointed to the materialization of a practice where caring configures itself from the movement of living affections within a territory, having elements that make this natural alternative practice in an environment of constant motion.

  14. Improving information for community-based adaptation

    Energy Technology Data Exchange (ETDEWEB)

    Huq, Saleemul

    2011-10-15

    Community-based adaptation aims to empower local people to cope with and plan for the impacts of climate change. In a world where knowledge equals power, you could be forgiven for thinking that enabling this type of adaptation boils down to providing local people with information. Conventional approaches to planning adaptation rely on 'expert' advice and credible 'science' from authoritative information providers such as the Intergovernmental Panel on Climate Change. But to truly support the needs of local communities, this information needs to be more site-specific, more user-friendly and more inclusive of traditional knowledge and existing coping practices.

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

    Science.gov (United States)

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

    2012-11-12

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

  16. Hospital-at-home Integrated Care Program for Older Patients With Orthopedic Processes: An Efficient Alternative to Usual Hospital-Based Care.

    Science.gov (United States)

    Closa, Conxita; Mas, Miquel À; Santaeugènia, Sebastià J; Inzitari, Marco; Ribera, Aida; Gallofré, Miquel

    2017-09-01

    To compare outcomes and costs for patients with orthogeriatric conditions in a home-based integrated care program versus conventional hospital-based care. Quasi-experimental longitudinal study. An acute care hospital, an intermediate care hospital, and the community of an urban area in the North of Barcelona, in Southern Europe. In a 2-year period, we recruited 367 older patients attended at an orthopedic/traumatology unit in an acute hospital for fractures and/or arthroplasty. Patients were referred to a hospital-at-home integrated care unit or to standard hospital-based postacute orthogeriatric unit, based on their social support and availability of the resource. We compared home-based care versus hospital-based care for Relative Functional Gain (gain/loss of function measured by the Barthel Index), mean direct costs, and potential savings in terms of reduction of stay in the acute care hospital. No differences were found in Relative Functional Gain, median (Q25-Q75) = 0.92 (0.64-1.09) in the home-based group versus 0.93 (0.59-1) in the hospital-based group, P =.333. Total health service direct cost [mean (standard deviation)] was significantly lower for patients receiving home-based care: €7120 (3381) versus €12,149 (6322), P home-based care [10.1 (7)] than in patients discharged to the postacute orthogeriatric hospital-based unit [15.3 (12) days, P home integrated care program was suitable for managing older patients with orthopedic conditions who have good social support for home care. It provided clinical care comparable to the hospital-based model, and it seems to enable earlier acute hospital discharge and lower direct costs. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  17. HIV/AIDS and home-based health care

    Directory of Open Access Journals (Sweden)

    Jayne TS

    2008-03-01

    Full Text Available Abstract This paper highlights the socio-economic impacts of HIV/AIDS on women. It argues that the socio-cultural beliefs that value the male and female lives differently lead to differential access to health care services. The position of women is exacerbated by their low financial base especially in the rural community where their main source of livelihood, agricultural production does not pay much. But even their active involvement in agricultural production or any other income ventures is hindered when they have to give care to the sick and bedridden friends and relatives. This in itself is a threat to household food security. The paper proposes that gender sensitive policies and programming of intervention at community level would lessen the burden on women who bear the brunt of AIDS as caregivers and livelihood generators at household level. Improvement of medical facilities and quality of services at local dispensaries is seen as feasible since they are in the rural areas. Other interventions should target freeing women's and girls' time for education and involvement in income generating ventures. Two separate data sets from Western Kenya, one being quantitative and another qualitative data have been used.

  18. ASSOCIATION OF EARLY CHILDHOOD CARIES WITH RISK FACTORS IN COMMUNITY HOMES OF INSTITUTO COLOMBIANO DE BIENESTAR FAMILIAR IN ZIPAQUIRÁ, COLOMBIA

    OpenAIRE

    Macías, Carmenza; Díaz, Diana; Caycedo, Marta; Lamus, Francisco; Rincón, Carlos

    2016-01-01

    ABSTRACT Introduction: the goal of this study was to establish the association of social and biological risk factors with early childhood caries (ECC) in children from community homes of Instituto Colombiano de Bienestar Familiar (ICBF) in Zipaquirá, Colombia. Methods: descriptive cross-sectional study conducted by universities in 546 children aged 24 to 60 months. The following conditions were identified: socio-demographic variables, hygiene habits, O’Leary index and DMFT index, anthropom...

  19. CAN MOTHERS CARE FOR ACUTE DIARRHOEAL DISEASE OF THEIR UNDER FIVE CHILDREN EFFECTIVELY AT HOME? A CROSS SECTIONAL STUDY IN SLUM COMMUNITY IN BANKURA

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    Eashin

    2015-09-01

    Full Text Available BACKGROUND : Diarrhea is one of the major causes of morbidity and mortality in under - five children in developing world like India. WHO & Integrated Management of Neonatal and Childhood Illness ( IMNCI diarrheal management guidelines encourage mothers and caretakers to treat diarrhoea at home by giving ORS and oral rehydration therapy (ORT to reduce the duration , severity , hospitalization , overall medical costs and death . OBJECTIVES : i t o assess the Knowledge , Attitude and Practice (KAP of mothers on home care of acu te diarrhoeal diseases and ii To find out the factors affecting it , if any. MATERIALS AND METHODS : Community based cross - sectional study was conducted for three months duration among 76 mothers of slum - dwelling under five children (2 - 59 months in Bankura . Information about KAP on management of acute diarrhoeal diseases was obtained by interview of mother using schedule based on WHO & IMNCI diarrheal management guidelines. RESULTS: In this study , majority mothers (64.7% of children were of BPL category an d mean schooling years of mothers was 7.97±4.12. Majority of mothers’ knowledge was average (66.2% and favourable attitude was (76.5%. While 72.2% mothers performed average practice ; only 9.3% of mothers performed good practice. Education , occupation and socio - economic status (SES were the influencing factors of KAP on home care of diarrhea. Conclusions : A lot of gap was still present in knowledge , attitude and practice of home management of acute diarrheal diseases in an urban slum of Bankura. Health pro viders are needed to be skilled , motivated to percolate the information to mothers regarding home care of diarrhea.

  20. Effects of improved home heating on asthma in community dwelling children: randomised controlled trial.

    Science.gov (United States)

    Howden-Chapman, Philippa; Pierse, Nevil; Nicholls, Sarah; Gillespie-Bennett, Julie; Viggers, Helen; Cunningham, Malcolm; Phipps, Robyn; Boulic, Mikael; Fjällström, Pär; Free, Sarah; Chapman, Ralph; Lloyd, Bob; Wickens, Kristin; Shields, David; Baker, Michael; Cunningham, Chris; Woodward, Alistair; Bullen, Chris; Crane, Julian

    2008-09-23

    To assess whether non-polluting, more effective home heating (heat pump, wood pellet burner, flued gas) has a positive effect on the health of children with asthma. Randomised controlled trial. Households in five communities in New Zealand. 409 children aged 6-12 years with doctor diagnosed asthma. Installation of a non-polluting, more effective home heater before winter. The control group received a replacement heater at the end of the trial. The primary outcome was change in lung function (peak expiratory flow rate and forced expiratory volume in one second, FEV(1)). Secondary outcomes were child reported respiratory tract symptoms and daily use of preventer and reliever drugs. At the end of winter 2005 (baseline) and winter 2006 (follow-up) parents reported their child's general health, use of health services, overall respiratory health, and housing conditions. Nitrogen dioxide levels were measured monthly for four months and temperatures in the living room and child's bedroom were recorded hourly. Improvements in lung function were not significant (difference in mean FEV(1) 130.7 ml, 95% confidence interval -20.3 to 281.7). Compared with children in the control group, however, children in the intervention group had 1.80 fewer days off school (95% confidence interval 0.11 to 3.13), 0.40 fewer visits to a doctor for asthma (0.11 to 0.62), and 0.25 fewer visits to a pharmacist for asthma (0.09 to 0.32). Children in the intervention group also had fewer reports of poor health (adjusted odds ratio 0.48, 95% confidence interval 0.31 to 0.74), less sleep disturbed by wheezing (0.55, 0.35 to 0.85), less dry cough at night (0.52, 0.32 to 0.83), and reduced scores for lower respiratory tract symptoms (0.77, 0.73 to 0.81) than children in the control group. The intervention was associated with a mean temperature rise in the living room of 1.10 degrees C (95% confidence interval 0.54 degrees C to 1.64 degrees C) and in the child's bedroom of 0.57 degrees C (0.05 degrees C

  1. Feasibility of a Brief Community-Based Train-the-Trainer Lesson to Reduce the Risk of Falls among Community Dwelling Older Adults

    Science.gov (United States)

    Gunter, Katherine B.; John, Deborah H.

    2014-01-01

    The Better Balance, Better Bones, Better Bodies (B-Better©) program was developed to disseminate simple home-based strategies to prevent falls and improve functional health of older adults using a train-the-trainer model. Delivered by Family & Community Education Study Group program volunteers, the lesson stresses the importance of a…

  2. Community-based dental education and the importance of faculty development.

    Science.gov (United States)

    McAndrew, Maureen

    2010-09-01

    Community-based dental education offers a variety of positive learning experiences for students while providing needed dental services for the underserved. More dental students are being instructed by a growing body of largely volunteer community-based faculty who practice in a wide range of community settings including community hospitals and clinics, nursing homes, and private practices. These geographically dispersed instructors may have little experience as educators. Their practice styles and their motivation to improve teaching effectiveness are likely to differ from the styles and motivation of school-based faculty members. Moreover, many dental schools have begun to emphasize practices that may be unfamiliar to community-based faculty such as evidence-based practice. Providing faculty development for them is challenging, yet crucial to the success of these programs and dental education in general. Fundamental elements that must be considered for effective community faculty development programming include fostering a culture of respect between school-based and community faculty members, basing programs on the actual needs of these educators, integrating principles of adult learning theory, and establishing ongoing institutional support. This article provides background on this movement, reviews the literature for faculty development programs geared specifically to community-based educators, makes recommendations for development programs for these dental educators, and includes suggestions for future research.

  3. Factors associated with the 6-minute walk test in nursing home residents and community-dwelling older adults

    Science.gov (United States)

    Caballer, Vicent-Benavent; Lisón, Juan Francisco; Rosado-Calatayud, Pedro; Amer-Cuenca, Juan José; Segura-Orti, Eva

    2015-01-01

    [Purpose] The main objective of this study was to determine the contributions and extent to which certain physical measurements explain performance in the 6-minute walk test in healthy older adults living in a geriatric nursing home and for older adults dwelling in the community. [Subjects] The subjects were 122 adults aged 65 and older with no cognitive impairment who were independent in their daily activities. [Methods] The 6-minute walk test, age, body mass index, walking speed, chair stand test, Berg Balance Scale, Timed Up-and-Go test, rectus femoris cross-sectional area, Short Physical Performance Battery, and hand-grip strength were examined. [Results] Strong significant associations were found between mobility, lower-limb function, balance, and the 6-minute walk test. A stepwise multiple regression on the entire sample showed that lower-limb function was a significant and independent predictor for the 6-minute walk test. Additionally, lower-limb function was a strong predictor for the 6-minute walk test in our nursing home group, whereas mobility was found to be the best predictor in our community-dwelling group. [Conclusion] Better lower-limb function, balance, and mobility result in a higher distance covered by healthy older adults. Lower-limb function and mobility appeared to best determine walking performance in the nursing home and community-dwelling groups, respectively. PMID:26696740

  4. A community-based program evaluation of community competency trainings.

    Science.gov (United States)

    Hanssmann, Christoph; Morrison, Darius; Russian, Ellery; Shiu-Thornton, Sharyne; Bowen, Deborah

    2010-01-01

    Transgender and gender-nonconforming individuals encounter a multitude of barriers to accessing clinically and culturally competent health care. One strategy to increase the quality and competence of care delivery is workplace trainings. This study describes a community-based program for the evaluation of this type of training. Using a mixed-methods approach, the research team assessed the effectiveness of three competency trainings administered by a local nonprofit organization in the Northwest United States. Quantitative data indicated a significant shift in self-assessed knowledge associated with completion of the training. Qualitative data confirmed this result and revealed a number of important themes about the effect of the trainings on providers and their ability to implement knowledge and skills in practice. Clinical considerations are proposed for providers who seek similar trainings and who aim to increase clinical and cultural competency in delivering care to transgender and gender-nonconforming patients and clients.

  5. Design and Implementation of GSM Based Automated Home Security System

    Directory of Open Access Journals (Sweden)

    Love Aggarwal

    2014-05-01

    Full Text Available The Automated Home Security System aims at building a security system for common households using GSM modem, sensors and microcontroller. Since many years, impeccable security system has been the prime need of every man who owns a house. The increasing crime rate has further pressed the need for it. Our system is an initiative in this direction. The system provides security function by monitoring the surroundings at home for intruders, fire, gas leakages etc. using sensors and issue alerts to the owners and local authorities by using GSM via SMS. It provides the automation function as it can control (On/Off the various home appliances while the owners are away via SMS. Thus the Automated Home Security System is self-sufficient and can be relied upon undoubtedly. Also, it is capable of establishing two way communication with its owner so that he/she can keep a watch on his/her home via sensor information or live video streaming. A camera can be installed for continuous monitoring of the system and its surroundings. The system consists of two main parts: hardware and software. Hardware consists of Microcontroller, Sensors, Buzzer and GSM modem while software is implemented by tools using Embedded ‘C’.

  6. Utilisation of home-based physician, nurse and personal support worker services within a palliative care programme in Ontario, Canada: trends over 2005-2015.

    Science.gov (United States)

    Sun, Zhuolu; Laporte, Audrey; Guerriere, Denise N; Coyte, Peter C

    2017-05-01

    With health system restructuring in Canada and a general preference by care recipients and their families to receive palliative care at home, attention to home-based palliative care continues to increase. A multidisciplinary team of health professionals is the most common delivery model for home-based palliative care in Canada. However, little is known about the changing temporal trends in the propensity and intensity of home-based palliative care. The purpose of this study was to assess the propensity to use home-based palliative care services, and once used, the intensity of that use for three main service categories: physician visits, nurse visits and care by personal support workers (PSWs) over the last decade. Three prospective cohort data sets were used to track changes in service use over the period 2005 to 2015. Service use for each category was assessed using a two-part model, and a Heckit regression was performed to assess the presence of selectivity bias. Service propensity was modelled using multivariate logistic regression analysis and service intensity was modelled using log-transformed ordinary least squares regression analysis. Both the propensity and intensity to use home-based physician visits and PSWs increased over the last decade, while service propensity and the intensity of nurse visits decreased. Meanwhile, there was a general tendency for service propensity and intensity to increase as the end of life approached. These findings demonstrate temporal changes towards increased use of home-based palliative care, and a shift to substitute care away from nursing to less expensive forms of care, specifically PSWs. These findings may provide a general idea of the types of services that are used more intensely and require more resources from multidisciplinary teams, as increased use of home-based palliative care has placed dramatic pressures on the budgets of local home and community care organisations. © 2016 John Wiley & Sons Ltd.

  7. Smart home design for electronic devices monitoring based wireless gateway network using cisco packet tracer

    Science.gov (United States)

    Sihombing, Oloan; Zendrato, Niskarto; Laia, Yonata; Nababan, Marlince; Sitanggang, Delima; Purba, Windania; Batubara, Diarmansyah; Aisyah, Siti; Indra, Evta; Siregar, Saut

    2018-04-01

    In the era of technological development today, the technology has become the need for the life of today's society. One is needed to create a smart home in turning on and off electronic devices via smartphone. So far in turning off and turning the home electronic device is done by pressing the switch or remote button, so in control of electronic device control less effective. The home smart design is done by simulation concept by testing system, network configuration, and wireless home gateway computer network equipment required by a smart home network on cisco packet tracer using Internet Thing (IoT) control. In testing the IoT home network wireless network gateway system, multiple electronic devices can be controlled and monitored via smartphone based on predefined configuration conditions. With the Smart Ho me can potentially increase energy efficiency, decrease energy usage costs, control electronics and change the role of residents.

  8. Get Fit with the Grizzlies: a community-school-home initiative to fight childhood obesity.

    Science.gov (United States)

    Irwin, Carol C; Irwin, Richard L; Miller, Maureen E; Somes, Grant W; Richey, Phyllis A

    2010-07-01

    Professional sport organizations in the United States have notable celebrity status, and several teams have used this "star power" to collaborate with local school districts toward the goal of affecting children's health. Program effectiveness is unknown due to the absence of comprehensive evaluations for these initiatives. The Memphis Grizzlies, the city's National Basketball Association franchise, launched "Get Fit with the Grizzlies," a 6-week, curricular addition focusing on nutrition and physical activity for the fourth and fifth grades in Memphis City Schools (MCS). The health-infused mini-unit was delivered by physical education teachers during their classes. The purpose of this study was to evaluate the "Get Fit" program effectiveness. Survey research was employed which measured health knowledge acquisition and health behavior change using a matched pre/posttest design in randomly chosen schools (n = 11) from all elementary schools in the MCS system (N = 110). The total number of matched pre/posttests (n = 888) equaled approximately 5% of the total fourth-/fifth-grade population. McNemar's test for significance (p < .05) was applied. Odds ratios were calculated for each question. Analyses confirmed that there was significant health knowledge acquisition (7 of 8 questions) with odds ratios confirming moderate to strong associations. Seven out of 10 health behavior change questions significantly improved after intervention, whereas odds ratios indicated a low level of association after intervention. This community-school-home initiative using a professional team's celebrity platform within a certain locale is largely overlooked by school districts and should be considered as a positive strategy to confront childhood obesity.

  9. Urine Culture Testing in Community Nursing Homes: Gateway to Antibiotic Overprescribing.

    Science.gov (United States)

    Sloane, Philip D; Kistler, Christine E; Reed, David; Weber, David J; Ward, Kimberly; Zimmerman, Sheryl

    2017-05-01

    OBJECTIVE To describe current practice around urine testing and identify factors leading to overtreatment of asymptomatic bacteriuria in community nursing homes (NHs) DESIGN Observational study of a stratified random sample of NH patients who had urine cultures ordered in NHs within a 1-month study period SETTING 31 NHs in North Carolina PARTICIPANTS 254 NH residents who had a urine culture ordered within the 1-month study period METHODS We conducted an NH record audit of clinical and laboratory information during the 2 days before and 7 days after a urine culture was ordered. We compared these results with the urine antibiogram from the 31 NHs. RESULTS Empirical treatment was started in 30% of cases. When cultures were reported, previously untreated cases received antibiotics 89% of the time for colony counts of ≥100,000 CFU/mL and in 35% of cases with colony counts of 10,000-99,000 CFU/mL. Due to the high rate of prescribing when culture results returned, 74% of these patients ultimately received a full course of antibiotics. Treated and untreated patients did not significantly differ in temperature, frequency of urinary signs and symptoms, or presence of Loeb criteria for antibiotic initiation. Factors most commonly associated with urine culture ordering were acute mental status changes (32%); change in the urine color, odor, or sediment (17%); and dysuria (15%). CONCLUSIONS Urine cultures play a significant role in antibiotic overprescribing. Antibiotic stewardship efforts in NHs should include reduction in culture ordering for factors not associated with infection-related morbidity as well as more scrutiny of patient condition when results become available. Infect Control Hosp Epidemiol 2017;38:524-531.

  10. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review.

    Science.gov (United States)

    Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J; Demiris, George

    2013-07-01

    There is a critical need for public health interventions to support the independence of older adults as the world's population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. One thousand, six hundred and thirty-nine candidate articles were identified. Thirty-one studies from the years 1998-2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of them used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults; social support; and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  11. Impact of community-based immunization services.

    Directory of Open Access Journals (Sweden)

    Sing K

    1986-07-01

    Full Text Available The knowledge, attitude and practice of mothers toward childhood immunization was surveyed in 2 neighborhoods in greater Bombay, India. The areas were a slum of 75,000 called Malavani, and a nearby area called Kharodi. Measles and triple (DPT or DPV vaccines were available at local health centers, 1.5 km away at the most; oral polio vaccines were given by field workers to the Malavani community to children in their homes, but only in the center for those in Kharodi. BCG tuberculosis vaccinations were available to all, but from a center 5 km away. Malavani mothers had significantly better knowledge of triple and measles vaccines, but knowledge about BCG was similar in the 2 groups. Slightly more women from Kharodi expressed negative attitudes toward immunization. Coverage of children, established from clinic records, was significantly better in the Malavani area: 91% vs. 58% for polio; 71% vs 61% for BCG (n.s.; 85% vs. 55% for triple vaccine; and 21% vs 1% for measles. Evidently, visitation by field teams with polio vaccinations affected mothers′ knowledge and practice for other immunizations available only at the center.

  12. Needing smart home technologies: the perspectives of older adults in continuing care retirement communities

    Directory of Open Access Journals (Sweden)

    Karen Courtney

    2008-11-01

    Conclusions Factors influencing self-perception of need for smart home technology, including the influence of primary care providers, are presented. Further exploration of the factors influencing older adults' perceptions of smart home technology need and the development of appropriate interventions is necessary.

  13. Home-based step training using videogame technology in people with Parkinson's disease: a single-blinded randomised controlled trial.

    Science.gov (United States)

    Song, Jooeun; Paul, Serene S; Caetano, Maria Joana D; Smith, Stuart; Dibble, Leland E; Love, Rachelle; Schoene, Daniel; Menant, Jasmine C; Sherrington, Cathie; Lord, Stephen R; Canning, Colleen G; Allen, Natalie E

    2018-03-01

    To determine whether 12-week home-based exergame step training can improve stepping performance, gait and complementary physical and neuropsychological measures associated with falls in Parkinson's disease. A single-blinded randomised controlled trial. Community (experimental intervention), university laboratory (outcome measures). Sixty community-dwelling people with Parkinson's disease. Home-based step training using videogame technology. The primary outcomes were the choice stepping reaction time test and Functional Gait Assessment. Secondary outcomes included physical and neuropsychological measures associated with falls in Parkinson's disease, number of falls over six months and self-reported mobility and balance. Post intervention, there were no differences between the intervention ( n = 28) and control ( n = 25) groups in the primary or secondary outcomes except for the Timed Up and Go test, where there was a significant difference in favour of the control group ( P = 0.02). Intervention participants reported mobility improvement, whereas control participants reported mobility deterioration-between-group difference on an 11-point scale = 0.9 (95% confidence interval: -1.8 to -0.1, P = 0.03). Interaction effects between intervention and disease severity on physical function measures were observed ( P = 0.01 to P = 0.08) with seemingly positive effects for the low-severity group and potentially negative effects for the high-severity group. Overall, home-based exergame step training was not effective in improving the outcomes assessed. However, the improved physical function in the lower disease severity intervention participants as well as the self-reported improved mobility in the intervention group suggest home-based exergame step training may have benefits for some people with Parkinson's disease.

  14. Home based care practices by caregivers of under five children with ...

    African Journals Online (AJOL)

    Background: Home treatment for childhood febrile illness is a common practice among caregivers in Nigeria as well as some other countries in sub- Saharan Africa. The aim of the study was to assess the home based care practices of caregivers of under- five children with febrile illnesses as seen in the general paediatric ...

  15. Home-Based Comprehensive Assessment of Rural Elderly Persons: The CARE Project

    Science.gov (United States)

    Cravens, David D.; Mehr, David R.; Campbell, James D.; Armer, Jane; Kruse, Robin L.; Rubenstein, Laurence Z.

    2005-01-01

    Context: Home-based comprehensive geriatric assessment (CGA) has been effective in urban areas but has had little study in rural areas. CGA involves medical history taking, a physical exam, and evaluation of functional status, mental status, cognitive status, gait and balance, medications, vision, extent of social supports, and home safety. We…

  16. Rural Alberta Home-Based Businesses: A Profile of Workshop Participants.

    Science.gov (United States)

    Capjack, M. Linda; Fetterman, Nelma I.

    1992-01-01

    Of 252 rural Alberta attendees of home-based business workshops, 60 were in business. Of these, 65 percent produced sewing, textile, or food-related products; 73 percent contributed less than 5 percent of family income; 72 percent worked at home because a hobby became profitable; and the majority were married women over 40. (SK)

  17. [Promotion of community-based care in Africa: example of community general practice in Benin].

    Science.gov (United States)

    Caplain, Roland; Yacoubou, Ismaïl; Adedemy, Didier; Sani, Alidou; Takam, Sandrine; Desplats, Dominique

    2014-01-01

    Considerable effort has been made to provide rural African populations with basic health care, but the quality of this care remains unsatisfactory due to the absence of first-line GPs. This is a paradoxical situation in view of the large number of physicians trained in medical schools in French-speaking Africa and Madagascar. of the lack of GPs working in rural areas is a real concern, as many young doctors remain unemployed in cities. For more than 20 years, the NGO Santé Sud has proposed a Community General Medicine concept, which, combined with a support system, has allowed the installation of more than 200 community GPs in Mali and Madagascar. The advantage of this concept is that it provides family medicine and primary health care in the same practice. Since 2009, Santé Sud supports an installation project in rural areas of northern Benin, where community GPs work independently, as a complementary partner of the public sector. Since 2013, the installation process comprises a university degree created with the University of Parakou Faculty of Medicine. Based on this experience in Benin, the authors show that the presence of a first-line general practitioner is an original strategy that provides a major contribution to health promotion : reducing health inequalities between rural and urban populations, allowing women to receive medically assisted childbirth close to home, developing family planning activities, education and health care for chronic diseases, strengthening health coverage by participating in vaccination campaigns, etc. Due to their functions and proximity, community GPs represent an added value for health promotion.

  18. Improving community development by linking agriculture, nutrition and education: design of a randomised trial of "home-grown" school feeding in Mali.

    Science.gov (United States)

    Masset, Edoardo; Gelli, Aulo

    2013-02-21

    Providing food through schools has well documented effects in terms of the education, health and nutrition of school children. However, there is limited evidence in terms of the benefits of providing a reliable market for small-holder farmers through "home-grown" school feeding approaches. This study aims to evaluate the impact of school feeding programmes sourced from small-holder farmers on small-holder food security, as well as on school children's education, health and nutrition in Mali. In addition, this study will examine the links between social accountability and programme performance. This is a field experiment planned around the scale-up of the national school feeding programme, involving 116 primary schools in 58 communities in food insecure areas of Mali. The randomly assigned interventions are: 1) a school feeding programme group, including schools and villages where the standard government programme is implemented; 2) a "home-grown" school feeding and social accountability group, including schools and villages where the programme is implemented in addition to training of community based organisations and local government; and 3) the control group, including schools and household from villages where the intervention will be delayed by at least two years, preferably without informing schools and households. Primary outcomes include small-holder farmer income, school participation and learning, and community involvement in the programme. Other outcomes include nutritional status and diet-diversity. The evaluation will follow a mixed method approach, including household, school and village level surveys as well as focus group discussions with small-holder farmers, school children, parents and community members. The impact evaluation will be incorporated within the national monitoring and evaluation (M&E) system strengthening activities that are currently underway in Mali. Baselines surveys are planned for 2012. A monthly process monitoring visits, spot

  19. A home-based clean water revolution | CRDI - Centre de recherches ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    8 déc. 2010 ... Highly effective yet simple BioSand Filters are providing clean water in more than 300000 homes around the world. Early support from ... Keeping the technology in the public domain has allowed non-governmental organizations to bring the filters to communities across the globe. “Sometimes I'll get an ...

  20. Evaluating Community-Based Participatory Research to Improve Community-Partnered Science and Community Health

    Science.gov (United States)

    Hicks, Sarah; Duran, Bonnie; Wallerstein, Nina; Avila, Magdalena; Belone, Lorenda; Lucero, Julie; Magarati, Maya; Mainer, Elana; Martin, Diane; Muhammad, Michael; Oetzel, John; Pearson, Cynthia; Sahota, Puneet; Simonds, Vanessa; Sussman, Andrew; Tafoya, Greg; Hat, Emily White

    2013-01-01

    Background Since 2007, the National Congress of American Indians (NCAI) Policy Research Center (PRC) has partnered with the Universities of New Mexico and Washington to study the science of community-based participatory research (CBPR). Our goal is to identify facilitators and barriers to effective community–academic partnerships in American Indian and other communities, which face health disparities. Objectives We have described herein the scientific design of our National Institutes of Health (NIH)-funded study (2009–2013) and lessons learned by having a strong community partner leading the research efforts. Methods The research team is implementing a mixed-methods study involving a survey of principal investigators (PIs) and partners across the nation and in-depth case studies of CBPR projects. Results We present preliminary findings on methods and measures for community-engaged research and eight lessons learned thus far regarding partnership evaluation, advisory councils, historical trust, research capacity development of community partner, advocacy, honoring each other, messaging, and funding. Conclusions Study methodologies and lessons learned can help community–academic research partnerships translate research in communities. PMID:22982842

  1. Community-based wetland comanagement in Bangladesh

    OpenAIRE

    Sherwood, D.B.

    2009-01-01

    Metadata only record This chapter explains new solutions to problems resulting from top-down approaches to resource conservation and sustainability. The management of natural resources - in this case, wetlands - is complicated and risky. To address the risks involved with resource management, a case study was done in Bangladesh to evaluate the effectiveness of community-based comanagement. Using multidisciplinary approaches and adaptive management strategies, the Management of Aquatic Ecos...

  2. Registered nurses' perceptions of their professional work in nursing homes and home-based care: a focus group study.

    Science.gov (United States)

    Carlson, Elisabeth; Rämgård, Margareta; Bolmsjö, Ingrid; Bengtsson, Mariette

    2014-05-01

    In Sweden, as well as in most industrialised countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialised in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care. The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work. This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analysed in line with the tradition of naturalistic inquiry. Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing. Three categories of professional work emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness. The findings are important as they represent positive alternatives to the somewhat prevailing view on elderly care as depressing and undemanding. Nurse educators might use the key aspects as good examples, thus influencing student nurses' attitudes towards elderly care in a positive way. Elderly care agencies might find them helpful when recruiting and retaining nurses to a much needed area. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

    Directory of Open Access Journals (Sweden)

    Remedios López-Liria

    2015-01-01

    Full Text Available Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients’ functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Results. The groups did not significantly differ in the leg side (right/left or clinical characteristics (P>0.05. After the intervention, both groups showed significant improvements (P<0.001 from the baseline values in the level of pain (visual analogue scale, the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices, balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective.

  4. Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2015-11-05

    This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

  5. 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.

  6. Regional variation in post-stroke multidisciplinary rehabilitation care among veteran residents in community nursing homes

    Directory of Open Access Journals (Sweden)

    Jia H

    2017-03-01

    Full Text Available Huanguang Jia,1 Qinglin Pei,1 Charles T Sullivan,1 Diane C Cowper Ripley,1 Samuel S Wu,1 W Bruce Vogel,1 Xinping Wang,1 Douglas E Bidelspach,2 Jennifer L Hale-Gallardo,1 Barbara E Bates3 1Center of Innovation on Disability and Rehabilitation Research, North Florida/South Georgia Veterans Health System, Gainesville, FL, 2Physical Medicine and Rehabilitation Service, Department of Veterans Affairs, Washington, DC, 3Aleda E. Lutz VA Medical Center, Saginaw, MI, USA Introduction: Effective post-acute multidisciplinary rehabilitation therapy improves stroke survivors’ functional recovery and daily living activities. The US Department of Veterans Affairs (VA places veterans needing post-acute institutional care in private community nursing homes (CNHs. These placements are made under the same rules and regulations across the VA health care system and through individual per diem contracts between local VA facilities and CNHs. However, there is limited information about utilization of these veterans’ health services as well as the geographic variation of the service utilization. Aim: The aims of this study were to determine rehabilitation therapy and restorative nursing care utilization by veterans with stroke in VA-contracted CNHs and to assess risk-adjusted regional variations in the utilization of rehabilitation therapy and restorative nursing care. Methods: This retrospective study included all veterans diagnosed with stroke residing in VA-contracted CNHs between 2006 and 2009. Minimum Dataset (a health status assessment tool for CNH residents for the study CNHs was linked with veterans’ inpatient and outpatient data within the VA health care system. CNHs were grouped into five VA-defined geographic regions: the North Atlantic, Southeast, Midwest, Continental, and Pacific regions. A two-part model was applied estimating risk-adjusted utilization probability and average weekly utilization days. Two dependent variables were rehabilitation

  7. Engaging military parents in a home-based reintegration program: a consideration of strategies.

    Science.gov (United States)

    Ross, Abigail M; DeVoe, Ellen R

    2014-02-01

    For more than a decade, the long wars in Afghanistan and Iraq have placed tremendous and cumulative strain on U.S. military personnel and their families. The high operational tempo, length, and number of deployments-and greater in-theater exposure to threat-have resulted in well-documented psychological health concerns among service members and veterans. In addition, there is increasing and compelling evidence describing the significant deleterious impact of the deployment cycle on family members, including children, in military-connected families. However, rates of engagement and service utilization in prevention and intervention services continue to lag far below apparent need among service members and their families, because of both practical and psychological barriers. The authors describe the dynamic and ultimately successful process of engaging military families with young children in a home-based reintegration program designed to support parenting and strengthen parent-child relationships as service member parents move back into family life. In addition to the integration of existing evidence-based engagement strategies, the authors applied a strengths-based approach to working with military families and worked from a community-based participatory foundation to enhance family engagement and program completion. Implications for engagement of military personnel and their loved ones are discussed.

  8. A community living management program for people with disabilities who have moved out of nursing homes: a pilot study.

    Science.gov (United States)

    Lee, Danbi; Hammel, Joy; Wilson, Tom

    2015-06-23

    This study describes implementation and evaluation of the Stepping Stones program, a community living management program designed to assist people with disabilities to gain community living skills after moving out of nursing homes. Thirteen people with diverse disabilities participated in the 10-week Stepping Stones program. The participants attended two sessions a day every week, over a 5-week period. Interviewer-administered surveys were used at baseline and 1 week post-intervention to evaluate the impact of the program. Focus group interviews were conducted at 1 week post-intervention. Analyses of quantitative data demonstrated improved self-efficacy in community living management skills, with medium-to-high effect sizes. Participants reported improved sense of empowerment and confidence in finding resources and managing community living. They also reported high satisfaction with the program. Preliminary findings suggest that the Stepping Stones program is beneficial to the target group. The study indicates that application of social learning and self-efficacy theories is effective to empower and enable people with disabilities to manage their lives in the community. The Stepping Stones program may be provided as a risk management intervention after individuals' transition into the community. Implications for Rehabilitation Long-term institutionalization negatively influences people with disabilities' self-esteem, autonomy and ability to independently live in the community. Successful community living requires complex management involving the coordination of personal, social, resource and environmental factors. This study shows that programming on choice and control and community living skill development improved participants' confidence in managing community living.

  9. Willingness to Pay for Home-Based Rehabilitation Service Among Older Adults.

    Science.gov (United States)

    Li, Xuemei; Wan, Xia; Pang, Yajuan; Zhou, Lanshu

    2018-06-18

    This study aims to investigate the willingness to pay (WTP) for a home-based rehabilitation service and explore the influencing factors of WTP among older adults in Shanghai, China. A cross-sectional design was used. A questionnaire survey based on the contingent valuation method was conducted by face-to-face survey over 3 months. Only 242 (44%) participants were willing to pay for a home-based rehabilitation service. The median amount they were willing to pay was RMB 8 (US$1.15) per visit. Older adults who had higher monthly income, had at least one partner who worked, and had medical insurance were willing to pay more for the service. Older adults showed low WTP for a home-based rehabilitation service. Economic status and health condition are the significant influencing factors of WTP. Studies on recipients' precise needs and ability to pay are required before home-based services are implemented.

  10. Factors associated with nursing home placement of all patients admitted for inpatient rehabilitation in Singapore community hospitals from 1996 to 2005: a disease stratified analysis.

    Directory of Open Access Journals (Sweden)

    Cynthia Chen

    Full Text Available OBJECTIVES: To (1 identify social and rehabilitation predictors of nursing home placement, (2 investigate the association between effectiveness and efficiency in rehabilitation and nursing home placement of patients admitted for inpatient rehabilitation from 1996 to 2005 by disease in Singapore. DESIGN: National data were retrospectively extracted from medical records of community hospital. DATA SOURCES: There were 12,506 first admissions for rehabilitation in four community hospitals. Of which, 8,594 (90.3% patients were discharged home and 924 (9.7% patients were discharged to a nursing home. Other discharge destinations such as sheltered home (n = 37, other community hospital (n = 31, death in community hospital (n = 12, acute hospital (n = 1,182 and discharge against doctor's advice (n = 24 were excluded. OUTCOME MEASURE: Nursing home placement. RESULTS: Those who were discharged to nursing home had 33% lower median rehabilitation effectiveness and 29% lower median rehabilitation efficiency compared to those who were discharged to nursing homes. Patients discharged to nursing homes were significantly older (mean age: 77 vs. 73 years, had lower mean Bathel Index scores (40 vs. 48, a longer median length of stay (40 vs. 33 days and a longer time to rehabilitation (19 vs. 15 days, had a higher proportion without a caregiver (28 vs. 7%, being single (21 vs. 7% and had dementia (23 vs. 10%. Patients admitted for lower limb amputation or falls had an increased odds of being discharged to a nursing home by 175% (p<0.001 and 65% (p = 0.043 respectively compared to stroke patients. CONCLUSIONS: In our study, the odds of nursing home placement was found to be increased in Chinese, males, single or widowed or separated/divorced, patients in high subsidy wards for hospital care, patients with dementia, without caregivers, lower functional scores at admission, lower rehabilitation effectiveness or efficiency at discharge and primary diagnosis groups such

  11. The Incidence and Wage Consequences of Home-Based Work in the United States, 1980-2000

    Science.gov (United States)

    Oettinger, Gerald S.

    2011-01-01

    This study documents the rapid growth in home-based wage and salary employment and the sharp decline in the home-based wage penalty in the United States between 1980 and 2000. These twin patterns, observed for both men and women in most occupation groups, suggest that employer costs of providing home-based work arrangements have decreased.…

  12. Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes

    Directory of Open Access Journals (Sweden)

    Beck Barbara-Beate

    2009-12-01

    Full Text Available Abstract Background Back pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care. Methods 1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings. Results Complete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance. Conclusions Future interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices

  13. The effectiveness of three sets of school-based instructional materials and community training on the acquisition and generalization of community laundry skills by students with severe handicaps.

    Science.gov (United States)

    Morrow, S A; Bates, P E

    1987-01-01

    This study examined the effectiveness of three sets of school-based instructional materials and community training on acquisition and generalization of a community laundry skill by nine students with severe handicaps. School-based instruction involved artificial materials (pictures), simulated materials (cardboard replica of a community washing machine), and natural materials (modified home model washing machine). Generalization assessments were conducted at two different community laundromats, on two machines represented fully by the school-based instructional materials and two machines not represented fully by these materials. After three phases of school-based instruction, the students were provided ten community training trials in one laundromat setting and a final assessment was conducted in both the trained and untrained community settings. A multiple probe design across students was used to evaluate the effectiveness of the three types of school instruction and community training. After systematic training, most of the students increased their laundry performance with all three sets of school-based materials; however, generalization of these acquired skills was limited in the two community settings. Direct training in one of the community settings resulted in more efficient acquisition of the laundry skills and enhanced generalization to the untrained laundromat setting for most of the students. Results of this study are discussed in regard to the issue of school versus community-based instruction and recommendations are made for future research in this area.

  14. Psychometrics of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults.

    Science.gov (United States)

    Tomita, Machiko R; Saharan, Sumandeep; Rajendran, Sheela; Nochajski, Susan M; Schweitzer, Jo A

    2014-01-01

    OBJECTIVE. To identify psychometric properties of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults. METHOD. We tested content validity, test-retest reliability, interrater reliability, construct validity, convergent and discriminant validity, and responsiveness to change. RESULTS. The content validity index was .98, the intraclass correlation coefficient for test-retest reliability was .97, and the interrater reliability was .89. The difference on identified risk factors between the use and nonuse of the HSSAT was significant (p = .005). Convergent validity with the Centers for Disease Control and Prevention Home Safety Checklist was high (r = .65), and discriminant validity with fear of falling was very low (r = .10). The responsiveness to change was moderate (standardized response mean = 0.57). CONCLUSION. The HSSAT is a reliable and valid instrument to identify fall risks in a home environment, and the HSSAT booklet is effective as educational material leading to improvement in home safety. Copyright © 2014 by the American Occupational Therapy Association, Inc.

  15. [Effects of a fall prevention program on falls in frail elders living at home in rural communities].

    Science.gov (United States)

    Yoo, Jae-Soon; Jeon, Mi Yang; Kim, Chul-Gyu

    2013-10-01

    This study was conducted to determine the effects of a fall prevention program on falls, physical function, psychological function, and home environmental safety in frail elders living at home in rural communities. The design of this study was a nonequivalent control group pre posttest design. The study was conducted from July to November, 2012 with 30 participants in the experimental group and 30 in the control group. Participants were registered at the public health center of E County. The prevention program on falls consisted of laughter therapy, exercise, foot care and education. The program was provided once a week for 8 weeks and each session lasted 80 minutes. The risk score for falls and depression in the experimental group decreased significantly compared with scores for the control group. Compliance with prevention behavior related to falls, knowledge score on falls, safety scores of home environment, physical balance, muscle strength of lower extremities, and self-efficacy for fall prevention significantly increased in the experimental group compared with the control group. These results suggest that the prevention program on falls is effective for the prevention of falls in frail elders living at home.

  16. Positivity and well-being among community-residing elders and nursing home residents: what is the optimal affect balance?

    Science.gov (United States)

    Meeks, Suzanne; Van Haitsma, Kimberly; Kostiwa, Irene; Murrell, Stanley A

    2012-07-01

    To explore whether a ratio of positive to negative affect, from the work of Fredricksen and Losada, could predict high levels of well-being in elderly samples and especially in nursing home residents despite multiple chronic health conditions, consonant with Ryff and Singer's notion of "flourishing under fire." We used two samples: a probability sample of community-residing elders and a sample from nursing homes. We calculated ratios of positive to negative affect in each sample and measured well-being with social interaction, mental health, life satisfaction, and general well-being. The positivity ratio of 2.9 differentiated high levels of well-being in both the samples, as in previous research on younger samples. Although we expected the positivity ratio to perform less well among nursing home residents, we found that it differentiated residents with high well-being just as well as in the community sample. The ability to regulate positive affect to maintain a relative ratio of positive over negative affect appears to be an important aspect of successful adjustment in late life. Further research is needed on objective indicators of quality of life and on whether intra-individual shifts in affect balance are coupled with shifts in indicators of positive mental health.

  17. Network-Based Community Brings forth Sustainable Society

    Science.gov (United States)

    Kikuchi, Toshiko

    It has already been shown that an artificial society based on the three relations of social configuration (market, communal, and obligatory relations) functioning in balance with each other formed a sustainable society which the social reproduction is possible. In this artificial society model, communal relations exist in a network-based community with alternating members rather than a conventional community with cooperative mutual assistance practiced in some agricultural communities. In this paper, using the comparison between network-based communities with alternating members and conventional communities with fixed members, the significance of a network-based community is considered. In concrete terms, the difference in appearance rate for sustainable society, economic activity and asset inequality between network-based communities and conventional communities is analyzed. The appearance rate for a sustainable society of network-based community is higher than that of conventional community. Moreover, most of network-based communities had a larger total number of trade volume than conventional communities. But, the value of Gini coefficient in conventional community is smaller than that of network-based community. These results show that communal relations based on a network-based community is significant for the social reproduction and economic efficiency. However, in such an artificial society, the inequality is sacrificed.

  18. Life concerns of elderly people living at home determined as by Community General Support Center staff: implications for organizing a more effective integrated community care system. The Kurihara Project.

    Science.gov (United States)

    Takada, Junko; Meguro, Kenichi; Sato, Yuko; Chiba, Yumiko

    2014-09-01

    In Japan, the integrated community care system aims to enable people to continue to live in their homes. Based on the concept, one of the activities of a Community General Support Center (CGSC) is to provide preventive intervention based on a Community Support Program. Currently, a Basic Checklist (BC) is sent to elderly people to identify persons appropriate for a Secondary Prevention Program. To find people who had not responded to the BC, CGSC staff evaluated the files of 592 subjects who had participated in the Kurihara Project to identify activities they cannot do that they did in the past, decreased activity levels at home, loss of interaction with people other than their family, and the need for medical interventions. This information was classified, when applicable, into the following categories: (A) 'no life concerns'; (B) 'undecided'; and (C) 'life concerns'. The relationships between these classifications and clinical information, certified need for long-term care, and items on the BC were examined. The numbers of subjects in categories A, B, and C were 291, 42, and 186, respectively. Life concerns were related to scores on the Clinical Dementia Rating, global cognitive function, depressive state, and apathy. Most items on the BC were not associated with classification into category C, but ≥25% of the subjects had life concerns related to these items. Assessment of life concerns by the CGSC staff has clinical validity. The results suggest that there are people who do not respond to the checklist or apply for Long-Term Care Insurance, meaning that they 'hide' in the community, probably due to apathy or depressive state. To organize a more effective integrated community care system, the CGSC staff should focus mainly on preventive care. © 2014 The Authors. Psychogeriatrics © 2014 Japanese Psychogeriatric Society.

  19. Formative research on creating smoke-free homes in rural communities

    OpenAIRE

    Escoffery, Cam; Kegler, Michelle Crozier; Butler, Susan

    2008-01-01

    The home is a significant place for exposure to secondhand smoke for children and non-smoking adults. This study explored factors that would convince families to adopt household smoking bans and actions to create and maintain smoke-free homes. Interviews were conducted with adults in 102 households in rural Georgia. Participating families had a young adolescent and included households with a mix of smokers and non-smokers and smoking ban status. Families reported they would consider a total b...

  20. Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes

    Directory of Open Access Journals (Sweden)

    Bako Ali

    2018-03-01

    Full Text Available The Internet of Things (IoT is an emerging paradigm focusing on the connection of devices, objects, or “things” to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes.

  1. Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births.

    Science.gov (United States)

    Cook, Elizabeth; Avery, Melissa; Frisvold, Melissa

    2014-01-01

    Implementing national home birth guidelines for certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States may facilitate a common approach to safe home birth practices. Guidelines are evidence-based care recommendations for specified clinical situations that can be modified by individual providers to meet specific client needs. Following a review of home birth guidelines from multiple countries, a set of home birth practices guidelines for US CNMs/CMs was drafted. Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines. The proposed guidelines addressed client screening, informed consent, antepartum care, routine intrapartum care, obstetric complications and hospital transports, postpartum care, neonatal care, gynecologic care, primary care, peer reviews, recordkeeping, and physician collaboration. The reviewers had varying assessments as to whether the guidelines reflected international standards and current best evidence. The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy. Incorporation of evidence-based guidelines is an ACNM standard and was recommended by the Home Birth Consensus Summit. Clinical practice guidelines are informed by current evidence and supported by experts in a given discipline. Implementation of guidelines ensures optimal patient care and is becoming increasingly central to reimbursement and to medicolegal support. A set of practice guidelines based on current best evidence and internationally accepted standards was developed and reviewed by an interested group of US CNMs/CMs. Further discussion with home birth midwives and other stakeholders about the development and implementation of home birth guidelines is needed, especially in

  2. Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes

    Science.gov (United States)

    2018-01-01

    The Internet of Things (IoT) is an emerging paradigm focusing on the connection of devices, objects, or “things” to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE) methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes. PMID:29518023

  3. How to start a home-based mobile app developer business

    CERN Document Server

    Brooks, Chad

    2014-01-01

    With the app market exploding, app designers will need a solid how-to guide to help them start their home-based business. This book will guide the reader through all the steps from design to marketing.

  4. Beyond Self-Monitoring: Understanding Non-functional Aspects of Home-based Healthcare Technology

    DEFF Research Database (Denmark)

    Grönvall, Erik; Verdezoto, Nervo

    2013-01-01

    the appropriation of healthcare technologies and people with comorbidity may have diverse but co-existing monitoring needs. In this paper, we seek to understand home-based health monitoring practices to better design and integrate them into people’s everyday life. We perform an analysis of socio......-technical complexities in home-based healthcare technologies through three case studies of self-monitoring: 1) pre-eclampsia (i.e. pregnancy poisoning), 2) heart conditions, and 3) preventive care. Through the analysis seven themes emerged (people, resources, places, routines, knowledge, control and motivation) that can...... facilitate the understanding of home-based healthcare activities. We present three modes of self-monitoring use and provide a set of design recommendations for future Ubicomp designs of home-based healthcare technology....

  5. A study of an intensive home-based treatment program and its ...

    African Journals Online (AJOL)

    Adele

    Key words: Intensive home based program, health services, admission, outpatient, inpatient, aged care. Received: ... vate agencies were sometimes also used and funded by APS or more .... result of other structural changes in the system.

  6. Shelter as Workplace: A Review of Home-Based Enterprise in Developing Countries.

    Science.gov (United States)

    Tipple, A. Graham

    1993-01-01

    Describes the most common types of home-based employment activities and looks at advantages and disadvantages of such small enterprises, their profitability, and measures that could be taken to solve problems that arise. (Author/JOW)

  7. Home telemonitoring for type 2 diabetes: an evidence-based analysis.

    Science.gov (United States)

    2009-01-01

    In June 2008, the Medical Advisory Secretariat began work on the Diabetes Strategy Evidence Project, an evidence-based review of the literature surrounding strategies for successful management and treatment of diabetes. This project came about when the Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the Ministry's newly released Diabetes Strategy.After an initial review of the strategy and consultation with experts, the secretariat identified five key areas in which evidence was needed. Evidence-based analyses have been prepared for each of these five areas: insulin pumps, behavioural interventions, bariatric surgery, home telemonitoring, and community based care. For each area, an economic analysis was completed where appropriate and is described in a separate report.To review these titles within the Diabetes Strategy Evidence series, please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html,DIABETES STRATEGY EVIDENCE PLATFORM: Summary of Evidence-Based AnalysesContinuous Subcutaneous Insulin Infusion Pumps for Type 1 and Type 2 Adult Diabetics: An Evidence-Based AnalysisBehavioural Interventions for Type 2 Diabetes: An Evidence-Based AnalysisBARIATRIC SURGERY FOR PEOPLE WITH DIABETES AND MORBID OBESITY: An Evidence-Based SummaryCommunity-Based Care for the Management of Type 2 Diabetes: An Evidence-Based AnalysisHome Telemonitoring for Type 2 Diabetes: An Evidence-Based AnalysisApplication of the Ontario Diabetes Economic Model (ODEM) to Determine the Cost-effectiveness and Budget Impact of Selected Type 2 Diabetes Interventions in Ontario The objective of this report is to determine whether home telemonitoring and management of blood glucose is effective for improving glycemic control in adults with type 2 diabetes. An aging population coupled with a shortage of nurses and physicians in

  8. Can comprehensive specialised end-of-life care be provided at home? Lessons from a study of an innovative consultant-led community service in the UK.

    Science.gov (United States)

    Noble, B; King, N; Woolmore, A; Hughes, P; Winslow, M; Melvin, J; Brooks, J; Bravington, A; Ingleton, C; Bath, P A

    2015-03-01

    The Midhurst Macmillan Specialist Palliative Care Service (MMSPCS) is a UK, medical consultant-led, multidisciplinary team aiming to provide round-the-clock advice and care, including specialist interventions, in the home, community hospitals and care homes. Of 389 referrals in 2010/11, about 85% were for cancer, from a population of about 155 000. Using a mixed method approach, the evaluation comprised: a retrospective analysis of secondary-care use in the last year of life; financial evaluation of the MMSPCS using an Activity Based Costing approach; qualitative interviews with patients, carers, health and social care staff and MMSPCS staff and volunteers; a postal survey of General Practices; and a postal survey of bereaved caregivers using the MMSPCS. The mean cost is about 3000 GBP (3461 EUR) per patient with mean cost of interventions for cancer patients in the last year of life 1900 GBP (2192 EUR). Post-referral, overall costs to the system are similar for MMSPCS and hospice-led models; however, earlier referral avoided around 20% of total costs in the last year of life. Patients and carers reported positive experiences of support, linked to the flexible way the service worked. Seventy-one per cent of patients died at home. This model may have application elsewhere. © 2014 The Authors. European Journal of Cancer Care published by John Wiley & Sons Ltd.

  9. Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial

    Directory of Open Access Journals (Sweden)

    Alperstein Garth

    2007-05-01

    Full Text Available Abstract Background Studies have shown that a proportion of children as young as two years are already overweight. This indicates that obesity prevention programs that commence as early as possible and are family-focused are needed. This Healthy Beginnings Trial aims to determine the efficacy of a community-based randomized controlled trial (RCT of a home visiting intervention in preventing the early onset of childhood overweight and obesity. The intervention will be conducted over the first two years of life to increase healthy feeding behaviours and physical activity, decrease physical inactivity, enhance parent-child interaction, and hence reduce overweight and obesity among children at 2 and 5 years of age in the most socially and economically disadvantaged areas of Sydney, Australia. Methods/design This RCT will be conducted with a consecutive sample of 782 first time mothers with their newborn children. Pregnant women who are expecting their first child, and who are between weeks 24 and 34 of their pregnancy, will be invited to participate in the trial at the antenatal clinic. Informed consent will be obtained and participants will then be randomly allocated to the intervention or the control group. The allocation will be concealed by sequentially numbered, sealed opaque envelopes containing a computer generated random number. The intervention comprises eight home visits from a specially trained community nurse over two years and pro-active telephone support between the visits. Main outcomes include a duration of breastfeeding measured at 6 and 12 months, b introduction of solids measured at 4 and 6 months, c nutrition, physical activity and television viewing measured at 24 months, and d overweight/obesity status at age 2 and 5 years. Discussion The results of this trial will ascertain whether the home based early intervention is effective in preventing the early onset of childhood overweight and obesity. If proved to be effective, it

  10. Specialized home treatment versus hospital-based outpatient treatment for first-episode psychosis: a randomized clinical trial.

    Science.gov (United States)

    Dewa, Carolyn S; Zipursky, Robert B; Chau, Nancy; Furimsky, Ivana; Collins, April; Agid, Ofer; Goering, Paula

    2009-11-01

    This pilot study compared the effectiveness of specialized care that was home based versus hospital based for individuals experiencing their first psychotic episode. A randomized controlled trial design was used. A total of 29 subjects were interviewed at baseline, 3 and 9 months. Repeated measures analysis of variance was employed to test for statistically significant changes over time within and between groups with regard to community psychosocial functioning and symptom severity. Our findings indicate that subjects in both the home-based and hospital-based programmes significantly improved with regard to symptoms and community functioning over time. However, the rates of change over time were not significantly different between the two programmes. There was a statistically significant difference between programmes with regard to the proportion of subjects with less than two visits (i.e. either did not attend their first assessment or attended follow-up visits after their assessment). This was a modest pilot study and the sample was too small to allow definitive conclusions to be drawn. However, the results raise questions about differences in initial treatment engagement. They suggest the need for additional research focusing on interventions that promote initial treatment seeking. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.

  11. Home-based, Online Mindfulness and Cognitive Training for Soldiers and Veterans with TBI

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-16-1-0685 TITLE: Home-based, Online Mindfulness and Cognitive Training for Soldiers and Veterans with TBI PRINCIPAL...TITLE AND SUBTITLE Home-based, Online Mindfulness and Cognitive Training for Soldiers and Veterans with TBI 5a. CONTRACT NUMBER 5b. GRANT NUMBER...individuated brain training program (cognitive training + mindfulness /stress- reduction training) with caregiver support portal and lifestyle monitor is

  12. Palliative home-based technology from a practitioner's perspective: benefits and disadvantages

    OpenAIRE

    Johnston, Bridget

    2014-01-01

    Bridget M Johnston Sue Ryder Care Centre for the Study of Supportive, Palliative, and End of Life Care, School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK Abstract: This critical review paper explores the concept of palliative home-based technology from a practitioner's perspective. The aim of the critical review was to scope information available from published and unpublished research on the current state of palliative home-based tec...

  13. Behaviour change techniques in home-based cardiac rehabilitation: a systematic review

    OpenAIRE

    Heron, Neil; Kee, Frank; Donnelly, Michael; Cardwell, Christopher; Tully, Mark A; Cupples, Margaret E

    2016-01-01

    BACKGROUND: Cardiac rehabilitation (CR) programmes offering secondary prevention for cardiovascular disease (CVD) advise healthy lifestyle behaviours, with the behaviour change techniques (BCTs) of goals and planning, feedback and monitoring, and social support recommended. More information is needed about BCT use in home-based CR to support these programmes in practice.AIM: To identify and describe the use of BCTs in home-based CR programmes.DESIGN AND SETTING: Randomised controlled trials o...

  14. Sensor Network-Based and User-Friendly User Location Discovery for Future Smart Homes.

    Science.gov (United States)

    Ahvar, Ehsan; Lee, Gyu Myoung; Han, Son N; Crespi, Noel; Khan, Imran

    2016-06-27

    User location is crucial context information for future smart homes where many location based services will be proposed. This location necessarily means that User Location Discovery (ULD) will play an important role in future smart homes. Concerns about privacy and the need to carry a mobile or a tag device within a smart home currently make conventional ULD systems uncomfortable for users. Future smart homes will need a ULD system to consider these challenges. This paper addresses the design of such a ULD system for context-aware services in future smart homes stressing the following challenges: (i) users' privacy; (ii) device-/tag-free; and (iii) fault tolerance and accuracy. On the other hand, emerging new technologies, such as the Internet of Things, embedded systems, intelligent devices and machine-to-machine communication, are penetrating into our daily life with more and more sensors available for use in our homes. Considering this opportunity, we propose a ULD system that is capitalizing on the prevalence of sensors for the home while satisfying the aforementioned challenges. The proposed sensor network-based and user-friendly ULD system relies on different types of inexpensive sensors, as well as a context broker with a fuzzy-based decision-maker. The context broker receives context information from different types of sensors and evaluates that data using the fuzzy set theory. We demonstrate the performance of the proposed system by illustrating a use case, utilizing both an analytical model and simulation.

  15. Sensor Network-Based and User-Friendly User Location Discovery for Future Smart Homes

    Directory of Open Access Journals (Sweden)

    Ehsan Ahvar

    2016-06-01

    Full Text Available User location is crucial context information for future smart homes where many location based services will be proposed. This location necessarily means that User Location Discovery (ULD will play an important role in future smart homes. Concerns about privacy and the need to carry a mobile or a tag device within a smart home currently make conventional ULD systems uncomfortable for users. Future smart homes will need a ULD system to consider these challenges. This paper addresses the design of such a ULD system for context-aware services in future smart homes stressing the following challenges: (i users’ privacy; (ii device-/tag-free; and (iii fault tolerance and accuracy. On the other hand, emerging new technologies, such as the Internet of Things, embedded systems, intelligent devices and machine-to-machine communication, are penetrating into our daily life with more and more sensors available for use in our homes. Considering this opportunity, we propose a ULD system that is capitalizing on the prevalence of sensors for the home while satisfying the aforementioned challenges. The proposed sensor network-based and user-friendly ULD system relies on different types of inexpensive sensors, as well as a context broker with a fuzzy-based decision-maker. The context broker receives context information from different types of sensors and evaluates that data using the fuzzy set theory. We demonstrate the performance of the proposed system by illustrating a use case, utilizing both an analytical model and simulation.

  16. Preliminary Study of the Effect of Low-Intensity Home-Based Physical Therapy in Chronic Stroke Patients

    Directory of Open Access Journals (Sweden)

    Jau-Hong Lin

    2004-01-01

    Full Text Available This study was a preliminary examination of the effect of low-intensity home-based physical therapy on the performance of activities of daily living (ADL and motor function in patients more than 1 year after stroke. Twenty patients were recruited from a community stroke register in Nan-Tou County, Taiwan, to a randomized, crossover trial comparing intervention by a physical therapist immediately after entry into the trial (Group I or after a delay of 10 weeks (Group II. The intervention consisted of home-based physical therapy once a week for 10 weeks. The Barthel Index (BI and Stroke Rehabilitation Assessment of Movement (STREAM were used as standard measures for ADL and motor function. At the first follow-up assessment at 11 weeks, Group I showed greater improvement in lower limb motor function than Group II. At the second follow-up assessment at 22 weeks, Group II showed improvement while Group I had declined. At 22 weeks, the motor function of upper limbs, mobility, and ADL performance in Group II had improved slightly more than in Group I, but the between-group differences were not significant. It appears that low-intensity home-based physical therapy can improve lower limb motor function in chronic stroke survivors. Further studies will be needed to confirm these findings.

  17. Home-based balance training programme using Wii Fit with balance board for Parkinsons's disease: a pilot study.

    Science.gov (United States)

    Esculier, Jean-Francois; Vaudrin, Joanie; Bériault, Patrick; Gagnon, Karine; Tremblay, Louis E

    2012-02-01

    To evaluate the effects of a home-based balance training programme using visual feedback (Nintendo Wii Fit game with balance board) on balance and functional abilities in subjects with Parkinson's disease, and to compare the effects with a group of paired healthy subjects. Ten subjects with moderate Parkinson's disease and 8 healthy elderly subjects. Subjects participated in a 6-week home-based balance training programme using Nintendo Wii Fit and balance board. Baseline measures were taken before training for the Sit-to-Stand test (STST), Timed-Up-and-Go (TUG), Tinetti Performance Oriented Mobility Assessment (POMA), 10-m walk test, Community Balance and Mobility assessment (CBM), Activities-specific Balance and Confidence scale (ABC), unipodal stance duration, and a force platform. All measurements were taken again after 3 and 6 weeks of training. The Parkinson's disease group significantly improved their results in TUG, STST, unipodal stance, 10-m walk test, CBM, POMA and force platform at the end of the 6-week training programme. The healthy subjects group significantly improved in TUG, STST, unipodal stance and CBM. This pilot study suggests that a home-based balance programme using Wii Fit with balance board could improve static and dynamic balance, mobility and functional abilities of people affected by Parkinson's disease.

  18. Immigrant-Host Community Relations in Malawi's Community Based ...

    African Journals Online (AJOL)

    government sponsored settlement schemes in Zimbabwe, for example, are viewed as ... diversity of community development projects and state provided public ..... Development Project in Malawi: case studies of beneficiary groups in Machinga ...

  19. Community Garden Information Systems: Analyzing and Strengthening Community-Based Resource Sharing Networks

    Science.gov (United States)

    Loria, Kristen

    2013-01-01

    Extension professionals play an increasingly central role in supporting community garden and other community-based agriculture projects. With growing interest in community gardens as tools to improve community health and vitality, the best strategies for supporting these projects should be explored. Due to the importance of inter-personal networks…

  20. Community-Based Programming: An Opportunity and Imperative for the Community College. Institutes & Workshops.

    Science.gov (United States)

    Boone, Edgar J.

    Community-based programming (CBP) is a cooperative process in which a community college serves as the leader and catalyst in effecting collaboration among the people, leaders and community organizations in its service area. This report discusses the changing role of the community college, the nature of CBP, and expected outcomes of the process,…

  1. Markers of Impaired Decision Making in Nursing Home Residents: Assessment by Nursing Home Staff in a Population-Based Study.

    Science.gov (United States)

    Fain, Kevin M; Rosenberg, Paul B; Pirard, Sandrine; Bogunovic, Olivera; Spira, Adam P

    2015-07-01

    Many nursing home residents have cognitive impairment that affects their decision making. In order to identify potential markers of impaired decision making, we investigated the association between a range of nursing home resident characteristics and impaired decision making in a population-based sample. Participants were 13,013 residents in the 2004 National Nursing Home Survey. We used logistic regression to determine the association between resident characteristics (ie, gender, age, race, mood, recent pain, falls, fractures, or hospitalizations, length of stay, number of activities of daily living (ADL) requiring help, and diagnoses of dementia, anxiety disorders, and depression) and impaired (vs independent) decision making. After controlling for depression and anxiety diagnoses, as well as gender, age, race, and recent hospitalization or pain, characteristics associated with impaired decision making included depressed, sad, or anxious mood ["mild" odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.23-1.58; "severe" OR = 2.69, 95% CI = 2.27-3.20); diagnosed dementia or living on a dementia hall (OR = 5.07, 95% CI = 4.52-5.67); number of ADL requiring assistance (with 5 ADL, OR = 10.69, 95% CI = 6.82-16.75); length of nursing home stay [101-365 days (OR = 1.60, 95% CI = 1.36-1.89); 366 days-2 years (OR = 1.60, 95% CI = 1.34-1.90); >2 years (OR = 2.25, 95% CI = 1.92-2.63)]; and history of falls or fractures in the last 6 months (OR = 1.19, 95% CI = 1.07-1.32)]. Residents reporting pain in the last week were less likely to have impaired decision making (OR = 0.58, 95% CI = 0.52-0.66). We found several independent markers of impaired decision making in nursing home residents, including depressed, sad, or anxious mood (independent of depression or anxiety diagnosis); dementia; and greater need for ADL assistance. Some of these factors, in particular mood, are modifiable and addressing them may help improve decision making. These markers should be explored

  2. Personal vulnerability and work-home interaction: the effect of job performance-based self-esteem on work/home conflict and facilitation.

    Science.gov (United States)

    Innstrand, Siw Tone; Langballe, Ellen Melbye; Espnes, Geir Arild; Aasland, Olaf Gjerløw; Falkum, Erik

    2010-12-01

    The aim of the present study was to examine the longitudinal relationship between job performance-based self-esteem (JPB-SE) and work-home interaction (WHI) in terms of the direction of the interaction (work-to-home vs. home-to-work) and the effect (conflict vs. facilitation). A sample of 3,475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, and people working in advertising and information technology) supplied data at two points of time with a two-year time interval. The two-wave, cross-lagged structural equations modeling (SEM) analysis demonstrated reciprocal relationships between these variables, i.e., job performance-based self-esteem may act as a precursor as well as an outcome of work-home interaction. The strongest association was between job performance-based self-esteem and work-to-home conflict. Previous research on work-home interaction has mainly focused on situational factors. This longitudinal study expands the work-home literature by demonstrating how individual vulnerability (job performance-based self-esteem) contributes to the explanation of work-home interactions. © 2010 The Authors. Scandinavian Journal of Psychology © 2010 The Scandinavian Psychological Associations.

  3. Community-based intervention for blood pressure reduction in Nepal (COBIN trial)

    DEFF Research Database (Denmark)

    Neupane, Dinesh; McLachlan, Craig S; Christensen, Bo

    2016-01-01

    . The study will provide detailed information on the burden of blood pressure and also whether treatment targets are being met. Moreover, evidence will be provided on the future role of female community health volunteers for hypertension management in Nepal. The lessons learned from this study may also...... study is to determine the effect of family-based home health education and blood pressure monitoring by trained female community health volunteers. The primary outcome is change in mean systolic blood pressure. A community-based, open-masked, two-armed, cluster-randomized trial will be conducted...... proportion size, 929 individuals for the intervention group and 709 individuals for the control group will participate in the study. Due to the nature of the study, study participants are not compensated or insured. As part of the blood pressure intervention, trained female community health volunteers...

  4. Use of mobile phone consultations during home visits by Community Health Workers for maternal and newborn care: community experiences from Masindi and Kiryandongo districts, Uganda.

    Science.gov (United States)

    Mangwi Ayiasi, Richard; Atuyambe, Lynn Muhimbuura; Kiguli, Juliet; Garimoi Orach, Christopher; Kolsteren, Patrick; Criel, Bart

    2015-06-18

    Home visits by Community Health Workers [In Uganda Community Health Workers are given the collective term of Village Health Teams (VHTs). Hereafter referred to as VHTs] is recommended to improve maternal and newborn care. We investigated perceived maternal and newborn benefits of home visits made by VHTs, combined with mobile phone consultations with professional health workers for advice. A qualitative study was conducted in Masindi and Kiryandongo districts, Uganda, in December-2013 to March-2014. Study participants were drawn from the intervention arm of a randomised community-intervention trial. In-depth interviews were conducted with 20 prenatal and 16 postnatal women who were visited by VHTs; 5 group discussions and 16 key informant interviews were held with VHTs and 10 Key Informant Interviews with professional health workers. Data were analysed using latent content analysis techniques. Majority women and VHTs contend that the intervention improved access to maternal and newborn information; reduced costs of accessing care and facilitated referral. Women, VHTs and professional health workers acknowledged that the intervention induced attitudinal change among women and VHTs towards adapting recommended maternal and newborn care practices. Mobile phone consultations between VHTs and professional health workers were considered to reinforce VHT knowledge on maternal newborn care and boosted the social status of VHTs in community. A minority of VHTs perceived the implementation of recommended maternal and newborn care practices as difficult. Some professional health workers did not approve of the transfer of promotional maternal and newborn responsibility to VHTs. For a range of reasons, a number of professional health workers were not always available on phone or at the health centre to address VHT concerns. Results suggest that home visits made by VHTs for maternal and newborn care are reasonably well accepted. Our study highlights potential benefits of

  5. Home-based specialized palliative care in patients with advanced cancer

    DEFF Research Database (Denmark)

    Nordly, Mie; Vadstrup, Eva Soelberg; Sjøgren, Per

    2016-01-01

    OBJECTIVE: Due to an urgent need for specialized palliative care (SPC) for patients with advanced cancer, an overview of available information on organization and outcomes of home-based SPC would be valuable. Our systematic review aims to give an overview of available information...... on the organization and outcomes of home-based SPC for patients with advanced cancer. Outcomes related to place of death, survival time, quality of life, performance status, and symptom management are included. METHOD: A PICO process search strategy consisting of terms related to cancer, palliation, and home care...... for patients with advanced cancer, resulting in poor information and a lack of evidence. Generally, home-based SPC seems to have some positive effect on pain and dyspnea, but more high-quality studies are required....

  6. Implementing Community-based Health Planning and Services in impoverished urban communities: health workers' perspective.

    Science.gov (United States)

    Nwameme, Adanna Uloaku; Tabong, Philip Teg-Nefaah; Adongo, Philip Baba

    2018-03-20

    Three-quarters of sub-Saharan Africa's urban population currently live under slum conditions making them susceptible to ill health and diseases. Ghana characterizes the situation in many developing countries where the urban poor have become a group much afflicted by complex health problems associated with their living conditions, and the intra-city inequity between them and the more privileged urban dwellers with respect to health care accessibility. Adopting Ghana's rural Community-Based Health Planning and Service (CHPS) programme in urban areas is challenging due to the differences in social networks and health challenges thus making modifications necessary. The Community Health Officers (CHOs) and their supervisors are the frontline providers of health in the community and there is a need to analyze and document the health sector response to urban CHPS. The study was solely qualitative and 19 in-depth interviews were conducted with all the CHOs and key health sector individuals in supervisory/coordinating positions working in urban CHPS zones to elicit relevant issues concerning urban CHPS implementation. Thematic content data analysis was done using the NVivo 7 software. Findings from this appraisal suggest that the implementation of this urban concept of the CHPS programme has been well undertaken by the health personnel involved in the process despite the challenges that they face in executing their duties. Several issues came to light including the lack of first aid drugs, as well as the need for the Integrated Management of Neonatal and Childhood Illnesses (IMNCI) programme and more indepth training for CHOs. In addition, the need to provide incentives for the volunteers and Community Health Committee members to sustain their motivation and the CHOs' apprehensions with regards to furthering their education and progression in their careers were key concerns raised. The establishment of the CHPS concept in the urban environment albeit challenging has been

  7. Home-based exercise may not decrease the insulin resistance in individuals with metabolic syndrome.

    Science.gov (United States)

    Chen, Chiao-Nan; Chuang, Lee-Ming; Korivi, Mallikarjuna; Wu, Ying-Tai

    2015-01-01

    This study investigated the differences in exercise self-efficacy, compliance, and effectiveness of home-based exercise in individuals with and without metabolic syndrome (MetS). One hundred and ten individuals at risk for diabetes participated in this study. Subjects were categorized into individuals with MetS and individuals without MetS. Metabolic risk factors and exercise self-efficacy were evaluated for all subjects before and after 3 months of home-based exercise. Univariate analysis of variance was used to compare the effectiveness of a home-based exercise program between individuals with and without MetS. The home-based exercise program improved body mass index and lipid profile in individuals at risk for diabetes, regardless of MetS status at baseline. Individuals without MetS had higher exercise self-efficacy at baseline and performed greater exercise volume compared with individuals with MetS during the intervention. The increased exercise volume in individuals without MetS may contribute to their better control of insulin resistance than individuals with MetS. Furthermore, baseline exercise self-efficacy was correlated with exercise volume executed by subjects at home. We conclude that home-based exercise programs are beneficial for individuals at risk for diabetes. However, more intensive and/or supervised exercise intervention may be needed for those with MetS.

  8. Social capital, community-based governance and resilience in an ...

    African Journals Online (AJOL)

    While the Mozambique government policy promotes community-based fisheries management in artisanal fisheries, we argue that under current conditions of ineffective community-based governance, a strong focus on reconstruction of social capital will be required before a community-based resource management process ...

  9. Automated Cognitive Health Assessment From Smart Home-Based Behavior Data.

    Science.gov (United States)

    Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

    2016-07-01

    Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behavior in the home and predicting clinical scores of the residents. To accomplish this goal, we propose a clinical assessment using activity behavior (CAAB) approach to model a smart home resident's daily behavior and predict the corresponding clinical scores. CAAB uses statistical features that describe characteristics of a resident's daily activity performance to train machine learning algorithms that predict the clinical scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years. We obtain a statistically significant correlation ( r=0.72) between CAAB-predicted and clinician-provided cognitive scores and a statistically significant correlation ( r=0.45) between CAAB-predicted and clinician-provided mobility scores. These prediction results suggest that it is feasible to predict clinical scores using smart home sensor data and learning-based data analysis.

  10. Research on Livable Community Evaluation Based on GIS

    Science.gov (United States)

    Yin, Zhangcai; Wu, Yang; Jin, Zhanghaonan; Zhang, Xu

    2018-01-01

    Community is the basic unit of the city. Research on livable community could provide a bottom-up research path for the realization of livable city. Livability is the total factor affecting the quality of community life. In this paper, livable community evaluation indexes are evaluated based on GIS and fuzzy comprehensive evaluation method. Then the sum-index and sub-index of community livability are both calculated. And community livable evaluation index system is constructed based on the platform of GIS. This study provides theoretical support for the construction and management of livable communities, so as to guide the development and optimization of city.

  11. Local natural and cultural heritage assets and community based ...

    African Journals Online (AJOL)

    Community based tourism (CBT) is seen as an opportunity which mass tourism does not offer for, especially, rural communities to develop their natural and cultural assets into tourism activities for the benefit of the community. The point of CBT is that the community, collectively and individually, gains a livelihood from ...

  12. Distance-Based Access Modifiers Applied to Safety in Home Networks

    DEFF Research Database (Denmark)

    Mortensen, Kjeld Høyer; Schougaard, Kari Rye; Schultz, Ulrik Pagh

    2004-01-01

    Home networks and the interconnection of home appliances is a classical theme in ubiquitous computing research. Security is a recurring concern, but there is a lack of awareness of safety: preventing the computerized house from harming the inhabitants, even in a worst-case scenario where...... be performed within a physical proximity that ensures safety. We use a declarative approach integrated with an IDL language to express location-based restrictions on operations. This model has been implemented in a middleware for home audio-video devices, using infrared communication and a local-area network...

  13. Community-based faculty: motivation and rewards.

    Science.gov (United States)

    Fulkerson, P K; Wang-Cheng, R

    1997-02-01

    The reasons why practicing physicians precept students in their offices, and the rewards they wish to receive for this work, have not been clearly elucidated. This study determined the reasons for precepting and the rewards expected among a network of preceptors in Milwaukee. A questionnaire was mailed to 120 community-based physician preceptors in a required, third-year ambulatory care clerkship. Respondents were asked to identify why they volunteered and what they considered appropriate recognition or reward. The personal satisfaction derived from the student-teacher interaction was, by far, the most important motivator for preceptors (84%). The most preferred rewards for teaching included clinical faculty appointment, CME and bookstore discounts, computer networking, and workshops for improving skills in clinical teaching. Community-based private physicians who participate in medical student education programs are primarily motivated by the personal satisfaction that they derive from the teaching encounter. An effective preceptor recognition/reward program can be developed using input from the preceptors themselves.

  14. 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.

  15. Dyadic psychological intervention for patients with cancer and caregivers in home-based, specialized palliative care

    DEFF Research Database (Denmark)

    von Heymann-Horan, Annika Berglind; Puggaard, Louise Berg; Nissen, Kathrine Grovn

    2017-01-01

    Patients with incurable cancer and their informal caregivers have numerous psychological and psychosocial needs. Many of these patients wish to receive their care and die at home. Few home-based specialized palliative care (SPC) interventions systematically integrate psychological support. We...... present a psychological intervention for patient–caregiver dyads developed for an ongoing randomized controlled trial (RCT) of home-based SPC, known as Domus, as well as the results of an assessment of its acceptability and feasibility. The Domus model of SPC for patients with incurable cancer...... and their caregivers offered systematic psychological assessment and dyadic intervention as part of interdisciplinary care. Through accelerated transition to SPC, the aim of the model was to enhance patients' chances of receiving care and dying at home. Integration of psychological support sought to facilitate...

  16. 78 FR 8131 - Federal Home Loan Bank Members Selected for Community Support Review

    Science.gov (United States)

    2013-02-05

    ... Indiana. The Citizens Exchange Bank Fairmount Indiana. Fire Fighter's City County Federal Credit Fort... Michigan. Federal Home Loan Bank of Chicago--District 7 Old Second National Bank Aurora Illinois. Tompkins... Chester Illinois. Lakeside Bank Chicago Illinois. Pacific Global Bank Chicago Illinois. The Northern Trust...

  17. 75 FR 16463 - Federal Home Loan Bank Members Selected for Community Support Review

    Science.gov (United States)

    2010-04-01

    .... Inova Federal Credit Union Elkhart Indiana. The Citizens Exchange Bank Fairmount Indiana. Fire Fighter's... Federal Credit Union...... Westland Michigan. Federal Home Loan Bank of Chicago--District 7 The First.... Lakeside Bank Chicago Illinois. Pacific Global Bank Chicago Illinois. Republic Bank of Chicago Chicago...

  18. Outcomes and Costs of Community Living: Semi-Independent Living and Fully Staffed Group Homes

    Science.gov (United States)

    Felce, David; Perry, Jonathan; Romeo, Renee; Robertson, Janet; Meek, Andrea; Emerson, Eric; Knapp, Martin

    2008-01-01

    In a matched-groups design, costs and quality of life outcomes for adults with intellectual disabilities with relatively low support needs were compared between those in fully staffed group homes (n = 35) and in semi-independent living (n = 35). Data were collected on participant characteristics, setting organization, various lifestyle outcomes,…

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

    OpenAIRE

    Kyaddondo, D.; Wanyenze, R.K.; Kinsman, J.; Hardon, A.

    2012-01-01

    BACKGROUND: Though prevention and treatment depend on individuals knowing their HIV status, the uptake of testing remains low in Sub-Saharan Africa. One initiative to encourage HIV testing involves delivering services at home. However, doubts have been cast about the ability of Home-Based HIV Counseling and Testing (HBHCT) to adhere to ethical practices including consent, confidentiality, and access to HIV care post-test. This study explored client experiences in relation these ethical issues...

  20. Starting a hospital-based home health agency: Part II--Key success factors.

    Science.gov (United States)

    Montgomery, P

    1993-09-01

    In Part II of a three-part series, the financial, technological and legislative issues of a hospital-based home health-agency are discussed. Beginning a home healthcare service requires intensive research to answer key environmental and operational questions--need, competition, financial projections, initial start-up costs and the impact of delayed depreciation. Assessments involving technology, staffing, legislative and regulatory issues can help project service volume, productivity and cost-control.