WorldWideScience

Sample records for group home staff

  1. The Effects of Staff Training on the Types of Interactions Observed at Two Group Homes for Foster Care Children

    Science.gov (United States)

    Crosland, Kimberly A.; Dunlap, Glen; Sager, Wayne; Neff, Bryon; Wilcox, Catherine; Blanco, Alfredo; Giddings, Tamela

    2008-01-01

    Objectives: An extensive literature base exists for behavioral parent training; however, few studies have focused on training direct care staff at group home and residential facilities for children. This study was conducted to determine whether a behavioral staff training program consisting of classroom training and in-home feedback would improve…

  2. Exploring technological and architectural solutions for nursing home residents, care professionals and technical staff: Focus groups with professional stakeholders.

    OpenAIRE

    Dooremalen, A.M.C.; van Hoof, J.; Weffers, H.T.G.; Wetzels, M.H.; Wouters, E.J.M.

    2014-01-01

    J. van Hoof, A.M.C. Dooremalen, M.H. Wetzels, H.T.G. Weffers, E.J.M. Wouters (2014) Exploring technological and architectural solutions for nursing home residents, care professionals and technical staff: Focus groups with professional stakeholders. International Journal for Innovative Research in Science & Technology 1(3): 90-105

  3. Exploring technological and architectural solutions for nursing home residents, care professionals and technical staff: Focus groups with professional stakeholders.

    NARCIS (Netherlands)

    A.M.C. Dooremalen; J. van Hoof; H.T.G. Weffers; M.H. Wetzels; MD E.J.M. Wouters

    2014-01-01

    J. van Hoof, A.M.C. Dooremalen, M.H. Wetzels, H.T.G. Weffers, E.J.M. Wouters (2014) Exploring technological and architectural solutions for nursing home residents, care professionals and technical staff: Focus groups with professional stakeholders. International Journal for Innovative Research in

  4. Being a valuable contributor on the frontline: The self-perception of staff in group homes for people with intellectual disability.

    Science.gov (United States)

    Quilliam, Claire; Bigby, Christine; Douglas, Jacinta

    2018-05-01

    Group home frontline staff have a critical role in implementing service policies, yet research typically examines implementation issues from an organisational perspective. The aim of this study was to explore the self-perception of frontline staff about their role in group homes for people with intellectual disability. Constructivist grounded theory methodology guided the study. Data were collected with frontline staff through semistructured interviews and participant observations. Coding and sorting methods were used to analyse participants' self-perception. Frontline staff felt they were valuable contributors who knew the service setting and residents well. Despite this staff felt powerless in their roles, excluded from organisational dialogue, stressed and exhausted. Frontline staff have critical insight into service implementation although disability service organisations may limit their capacity to contribute to this. Further action could explore new ways to better nurture frontline staff engagement in organisational dialogue. © 2017 The Authors Journal of Applied Research in Intellectual Disabilities Published by John Wiley & Sons Ltd.

  5. Improving Elderly's Dental Hygiene Through Nursing Home Staff's Dental Health Education at the Nursing Home

    OpenAIRE

    Santoso, Bedjo; Eko Ningtyas, Endah Aryati; Fatmasari, Diyah

    2017-01-01

    Stomatitis often occurs in elderly at nursing home. They need nursing home staff assistance to maintain their dental and oral health. Therefore, nursing home staff need dental health education. Lecture or discussion methods, which are more effective to improve knowledge, attitude and skill of nursing home staff was the purpose of this research. The research design was quasi-experiment research and pretest-posttest with control group. The sample was 42 nursing home staffs and 74 elderlies, div...

  6. Exploring technological and architectural solutions for nursing home residents, care professionals and technical staff: Focus groups with professional stakeholders.

    NARCIS (Netherlands)

    M.H. Wetzels; H.T.G. Weffers; A.M.C. Dooremalen; Joost van Hoof; Eveline Wouters

    2014-01-01

    Buildings with innovative technologies and architectural solutions are needed as a means of support for future nursing homes alongside adequate care services. This study investigated how various groups of stakeholders from healthcare and technology envision the nursing home of the future in the

  7. Effect of Nursing Home Staff Training on Quality of Patient Survival.

    Science.gov (United States)

    Linn, Margaret W.; And Others

    1989-01-01

    Assessed effects of nursing home staff training in care for the dying on quality of life of 306 terminally ill patients in 5 pairs of matched nursing homes assigned randomly to trained and not trained staff groups. Patients in trained homes had less depression and greater satisfaction with care than patients in control homes at 1 and 3 months.…

  8. Medical staff organization in nursing homes: scale development and validation.

    Science.gov (United States)

    Katz, Paul R; Karuza, Jurgis; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent; Caprio, Thomas; Caprio, Anthony; Dauenhauer, Jason; Lima, Julie

    2009-09-01

    To construct a multidimensional self-report scale to measure nursing home (NH) medical staff organization (NHMSO) dimensions and then pilot the scale using a national survey of medical directors to provide data on its psychometric properties. Instrument development process consisting of the proceedings from the Nursing Home Physician Workforce Conference and focus groups followed by cognitive interviews, which culminated in a survey of a random sample of American Medical Directors Association (AMDA) affiliated medical directors. Analyses were conducted on surveys matched to Online Survey Certification and Reporting (OSCAR) data from freestanding nonpediatric nursing homes. A total of 202 surveys were available for analysis and comprised the final sample. Dimensions were identified that measured the extent of medical staff organization in nursing homes and included staff composition, appointment process, commitment (physiciancohesion; leadership turnover/capability), departmentalization (physician supervision, autonomy and interdisciplinary involvement), documentation, and informal dynamics. The items developed to measure each dimension were reliable (Cronbach's alpha ranged from 0.81 to 0.65).Intercorrelations among the scale dimensions provided preliminary evidence of the construct validity of the scale. This report, for the first time ever, defines and validates NH medical staff organization dimensions, a critical first step in determining the relationship between physician practice and the quality of care delivered in the NH.

  9. [A listening support group for nursing staff].

    Science.gov (United States)

    Lemoine, Dominique

    2016-05-01

    The feedback from a consultant nurse in a listening support group for health professionals shows that, for hospital nursing staff, the phenomenon of suffering in the workplace is a reality. In addition to providing help to professionals who request it, the missions of such a group are to promote discussion around psycho-social risks in the framework of a policy of compassionate care for staff. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  10. Improving Nursing Home Staff Knowledge and Attitudes about Pain

    Science.gov (United States)

    Jones, Katherine R.; Fink, Regina; Pepper, Ginny; Hutt, Eveyln; Vojir, Carol P.; Scott, Jill; Clark, Lauren; Mellis, Karen

    2004-01-01

    Purpose: Effective pain management remains a serious problem in the nursing home setting. Barriers to achieving optimal pain practices include staff knowledge deficits, biases, and attitudes that influence assessment and management of the residents' pain. Design and Methods: Twelve nursing homes participated in this intervention study: six…

  11. Characteristics of Absenteeism in Nursing Home Staff.

    Science.gov (United States)

    Cohen-Mansfield, Jiska; Rosenthal, Alvin S.

    This study investigated factors associated with absenteeism among nursing staff (N=219) at a long-term care facility. Four absenteeism measures were calculated from personnel records for each month of the year: no pay (the sum of unscheduled, unpaid sick, and leave without pay), part day (the sum of arrived late and left early), paid sick, and…

  12. 24 CFR 982.612 - Group home: State approval of group home.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: State approval of group... Types Group Home § 982.612 Group home: State approval of group home. A group home must be licensed..., Retardation, or Social Services) as a group home for elderly persons or persons with disabilities. ...

  13. Development of a Refined Staff Group Trainer

    National Research Council Canada - National Science Library

    Quensel, Susan

    1999-01-01

    ... individual staff sections in the brigade command post. The program was designed to deliver training to newly formed, inexperienced staffs conducting the staff functions that support the military decision-making process within the execution phase...

  14. Staff assignment practices in nursing homes: review of the literature.

    Science.gov (United States)

    Rahman, Anna; Straker, Jane K; Manning, Lydia

    2009-01-01

    Consistent assignment, whereby nursing home staff members, particularly certified nurse aides, are assigned to the same residents on most shifts, is increasingly viewed as a cornerstone of culture change in nursing homes. It has been advocated as a best-care model that increases residents' quality of life while contributing to a more stable frontline staff. Given these potential benefits, consistent assignment is now widely viewed as superior to rotating assignment, an alternative staffing model that aims to distribute care burden more fairly among staff and ensure that workers are familiar with most residents. Despite favorable anecdotal reports about the benefits of consistent assignment, the research literature reports mixed and sometimes contradictory findings for this staffing practice. This article reviews the research pertaining to staff assignment practices in nursing homes. Reviewed here are 13 reports on experimental trials (6 reports), evaluation research (4 reports), and nursing home surveys (3 reports). The review reveals broad diversity in staffing practices and raises questions that challenge popular assumptions about consistent assignment. The article closes with a discussion of the research, policy, and practice implications of the research findings.

  15. 24 CFR 982.610 - Group home: Who may reside in a group home.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: Who may reside in a group home. 982.610 Section 982.610 Housing and Urban Development Regulations Relating to Housing and... Housing Types Group Home § 982.610 Group home: Who may reside in a group home. (a) An elderly person or a...

  16. Evaluation of a Staff Training Programme using Positive Psychology coaching with film and theatre elements in care homes: views and attitudes of residents, staff and relatives.

    Science.gov (United States)

    Guzmán, Azucena; Wenborn, Jennifer; Ledgerd, Ritchard; Orrell, Martin

    2017-03-01

    There is a recognised need to improve staff training in care homes. The aim of this study was to conduct a qualitative evaluation of the Ladder to the Moon Culture Change Studio Engagement Programme (CCSEP), a staff training programme aimed at enhancing staff-resident communication. Focus groups were conducted with residents able to provide consent; staff and relatives and managers were interviewed in two care homes. A theoretical framework was developed to interpret the impact of CCSEP using Framework Analysis. Residents noted that the programme appeared to result in staff interacting more with them, as well as enjoying working together as a team. Staff reported an improved sense of teamwork, developing more positive attitudes towards residents, as well as their concerns about using theatrical techniques in the care setting. Relatives identified care home organisational aspects as being barriers to implementation, and some regarded CCSEP simply as 'entertainment' rather than 'creative care'. This study provides an insight into the potential of this staff training programme to improve staff-resident interactions. However, participants' varying views of CCSEP highlight the need to brief staff, residents and relatives before implementation so as to enable full understanding of the aim. © 2016 John Wiley & Sons Ltd.

  17. Interior design preferences of residents, families, and staff in two nursing homes.

    Science.gov (United States)

    Miller, D B; Goldman, L E; Woodman, S A

    1985-01-01

    The small number of respondents and the absence of specific demographic data concerning the three categories of respondents represented definite limitations. Further investigation in other long-term care facilities clearly is indicated. However, as a preliminary survey of preferences in nursing home interior design, several interesting findings have emerged: Patients, staff and families all emphasized patient safety and function over aesthetics. Yet, more residents than staff and families were concerned with appearance. Although experts advocate creating a home-like atmosphere in the nursing home, 50% or more of each group applied different criteria for specific design elements for private homes and for long-term care institutions. Design preferences for the three groups were similar, with an emphasis on modern furniture, painted walls, resilient tile rather than carpet, blinds, pastel and warm colors, and the use of paintings as accessories. Contrary to study assumptions, design features that promote patient individuality (e.g., patient artwork) received much greater emphasis from staff than from patients and families. Environmental change was considered an important aspect of interior design. Of the three constituencies, staff was most aware of periodic changes in decor and considered change as "very important" more often than did families or patients. As the nature of the nursing home patient population has changed--with residents presenting more disability and less rehabilitation potential and less likelihood of returning home--the ambiance of facilities has assumed even more importance. Clearly, the design preferences of residents who live in the facility are of paramount importance. However, it is also helpful to have an environment that is pleasing to family members who often experience difficulty in ongoing visitations, particularly to intellectually impaired relatives. Maintaining staff morale at a high level is a constant challenge in a long-term care

  18. Development of a Refined Staff Group Trainer

    National Research Council Canada - National Science Library

    Quensel, Susan

    1999-01-01

    .... As a follow-on effort to the previous SGT project, the goal was to refine a brigade-level staff training program to more effectively and efficiently coordinate the activities within and between the...

  19. Feasibility of a web-based dementia feeding skills training program for nursing home staff.

    Science.gov (United States)

    Batchelor-Murphy, Melissa; Amella, Elaine J; Zapka, Jane; Mueller, Martina; Beck, Cornelia

    2015-01-01

    Nursing home (NH) staff do not receive adequate training for providing feeding assistance to residents with dementia who exhibit aversive feeding behaviors (e.g., clamping mouth shut). The result is often low meal intake for these residents. This feasibility study tested a web-based dementia feeding skills program for staff in two United States NHs. Randomly assigned, the intervention staff received web-based dementia feeding skills training with coaching. Both groups participated in web-based pre-/post-tests assessing staff knowledge and self-efficacy; and meal observations measured NH staff and resident feeding behaviors, time for meal assistance, and meal intake. Aversive feeding behaviors increased in both groups of residents; however, the intervention NH staff increased the amount of time spent providing assistance and meal intake doubled. In the control group, less time was spent providing assistance and meal intake decreased. This study suggests that training staff to use current clinical practice guidelines improves meal intake. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Staff views on how to improve mealtimes for elderly people with dementia living at home.

    Science.gov (United States)

    Johansson, Linda; Björklund, Anita; Sidenvall, Birgitta; Christensson, Lennart

    2017-10-01

    Dementia commonly leads to difficulties in performing daily activities, which can also often affect the ability to prepare and eat meals. As a result, formal support to maintain good nutritional intake might be needed, but there is a lack of knowledge concerning how to support older persons with dementia living at home. The aim of this study was to explore and describe staff views on how to improve mealtimes for persons with dementia who are still living at home. A qualitative descriptive study was performed and data were collected during 2011-2012 through four focus group interviews with staff working in the homes of persons with dementia. Data were analyzed using inductive content analysis. The participants described several ways to improve mealtimes for persons with dementia and advocated adjustments facilitating the preservation of the persons' independence. Finding suitable actions calls for knowledge about the person and his/her individual situation. Proposed actions were enabling meals at home, taking over, and moving meals outside of the home. In addition, it was found that, the types of meals served to these persons should be as familiar to the individual as possible. The results of this study indicate the importance of using a person-centered approach and meeting the individual needs when supporting people with dementia in regards to their meals when living at home. Individualized care in the home may be expensive, however, it is fair to say that people who become malnourished and admitted to hospitals is even more costly. Furthermore, sharing and reflecting experiences and knowledge can assist staff to identify ways to manage complex situations. Therefore, the use of refection should be a part of staff members' everyday work.

  1. Oral health educational interventions for nursing home staff and residents.

    Science.gov (United States)

    Albrecht, Martina; Kupfer, Ramona; Reissmann, Daniel R; Mühlhauser, Ingrid; Köpke, Sascha

    2016-09-30

    Associations between nursing home residents' oral health status and quality of life, respiratory tract infections, and nutritional status have been reported. Educational interventions for nurses or residents, or both, focusing on knowledge and skills related to oral health management may have the potential to improve residents' oral health. To assess the effects of oral health educational interventions for nursing home staff or residents, or both, to maintain or improve the oral health of nursing home residents. We searched the Cochrane Oral Health Trials Register (to 18 January 2016), the Cochrane Central Register of Controlled Trials (CENTRAL) (the Cochrane Library, 2015, Issue 12), MEDLINE Ovid (1946 to 18 January 2016), Embase Ovid (1980 to 18 January 2016), CINAHL EBSCO (1937 to 18 January 2016), and Web of Science Conference Proceedings (1990 to 18 January 2016). We searched ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials to 18 January 2016. In addition, we searched reference lists of identified articles and contacted experts in the field. We placed no restrictions on language or date of publication when searching the electronic databases. Randomised controlled trials (RCTs) and cluster-RCTs comparing oral health educational programmes for nursing staff or residents, or both with usual care or any other oral healthcare intervention. Two review authors independently screened articles retrieved from the searches for relevance, extracted data from included studies, assessed risk of bias for each included study, and evaluated the overall quality of the evidence. We retrieved data about the development and evaluation processes of complex interventions on the basis of the Criteria for Reporting the Development and Evaluation of Complex Interventions in healthcare: revised guideline (CReDECI 2). We contacted authors of relevant studies for additional information. We included nine RCTs involving

  2. Nursing home staff's views on residents' dignity: a qualitative interview study

    NARCIS (Netherlands)

    Oosterveld-Vlug, Mariska G.; Pasman, H. Roeline W.; van Gennip, Isis E.; Willems, Dick L.; Onwuteaka-Philipsen, Bregje D.

    2013-01-01

    Maintaining dignity is an important element of end-of-life care and also of the care given in nursing homes. Factors influencing personal dignity have been studied from both nursing home residents' and staff's perspective. Little is however known about the way nursing home staff perceive and promote

  3. Grief after patient death: direct care staff in nursing homes and homecare.

    Science.gov (United States)

    Boerner, Kathrin; Burack, Orah R; Jopp, Daniela S; Mock, Steven E

    2015-02-01

    Patient death is common in long-term care (LTC). Yet, little attention has been paid to how direct care staff members, who provide the bulk of daily LTC, experience patient death and to what extent they are prepared for this experience. To 1) determine how grief symptoms typically reported by bereaved family caregivers are experienced among direct care staff, 2) explore how prepared the staff members were for the death of their patients, and 3) identify characteristics associated with their grief. This was a cross-sectional study of direct care staff experiencing recent patient death. Participants were 140 certified nursing assistants and 80 homecare workers. Standardized assessments and structured questions addressed staff (e.g., preparedness for death), institutional (e.g., support availability), and patient/relational factors (e.g., relationship quality). Data analyses included bivariate group comparisons and hierarchical regression. Grief reactions of staff reflected many of the core grief symptoms reported by bereaved family caregivers in a large-scale caregiving study. Feelings of being "not at all prepared" for the death and struggling with "acceptance of death" were prevalent among the staff. Grief was more intense when staff-patient relationships were closer, care was provided for longer, and staff felt emotionally unprepared for the death. Grief symptoms like those experienced by family caregivers are common among direct care workers after patient death. Increasing preparedness for this experience via better training and support is likely to improve the occupational experience of direct care workers and ultimately allow them to provide better palliative care in nursing homes and homecare. Copyright © 2015 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  4. Conflict between nursing home staff and residents' families: does it increase burnout?

    Science.gov (United States)

    Abrahamson, Kathleen; Jill Suitor, J; Pillemer, Karl

    2009-09-01

    In this study, the authors examine the influence of conflict between nursing home staff and family members of residents on staff burnout. Data were collected from interviews with a representative sample of 655 nursing home nurses and nursing assistants. Hypotheses were tested using structural equation modeling. Results indicate that conflict with family members increases staff burnout and decreases staff satisfaction. Staff and family conflict increases when staff members feel they do not have enough time to complete required tasks. Level of conflict decreases when staff perceive that family members have care expectations that are similar to their own. Interestingly, staff who have personal experience as family caregivers are more likely to report conflict with family members of residents, a result that necessitates further study. Staff burnout and dissatisfaction affects both individuals and organizations. Policy that addresses staff and family interaction can have an important place in the design and delivery of long-term care.

  5. Comfort Care Rounds: a staff capacity-building initiative in long-term care homes.

    Science.gov (United States)

    Wickson-Griffiths, Abigail; Kaasalainen, Sharon; Brazil, Kevin; McAiney, Carrie; Crawshaw, Diane; Turner, Mickey; Kelley, Mary Lou

    2015-01-01

    This article reports a pilot evaluation of Comfort Care Rounds (CCRs)--a strategy for addressing long-term care home staff's palliative and end-of-life care educational and support needs. Using a qualitative descriptive design, semistructured individual and focus group interviews were conducted to understand staff members' perspectives and feedback on the implementation and application of CCRs. Study participants identified that effective advertising, interest, and assigning staff to attend CCRs facilitated their participation. The key barriers to their attendance included difficulty in balancing heavy workloads and scheduling logistics. Interprofessional team member representation was sought but was not consistent. Study participants recognized the benefits of attending; however, they provided feedback on how the scheduling, content, and focus could be improved. Overall, study participants found CCRs to be beneficial to their palliative and end-of-life care knowledge, practice, and confidence. However, they identified barriers and recommendations, which warrant ongoing evaluation. Copyright 2015, SLACK Incorporated.

  6. Medication reconciliation in nursing homes: thematic differences between RN and LPN staff.

    Science.gov (United States)

    Vogelsmeier, Amy A; Scott-Cawiezell, Jill R; Pepper, Ginette A

    2011-12-01

    The purpose of this qualitative descriptive study was to describe medication reconciliation practices in nursing homes with a specific focus on nursing staff involvement in the process. The study was conducted in eight Midwestern nursing homes and included 46 onsite observations of resident transfers to the nursing home. Informal interviews of nursing staff performing medication reconciliation were conducted during each observation. Findings suggest nursing home nursing staff, including both RN and licensed practical nurse (LPN) staff, were primarily responsible for performing medication reconciliation; however, these staff often varied in how they processed resident transfer information to identify medication order discrepancies. Patterns of differences were found related to their perceptions about medication reconciliation, as well as their actions when performing the process. RN staff were more often focused on resident safety and putting the "big picture" together, whereas LPN staff were more often focused on the administrative assignment and "completing the task." Copyright 2011, SLACK Incorporated.

  7. Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

    Science.gov (United States)

    Vondras, Dean D.; Flittner, Diane; Malcore, Sylvia A.; Pouliot, Gregory

    2009-01-01

    This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global…

  8. The effects of nutritional guideline implementation on nursing home staff performance: a controlled trial.

    Science.gov (United States)

    Törmä, Johanna; Winblad, Ulrika; Saletti, Anja; Cederholm, Tommy

    2017-08-29

    Suboptimal nutritional practices in elderly care settings may be resolved by an efficient introduction of nutritional guidelines. To compare two different implementation strategies, external facilitation (EF) and educational outreach visits (EOVs), when introducing nutritional guidelines in nursing homes (NHs), and study the impact on staff performance. A quasi-experimental study with baseline and follow-up measurements. The primary outcome was staff performance as a function of mealtime ambience and food service routines. The EF strategy was a 1-year, multifaceted intervention that included support, guidance, practice audit and feedback in two NH units. The EOV strategy comprised one-three-hour lecture about nutritional guidelines in two other NH units. Both strategies were targeted to selected NH teams, which consisted of a unit manager, a nurse and 5-10 care staff. Mealtime ambience was evaluated by 47 observations using a structured mealtime instrument. Food service routines were evaluated by 109 food records performed by the staff. Mealtime ambience was more strongly improved in the EF group than in the EOV group after the implementation. Factors improved were laying a table (p = 0.03), offering a choice of beverage (p = 0.02), the serving of the meal (p = 0.02), interactions between staff and residents (p = 0.02) and less noise from the kitchen (p = 0.01). Food service routines remained unchanged in both groups. An EF strategy that included guidance, audit and feedback improved mealtime ambience when nutritional guidelines were introduced in a nursing home setting, whereas food service routines were unchanged by the EF strategy. © 2017 Nordic College of Caring Science.

  9. Does Finnish hospital staff job satisfaction vary across occupational groups?

    Science.gov (United States)

    Kvist, Tarja; Mäntynen, Raija; Vehviläinen-Julkunen, Katri

    2013-10-02

    Job satisfaction of staff is an essential outcome variable in research when describing the work environment of successful hospitals. Numerous studies have evaluated the topic, but few previous studies have assessed the job satisfaction of all staff in hospital settings. It is important to discover if there are any unsatisfied groups of people working in hospitals, the aspects they are unsatisfied with and why. The aim of this study was to evaluate job satisfaction of all staff working at a Finnish university hospital, identify differences in job satisfaction between staff groups, and explore the relationship between their self-evaluated quality of work and job satisfaction. Data were collected from 1424 employees of the hospital using the web-based Kuopio University Job Satisfaction Scale survey instrument in autumn 2010. The research data were analysed by using SPSS 19.0 for Windows. Frequency and percentage distributions, as well as mean values, were used to describe the data. A non-parametric test (Kruskal-Wallis test) was used to determine the significance of differences in scores between different groups of staff members and between quality evaluations. The overall job satisfaction of the employees was good. They rated both motivating factors of their work and work welfare as excellent. The areas causing most dissatisfaction were work demands and participation in decision making. Physicians formed the most satisfied group, nurses and maintenance staff were the least satisfied, and office and administrative staff were fairly satisfied. Staff who rated the quality of work in their units as high usually also considered their job satisfaction to be excellent. Every staff member has an influence on job satisfaction in her/his unit. A culture of participation should be developed and maintained in the units and the whole hospital to ensure that all staff feel they play important roles in the hospital. A university hospital is a complex, continuously changing work

  10. Staff Distress Improves by Treating Pain in Nursing Home Patients With Dementia: Results From a Cluster-Randomized Controlled Trial.

    Science.gov (United States)

    Aasmul, Irene; Husebo, Bettina Sandgathe; Flo, Elisabeth

    2016-12-01

    Most people with dementia develop neuropsychiatric symptoms (NPSs), which are distressing for their carers. Untreated pain may increase the prevalence and severity of NPSs and thereby staff burden. We investigated the association between NPSs and the impact of individual pain treatment on distress in nursing home staff. Nursing home (NH) units were cluster-randomized to an intervention group (33 NH units; n = 175) or control group (27 NH units; n = 177). Patients in the intervention group received individual pain treatment for eight weeks, followed by a four-week washout period; control groups received care as usual. Staff informants (n = 138) used the Neuropsychiatric Inventory-NH version (including caregiver distress) as primary outcome to assess their own distress. Other outcomes were pain (Mobilization-Observation-Behavior-Intensity-Dementia-2 Pain Scale) and cognitive functioning (Mini-Mental State Examination). Using hierarchical regression analysis, all NPS items at baseline were associated with staff distress (P pain treatment reduced staff distress in the intervention group compared to control group especially in regard to agitation-related symptoms and apathy. Furthermore, our results indicated a multifactorial model of staff distress, in which enhanced knowledge and understanding of NPSs and pain in people with advanced dementia may play an important role. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  11. The nature, characteristics and associations of care home staff stress and wellbeing: a national survey.

    Science.gov (United States)

    Islam, Muhammad Saiful; Baker, Christine; Huxley, Peter; Russell, Ian T; Dennis, Michael S

    2017-01-01

    The majority of residents in care homes in the United Kingdom are living with dementia or significant memory problems. Caring in this setting can be difficult and stressful for care staff who work long hours, have little opportunity for training, are poorly paid and yet subject to high expectation. This may affect their mental and physical wellbeing, cause high rates of staff turnover and absenteeism, and affect the quality of care they provide. The main objective of this survey was to explore the nature, characteristics and associations of stress in care home staff. Staff working in a stratified random sample of care homes within Wales completed measures covering: general health and wellbeing (SF-12); stress (Work Stress Inventory); job content (Karasek Job Content); approach to, and experience of, working with people living with dementia (Approaches to Dementia Questionnaire; and Experience of Working with Dementia Patients); and Productivity and Health Status (SPS-6). Multiple linear regressions explored the effects of home and staff characteristics on carers. 212 staff from 72 care homes completed questionnaires. Staff from nursing homes experienced more work stress than those from residential homes (difference 0.30; 95% confidence interval (CI) from 0.10 to 0.51; P  work (difference -4.77; CI -7.80 to -1.73; P  working in local authority homes than in the private sector (difference 7.75; CI 2.56 to 12.94; P  < 0.01). Our study highlights the importance of dementia training in care homes, with a particular need in the private sector. An effective intervention to reduce stress in health and social care staff is required, especially in nursing and larger care homes, and for nursing staff. ISRCTN registry: ISRCTN80487202. Registered 24 July 2013.

  12. Influence of staff infection control training on infection-related quality measures in US nursing homes.

    Science.gov (United States)

    Kaur, Jasjit; Stone, Patricia W; Travers, Jasmine L; Cohen, Catherine C; Herzig, Carolyn T A

    2017-09-01

    Health care-associated infections are a leading cause of morbidity and mortality in US nursing home residents. Ongoing training of nursing home staff is vital to the implementation of infection prevention and control processes. Our aim was to describe associations between methods, frequency, and timing of staff infection prevention and control training and infection-related quality measures. In this national survey of nursing homes, timing of staff infection prevention and control training was associated with reduced indwelling urinary catheter use. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  13. Cancer Ward Staff Group: An Intervention Designed to Prevent Disaster.

    Science.gov (United States)

    Barber, William H.

    1985-01-01

    Describes a case study illustrating organizational and system contingencies for introducing and maintaining a support group for oncology nursing staff in a large general hospital culture. Criteria for long-run survivability of innovation in a work system are applied to a group structured like that described by Balint for training physicians in…

  14. Development and Psychometric Testing of a Novel Food Service Satisfaction Questionnaire for Food Service Staff of Aged Care Homes.

    Science.gov (United States)

    Miller, M; Hamilton, J; Scupham, R; Matwiejczyk, L; Prichard, I; Farrer, O; Yaxley, A

    2018-01-01

    Food service staff are integral to delivery of quality food in aged care homes yet measurement of their satisfaction is unable to be performed due to an absence of a valid and reliable questionnaire. The aim of this study was to develop and perform psychometric testing for a new Food Service Satisfaction Questionnaire developed in Australia specifically for use by food service staff working in residential aged care homes (Flinders FSSQFSAC). A mixed methods design utilizing both a qualitative (in-depth interviews, focus groups) and a quantitative approach (cross sectional survey) was used. Content validity was determined from focus groups and interviews with food service staff currently working in aged care homes, related questionnaires from the literature and consultation with an expert panel. The questionnaire was tested for construct validity and internal consistency using data from food service staff currently working in aged care homes that responded to an electronic invitation circulated to Australian aged care homes using a national database of email addresses. Construct validity was tested via principle components analysis and internal consistency through Cronbach's alpha. Temporal stability of the questionnaire was determined from food service staff undertaking the Flinders FSSQFSAC on two occasions, two weeks apart, and analysed using Pearson's correlations. Content validity for the Flinders FSSQFSAC was established from a panel of experts and stakeholders. Principle components analysis revealed food service staff satisfaction was represented by 61-items divided into eight domains: job satisfaction (α=0.832), food quality (α=0.871), staff training (α=0.922), consultation (α=0.840), eating environment (α=0.777), reliability (α=0.695), family expectations (α=0.781) and resident relationships (α=0.429), establishing construct validity in all domains, and internal consistency in all (α>0.5) except for "resident relationships" (α=0.429). Test

  15. Training Nonnursing Staff to Assist with Nutritional Care Delivery in Nursing Homes: A Cost-Effectiveness Analysis.

    Science.gov (United States)

    Simmons, Sandra F; Hollingsworth, Emily K; Long, Emily A; Liu, Xulei; Shotwell, Matthew S; Keeler, Emmett; An, Ruopeng; Silver, Heidi J

    2017-02-01

    To determine the effect and cost-effectiveness of training nonnursing staff to provide feeding assistance for nutritionally at-risk nursing home (NH) residents. Randomized, controlled trial. Five community NHs. Long-stay NH residents with an order for caloric supplementation (N = 122). Research staff provided an 8-hour training curriculum to nonnursing staff. Trained staff were assigned to between-meal supplement or snack delivery for the intervention group; the control group received usual care. Research staff used standardized observations and weighed-intake methods to measure frequency of between-meal delivery, staff assistance time, and resident caloric intake. Fifty staff (mean 10 per site) completed training. The intervention had a significant effect on between-meal caloric intake (F = 56.29, P staff time to provide assistance. It is cost effective to train nonnursing staff to provide caloric supplementation, and this practice has a positive effect on residents' between-meal intake. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  16. Does Finnish hospital staff job satisfaction vary across occupational groups?

    Science.gov (United States)

    2013-01-01

    Background Job satisfaction of staff is an essential outcome variable in research when describing the work environment of successful hospitals. Numerous studies have evaluated the topic, but few previous studies have assessed the job satisfaction of all staff in hospital settings. It is important to discover if there are any unsatisfied groups of people working in hospitals, the aspects they are unsatisfied with and why. The aim of this study was to evaluate job satisfaction of all staff working at a Finnish university hospital, identify differences in job satisfaction between staff groups, and explore the relationship between their self-evaluated quality of work and job satisfaction. Methods Data were collected from 1424 employees of the hospital using the web-based Kuopio University Job Satisfaction Scale survey instrument in autumn 2010. The research data were analysed by using SPSS 19.0 for Windows. Frequency and percentage distributions, as well as mean values, were used to describe the data. A non-parametric test (Kruskal–Wallis test) was used to determine the significance of differences in scores between different groups of staff members and between quality evaluations. Results The overall job satisfaction of the employees was good. They rated both motivating factors of their work and work welfare as excellent. The areas causing most dissatisfaction were work demands and participation in decision making. Physicians formed the most satisfied group, nurses and maintenance staff were the least satisfied, and office and administrative staff were fairly satisfied. Staff who rated the quality of work in their units as high usually also considered their job satisfaction to be excellent. Conclusions Every staff member has an influence on job satisfaction in her/his unit. A culture of participation should be developed and maintained in the units and the whole hospital to ensure that all staff feel they play important roles in the hospital. A university hospital is

  17. Autonomous home-care nursing staff are more engaged in their work and less likely to consider leaving the healthcare sector: a questionnaire survey.

    Science.gov (United States)

    Maurits, Erica E M; de Veer, Anke J E; van der Hoek, Lucas S; Francke, Anneke L

    2015-12-01

    The need for home care is rising in many Western European countries, due to the ageing population and governmental policies to substitute institutional care with home care. At the same time, a general shortage of qualified home-care staff exists or is expected in many countries. It is important to retain existing nursing staff in the healthcare sector to ensure a stable home-care workforce for the future. However, to date there has been little research about the job factors in home care that affect whether staff are considering leaving the healthcare sector. The main purpose of the study was to examine how home-care nursing staff's self-perceived autonomy relates to whether they have considered leaving the healthcare sector and to assess the possible mediating effect of work engagement. The questionnaire-based, cross-sectional study involved 262 registered nurses and certified nursing assistants employed in Dutch home-care organisations (mean age of 51; 97% female). The respondents were members of the Dutch Nursing Staff Panel, a nationwide group of nursing staff members in various healthcare settings (67% response rate). The questionnaire included validated scales concerning self-perceived autonomy and work engagement and a measure for considering pursuing an occupation outside the healthcare sector. Logistic regression and mediation analyses were conducted to test associations between self-perceived autonomy, work engagement and considering leaving the healthcare sector. Nursing staff members in home care who perceive more autonomy are more engaged in their work and less likely to have considered leaving the healthcare sector. The positive association between self-perceived autonomy and considering leaving, found among nursing staff members regardless of their level of education, is mediated by work engagement. In developing strategies for retaining nursing staff in home care, employers and policy makers should target their efforts at enhancing nursing staff

  18. The Impact of Organizational Innovations in Nursing Homes on Staff Perceptions: A Secondary Data Analysis.

    Science.gov (United States)

    Adams, Joost; Verbeek, Hilde; Zwakhalen, Sandra M G

    2017-01-01

    The shift in nursing home care for patients with dementia from traditional task-driven environments towards patient-centered small-scale environments has implications for nursing practice. Information about its implications for nursing staff is lacking, and only a few studies have addressed staff perceptions. We sought to explore staff perceptions of required skills and to determine differences in job satisfaction, motivation, and job characteristics of staff working in both care settings. A secondary data analysis was conducted. The data source used was drawn from a larger study testing the effects of small-scale living (Verbeek et al., 2009). Nursing staff working on a permanent basis and who were directly involved in care were eligible to participate in the study. Data on job satisfaction, motivation, and job characteristics of nursing staff working in typical small-scale and traditional care environments were derived using a questionnaire. Data were analyzed using descriptive statistics. Differences between nursing staff job satisfaction, motivation, and job characteristics were tested using multilinear regression analysis. In total, 138 staff members were included (81 staff members working in traditional nursing home wards and 57 staff members working in small-scale nursing home wards). The findings showed that in typical small-scale nursing homes, job satisfaction and job motivation were significantly higher compared to those in typical traditional nursing homes. Job autonomy and social support were also significantly higher, while job demands were significantly lower in these small-scale nursing homes. Social support was found to be the most significant predictor of job motivation and job satisfaction in both types of typical nursing homes. Nursing staff working in traditional care environments more often expressed the intention to switch to small-scale environments. Based on the findings of this study, it can be concluded that nursing homes environments

  19. Care staff training in detection of depression in residential homes for the elderly - Randomised trial

    NARCIS (Netherlands)

    Eisses, AMH; Kluiter, H; Jongenelis, K; Beekman, ATF; Ormel, J

    Background. Many people with depression in residential care homes for the elderly do not receive treatment because their depression remains undetected. Aims. To determine the effects of staff training on the detection, treatment and outcome of depression in residents often homes. Method. We

  20. Care staff training in detection of depression in residential homes for the elderly: randomised trial

    NARCIS (Netherlands)

    Eisses, A.M.H.; Kluiter, H.; Jongenelis, K.; Pot, A.M.; Beekman, A.T.F.; Ormel, J.

    2005-01-01

    Background: Many people with depression in residential care homes for the elderly do not receive treatment because their depression remains undetected. Aims: To determine the effects of staff training on the detection, treatment and outcome of depression in residents of ten homes. Method: We

  1. Barriers to nursing home staff accessing CPD must be broken down.

    Science.gov (United States)

    2016-09-29

    A study on priorities for the professional development of registered nurses (RNs) in nursing homes published in Age and Ageing ( page 6 ) has identified that staff shortages, lack of access to NHS courses and lack of paid study time are the main reasons why RNs do not access continuing professional development (CPD) activities. Specialist gerontological education for care home nurses was, however, seen as a means to ensure that care home nursing attracts the best people.

  2. How nursing staff spend their time on activities in a nursing home: an observational study.

    Science.gov (United States)

    Munyisia, Esther Naliaka; Yu, Ping; Hailey, David

    2011-09-01

    This article is a report of a study to examine how nursing staff spend their time on activities in a nursing home. Few studies have investigated how nursing staff spend their time on activities in a nursing home. Such information is important for nurse managers in deciding on staff deployment, and for evaluating the effects of changes in nursing practice. A work sampling study with an observational component was undertaken in 2009 with nursing staff at a nursing home. A total of 430 activities were recorded for Registered Nurses, 331 for Endorsed Enrolled Nurses, 5276 for Personal Carers, and 501 for Recreational Activity Officers. Registered Nurses spent 48·4% of their time on communication and 18·1% on medication management. Endorsed Enrolled Nurses spent 37·7% on communication and 29·0% on documentation tasks. Communication was the most time-consuming activity for Recreational Activity Officers and Personal Carers, except that Personal Carers in a high care house spent more time on direct care duties. Hygiene duties and resident interaction were more frequently multitasked by the nursing staff in high care than in low care house. Nursing staff value their face-to-face interaction for successful care delivery. There is need, however, to investigate the effects of this form of communication on quality of care given to residents. Differences in multi-tasked activities between high care and low care houses should be considered when deploying staff in a nursing home. © 2011 Blackwell Publishing Ltd.

  3. Staff-family relationships in nursing home care: a typology of challenging behaviours.

    Science.gov (United States)

    Bauer, Michael

    2007-09-01

    Aim.  This paper draws on data from a study which investigated how Australian nursing home staff constructed staff-family relationships. Background.  Working with the family in aged care to provide the best care possible is consistent with modern nursing philosophy which espouses holistic care. The quality and enjoyment of the experience however, is frequently fraught with problems and challenges for both the staff and the family involved. Design.  A qualitative constructivist design as described by Guba and Lincoln [Fourth Generation Evaluation. Sage Publications, London.] was used. Method.  Thirty paid caregivers drawn from eight nursing homes were interviewed about their experiences of working with residents' families. A constant comparative method of data analysis was used to arrive at the findings. Results.  This paper reports on seven themes under the category of 'unacceptable behaviours'. These themes describe a range of attitudes and behaviours exhibited by families which staff members found undesirable. Conclusions.  Staff members found a number of family behaviours challenging. Nursing home staff perceives the family as subordinate to their needs and want to retain control of the work environment. Relevance to clinical practice.  Nursing home staff need to move away from custodial models of care focused on 'getting the work done' and develop more family friendly work practices that are inclusive of the needs of the family and view them as equal partners in care.

  4. Impact of Intervention to Improve Nursing Home Resident-Staff Interactions and Engagement.

    Science.gov (United States)

    Hartmann, Christine W; Mills, Whitney L; Pimentel, Camilla B; Palmer, Jennifer A; Allen, Rebecca S; Zhao, Shibei; Wewiorski, Nancy J; Sullivan, Jennifer L; Dillon, Kristen; Clark, Valerie; Berlowitz, Dan R; Snow, Andrea Lynn

    2018-04-30

    For nursing home residents, positive interactions with staff and engagement in daily life contribute meaningfully to quality of life. We sought to improve these aspects of person-centered care in an opportunistic snowball sample of six Veterans Health Administration nursing homes (e.g., Community Living Centers-CLCs) using an intervention that targeted staff behavior change, focusing on improving interactions between residents and staff and thereby ultimately aiming to improve resident engagement. We grounded this mixed-methods study in the Capability, Opportunity, Motivation, Behavior (COM-B) model of behavior change. We implemented the intervention by (a) using a set of evidence-based practices for implementing quality improvement and (b) combining primarily CLC-based staff facilitation with some researcher-led facilitation. Validated resident and staff surveys and structured observations collected pre and post intervention, as well as semi-structured staff interviews conducted post intervention, helped assess intervention success. Sixty-two CLC residents and 308 staff members responded to the surveys. Researchers conducted 1,490 discrete observations. Intervention implementation was associated with increased staff communication with residents during the provision of direct care and decreased negative staff interactions with residents. In the 66 interviews, staff consistently credited the intervention with helping them (a) develop awareness of the importance of identifying opportunities for engagement and (b) act to improve the quality of interactions between residents and staff. The intervention proved feasible and influenced staff to make simple enhancements to their behaviors that improved resident-staff interactions and staff-assessed resident engagement.

  5. Education and training to enhance end-of-life care for nursing home staff: a systematic literature review.

    Science.gov (United States)

    Anstey, Sally; Powell, Tom; Coles, Bernadette; Hale, Rachel; Gould, Dinah

    2016-09-01

    The delivery of end-of-life care in nursing homes is challenging. This situation is of concern as 20% of the population die in this setting. Commonly reported reasons include limited access to medical care, inadequate clinical leadership and poor communication between nursing home and medical staff. Education for nursing home staff is suggested as the most important way of overcoming these obstacles. To identify educational interventions to enhance end-of-life care for nursing home staff and to identify types of study designs and outcomes to indicate success and benchmark interventions against recent international guidelines for education for palliative and end-of-life care. Thirteen databases and reference lists of key journals were searched from the inception of each up to September 2014. Included studies were appraised for quality and data were synthesised thematically. Twenty-one studies were reviewed. Methodological quality was poor. Education was not of a standard that could be expected to alter clinical behaviour and was evaluated mainly from the perspectives of staff: self-reported increase in knowledge, skills and confidence delivering care rather than direct evidence of impact on clinical practice and patient outcomes. Follow-up was often short term, and despite sound economic arguments for delivering effective end-of-life care to reduce burden on the health service, no economic analyses were reported. There is a clear and urgent need to design educational interventions that have the potential to improve end-of-life care in nursing homes. Robust evaluation of these interventions should include impact on residents, families and staff and include economic analysis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  6. The BDA Dental Academic Staff Group Student Elective Workshop.

    Science.gov (United States)

    Walmsley, A D; White, D A; Hobson, R; Ensor, S

    2007-08-25

    In the current climate in dental education, many schools are re-evaluating the role of the student elective in the curriculum, with two schools no longer running elective programmes. In order to discuss the future of student electives in the dental curriculum, the Dental Academic Staff Group (DASG) of the British Dental Association organised a Student Elective Workshop, which attracted 42 delegates including nine student representatives. The following article is an account of the Workshop and its conclusions.

  7. Adaptation of a nursing home culture change research instrument for frontline staff quality improvement use.

    Science.gov (United States)

    Hartmann, Christine W; Palmer, Jennifer A; Mills, Whitney L; Pimentel, Camilla B; Allen, Rebecca S; Wewiorski, Nancy J; Dillon, Kristen R; Snow, A Lynn

    2017-08-01

    Enhanced interpersonal relationships and meaningful resident engagement in daily life are central to nursing home cultural transformation, yet these critical components of person-centered care may be difficult for frontline staff to measure using traditional research instruments. To address the need for easy-to-use instruments to help nursing home staff members evaluate and improve person-centered care, the psychometric method of cognitive-based interviewing was used to adapt a structured observation instrument originally developed for researchers and nursing home surveyors. Twenty-eight staff members from 2 Veterans Health Administration (VHA) nursing homes participated in 1 of 3 rounds of cognitive-based interviews, using the instrument in real-life situations. Modifications to the original instrument were guided by a cognitive processing model of instrument refinement. Following 2 rounds of cognitive interviews, pretesting of the revised instrument, and another round of cognitive interviews, the resulting set of 3 short instruments mirrored the concepts of the original longer instrument but were significantly easier for frontline staff to understand and use. Final results indicated frontline staff found the revised instruments feasible to use and clinically relevant in measuring and improving the lived experience of a changing culture. This article provides a framework for developing or adapting other measurement tools for frontline culture change efforts in nursing homes, in addition to reporting on a practical set of instruments to measure aspects of person-centered care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. A Systematic Review of Interventions to Change Staff Care Practices in Order to Improve Resident Outcomes in Nursing Homes.

    Directory of Open Access Journals (Sweden)

    Lee-Fay Low

    Full Text Available We systematically reviewed interventions that attempted to change staff practice to improve long-term care resident outcomes.Studies met criteria if they used a control group, included 6 or more nursing home units and quantitatively assessed staff behavior or resident outcomes. Intervention components were coded as including education material, training, audit and feedback, monitoring, champions, team meetings, policy or procedures and organizational restructure.Sixty-three unique studies were broadly grouped according to clinical domain-oral health (3 studies, hygiene and infection control (3 studies, nutrition (2 studies, nursing home acquired pneumonia (2 studies, depression (2 studies appropriate prescribing (7 studies, reduction of physical restraints (3 studies, management of behavioral and psychological symptoms of dementia (6 studies, falls reduction and prevention (11 studies, quality improvement (9 studies, philosophy of care (10 studies and other (5 studies. No single intervention component, combination of, or increased number of components was associated with greater likelihood of positive outcomes. Studies with positive outcomes for residents also tended to change staff behavior, however changing staff behavior did not necessarily improve resident outcomes. Studies targeting specific care tasks (e.g. oral care, physical restraints were more likely to produce positive outcomes than those requiring global practice changes (e.g. care philosophy. Studies using intervention theories were more likely to be successful. Program logic was rarely articulated, so it was often unclear whether there was a coherent connection between the intervention components and measured outcomes. Many studies reported barriers relating to staff (e.g. turnover, high workload, attitudes or organizational factors (e.g. funding, resources, logistics.Changing staff practice in nursing homes is possible but complex. Interventionists should consider barriers and

  9. Knowledge, perceived skills and activities of nursing staff to support oral home care among older domiciliary care clients.

    Science.gov (United States)

    Salmi, Riikka; Tolvanen, Mimmi; Suhonen, Riitta; Lahti, Satu; Närhi, Timo

    2018-04-25

    Increasing number of older adults lives in their own homes, but needs help in many daily routines. Domiciliary care nursing staff (DCNS) is often needed to support oral home care. However, information of nursing staff's knowledge, skills and activity in this task is sparse. The study aimed to assess DCNS knowledge, perceived skills and activities to support oral home care of older domiciliary care clients. The study was conducted among DCNS in one of the largest cities in Finland. All DCNS members (n = 465) received a questionnaire with 14 multiple choice and open questions regarding the perceived skills, knowledge and activities of oral health guidance of older domiciliary care clients. In total, 115 (25%) DCNS members returned the questionnaires. Frequencies, percentages, means and standard deviations were used to describe the samples and study variables. DCNS was categorised according to age and working years for group comparisons, which were assessed with chi-squared test. Knowledge concerning oral health was mostly on a high level. Around 50% of DCNS considered their knowledge regarding dental prosthesis hygiene as sufficient. Of the DCNS, 67% informed that they had received education on oral health care. However, over 50% of the DCNS had a need for further education in issues related to oral home care. DCNS were active in supporting most oral and prosthesis hygiene means, yet less in guidance concerning toothbrushing. Activity to support cleaning the interdental spaces was the weakest, in which only 12% of the respondents considered having average or excellent skills. Younger DCNS had better knowledge on oral home care due to recent education, but older staff members were more skilful in performing oral hygiene measures. There is a need for structured instructions and training on oral home care for DCNS. Oral home care should be taken into account more often and regularly. © 2018 Nordic College of Caring Science.

  10. Nursing home staffing requirements and input substitution: effects on housekeeping, food service, and activities staff.

    Science.gov (United States)

    Bowblis, John R; Hyer, Kathryn

    2013-08-01

    To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff. Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements. Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression. OSCAR surveys from 1999 to 2004. Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff. Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels. © Health Research and Educational Trust.

  11. Care staff perspective on use of texture modified food in care home residents with dysphagia and dementia.

    Science.gov (United States)

    Austbø Holteng, Lise Birgitte; Frøiland, Christina Tølbøl; Corbett, Anne; Testad, Ingelin

    2017-10-01

    Dysphagia and dementia are conditions, which combined, can lead to complications for the person and require good nutritional care. There is very little evidence-based literature regarding nutritional care for people with dysphagia and dementia. It is clear that care staff plays a vital role, and that communication and informed decision-making are critical to the process, yet little is known regarding the use of available interventions such as texture modified food (TMF), and their acceptability and feasibility for care staff and residents. Therefore the aim of this study was to investigate the experiences of care staff when providing nutritional care for people with dysphagia and dementia, and their impressions and experience of using TMF as a new intervention for nutrition. This was a qualitative study with an inductive approach, which aimed to explore the experience of care staff using TMF in a care home setting. Data were collected using focus group interviews, an approach which is validated as a means of supporting and developing the understanding of a phenomenon, through interactions and discussions in the group. Participants were care staff working in a care home setting in Norway. Twelve participants were recruited to this study across two focus groups. The cohort included four nurses, six practical nurses, one nurse assistants and one student nurse. Four main categories emerged from the focus group discussions regarding the use of TMF. These were: (I) emotional strain; (II) deficient nutritional care; (III) increased self-efficacy with use of TMF; (IV) better nutritional care with TMF. Use of TMF to improve nutritional care for people with dysphagia appears to have merit for both residents and care staff, and should be considered as a means of improving nutritional care for people with dementia in care homes. Minimizing feeding difficulties and increasing nutritional intake is an important goal when caring for this vulnerable group of people, and there is a

  12. How nursing home residents develop relationships with peers and staff: a grounded theory study.

    Science.gov (United States)

    Roberts, Tonya; Bowers, Barbara

    2015-01-01

    Social support and social relationships have been repeatedly identified as essential to nursing home resident quality of life. However, little is known about ways residents develop relationships with peers or staff. This study was conducted to explore the ways resident develop relationships with peers and staff in nursing homes. Fifteen cognitively intact nursing home residents from two facilities were interviewed for this grounded theory study. Sampling, interviewing, and analysis occurred in a cyclical process with results at each stage of the study informing decisions about data collection and analysis in the next. Unstructured interviews and field observations were conducted. Data were analyzed with open, axial, and selective coding. Residents developed relationships with peers and staff largely as an unintended consequence of trying to have a life in the nursing home. Having a life was a two-step process. First, life motivations (Being Self and Creating a Positive Atmosphere) influenced resident preferences for daily activities and interaction goals and subsequently their strategies for achieving and establishing both. Second, the strategies residents used for achieving their required daily activities (Passing Time and Getting Needs Met) and interaction goals then influenced the nature of interaction and the subsequent peer or staff response to these interactions. Residents defined relationships as friendly or unfriendly depending on whether peers or staff responded positively or negatively. There was considerable overlap in the ways peer and staff relationships developed and the results highlight the role of peer and staff responsiveness in relationship development. The results provide possible explanations for the success of interventions in the literature designed to improve staff responsiveness to residents. The results suggest that adapting these kinds of interventions for use with peers may also be successful. The conceptual model also presents a number

  13. 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

  14. 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

  15. Resilience and challenges among staff of gulf coast nursing homes sheltering frail evacuees following Hurricane Katrina, 2005: implications for planning and training.

    Science.gov (United States)

    Laditka, Sarah B; Laditka, James N; Cornman, Carol B; Davis, Courtney B; Richter, Jane V E

    2009-01-01

    The purpose of this study was to: (1) explore experiences and responses of staff in caring for sheltered, frail, Hurricane Katrina evacuees; and (2) identify how planning and training can be enhanced for staff who may care for frail older populations during and after disasters. Individual, in-person, semi-structured interviews were conducted with 38 staff members in four nursing homes in Mississippi, sheltering 109 evacuees in November 2005, nine weeks after Hurricane Katrina. Twenty-four were direct care staff, including certified nursing assistants, licensed nurses, dietary aides, and social workers; 14 were support staff, including maintenance and business managers. The number interviewed in each nursing home averaged 9.5 (range 6-15). Using a discussion guide and focusing on their experiences caring for nursing home evacuees, staff were asked to describe: (1) experiences; (2) problems; (3) what helped; and (4) what was learned. Data were processed using grounded theory and thematic analysis. Responses of direct care staff differed in emphasis from those of support staff in several areas; responses from these groups were analyzed separately and together. Three of the researchers identified recurring themes; two organized themes conceptually. Staff emphasized providing emotional reassurance to evacuees as well as physical care. Many described caring for evacuees as "a blessing," saying the experience helped them bond with residents, evacuees, and other staff. However, caring for evacuees was difficult because staff members were extremely anxious and in poor physical condition after an arduous evacuation. Challenges included communicating with evacuees' families, preventing dehydration, lack of personal hygiene supplies, staff exhaustion, and emotional needs of residents, evacuees, and staff. Teamwork, community help, and having a well-organized disaster plan, extra supplies, and dependable staff helped personnel cope with the situation. Staff of nursing homes

  16. Medical staff involvement in nursing homes: development of a conceptual model and research agenda.

    Science.gov (United States)

    Shield, Renée; Rosenthal, Marsha; Wetle, Terrie; Tyler, Denise; Clark, Melissa; Intrator, Orna

    2014-02-01

    Medical staff (physicians, nurse practitioners, physicians' assistants) involvement in nursing homes (NH) is limited by professional guidelines, government policies, regulations, and reimbursements, creating bureaucratic burden. The conceptual NH Medical Staff Involvement Model, based on our mixed-methods research, applies the Donabedian "structure-process-outcomes" framework to the NH, identifying measures for a coordinated research agenda. Quantitative surveys and qualitative interviews conducted with medical directors, administrators and directors of nursing, other experts, residents and family members and Minimum Data Set, the Online Certification and Reporting System and Medicare Part B claims data related to NH structure, process, and outcomes were analyzed. NH control of medical staff, or structure, affects medical staff involvement in care processes and is associated with better outcomes (e.g., symptom management, appropriate transitions, satisfaction). The model identifies measures clarifying the impact of NH medical staff involvement on care processes and resident outcomes and has strong potential to inform regulatory policies.

  17. The behaviours that dementia care home staff in South Africa find challenging: An exploratory study.

    Science.gov (United States)

    van Wyk, Adele; Manthorpe, Jill; Clark, Charlotte

    2017-10-01

    Background Behavioural and psychological symptoms of dementia are often the reasons for moving to a care home. Care staff, often with limited dementia training, may have to support residents with distressed behaviour on a daily basis. Evidence about the support of residents with distressed or challenging behaviour in the South African context is lacking. This exploratory study aimed to gain an understanding of what care home staff perceived to be distressed behaviour, their coping strategies and how they learned to work with residents with behavioural symptoms of dementia. Methods An exploratory study was conducted among 17 participants working in four care homes in the Western Cape province of South Africa in 2014. Semi-structured interviews were audio-recorded. Data were analysed thematically. Findings Findings reflected the literature with regard to examples of behavioural symptoms of people with dementia that staff find challenging to manage. Overall, the majority of staff reported holding positive feelings about working with people with dementia. All preferred interpersonal approaches to manage distressed behaviour above medication although a small minority noted the use of medication in some cases. Dementia training was considered by most participants as an unmet need. Conclusion This exploratory study identified care home workers' desires for training about dementia and their preferences for interpersonal as opposed to pharmacological approaches to managing residents' distressed behaviour. The legacy of race and cultural perspectives in South Africa appears to still influence care practice and provision. Staff commitment, their interest in advancing their practice and their aspirations to offer more person-centred care were evident. Dementia training was identified as potentially helpful to care home staff who manage residents' distressed behaviour. Training should be developed in South Africa to promote good practice.

  18. Qualitative Evaluation of a Physical Activity Health Promotion Programme for People with Intellectual Disabilities in a Group Home Setting

    Science.gov (United States)

    Dixon-Ibarra, A.; Driver, S.; Nery-Hurwit, M.; VanVolkenburg, H.

    2018-01-01

    Background: There is a lack of health promotion programming designed to change the physical activity environment of the group home setting. The Menu-Choice programme assists staff in creating physical activity goals alongside residents with intellectual disabilities and provides strategies to incorporate activity into the group home schedule. The…

  19. Staff Group Trainer: Development of a Computer-Driven, Structured, Staff Training Environment

    National Research Council Canada - National Science Library

    Koger, Milton

    1998-01-01

    .... The project produced two training support packages (TSP)--battalion and brigade--designed to train these staffs to more effectively and efficiently communicate within and between staff sections, command post, and the unit commander...

  20. Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

    Science.gov (United States)

    Colón-Emeric, Cathleen S; Corazzini, Kirsten; McConnell, Eleanor S; Pan, Wei; Toles, Mark; Hall, Rasheeda; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Anderson, Amber L; Burd, Andrew; Amarasekara, Sathya; Anderson, Ruth A

    2017-11-01

    New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control). Nursing home staff in all positions were asked to complete surveys at baseline, 3, 6, and 9 months. Medical records of residents with at least 1 fall in the 6-month pre- and postintervention windows (n = 1794) were abstracted for fall risk reduction measures, falls, and injurious falls. CONNECT taught staff to improve their connections with coworkers, increase information flow, and use cognitive diversity in problem solving. Intervention components included 2 classroom sessions, relationship mapping, and self-monitoring. FALLS provided instruction in the Agency for Healthcare Research and Quality's Falls Management Program. Primary outcomes were (1) mean number of fall risk reduction activities documented within 30 days of falls and (2) median fall rates among residents with at least 1 fall during the study period. In addition, validated scales measured staff communication quality, frequency, timeliness, and safety climate. Surveys were completed by 1545 staff members, representing 734 (37%) and 811 (44%) of eligible staff in intervention and control facilities, respectively; 511 (33%) respondents were hands-on care workers. Neither the CONNECT nor the FALLS-only facilities improved the mean count of fall risk reduction activities following FALLS (3.3 [1.6] vs 3.2 [1.5] of 10); furthermore, adjusted median recurrent fall rates did not differ between the groups (4.06 [interquartile range {IQR}, 2.03-8.11] vs 4.06 [IQR, 2.04-8.11] falls/resident/y). A modest improvement in staff communication measures was observed

  1. Staff Assist: A Resource to Improve Nursing Home Quality and Staffing

    Science.gov (United States)

    Castle, Nicholas G.

    2011-01-01

    Purpose: This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics. Design and Methods: Information on staffing characteristics (i.e., staffing levels, turnover, stability, and use of agency staff), facility characteristics (e.g.,…

  2. Violence exposure and burn-out among Turkish nursing home staff.

    Science.gov (United States)

    Mandiracioglu, Aliye; Cam, Olcay

    2006-10-01

    The aim of this study was to describe the frequency of violence against personnel from residents and to identify the prevalence of burn-out among staff working in nursing homes. The study was performed in two cities in the west of Turkey. A semi-structured questionnaire on violence and Pines' Burnout scale were distributed among all the staff working in six nursing homes, and 214 of them responded. Of the total number of respondents, 56% stated that they had been exposed to violence during the preceding year. More than 20% stated that they had reported violence to their supervisor. Less than 10% had received medical or psychological support following the event. Violent incidents were reported significantly more frequently among staff who reported problems working with elderly residents. There was no relationship between violence towards staff and burn-out. Violence is commonly experienced by care workers in nursing homes for the elderly. Strategies to improve occupational conditions in nursing homes are required.

  3. Determinants of staff job satisfaction of caregivers in two nursing homes in Pennsylvania

    Directory of Open Access Journals (Sweden)

    Degenholtz Howard

    2006-05-01

    Full Text Available Abstract Background Job satisfaction is important for nursing home staff and nursing home management, as it is associated with absenteeism, turnover, and quality of care. However, we know little about factors associated with job satisfaction and dissatisfaction for nursing home workers. Methods In this investigation, we use data from 251 caregivers (i.e., Registered Nurses, Licensed Practical Nurses, and Nurse Aides to examine: job satisfaction scores of these caregivers and what characteristics of these caregivers are associated with job satisfaction. The data were collected from two nursing homes over a two and a half year period with five waves of data collection at six-month intervals. The Job Description Index was used to collect job satisfaction data. Results We find that, overall nursing home caregivers are satisfied with the work and coworkers, but are less satisfied with promotional opportunities, superiors, and compensation. From exploratory factor analysis three domains represented the data, pay, management, and work. Nurse aides appear particularly sensitive to the work domain. Of significance, we also find that caregivers who perceived the quality of care to be high have higher job satisfaction on all three domains than those who do not. Conclusion These results may be important in guiding caregiver retention initiatives in nursing homes. The finding for quality may be especially important, and indicates that nursing homes that improve their quality may have a positive impact on job satisfaction of staff, and thereby reduce their turnover rates.

  4. Leadership styles of nursing home administrators and their association with staff turnover.

    Science.gov (United States)

    Donoghue, Christopher; Castle, Nicholas G

    2009-04-01

    The purpose of this study was to examine the associations between nursing home administrator (NHA) leadership style and staff turnover. We analyzed primary data from a survey of 2,900 NHAs conducted in 2005. The Online Survey Certification and Reporting database and the Area Resource File were utilized to extract organizational and local economic characteristics of the facilities. A general linear model (GLM) was used to estimate the effects of NHA leadership style, organizational characteristics, and local economic characteristics on nursing home staff turnover for registered nurses (RNs), licensed practical nurses (LPNs), and nurse's aides (NAs). The complete model estimates indicate that NHAs who are consensus managers (leaders who solicit, and act upon, the most input from their staff) are associated with the lowest turnover levels, 7% for RNs, 3% for LPNs, and 44% for NAs. Shareholder managers (leaders who neither solicit input when making a decision nor provide their staffs with relevant information for making decisions on their own) are associated with the highest turnover levels, 32% for RNs, 56% for LPNs, and 168% for NAs. The findings indicate that NHA leadership style is associated with staff turnover, even when the effects of organizational and local economic conditions are held constant. Because leadership strategies are amenable to change, the findings of this study may be used to develop policies for lowering staff turnover.

  5. The emergent relevance of care staff decision-making and situation awareness to mobility care in nursing homes: an ethnographic study.

    Science.gov (United States)

    Taylor, Janice; Sims, Jane; Haines, Terry P

    2014-12-01

    To explore mobility care as provided by care staff in nursing homes. Care staff regularly assist residents with their mobility. Nurses are increasingly reliant on such staff to provide safe and quality mobility care. However, the nature of care staff decision-making when providing assistance has not been fully addressed in the literature. A focused ethnography. The study was conducted in four nursing homes in Melbourne, Australia. Non-participant observations of residents and staff in 2011. Focus groups with 18 nurses, care and lifestyle staff were conducted at three facilities in 2012. Thematic analysis was employed for focus groups and content analysis for observation data. Cognitive Continuum Theory and the notion of 'situation awareness' assisted data interpretation. Decision-making during mobility care emerged as a major theme. Using Cognitive Continuum Theory as a guide, nursing home staff's decision-making was described as ranging from system-aided, through resident- and peer-aided, to reflective and intuitive. Staff seemed aware of the need for resident-aided decision-making consistent with person-centred care. Habitual mobility care based on shared mental models occurred. It was noted that levels of situation awareness may vary among staff. Care staff may benefit from support via collaborative and reflective practice to develop decision-making skills, situation awareness and person-centred mobility care. Further research is required to explore the connection between staff's skills in mobility care and their decision-making competence as well as how these factors link to quality mobility care. © 2014 John Wiley & Sons Ltd.

  6. Workforce Characteristics, Perceptions, Stress, and Satisfaction among Staff in Green House and Other Nursing Homes.

    Science.gov (United States)

    Brown, Patrick B; Hudak, Sandra L; Horn, Susan D; Cohen, Lauren W; Reed, David Allen; Zimmerman, Sheryl

    2016-02-01

    To compare workforce characteristics and staff perceptions of safety, satisfaction, and stress between Green House (GH) and comparison nursing homes (CNHs). Primary data on staff perceptions of safety, stress, and satisfaction from 13 GHs and 8 comparison NHs in 11 states; secondary data from human resources records on workforce characteristics, turnover, and staffing from 01/01/2011-06/30/2012. Observational study. Workforce data were from human resources offices; staff perceptions were from surveys. Few significant differences were found between GH and CNHs. Exceptions were GH direct caregivers were older, provided twice the normalized hours per week budgeted per resident than CNAs in CNHs or Legacy NHs, and trended toward lower turnover. GH environment may promote staff longevity and does not negatively affect worker's stress, safety perceptions, or satisfaction. Larger studies are needed to confirm findings. © Health Research and Educational Trust.

  7. "Dignity": A central construct in nursing home staff understandings of quality continence care.

    Science.gov (United States)

    Ostaszkiewicz, Joan; Tomlinson, Emily; Hutchinson, Alison M

    2018-02-03

    To explore nursing home staff members' beliefs and expectations about what constitutes "quality continence care" for people living in nursing homes. Most nursing home residents require assistance to maintain continence or manage incontinence. Best practice guidelines promote active investigation of incontinence, treatment of underlying potentially reversible causes, and initial conservative interventions to prevent, minimise and/or treat incontinence. Despite research showing the positive benefits of implementing active interventions, translating the findings of research into practice in nursing homes has been modest. Understanding the perspectives of individuals who provide continence care may help bridge the gap between evidence and practice. A qualitative exploratory descriptive design. Qualitative interviews were conducted with 19 nursing home staff: eight registered nurses, four enrolled nurses and seven personal care workers working in a nursing home in Australia between 2014-2015. Data were analysed inductively to identify themes and subthemes that described and explained staff beliefs about quality continence care in nursing homes. Participants' understanding and expectations about quality continence care were linked to beliefs about incontinence being an intractable and undignified condition in nursing homes. The key theme to emerge was "protecting residents' dignity" which was supported by the following six subthemes: (i) using pads, ii) providing privacy, (iii) knowing how to "manage" incontinence, (iv) providing timely continence care, (v) considering residents' continence care preferences and (vi) communicating sensitively. The findings provide new insight into the basis for continence care practices in nursing homes. Education about continence care should challenge beliefs that limit continence care practice to cleaning, containing and concealing incontinence. There is a need for a multidimensional framework that is informed by social, psychological

  8. Working in group living homes for older people with dementia: the effects on job satisfaction and burnout and the role of job characteristics

    NARCIS (Netherlands)

    te Boekhorst, S.; Willemse, B.; Depla, M.F.I.A.; Eefsting, J.A.; Pot, A.M.

    2008-01-01

    Background: Group living homes are a fast-growing form of nursing home care for older people with dementia. This study seeks to determine the differences in job characteristics of nursing staff in group living homes and their influence on well-being. Methods: We examined the Job Demand Control

  9. Working in group living homes for older people with dementia: the effects on job satisfaction and burnout and the role of job characteristics

    NARCIS (Netherlands)

    Boekhorst, S. te; Willemse, B.; Depla, M.F.I.A.; Eefsting, J.A.; Pot, A.M.

    2008-01-01

    ABSTRACT Background: Group living homes are a fast-growing form of nursing home care for older people with dementia. This study seeks to determine the differences in job characteristics of nursing staff in group living homes and their influence on well-being. Methods: We examined the Job Demand

  10. Attractiveness of working in home care: An online focus group study among nurses.

    Science.gov (United States)

    De Groot, Kim; Maurits, Erica E M; Francke, Anneke L

    2018-01-01

    Many western countries are experiencing a substantial shortage of home-care nurses due to the increasing numbers of care-dependent people living at home. In-depth knowledge is needed about what home-care nurses find attractive about their work in order to make recommendations for the recruitment and retention of home-care nursing staff. The aims of this explorative, qualitative study were to gain in-depth knowledge about which aspects home-care nurses find attractive about their work and to explore whether these aspects vary for home-care nurses with different levels of education. Discussions were conducted with six online focus groups in 2016 with a total of 38 Dutch home-care nurses. The transcripts were analysed using the principles of thematic analysis. The findings showed that home-care nurses find it attractive that they are a "linchpin", in the sense of being the leading professional and with the patient as the centre of care. Home-care nurses also find having autonomy attractive: autonomy over decision-making about care, freedom in work scheduling and working in a self-directed team. Variety in patient situations and activities also makes their work attractive. Home-care nurses with a bachelor's degree did not differ much in what they found attractive aspects from those with an associate degree (a nursing qualification after completing senior secondary vocational education). It is concluded that autonomy, variety and being a "linchpin" are the attractive aspects of working in home care. To help recruit and retain home-care nursing staff, these attractive aspects should be emphasised in nursing education and practice, in recruitment programmes and in publicity material. © 2017 John Wiley & Sons Ltd.

  11. Social and occupational engagement of staff in two Irish nursing homes for people with dementia

    LENUS (Irish Health Repository)

    Morgan-Brown, M

    2011-01-01

    This observational study evaluated the amounts of social and occupational engagement of staff (nurses, care workers, activity coordinators) in two traditional style Irish residential nursing homes for people with dementia. A snapshot observational technique was used to obtain daily quantitative data. Approximately 65% of the time that staff were in communal sitting rooms during the observational periods was spent in work and care tasks, with approximately 25% of the time spent in social engagement and 10% spent in interactive occupational activities with the residents. Staff were absent from the room for over one-third of the observed time. Environmental and operational observations are discussed using narrative descriptions to give a context to the quantitative outcome measures.

  12. Gatekeepers as Care Providers: The Care Work of Patient-centered Medical Home Clerical Staff.

    Science.gov (United States)

    Solimeo, Samantha L; Ono, Sarah S; Stewart, Kenda R; Lampman, Michelle A; Rosenthal, Gary E; Stewart, Greg L

    2017-03-01

    International implementation of the patient-centered medical home (PCMH) model for delivering primary care has dramatically increased in the last decade. A majority of research on PCMH's impact has emphasized the care provided by clinically trained staff. In this article, we report our ethnographic analysis of data collected from Department of Veterans Affairs staff implementing PACT, the VA version of PCMH. Teams were trained to use within-team delegation, largely accomplished through attention to clinical licensure, to differentiate staff in providing efficient, patient-centered care. In doing so, PACT may reinforce a clinically defined culture of care that countermands PCMH ideals. Such competing rubrics for care are brought into relief through a focus on the care work performed by clerks. Ethnographic analysis identifies clerks' care as a kind of emotional dirty work, signaling important areas for future anthropological study of the relationships among patient-centered care, stigma, and clinical authority. © 2016 by the American Anthropological Association.

  13. Nursing staff-led behavioural group intervention in psychiatric in-patient care: Patient and staff experiences.

    Science.gov (United States)

    Salberg, Johanna; Folke, Fredrik; Ekselius, Lisa; Öster, Caisa

    2018-02-15

    A promising intervention in mental health in-patient care is behavioural activation (BA). Interventions based on BA can be used by mental health nurses and other staff members. The aim of this study was to evaluate patients' and staff members' experiences of a nursing staff-led behavioural group intervention in mental health in-patient care. The intervention was implemented at three adult acute general mental health in-patient wards in a public hospital setting in Sweden. A self-administrated questionnaire, completed by 84 patients and 34 nurses and nurse assistants, was administered, and nonparametric data analysed using descriptive statistics. Our findings revealed that both patients and nursing staff ranked nursing care and care environment as important aspects in the recovery process. Patients and staff members reported overall positive experiences of the group sessions. Patients with higher frequencies of attendance and patients satisfied with overall care had a more positive attitude towards the intervention. A more positive experience of being a group leader was reported by staff members who had been leading groups more than ten times. The most common impeding factor during implementation, reported by staff members, was a negative attitude to change. Conducive factors were having support from a psychologist and the perception that patients were showing interest. These positive experiences reported by patients and nursing staff, combined with previous research in this field, are taking us one step further in evaluating group sessions based on BA as a meaningful nursing intervention in mental health in-patient care. © 2018 Australian College of Mental Health Nurses Inc.

  14. Nursing staff intentions towards managing deteriorating health in nursing homes: A convergent parallel mixed-methods study using the theory of planned behaviour.

    Science.gov (United States)

    O'Neill, Barbara J; Dwyer, Trudy; Reid-Searl, Kerry; Parkinson, Lynne

    2018-03-01

    To predict the factors that are most important in explaining nursing staff intentions towards early detection of the deteriorating health of a resident and providing subacute care in the nursing home setting. Nursing staff play a pivotal role in managing the deteriorating resident and determining whether the resident needs to be transferred to hospital or remain in the nursing home; however, there is a dearth of literature that explains the factors that influence their intentions. This information is needed to underpin hospital avoidance programs that aim to enhance nursing confidence and skills in this area. A convergent parallel mixed-methods study, using the theory of planned behaviour as a framework. Surveys and focus groups were conducted with nursing staff (n = 75) at a 94-bed nursing home at two points in time, prior to and following the implementation of a hospital avoidance program. The quantitative and qualitative data were analysed separately and merged during final analysis. Nursing staff had strong intentions, a positive attitude that became significantly more positive with the hospital avoidance program in place, and a reasonable sense of control; however, the influence of important referents was the strongest predictor of intention towards managing residents with deteriorating health. Support from a hospital avoidance program empowered staff and increased confidence to intervene. The theory of planned behaviour served as an effective framework for identifying the strong influence referents had on nursing staff intentions around managing residents with deteriorating health. Although nursing staff had a reasonable sense of control over this area of their work, they believed they benefitted from a hospital avoidance program initiated by the nursing home. Managers implementing hospital avoidance programs should consider the role of referents, appraise the known barriers and facilitators and take steps to identify those unique to their local situation

  15. Pain management intervention targeting nursing staff and general practitioners: Pain intensity, consequences and clinical relevance for nursing home residents.

    Science.gov (United States)

    Dräger, Dagmar; Budnick, Andrea; Kuhnert, Ronny; Kalinowski, Sonja; Könner, Franziska; Kreutz, Reinhold

    2017-10-01

    Although chronic pain is common in older adults, its treatment is frequently inappropriate. This problem is particularly prevalent in nursing home residents. We therefore developed an intervention to optimize pain management and evaluated its effects on pain intensity and pain interference with function in nursing home residents in Germany. In a cluster-randomized controlled intervention, 195 residents of 12 Berlin nursing homes who were affected by pain were surveyed at three points of measurement. A modified German version of the Brief Pain Inventory was used to assess pain sites, pain intensity and pain interference with function in various domains of life. The intervention consisted of separate training measures for nursing staff and treating physicians. The primary objective of reducing the mean pain intensity by 2 points was not achieved, partly because the mean pain intensity at baseline was relatively low. However, marginal reductions in pain were observed in the longitudinal assessment at 6-month follow up. The intervention and control groups differed significantly in the intensity sum score and in the domain of walking. Furthermore, the proportion of respondents with pain scores >0 on three pain intensity items decreased significantly. Given the multifocal nature of the pain experienced by nursing home residents, improving the pain situation of this vulnerable group is a major challenge. To achieve meaningful effects not only in pain intensity, but especially in pain interference with function, training measures for nursing staff and physicians need to be intensified, and long-term implementation appears necessary. Geriatr Gerontol Int 2017; 17: 1534-1543. © 2016 Japan Geriatrics Society.

  16. Staff Group Unanimity in the Care of Juveniles in Institutional Treatment: Routines, Rituals, and Relationships

    Science.gov (United States)

    Ahonen, Lia; Degner, Jurgen

    2013-01-01

    One prerequisite for effective institutional care is that staff agree on how to deliver treatment and have a unified view of how to achieve change--in other words, to have staff group unanimity (SGU). This study used the Correctional Program Assessment Inventory (CPAI) 2000, interviews with key staff, and observations of daily activities to…

  17. [総説]Aging and Sexuality : Knowledge, Attitudes, and Image of Care Staff in Nursing Homes

    OpenAIRE

    Akamine, Yoriko; Division of Adult Nursing II, School of Health Sciences, Faculty of Medicine, University of the Ryukyus

    2006-01-01

    In this descriptive study, I examined the nursing home care staffs knowledge, attitudes, and image of elderly sexuality and the determination of a possible relationship among them. Nurses and care workers from five nursing homes in Okinawa, Japan volunteered to participate the study. One hundred fifty-two care staffs answered and returned the self-administered packet for a response rate of 74.5%, with 126 of the respondents completing the questions appropriately. The packet included questionn...

  18. Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services.

    Science.gov (United States)

    Sandberg, Linda; Borell, Lena; Edvardsson, David; Rosenberg, Lena; Boström, Anne-Marie

    2018-01-01

    An increasing number of older persons worldwide live at home with various functional limitations such as dementia. So, home care staff meet older persons with extensive, complex needs. The staff's well-being is crucial because it can affect the quality of their work, although literature on job strain among home care staff is limited. To describe perceived job strain among home care staff and to examine correlations between job strain, personal factors, and organizational factors. The study applied a cross-sectional survey design. Participants were dementia care specialists who work in home care (n=34) and other home care staff who are not specialized in dementia care (n=35). The Strain in Dementia Care Scale (SDCS) and Creative Climate Questionnaire instruments and demographic variables were used. Descriptive and inferential statistics (including regression modeling) were applied. The regional ethical review board approved the study. Home care staff perceived job strain - particularly because they could not provide what they perceived to be necessary care. Dementia care specialists ranked job strain higher (m=5.71) than other staff members (m=4.71; p =0.04). Job strain (for total score and for all five SDCS factors) correlated with being a dementia care specialist. Correlations also occurred between job strain for SDCS factor 2 (difficulties understanding and interpreting) and not having Swedish as first language and SDCS factor 5 (lack of recognition) and stagnated organizational climate. The study indicates that home care staff and particularly dementia care specialists perceived high job strain. Future studies are needed to confirm or reject findings from this study.

  19. Implementing the Namaste Care Program for residents with advanced dementia: exploring the perceptions of families and staff in UK care homes.

    Science.gov (United States)

    Stacpoole, Min; Hockley, Jo; Thompsell, Amanda; Simard, Joyce; Volicer, Ladislav

    2017-10-01

    Increasing numbers of older people with advanced dementia are cared for in care homes. No cure is available, so research focused on improving quality of life and quality of care for people with dementia is needed to support them to live and die well. The Namaste Care programme is a multi-dimensional care program with sensory, psycho-social and spiritual components intended to enhance quality of life and quality of care for people with advanced dementia. The aim of the study was to establish whether the Namaste Care program can be implemented in UK care homes; and what effect Namaste Care has on the quality of life of residents with advanced dementia, their families and staff. This article explores the qualitative findings of the study, reporting the effect of the programme on the families of people with advanced dementia and care home staff, and presenting their perceptions of change in care. An organisational action research methodology was used. Focus groups and interviews were undertaken pre/post implementation of the Namaste Care program. The researcher kept a reflective diary recording data on the process of change. A comments book was available to staff and relatives in each care home. Data was analysed thematically within each care home and then across all care homes. Six care homes were recruited in south London: one withdrew before the study was underway. Of the five remaining care homes, four achieved a full Namaste Care program. One care home did not achieve the full program during the study, and another discontinued Namaste Care when the study ended. Every home experienced management disruption during the study. Namaste Care challenged normal routinised care for older people with advanced dementia. The characteristics of care uncovered before Namaste was implemented were: chaos and confusion, rushing around, lack of trust, and rewarding care. After the programme was implemented these perceptions were transformed, and themes of calmness, reaching out to

  20. 24 CFR 982.614 - Group home: Housing quality standards.

    Science.gov (United States)

    2010-04-01

    ...) Sanitary facilities in the group home must be readily accessible to and usable by residents, including... adequate facilities and services for the sanitary disposal of food waste and refuse, including facilities... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: Housing quality...

  1. Home Help Service Staffs' Descriptions of Their Role in Promoting Everyday Activities Among Older People in Sweden Who Are Dependent on Formal Care.

    Science.gov (United States)

    Cederbom, Sara; Thunborg, Charlotta; Denison, Eva; Söderlund, Anne; von Heideken Wågert, Petra

    2017-08-01

    The study aimed to explore how home help service staff described their role in improving the abilities of older people, in particular, older women with chronic pain who are dependent on formal care, to perform everyday activities. Three focus group interviews were conducted, and a qualitative inductive thematic content analysis was used. The analysis resulted in one theme: struggling to improve the care recipients' opportunities for independence but being inhibited by complex environmental factors. By encouraging the care recipients to perform everyday activities, the staff perceived themselves to both maintain and improve their care recipients' independence and quality of life. An important goal for society and health care professionals is to improve older people's abilities to "age in place" and to enable them to age independently while maintaining their quality of life. A key resource is home help service staff, and this resource should be utilized in the best possible way.

  2. Relationship between Staff-Reported Culture Change and Occupancy Rate and Organizational Commitment among Nursing Homes in South Korea

    Science.gov (United States)

    Lee, Minhong; Choi, Jae-Sung; Lim, Jinseop; Kim, Young Sun

    2013-01-01

    Purpose: This study aims to examine culture change in nursing homes in South Korea and to identify the outcomes of culture change implementation. Design and Methods: Data were taken from survey responses from 223 top- or mid-level staff among nursing homes in South Korea that were selected through a proportionate random-stratified sampling method…

  3. Enhancing knowledge and attitudes in pain management: a pain management education program for nursing home staff.

    Science.gov (United States)

    Tse, Mimi Mun Yee; Ho, Suki S K

    2014-03-01

    The aim of the study was to examine the effectiveness of a pain management program (PMP) in enhancing the knowledge and attitudes of health care workers in pain management. Many nursing home residents suffer from pain, and treatment of pain is often inadequate. Failure of health care workers to assess pain and their insufficient knowledge of pain management are barriers to adequate treatment. It was a quasiexperimental pretest and posttest study. Four nursing homes were approached, and 88 staff joined the 8-week PMP. Demographics and the knowledge and attitudes regarding pain were collected with the use of the Nurse's Knowledge and Attitudes Survey Regarding Pain-Chinese version (NKASRP-C) before and after the PMP. A deficit in knowledge and attitudes related to pain management was prominent before the PMP, and there was a significant increase in pain knowledge and attitudes from 7.9 ± SD 3.52 to 19.2 ± SD4.4 (p nursing staff and enable them to provide adequate and appropriate care to older persons in pain. PMPs for nurses and all health care professionals are important in enhancing care for older adults and to inform policy on the provision of pain management. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  4. Dementia-specific training for nursing home staff : A systematic literature review.

    Science.gov (United States)

    Riesch, Julia; Meyer, Lucy; Lehr, Bosco; Severin, Thomas

    2017-08-22

    For people with dementia high-quality care is vital, since at present dementia cannot be cured. In nursing homes this care is provided by the staff, who therefore require dementia-specific training enabling them to improve the quality of life for people with dementia. This article compares existing dementia-specific training for nursing home staff with recommendations, based on the current state of research, by the Alzheimer's Association and the National Institute for Health and Care Excellence, and discusses the outcome of this training. A systematic review of the literature was conducted to identify studies addressing dementia-specific training. The electronic databases Embase, Medline, Cochrane, CINAHL, PsychINFO, PSYNDEX, and ScienceDirect were searched. The training topics most commonly considered were person-centered care, communicating with people affected by dementia, and information about dementia. The roles of different social and healthcare professionals, palliative care of people with dementia, and understanding family dynamics are least featured in the training. There are training concepts which focus not only on the transfer of knowledge but also on practical exercises. In general, the recommended topics were addressed in dementia-specific training concepts, but there is potential for optimization. Further research is needed to identify success criteria in dementia-specific training and identify the successful combination of theoretical knowledge and practical exercise.

  5. A cloud-based home health care information sharing system to connect patients with home healthcare staff -A case report of a study in a mountainous region.

    Science.gov (United States)

    Nomoto, Shinichi; Utsumi, Momoe; Sasayama, Satoshi; Dekigai, Hiroshi

    2017-01-01

    We have developed a cloud system, the e-Renraku Notebook (e-RN) for sharing of home care information based on the concept of "patient-centricity". In order to assess the likelihood that our system will enhance the communication and sharing of information between home healthcare staff members and home-care patients, we selected patients who were residing in mountainous regions for inclusion in our study. We herein report the findings.Eighteen staff members from 7 medical facilities and 9 patients participated in the present study.The e-RN was developed for two reasons: to allow patients to independently report their health status and to have staff members view and respond to the information received. The patients and staff members were given iPads with the pre-installed applications and the information being exchanged was reviewed over a 54-day period.Information was mainly input by the patients (61.6%), followed by the nurses who performed home visits (19.9%). The amount of information input by patients requiring high-level nursing care and their corresponding staff member was significantly greater than that input by patients who required low-level of nursing care.This patient-centric system in which patients can independently report and share information with a member of the healthcare staff provides a sense of security. It also allows staff members to understand the patient's health status before making a home visit, thereby giving them a sense of security and confidence. It was also noteworthy that elderly patients requiring high-level nursing care and their staff counterpart input information in the system significantly more frequently than patients who required low-level care.

  6. Modeling and evaluating evidence-based continuing education program in nursing home dementia care (MEDCED)--training of care home staff to reduce use of restraint in care home residents with dementia. A cluster randomized controlled trial.

    Science.gov (United States)

    Testad, Ingelin; Mekki, Tone Elin; Førland, Oddvar; Øye, Christine; Tveit, Eva Marie; Jacobsen, Frode; Kirkevold, Øyvind

    2016-01-01

    The aim of this study was to evaluate the effectiveness of a tailored 7-month training intervention "Trust Before Restraint," in reducing use of restraint, agitation, and antipsychotic medications in care home residents with dementia. This is a single-blind cluster randomized controlled trial in 24 care homes within the Western Norway Regional Health Authority 2011-2013. From 24 care homes, 274 residents were included in the study, with 118 in the intervention group and 156 in the control group. Use of restraint was significantly reduced in both the intervention group and the control group despite unexpected low baseline, with a tendency to a greater reduction in the control group. There was a significant reduction in Cohen-Mansfield Agitation Inventory score in both the intervention group and the follow-up group with a slightly higher reduction in the control group, although this did not reach significance and a small nonsignificant increase in use of antipsychotics (14.1-17.7%) and antidepressants (35.9-38.4%) in both groups. This study reports on the statistically significant reduction in use of restraint in care homes, both prior and during the 7-month intervention periods, in both intervention and control groups. When interpreted within the context of the current climate of educational initiatives to reduce restraint and a greater focus on the importance of person-centered care, the study also highlights the potential success achieved with national training programs for care staff and should be further evaluated to inform future training initiatives both in Norway and internationally. Copyright © 2015 John Wiley & Sons, Ltd.

  7. 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.

  8. Staff preparedness for providing palliative and end-of-life care in long-term care homes: Instrument development and validation.

    Science.gov (United States)

    Chan, Helen Yl; Chun, Gloria Km; Man, C W; Leung, Edward Mf

    2018-05-01

    Although much attention has been on integrating the palliative care approach into services of long-term care homes for older people living with frailty and progressive diseases, little is known about the staff preparedness for these new initiatives. The present study aimed to develop and test the psychometric properties of an instrument for measuring care home staff preparedness in providing palliative and end-of-life care. A 16-item instrument, covering perceived knowledge, skill and psychological readiness, was developed. A total of 247 staff members of different ranks from four care homes participated in the study. Exploratory factor analysis using the principal component analysis extraction method with varimax rotation was carried out for initial validation. Known group comparison was carried out to examine its discriminant validity. Reliability of the instrument was assessed based on test-retest reliability of a subsample of 20 participants and the Cronbach's alpha of the items. Exploratory factor analysis showed that the instrument yielded a three-factor solution, which cumulatively accounted for 68.5% of the total variance. Three subscales, namely, willingness, capability and resilience, showed high internal consistency and test-retest reliability. It also showed good discriminant validity between staff members of professional and non-professional groups. This is a brief, valid and reliable scale for measuring care home staff preparedness for providing palliative and end-of-life care. It can be used to identify their concerns and training needs in providing palliative and end-of-life care, and as an outcome measure to evaluate the effects of interventional studies for capacity building in this regard. Geriatr Gerontol Int 2018; 18: 745-749. © 2018 Japan Geriatrics Society.

  9. Public nursing home staff's experience of participating in an intervention aimed at enhancing their self-esteem.

    Science.gov (United States)

    Wadensten, Barbro; Engström, Maria; Häggström, Elisabeth

    2009-11-01

    The aim of the present study was to gain an understanding of how nursing staff experienced participating in a training programme aimed at strengthening their self-esteem and empowering them, to determine whether participation benefited them in any way, and to describe their opinions about possible benefits or disadvantages. Staff working in institutions such as nursing homes have a low status in society. A training programme was introduced to staff in a public nursing home. It focused on helping them understand factors in the work situation that influence them and on empowering them. The study was explorative and qualitative in design. The participants in the programme were generally satisfied with it. Their opinions about the benefits they received from the programme can be described using three themes: 'improved communication skills', 'enhanced self-esteem' and 'sees work in a different light'. The most important finding of the present study is that it was possible to strengthen and empower staff. Staff members were generally pleased and satisfied with the content/organization of the training programme. They felt the programme had been of value to them by improving their communication skills and increasing their self-esteem. The present result could be of value to managers and educators working in the area of nursing home care when planning education and development activities for staff. Learning to communicate better and understand the social structure at the workplace could improve staff members' self-esteem, thereby enhancing the work situation and atmosphere as well as empowering the individuals.

  10. [Habermas' and Giddens' modernization theories applied to homes for the aged and to somatic nursing homes. The long road toward greater equivalence between residents and staff].

    Science.gov (United States)

    Belderok, J J

    1997-12-01

    The situation in homes for the elderly and nursing homes is for the residents both alarming and tragic. Recent Dutch legislation supports the movement towards more self-determination and autonomy for the residents. The staff are dedicated to making the living situation as good as possible for the residents. Nevertheless many publications describe how the dependence and helplessness of the residents stil continue. In this paper this helplessness is placed within the broader framework of modern society by application of Habermas' theory of communicative action and Giddens' structuration theory. Both theories show that the key to improve dependent making structures should be sought principally in the behaviour of both staff and residents. Habermas offers a perspective to more equivalent communicative action between residents and staff. Giddens draws attention to the knowledgeability of residents, with which they should be able to interact on an equal basis with professionals. This presupposes much dedication of both staff and residents.

  11. Nursing home staff members' subjective frames of reference on residents' achievement of ego integrity: A Q-methodology study.

    Science.gov (United States)

    Lim, Sun-Young; Chang, Sung-Ok

    2018-01-01

    To discover the structure of the frames of reference for nursing home staff members' subjective judgment of residents' achievement of ego integrity. Q-methodology was applied. Twenty-eight staff members who were working in a nursing home sorted 34 Q-statements into the shape of a normal distribution. A centroid factor analysis and varimax rotation, using the PQ-method program, revealed four factors: identifying clues to residents' positive acceptance of their whole life span, identifying residents' ways of enjoying their current life, referencing residents' attitudes and competencies toward harmonious relationships, and identifying residents' integrated efforts to establish self-esteem. These subjective frames of reference need to be investigated in order to improve the relationships with nursing home residents and their quality of life. Consequently, the fundamental monitoring tools to help staff members make subjective judgments can be formed. © 2017 Japan Academy of Nursing Science.

  12. Teamwork and delegation in medical homes: primary care staff perspectives in the Veterans Health Administration.

    Science.gov (United States)

    True, Gala; Stewart, Greg L; Lampman, Michelle; Pelak, Mary; Solimeo, Samantha L

    2014-07-01

    The patient-centered medical home (PCMH) relies on a team approach to patient care. For organizations engaged in transitioning to a PCMH model, identifying and providing the resources needed to promote team functioning is essential. To describe team-level resources required to support PCMH team functioning within the Veterans Health Administration (VHA), and provide insight into how the presence or absence of these resources facilitates or impedes within-team delegation. Semi-structured interviews with members of pilot teams engaged in PCMH implementation in 77 primary care clinics serving over 300,000 patients across two VHA regions covering the Mid-Atlantic and Midwest United States. A purposive sample of 101 core members of pilot teams, including 32 primary care providers, 42 registered nurse care managers, 15 clinical associates, and 12 clerical associates. Investigators from two evaluation sites interviewed frontline primary care staff separately, and then collaborated on joint analysis of parallel data to develop a broad, comprehensive understanding of global themes impacting team functioning and within-team delegation. We describe four themes key to understanding how resources at the team level supported ability of primary care staff to work as effective, engaged teams. Team-based task delegation was facilitated by demarcated boundaries and collective identity; shared goals and sense of purpose; mature and open communication characterized by psychological safety; and ongoing, intentional role negotiation. Our findings provide a framework for organizations to identify assets already in place to support team functioning, as well as areas in need of improvement. For teams struggling to make practice changes, our results indicate key areas where they may benefit from future support. In addition, this research sheds light on how variation in medical home implementation and outcomes may be associated with variation in team-based task delegation.

  13. Job strain: a cross-sectional survey of dementia care specialists and other staff in Swedish home care services

    Directory of Open Access Journals (Sweden)

    Sandberg L

    2018-05-01

    Full Text Available Linda Sandberg,1 Lena Borell,1 David Edvardsson,2,3 Lena Rosenberg,1 Anne-Marie Boström1,4,5 1Department of Neurobiology, Care Sciences and Society (NVS, Division of Occupational Therapy, Karolinska Institutet, Huddinge, Sweden; 2School of Nursing and Midwifery, La Trobe University, Heidelberg, VIC, Australia; 3Department of Nursing, Umea University, Umea, Sweden; 4Theme Aging, Karolinska University Hospital, Stockholm, Sweden; 5Department of Nursing, Western Norway University of Applied Sciences, Haugesund, Norway Introduction: An increasing number of older persons worldwide live at home with various functional limitations such as dementia. So, home care staff meet older persons with extensive, complex needs. The staff’s well-being is crucial because it can affect the quality of their work, although literature on job strain among home care staff is limited. Aim: To describe perceived job strain among home care staff and to examine correlations between job strain, personal factors, and organizational factors. Methods: The study applied a cross-sectional survey design. Participants were dementia care specialists who work in home care (n=34 and other home care staff who are not specialized in dementia care (n=35. The Strain in Dementia Care Scale (SDCS and Creative Climate Questionnaire instruments and demographic variables were used. Descriptive and inferential statistics (including regression modeling were applied. The regional ethical review board approved the study. Results: Home care staff perceived job strain – particularly because they could not provide what they perceived to be necessary care. Dementia care specialists ranked job strain higher (m=5.71 than other staff members (m=4.71; p=0.04. Job strain (for total score and for all five SDCS factors correlated with being a dementia care specialist. Correlations also occurred between job strain for SDCS factor 2 (difficulties understanding and interpreting and not having Swedish as

  14. Making tradeoffs between the reasons to leave and reasons to stay employed in long-term care homes: perspectives of licensed nursing staff.

    Science.gov (United States)

    McGilton, Katherine S; Boscart, Veronique M; Brown, Maryanne; Bowers, Barbara

    2014-06-01

    Turnover of licensed nursing staff in long-term care (LTC) settings (e.g., nursing homes) is a mounting concern and is associated with poor quality of care and low staff morale. Retention and turnover research in LTC have focused primarily on direct care workers (i.e., nurse aides) leaving the issues largely unexplored for licensed nursing staff (i.e., registered nurses and licensed practical nurses). The main objective of this study was to understand factors that influence nurses' intentions to remain employed at their current job. Qualitative descriptive study. Seven nursing homes in Ontario, Canada. A convenience sample of forty-one licensed LTC nurses. Data were collected through focus groups conducted at each of the participating nursing homes. Focus group discussions were transcribed verbatim. Directed content analysis was used to identify and develop themes. Work conditions were a salient element affecting nurses' intention to stay and included impact of regulations on nurse role flexibility and professional judgment, an underfunded system contributing to insufficient resources and staffing, and a lack of supportive leadership. Factors promoting nurses' willingness to stay included the development of meaningful relationships with residents and staff and opportunities for learning and professional development. Nurses also considered personal and life circumstances (e.g., marital status and seniority) when discussing intention to stay. Nurses in this study weighed positive and negative work-related factors as well as personal circumstances to determine their intent to stay. Developing a more individualized approach to address attrition of licensed nurses in LTC may be the most successful strategy for improving retention of highly skilled staff in this sector. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Home Medication Cabinets and Medication Taking Behavior of the Staffs in a University in China

    Science.gov (United States)

    Xue, Chengbin; Ye, Juan; Dong, Yuzhen; Xu, Chunmei

    2018-01-01

    Background: A growing sum of medicines is stored in home medication cabinets in China, with the behavior of self-medication increasing. Although responsible self-medication can help prevent and treat ailments that do not need professional consultation, it bears the risk of misuse of medicines issued on prescription due to inadequate prescription medicine administration. Objective: The objective of this study was to investigate the condition and safety of medication storage and intended self-medication in a University in China. Method: The study was conducted over 10 month period (May 2015-March 2016) and involved a random sample of households. The questionnaire survey and personal insight into household medicine supplies was performed by a team of trained pharmacy staffs. Interviewees (N = 398, aged 16-88 y) were visited door to door and the home medication cabinets were catalogued after the participants were interviewed. Results: The majority (89.71%) households have home medicine cabinets. The total number of medicine items in the 398 households was 5600, with a median of 14 per household. The most frequently encountered categories of registered medicines were cough and cold medcines (47.8%), antibacterials for systemic use (30.0%), topical products for joint and muscular pain(26.1%), vitamins (23.2%), medication for functional gastrointestinal disorders (23.2%), oral and external forms have not kept separately(55.1%). The most treatment related problems recorded were curative effect not ideal (57.9%). 68% of the sample population would choose doctors as medication consultation object about medicines purchased. Conclusion: Large sum of medicines were found per household, with a high prevalence of cough and cold medcines. Public services in China, mainly government and health organizations, need put more effort on educating people on how to store medicines, as well as finding a way to raise awareness of the public in promoting behavioral change about medication

  16. Consistent assignment of nursing staff to residents in nursing homes: a critical review of conceptual and methodological issues.

    Science.gov (United States)

    Roberts, Tonya; Nolet, Kimberly; Bowers, Barbara

    2015-06-01

    Consistent assignment of nursing staff to residents is promoted by a number of national organizations as a strategy for improving nursing home quality and is included in pay for performance schedules in several states. However, research has shown inconsistent effects of consistent assignment on quality outcomes. In order to advance the state of the science of research on consistent assignment and inform current practice and policy, a literature review was conducted to critique conceptual and methodological understandings of consistent assignment. Twenty original research reports of consistent assignment in nursing homes were found through a variety of search strategies. Consistent assignment was conceptualized and operationalized in multiple ways with little overlap from study to study. There was a lack of established methods to measure consistent assignment. Methodological limitations included a lack of control and statistical analyses of group differences in experimental-level studies, small sample sizes, lack of attention to confounds in multicomponent interventions, and outcomes that were not theoretically linked. Future research should focus on developing a conceptual understanding of consistent assignment focused on definition, measurement, and links to outcomes. To inform current policies, testing consistent assignment should include attention to contexts within and levels at which it is most effective. Published by Oxford University Press on behalf of the Gerontological Society of America 2013.

  17. Medication errors in home care: a qualitative focus group study.

    Science.gov (United States)

    Berland, Astrid; Bentsen, Signe Berit

    2017-11-01

    To explore registered nurses' experiences of medication errors and patient safety in home care. The focus of care for older patients has shifted from institutional care towards a model of home care. Medication errors are common in this situation and can result in patient morbidity and mortality. An exploratory qualitative design with focus group interviews was used. Four focus group interviews were conducted with 20 registered nurses in home care. The data were analysed using content analysis. Five categories were identified as follows: lack of information, lack of competence, reporting medication errors, trade name products vs. generic name products, and improving routines. Medication errors occur frequently in home care and can threaten the safety of patients. Insufficient exchange of information and poor communication between the specialist and home-care health services, and between general practitioners and healthcare workers can lead to medication errors. A lack of competence in healthcare workers can also lead to medication errors. To prevent these, it is important that there should be up-to-date information and communication between healthcare workers during the transfer of patients from specialist to home care. Ensuring competence among healthcare workers with regard to medication is also important. In addition, there should be openness and accurate reporting of medication errors, as well as in setting routines for the preparation, alteration and administration of medicines. To prevent medication errors in home care, up-to-date information and communication between healthcare workers is important when patients are transferred from specialist to home care. It is also important to ensure adequate competence with regard to medication, and that there should be openness when medication errors occur, as well as in setting routines for the preparation, alteration and administration of medications. © 2017 John Wiley & Sons Ltd.

  18. Relationship between staff-reported culture change and occupancy rate and organizational commitment among nursing homes in South Korea.

    Science.gov (United States)

    Lee, Minhong; Choi, Jae-Sung; Lim, Jinseop; Kim, Young Sun

    2013-04-01

    This study aims to examine culture change in nursing homes in South Korea and to identify the outcomes of culture change implementation. Data were taken from survey responses from 223 top- or mid-level staff among nursing homes in South Korea that were selected through a proportionate random-stratified sampling method from four regions nationwide. Culture change in nursing homes was operationalized by five person-directed care (PDC) constructs and three organizational environment constructs, and outcome quality was indicated by changes to occupancy rate and organizational commitment. After controlling for facility characteristics, the effect of staff-reported culture change on occupancy rate and organizational commitment was analyzed through the multiple-regression method. Consistent with previous research, this study revealed positive effects of culture change for nursing homes in South Korea. The study found that staff-reported culture change correlated with occupancy rate and organizational commitment. Given that culture change variables were significantly related to occupancy rate and organizational commitment, the findings of the study provide a persuasive argument that policies and/or programs to support culture change in nursing homes should be enhanced. Management-level workers in these facilities should have the skills and knowledge to foster more PDC and a more person-directed environment.

  19. Perceived motivators to home food preparation: focus group findings.

    Science.gov (United States)

    Jones, Sheila A; Walter, Janelle; Soliah, LuAnn; Phifer, Janna T

    2014-10-01

    Family meals are positively associated with increased consumption of fruits and vegetables and numerous nutrients, promoting good eating habits and disease prevention. Families benefiting from home-cooked meals are more likely to consume smaller portions and fewer calories, less fat, less salt, and less sugar. Some Western cultures have lost confidence in preparing meals and tend to rely on foods prepared outside the home. The ability of young adults to prepare foods at home may be impaired. The purpose of our study is to identify motivators and, consequently, barriers to preparing foods at home vs purchasing preprepared foods from a deli or eating in a restaurant. Focus groups of college students (n=239) from two universities were asked questions about motivators to preparing meals at home in two subsequent sessions. The primary motivators among the students were that they desired to save money; had a model in food preparation; were familiar with cooking techniques; and had enough time to shop, cook, and clean up after meals. Food and nutrition practitioners have opportunities to promote cost-effective, simple, and time-saving home food preparation techniques as healthful habits. Copyright © 2014 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  20. Doctors' learning experiences in end-of-life care - a focus group study from nursing homes.

    Science.gov (United States)

    Fosse, Anette; Ruths, Sabine; Malterud, Kirsti; Schaufel, Margrethe Aase

    2017-01-31

    Doctors often find dialogues about death difficult. In Norway, 45% of deaths take place in nursing homes. Newly qualified medical doctors serve as house officers in nursing homes during internship. Little is known about how nursing homes can become useful sites for learning about end-of-life care. The aim of this study was to explore newly qualified doctors' learning experiences with end-of-life care in nursing homes, especially focusing on dialogues about death. House officers in nursing homes (n = 16) participated in three focus group interviews. Interviews were audiotaped and transcribed verbatim. Data were analysed with systematic text condensation. Lave & Wenger's theory about situated learning was used to support interpretations, focusing on how the newly qualified doctors gained knowledge of end-of-life care through participation in the nursing home's community of practice. Newly qualified doctors explained how nursing home staff's attitudes taught them how calmness and acceptance could be more appropriate than heroic action when death was imminent. Shifting focus from disease treatment to symptom relief was demanding, yet participants comprehended situations where death could even be welcomed. Through challenging dialogues dealing with family members' hope and trust, they learnt how to adjust words and decisions according to family and patient's life story. Interdisciplinary role models helped them balance uncertainty and competence in the intermediate position of being in charge while also needing surveillance. There is a considerable potential for training doctors in EOL care in nursing homes, which can be developed and integrated in medical education. This practice based learning arena offers newly qualified doctors close interaction with patients, relatives and nurses, teaching them to perform difficult dialogues, individualize medical decisions and balance their professional role in an interdisciplinary setting.

  1. When care situations evoke difficult emotions in nursing staff members: an ethnographic study in two Norwegian nursing homes.

    Science.gov (United States)

    Sandvoll, Anne Marie; Grov, Ellen Karine; Kristoffersen, Kjell; Hauge, Solveig

    2015-01-01

    Caring practice in nursing homes is a complex topic, especially the challenges of meeting the basic needs of residents when their behaviour evokes difficult emotions. Cognitive and physical changes related to aging and disability can contribute to behaviours considered to be unacceptable. For example, resident behaviours such as spitting, making a mess with food or grinding teeth are behaviours that most people do not want to see, hear or experience. The aim of this study was to gain a deeper understanding of how nursing home staff members deal with such behaviours in care situations. This article draws on ethnographic data to describe how nursing home staff members manage unpleasant resident behaviours. The study was based on two long-term units in two Norwegian public nursing homes. The Region's Medical Ethics Committee and the Norwegian Social Science Data Services granted approval. In total, 45 participants (37 nursing aides and eight nurses) agreed to participate in this study. Ten of the participants were interviewed at the end of the field study. This study indicates that nursing home staff members experience difficult emotions related to some residents' behaviours. However, they found these feelings difficult to express and rarely verbalized them openly. In addition, they were characterized by a strong obligation to help all residents, despite their own feelings. Therefore, it appears that an inner struggle occurs as a part of everyday practice. Despite these difficult emotions, nursing staff members believed that they needed to manage their responses and continued to offer good care to all residents. These findings extend our understanding of this unarticulated part of nursing home practice.

  2. Developing Mobile Clinical Decision Support for Nursing Home Staff Assessment of Urinary Tract Infection using Goal-Directed Design.

    Science.gov (United States)

    Jones, Wallace; Drake, Cynthia; Mack, David; Reeder, Blaine; Trautner, Barbara; Wald, Heidi

    2017-06-20

    Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff. Focus groups were conducted with providers and nurses in NHs in Denver, Colorado (n= 24). Qualitative descriptive analysis was applied to focus group transcripts to identify information needs and themes related to mobile clinical decision support for UTI identification and management. Personas representing typical end users were developed; typical clinical context scenarios were constructed using information needs as goals. Usability testing was performed using cognitive walk-throughs and a think-aloud protocol. Four information needs were identified including guidance regarding resident assessment; communication with providers; care planning; and urine culture interpretation. Design of a web-based application incorporating a published decision support algorithm for evidence-based UTI diagnoses proceeded with a focus on nursing information needs during resident assessment and communication with providers. Certified nursing assistant (CNA) and registered nurse (RN) personas were constructed in 4 context scenarios with associated key path scenarios. After field testing, a high fidelity prototype of UTI Decide was completed and evaluated by potential end users. Design recommendations and content recommendations were elicited. Goal-Directed Design informed the development of a mobile CDSS supporting participant-identified information needs for UTI assessment and communication

  3. Staff attitude and experience in dealing with rational nursing home patients who refuse to eat and drink.

    Science.gov (United States)

    Mattiasson, A C; Andersson, L

    1994-11-01

    This paper describes the personal attitudes of nursing home staff and their experience of coping with rational nursing home patients who refused to eat and drink. Professional caregivers in 13 nursing homes and nursing home units in the county of Stockholm, Sweden, were asked to judge an ethical conflict involving a situation in which a patient of sound mind refused to eat and drink. Two questions were raised: (a) What would your unit's decision be in this case? (b) What is your personal opinion in this case? Answers to question (a) showed that 20% believed that the patient's autonomy would be respected, i.e. the patient would be allowed to die without medical intervention. Concerning question (b), the results showed that approximately 50% believed that the patient's wishes regarding food refusal must be respected. Furthermore, the results suggested that both professional category and number of years' service made a difference to the staff views on patient autonomy. Finally, the findings indicated that the nursing homes included in the study did not show any distinct policy with regard to the autonomy of elderly nursing home patients in refusing to eat and drink.

  4. Ethical challenges in nursing homes--staff's opinions and experiences with systematic ethics meetings with participation of residents' relatives.

    Science.gov (United States)

    Bollig, Georg; Schmidt, Gerda; Rosland, Jan Henrik; Heller, Andreas

    2015-12-01

    Many ethical problems exist in nursing homes. These include, for example, decision-making in end-of-life care, use of restraints and a lack of resources. The aim of the present study was to investigate nursing home staffs' opinions and experiences with ethical challenges and to find out which types of ethical challenges and dilemmas occur and are being discussed in nursing homes. The study used a two-tiered approach, using a questionnaire on ethical challenges and systematic ethics work, given to all employees of a Norwegian nursing home including nonmedical personnel, and a registration of systematic ethics discussions from an Austrian model of good clinical practice. Ninety-one per cent of the nursing home staff described ethical problems as a burden. Ninety per cent experienced ethical problems in their daily work. The top three ethical challenges reported by the nursing home staff were as follows: lack of resources (79%), end-of-life issues (39%) and coercion (33%). To improve systematic ethics work, most employees suggested ethics education (86%) and time for ethics discussion (82%). Of 33 documented ethics meetings from Austria during a 1-year period, 29 were prospective resident ethics meetings where decisions for a resident had to be made. Agreement about a solution was reached in all 29 cases, and this consensus was put into practice in all cases. Residents did not participate in the meetings, while relatives participated in a majority of case discussions. In many cases, the main topic was end-of-life care and life-prolonging treatment. Lack of resources, end-of-life issues and coercion were ethical challenges most often reported by nursing home staff. The staff would appreciate systematic ethics work to aid decision-making. Resident ethics meetings can help to reach consensus in decision-making for nursing home patients. In the future, residents' participation should be encouraged whenever possible. © 2015 The Authors. Scandinavian Journal of Caring

  5. Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups.

    Science.gov (United States)

    Yap, Tracey L; Kennerly, Susan; Corazzini, Kirsten; Porter, Kristie; Toles, Mark; Anderson, Ruth A

    2014-07-25

    The purpose of the manuscript is to describe long-term care (LTC) staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU) prevention guidelines regarding consistent and regular movement of LTC residents a minimum of every two hours. The Diffusion of Innovation (DOI) model guided staff interviews about their perceptions of the intervention's characteristics, outcomes, and sustainability. This was a qualitative, observational study of staff perceptions of the PrU prevention intervention conducted in Midwestern U.S. LTC facilities (N = 45 staff members). One focus group was held in each of eight intervention facilities using a semi-structured interview protocol. Transcripts were analyzed using thematic content analysis, and summaries for each category were compared across groups. The a priori codes (observability, trialability, compatibility, relative advantage and complexity) described the innovation characteristics, and the sixth code, sustainability, was identified in the data. Within each code, two themes emerged as a positive or negative response regarding characteristics of the innovation. Moreover, within the sustainability code, a third theme emerged that was labeled "brainstormed ideas", focusing on strategies for improving the innovation. Cueing LTC staff using music offers a sustainable potential to improve PrU prevention practices, to increase resident movement, which can subsequently lead to a reduction in PrUs.

  6. Evaluation of Cueing Innovation for Pressure Ulcer Prevention Using Staff Focus Groups

    Directory of Open Access Journals (Sweden)

    Tracey L. Yap

    2014-07-01

    Full Text Available The purpose of the manuscript is to describe long-term care (LTC staff perceptions of a music cueing intervention designed to improve staff integration of pressure ulcer (PrU prevention guidelines regarding consistent and regular movement of LTC residents a minimum of every two hours. The Diffusion of Innovation (DOI model guided staff interviews about their perceptions of the intervention’s characteristics, outcomes, and sustainability. Methods: This was a qualitative, observational study of staff perceptions of the PrU prevention intervention conducted in Midwestern U.S. LTC facilities (N = 45 staff members. One focus group was held in each of eight intervention facilities using a semi-structured interview protocol. Transcripts were analyzed using thematic content analysis, and summaries for each category were compared across groups. Results: The a priori codes (observability, trialability, compatibility, relative advantage and complexity described the innovation characteristics, and the sixth code, sustainability, was identified in the data. Within each code, two themes emerged as a positive or negative response regarding characteristics of the innovation. Moreover, within the sustainability code, a third theme emerged that was labeled “brainstormed ideas”, focusing on strategies for improving the innovation. Implications: Cueing LTC staff using music offers a sustainable potential to improve PrU prevention practices, to increase resident movement, which can subsequently lead to a reduction in PrUs.

  7. 24 CFR 982.611 - Group home: Lease and HAP contract.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: Lease and HAP contract... Types Group Home § 982.611 Group home: Lease and HAP contract. For assistance in a group home, there is a separate HAP contract and lease for each assisted person. ...

  8. Interaction rules underlying group decisions in homing pigeons

    Science.gov (United States)

    Pettit, Benjamin; Perna, Andrea; Biro, Dora; Sumpter, David J. T.

    2013-01-01

    Travelling in groups gives animals opportunities to share route information by following cues from each other's movement. The outcome of group navigation will depend on how individuals respond to each other within a flock, school, swarm or herd. Despite the abundance of modelling studies, only recently have researchers developed techniques to determine the interaction rules among real animals. Here, we use high-resolution GPS (global positioning system) tracking to study these interactions in pairs of pigeons flying home from a familiar site. Momentary changes in velocity indicate alignment with the neighbour's direction, as well as attraction or avoidance depending on distance. Responses were stronger when the neighbour was in front. From the flocking behaviour, we develop a model to predict features of group navigation. Specifically, we show that the interactions between pigeons stabilize a side-by-side configuration, promoting bidirectional information transfer and reducing the risk of separation. However, if one bird gets in front it will lead directional choices. Our model further predicts, and observations confirm, that a faster bird (as measured from solo flights) will fly slightly in front and thus dominate the choice of homing route. Our results explain how group decisions emerge from individual differences in homing flight behaviour. PMID:24068173

  9. THE ROLE OF SUPPORT GROUPS IN THE COOPERATION BETWEEN PARENTS OF PEOPLE WITH INTELLECTUAL DISABILITIES AND PROFESSIONAL STAFF

    Directory of Open Access Journals (Sweden)

    Metka NOVAK

    2014-09-01

    Full Text Available Introduction: One of the ways of building and developing a better cooperative relationship between parents of people with severe and profound intellectual disabilities and professional staff is the inclusion of parents in support groups for parents and staff in support groups for staff. Goal: To examine the correlation of the level of cooperative relationship between the parents of people with severe and profound intellectual disabilities and professional staff with the inclusion of parents in support groups for parents and staff in support groups for staff. Methodology: Respondents: parents (296 of people with severe and profound learning disabilities and staff (298 in five centres across Slovenia; Methods: descriptive statistics, test of homogeneity, the rankit method, one-way analysis of variance; Procedures: survey questionnaires for parents and staff. The data was processed using SPSS software for personal computers. Results: The difference between the variances of the groups (parent found is statistically significant (F = 6.16; p = 0.01. Staff included in support groups have a significantly lower level of cooperative relationship with parents (f=10; M = - 0.12 than staff not included in these groups (f = 191; M = 0.04. Conclusion:In contrast to theoretical findings the results indicated less successful cooperation for professional staff included in support groups. The results furthermore did not confirm any differences in the cooperative relationship of parents included in support groups and those who are not. We suggest an in-depth analysis of the workings of support groups.

  10. Autonomous home-care nursing staff are more engaged in their work and less likely to consider leaving the healthcare sector: a questionnaire survey.

    NARCIS (Netherlands)

    Maurits, E.E.M.; Veer, A.J.E. de; Hoek, L.S. van der; Francke, A.L.

    2015-01-01

    Background: The need for home care is rising in many Western European countries, due to the ageing population and governmental policies to substitute institutional care with home care. At the same time, a general shortage of qualified home-care staff exists or is expected in many countries. It is

  11. Group 13 1990 ASCAN Ochoa talks to NASA staff pilot during T-38A training

    Science.gov (United States)

    1990-01-01

    Astronaut candidate (ASCAN) Ellen Ochoa reviews T-38A flight procedures with a NASA staff pilot while standing on an Ellington Field runway. Later, Ochoa, along with classmates from the Group 13 1990 Astronaut class, took a T-38A familiarization flight. Ellington Field is located near JSC.

  12. [The elderly, nursing homes and life voyages: a psychodrama group study].

    Science.gov (United States)

    Kalkan Oğuzhanoğlu, Nalan; Osman, Ozdel

    2005-01-01

    To investigate the applicability of psychodrama orientated group work among the elderly living in nursing homes, and effect of this group work on coping with psychological and behavioral problems. Eleven male volunteers were chosen for the group. None of them had any negative features on communicating with others or had somatic or serious psychological problems. Eighteen psychodrama orientated group work sessions were held. Each was 2.5 to 3 hours long and took place only once a week. The staff of the nursing home became involved in the process after the twelfth session. Therapists registered their observations at every meeting. To evaluate the anxiety-depression levels the Geriatric Depression Scale and Hamilton Anxiety Rating Scale were used. Due to a late warm up among the members in this group, dramatization took place in later sessions. During the study, an increase in the members' spontaneity, creativity and empathy and consequently an improvement in communicating with and helping others, and coping with problems were observed. Articulation of emotions and thoughts improved gradually during the study. Somatic and total anxiety scores decreased significantly. This study shows that psychodrama group work can be used with the elderly and it may be helpful for improving psychological and behavioral areas, and for discovering the meaning of life.

  13. [Assessing deinstitutionalization of the nursing home area of a large state mental hospital from the point of view of patients and staff].

    Science.gov (United States)

    Kallert, T W; Stoll, A; Leisse, M; Winiecki, P

    2004-08-01

    Within the deinstitutionalization process of a large psychiatric hospital, the development of two cohorts of patients with chronic schizophrenia is compared over a two-year period: patients living in the hospital's nursing-home area (n = 50) vs. patients already released to two social therapeutic hostels (n = 51). Results of the cohort study were compared with assessments of nurses working in the nursing home (n = 55), focusing on their subjective views of the deinstitutionalization process and its impact on their working conditions. Patients are assessed through yearly home-visits in their place of residence. The instruments used measure several outcome parameters: psychopathology, social disabilities, subjective quality of life, and normative needs for care. Concurrent staff assessments were conducted using standardized survey instruments focusing on current working conditions and quality of teamwork. Nineteen nurses participated in qualitative interviews evaluating the deinstitutionalization process. For all measures, patients living in the nursing home show significantly worse outcomes. Furthermore, during the study period 34 % experienced a change in their living situation with which they were dissatisfied. Needs for care and the number of areas of "unmet" need increased significantly for this subgroup. Patients living in social therapeutic hostels demonstrate stable levels of psychopathological symptoms, social disabilities, and needs for care. Assessments indicating a deterioration in patients' subjective quality of life focus mainly on areas important for social contacts. Regarding "personal concerns" and "insecurity at work", ratings from nursing home staff were significantly worse than those of a reference group from several other health care institutions (n = 224). Staff showed a tendency to give higher ratings for their opportunities to participate in decisions, in contrast with the low ratings for chances to improve their knowledge in the workplace, a

  14. Person-centered care in Norwegian nursing homes and its relation to organizational factors and staff characteristics: a cross-sectional survey.

    Science.gov (United States)

    Røen, Irene; Kirkevold, Øyvind; Testad, Ingelin; Selbæk, Geir; Engedal, Knut; Bergh, Sverre

    2017-12-04

    Person-centered care (PCC) is regarded as good quality care for persons with dementia. This study aimed to explore and understand the association between PCC and organizational, staff and unit characteristics in nursing homes (NHs). Staff from 175 NH units in Norway (n = 1,161) completed a survey, including measures of PCC and questions about staff characteristics and work-related psychosocial factors. In addition, data about organizational and structural factors and assessment of the physical environment in the units were obtained. The distribution of these factors in regular units (RUs) and special care units (SCUs) is described, and the differences between the two types of units are analyzed. Furthermore, multilevel linear regression analyses explored the extent to which variables were associated with PCC. Higher levels of PCC were associated with a greater job satisfaction, three years or more of health-related education, a lower level of quantitative demands and role conflict, a higher level of perception of mastery, empowering leadership, innovative climate and perception of group work, in addition to the type of unit and the physical environment in the NH unit designed for people with dementia. SCU and staff job satisfaction explained most of the variation in PCC. This study shows an association between PCC and organizational, staff and unit characteristics in NH. These findings indicate that providing PCC in NH care is closely linked to how the staff experiences their job situation in addition to both organizational and structural factors and the physical environment. Attention needs to be given to such factors when planning NH care.

  15. Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (Managing Agitation and Raising Quality of Life) English national care home survey.

    Science.gov (United States)

    Cooper, Claudia; Marston, Louise; Barber, Julie; Livingston, Deborah; Rapaport, Penny; Higgs, Paul; Livingston, Gill

    2018-01-01

    There are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive care behaviours. 1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory. Most staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent. Many care home staff were never or almost never aware of a resident being taken out of the home for their enjoyment (34%, n = 520); or an activity planned around a resident's interests (15%, n = 234). 763 (51%; 95% Confidence Interval (CI) 47% to 54%) of care home staff reported carrying out or observing potentially abusive or neglectful behaviours at least sometimes in the preceding 3 months; some abuse was reported as happening "at least sometimes" in 91/92 care homes. Neglect was most frequently reported: making a resident wait for care (n = 399, 26%), avoiding a resident with challenging behaviour (n = 391, 25%), giving residents insufficient time for food (n = 297, 19%), and taking insufficient care when moving residents (n = 169, 11%). 1.1% of staff reported physical and 5% verbal abuse. More staff reported abusive/neglectful behaviour in homes with higher staff burnout-depersonalisation scores (adjusted odds ratio 1.191, CI 1.052-1.349). Staff anonymous reports of abusive behaviour and neglect could be used to monitor care quality, as cases currently reported are probably tip of the iceberg, and be an outcome in intervention studies.

  16. A facility specialist model for improving retention of nursing home staff: results from a randomized, controlled study.

    Science.gov (United States)

    Pillemer, Karl; Meador, Rhoda; Henderson, Charles; Robison, Julie; Hegeman, Carol; Graham, Edwin; Schultz, Leslie

    2008-07-01

    This article reports on a randomized, controlled intervention study designed to reduce employee turnover by creating a retention specialist position in nursing homes. We collected data three times over a 1-year period in 30 nursing homes, sampled in stratified random manner from facilities in New York State and Connecticut and randomly assigned to treatment and control conditions. Staff outcomes were measured through certified nursing assistant interviews, and turnover rates were measured over the course of the year. In the intervention condition, a staff member was selected to be the facility retention specialist, who would advocate for and implement programs to improve staff retention and commitment throughout the facility. Retention specialists received an intensive 3-day training in retention leadership and in a number of evidence-based retention programs. Ongoing support was provided throughout the project. Treatment facilities experienced significant declines in turnover rates compared to control facilities. As predicted, we found positive effects on certified nursing assistant assessments of the quality of retention efforts and of care provided in the facility; we did not find effects for job satisfaction or stress. The study provides evidence for the effectiveness of the retention specialist model. Findings from a detailed process evaluation suggest modifications of the program that may increase program effects.

  17. Nursing home staff members' attitudes and knowledge about urinary incontinence: the impact of technology and training.

    Science.gov (United States)

    Ehlman, Katie; Wilson, Amy; Dugger, Renee; Eggleston, Brandon; Coudret, Nadine; Mathis, Sherri

    2012-01-01

    Urinary incontinence (UI) poses challenges for nursing home personnel. The authors of this study explored differences in attitude and knowledge about UI among registered nurses, licensed practical nurses, and certified nursing assistants working in skilled nursing homes before and after study interventions.

  18. A nursing home staff tool for the indoor visual environment : the content validity

    NARCIS (Netherlands)

    Sinoo, M.M.; Kort, H.S.M.; Loomans, M.G.L.C.; Schols, J.M.G.A.

    2016-01-01

    In the Netherlands, over 40% of nursing home residents are estimated to have visual impairments. This results in the loss of basic visual abilities. The nursing home environment fits more or less to residents’ activities and social participation. This is referred to as environmental fit. To raise

  19. A nursing home staff tool for the indoor visual environment: The content validity

    NARCIS (Netherlands)

    Marcel G.L.C. Loomans; Dr. H.S.M. Kort; Marianne M. Sinoo; Jos M.G.A Schols

    2016-01-01

    In the Netherlands, over 40% of nursing home residents are estimated to have visual impairments. This results in the loss of basic visual abilities. The nursing home environment fits more or less to residents’ activities and social participation. This is referred to as environmental fit. To raise

  20. Attitudes towards patient gender among psychiatric hospital staff: results of a case study with focus groups.

    Science.gov (United States)

    Krumm, Silvia; Kilian, Reinhold; Becker, Thomas

    2006-03-01

    There is an increasing awareness of gender-related issues in psychiatry. However, empirical findings on attitudes of psychiatric staff towards patient gender are limited. Gender-related issues are particularly relevant in the debate about mixed versus segregated sex wards, yet while the appropriateness of mixed-sex wards is questioned in Great Britain this is not the case in Germany. To investigate attitudes of psychiatric staff towards both patient gender and mixed versus segregated sex wards, we conducted a case study using focus groups with members of professional teams. We evaluated the transition process from two single-sex wards to two mixed-sex wards in a 330-bed psychiatric hospital in a rural area in south Germany. Staff described female patients as more externally oriented, motivating of others, demanding, and even sexually aggressive. Male patients, on the other hand, were described as more quiet, modest, or lazy. Furthermore, participants described the mixing process as a positive development whereas they did not see a need for gender-separated wards in order to protect vulnerable female patients. Some gender descriptions by professionals are "reversed" in comparison with gender stereotypes supposed to be present in wider society. The perception of crossed gender norms may affect staff attitudes towards the vulnerability of female patients in psychiatric settings and the provision of single-sex wards in in-patient psychiatric care. Practical implications are discussed against the background of a high rate of female patients with sexual abuse histories.

  1. OCCUPATIONAL BURNOUT LEVELS OF ACADEMIC STAFF: TURKEY-MALTA STUDY GROUP SAMPLE

    OpenAIRE

    Demirtas, Cagri; Kapusuzoglu, Saduman

    2016-01-01

    The study group of this survey comprises of 185academic staff working in the University, Faculty of Education and Faculty ofEconomics and Administrative Sciences, in Turkey, and Malta University, Facultyof Education and Faculty of Economy, Management and Accounting. This study is adescriptive survey model, in which the assessment tool of Maslach BurnoutInventory is used. The burnout levels of academic personnel are investigated interm of gender, age and Faculty variables. As a result, it was ...

  2. 24 CFR 982.613 - Group home: Rent and voucher housing assistance payment.

    Science.gov (United States)

    2010-04-01

    ... Special Housing Types Group Home § 982.613 Group home: Rent and voucher housing assistance payment. (a... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Group home: Rent and voucher housing assistance payment. 982.613 Section 982.613 Housing and Urban Development Regulations Relating to...

  3. 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

  4. Outcomes in knowledge, attitudes and confidence of nursing staff working in nursing and residential care homes following a dementia training programme.

    Science.gov (United States)

    Scerri, Anthony; Scerri, Charles

    2017-11-08

    Dementia training programmes for staff working in long-term care settings have been found to be effective in improving staff outcomes. This study investigated the impact of a dementia training programme for all Maltese nursing staff working in public nursing/residential homes on their knowledge, attitudes and confidence. Additionally, we identified the predictors of these domains before and after the programme. A 14-hour training programme focusing on dementia management, care and policy was developed for all nursing staff working in public nursing and residential homes in Malta. A pretest-posttest design was used to evaluate the participants' knowledge of dementia, attitudes and confidence in working with residents with dementia using validated tools. Demographic variables were measured and compared with each staff domain. The majority of nursing staff attended the training programme with 261 fully completed questionnaires being collected pre-training and 214 post-training. The programme significantly improved nursing staff knowledge, attitudes and confidence. Stepwise regression analysis of each staff domain showed that the strongest predictor in all models at pre-training was the intensity of previous training programmes. Furthermore, staff who attended previous training continued to improve in their attitudes and confidence following programme completion. The study continues to shed further evidence on the impact of dementia training programs on staff outcomes. It also indicated that the intensity of previous participation in dementia training programmes was related to the participants' knowledge, attitudes and confidence and that continual exposure to training had a cumulative effect.

  5. The effect of staff training on agitation and use of restraint in nursing home residents with dementia: a single-blind, randomized controlled trial.

    Science.gov (United States)

    Testad, Ingelin; Ballard, Clive; Brønnick, Kolbjørn; Aarsland, Dag

    2010-01-01

    Agitation is common in dementia and is associated with use of restraints and use of psychotropic drugs. The aim of this study was to determine whether an education and supervision intervention could reduce agitation and the use of restraints and antipsychotic drugs in nursing homes. Four Norwegian nursing homes were randomly allocated to receive either treatment as usual or an intervention consisting of a 2-day educational seminar and monthly group guidance for 6 months. One hundred forty-five residents with dementia (based on medical records and corroborated with a Functional Assessment Staging score >or= 4) completed baseline and 6-month intervention assessments and were included in the analyses. The co-primary outcome measures were the proportion of residents subject to interactional restraint and the severity of agitation using the Cohen-Mansfield Agitation Inventory (CMAI). Patients were assessed at baseline, immediately after completion of the intervention at 6 months, and 12 months after baseline. Comparison of change in the 2 groups was made using repeated-measures analysis of variance (CMAI) and Mann-Whitney test (restraints). The study was conducted from 2003 to 2004. The proportion of residents starting new restraint was lower in the intervention than in the control group at 6-month evaluation (P = .02), but no statistically significant differences were found at 12-month assessment (P = .57). The total CMAI score declined from baseline to 6 and 12 months' follow-up in the intervention homes compared to a small increase in the control homes (F2,176 = 3.46, P = .034). There were no statistically significant differences in use of antipsychotic drugs. A brief 2-day staff education program followed by continued monthly guidance was able both to improve quality of care by reducing the frequency of interactional restraints and to reduce severity of agitation. ©Copyright 2010 Physicians Postgraduate Press, Inc.

  6. "Giving us hope": Parent and neonatal staff views and expectations of a planned family-centred discharge process (Train-to-Home).

    Science.gov (United States)

    Ingram, Jenny; Redshaw, Maggie; Manns, Sarah; Beasant, Lucy; Johnson, Debbie; Fleming, Peter; Pontin, David

    2017-08-01

    Preparing families and preterm infants for discharge is relatively unstructured in many UK neonatal units (NNUs). Family-centred neonatal care and discharge planning are recommended but variable. Qualitative interviews with 37 parents of infants in NNUs, and 18 nursing staff and 5 neonatal consultants explored their views of discharge planning and perceptions of a planned family-centred discharge process (Train-to-Home). Train-to-Home facilitates communication between staff and parents throughout the neonatal stay, using a laminated train and parent booklets. Parents were overwhelmingly positive about Train-to-Home. They described being given hope, feeling in control and having something visual to show their baby's progress. They reported positive involvement of fathers and families, how predicted discharge dates helped them prepare for home and ways staff engaged with Train-to-Home when communicating with them. Nursing staff reactions were mixed-some were uncertain about when to use it, but found the visual images powerful. Medical staff in all NNUs were positive about the intervention recognizing that it helped in communicating better with parents. Using a parent-centred approach to communication and informing parents about the needs and progress of their preterm infant in hospital is welcomed by parents and many staff. This approach meets the recommended prioritization of family-centred care for such families. Predicted discharge dates helped parents prepare for home, and the ways staff engaged with Train-to-Home when communicating with them helped them feel more confident as well as having something visual to show their baby's progress. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  7. Perceptions of telecare training needs in home healthcare services: a focus group study.

    Science.gov (United States)

    Guise, Veslemøy; Wiig, Siri

    2017-02-23

    The implementation and use of telecare requires significant changes to healthcare service organisation and delivery, including new ways of working for staff. Competency development and training for healthcare professionals is therefore required to enable necessary adaptation of clinical practice and ensure competent provision of telecare services. It is however unclear what skills healthcare staff need when providing care at a distance and there is little empirical evidence on effective training strategies for telecare practice. Training should however emphasise the experiences and preferences of prospective trainees to ensure its relevance to their educational needs. The aim of this study was to explore healthcare professionals' perceptions of training related to the general use of telecare, and to identify specific training needs associated with the use of virtual visits in the home healthcare services. Six focus group interviews were held with a total of 26 participants working in the home healthcare services in Norway, including registered nurses, enrolled nurses, physiotherapists, occupational therapists, social workers, health workers, and healthcare assistants. The data material was analysed by way of systematic text condensation. The analysis resulted in five categories relevant to telecare training for healthcare professionals: Purposeful training creates confidence and changes attitudes; Training needs depend on ability to cope with telecare; The timing of training; Training must facilitate practical insight into the patients' perspective; and Training content must focus on the telecare process. Findings are discussed in light of implications for the form and content of a training program for healthcare professionals on how to undertake virtual home healthcare visits. Appropriate preparation and training for telecare use is important for healthcare professionals and must be taken seriously by healthcare organisations. To facilitate the knowledge, skills

  8. Quality of Care in the Nursing Home: Effects of Staff Assignment and Work Shift

    Science.gov (United States)

    Burgio, Louis D.; Fisher, Susan E.; Fairchild, J. Kaci; Scilley, Kay; Hardin, J. Michael

    2004-01-01

    Purpose: The purpose of this study was to compare a variety of resident and staff outcomes across two types of staffing patterns, permanent and rotating assignment, and work shift. Although studies have examined these staffing patterns as part of multicomponent intervention packages, few studies have examined the isolated effects of staffing…

  9. Using research evidence to inform staff learning needs in cross-cultural communication in aged care homes.

    Science.gov (United States)

    Gillham, David; De Bellis, Anita; Xiao, Lily; Willis, Eileen; Harrington, Ann; Morey, Wendy; Jeffers, Lesley

    2018-04-01

    Developed countries worldwide are facing an unprecedented demand for aged care services, with recent migrants of diverse linguistic and cultural backgrounds increasingly recruited as care workers while at the same time there is growing cultural diversity among aged care residents. This situation is compounded by rapidly changing technology and varied educational levels of care workers from diverse backgrounds. The objectives were threefold: to identify staff learning needs to enable them to provide high-quality cross-cultural care; to improve team cohesion; and identify preferred learning approaches. An interpretive qualitative study utilising focus group and interview data informed the development of an education resource. Fifty six care workers from four residential aged care facilities participated in either focus groups or interviews conducted in private meeting rooms within the care facilities. Participants included personal care attendants, registered and clinical nurses, managers, hospitality staff and allied health professionals. Focus group and interview data were categorised and thematically analysed. Data relevant to cross-cultural care, team cohesion and preferred learning approaches informed education resource development, including case studies. Major themes identified the need to promote cultural awareness and understanding, and strategies for cross-cultural care and communication. Themes related to team cohesion demonstrated that staff were already sympathetic and sensitive to cross-cultural issues, and that culturally and linguistically diverse staff add value to the workforce and are supported by the organisation. Staff required clear, uncomplicated education resources to equip them with skills to address problematic cultural situations. Preferred learning approaches varied and highlighted the need for varied educational materials and approaches, as well as time efficient, opportunistic education strategies for the busy workplace. An education

  10. Qualitative evaluation of a physical activity health promotion programme for people with intellectual disabilities in a group home setting.

    Science.gov (United States)

    Dixon-Ibarra, A; Driver, S; Nery-Hurwit, M; VanVolkenburg, H

    2018-01-01

    There is a lack of health promotion programming designed to change the physical activity environment of the group home setting. The Menu-Choice programme assists staff in creating physical activity goals alongside residents with intellectual disabilities and provides strategies to incorporate activity into the group home schedule. The purpose of this study was to complete a process evaluation of Menu-Choice utilizing qualitative methods. Twelve participants, who completed a 10-week pilot intervention (n = 7 staff, mean age 42; n = 5 residents, mean age 52), participated in face-to-face interviews. Participants represented five group home sites involved in the intervention. Meta-themes included: (i) Programme training, (ii) Programme implementation, (iii) Programme physical activity, (iv) Programme barriers, (v) Programme facilitators and (vi) Programme feedback. Changes in programme training and simplified programme materials are needed to accommodate identified barriers for implementation. The importance of obtaining increased agency support and policy change is highlighted. © 2017 John Wiley & Sons Ltd.

  11. Impaired mental well-being and psychosocial risk: a cross-sectional study in female nursing home direct staff

    Science.gov (United States)

    Pélissier, C; Fontana, L; Fort, E; Vohito, M; Sellier, B; Perrier, C; Glerant, V; Couprie, F; Agard, J P; Charbotel, B

    2015-01-01

    Objectives The present study sought to quantify the impaired mental well-being and psychosocial stress experienced by nursing home staff and to determine the relationship between impaired mental well-being assessed on the 12-item General Health Questionnaire (GHQ-12) and exposure to psychosocial stress assessed on Siegrist's effort/reward and overcommitment model. Methods A transverse study was conducted in France on 2471 female employees in 105 nursing homes for the elderly. Personal and occupational data were collected by questionnaire for 668 housekeepers, 1454 nursing assistants and 349 nurses. Results 36.8% of participants (n=896) showed impaired mental well-being, 42.7% (n=1039) overcommitment and 9% (n=224) effort/reward imbalance. Overcommitment (prevalence ratio (PR)=1.27; 95% CI (1.21 to 1.34)) and effort–reward imbalance (PR=1.19; 95% CI (1.12 to 1.27)) were significantly associated with presence of impaired mental well-being after adjustment for personal factors (age and private life events). Taking effort and reward levels into account, the frequency of impaired mental well-being was highest in case of exposure to great extrinsic effort and low rewards of any type: esteem, PR=3.53, 95% CI (3.06 to 4.08); earnings, PR=3.48, 95% CI (2.99 to 4.06); or job security, PR=3.30, 95% CI (2.88 to 3.78). Participants in situations of overcommitment and of effort/reward imbalance were at the highest risk of impaired mental well-being: PR=3.86, 95% CI (3.42 to 4.35). Conclusions Several changes in nursing home organisation can be suggested to reduce staff exposure to factors of psychosocial stress. Qualitative studies of the relation between impaired mental well-being and psychosocial stress in nursing home staff could guide prevention of impaired mental well-being at work. PMID:25829371

  12. Risk factors for work-related stress and subjective hardship in health-care staff in nursing homes for the elderly: A cross-sectional study.

    Science.gov (United States)

    Pélissier, Carole; Vohito, Michel; Fort, Emmanuel; Sellier, Brigitte; Agard, Jean Pierre; Fontana, Luc; Charbotel, Barbara

    2015-01-01

    This study aimed to explore potential risk factors for work-related stress by, detailing working conditions and subjective hardship according to occupational category in health-care staff working with elderly patients. A cross-sectional descriptive survey was conducted in 105 nursing homes for the elderly in France. Data on nursing home working conditions were collected by occupational physicians. The study population was limited to those in direct contact with the elderly, who were divided into 3 occupational groups defined by qualifications and tasks: housekeepers (HKs), nursing assistants (NAs) and nurses (Ns). Employees answered a questionnaire on their perceived working conditions and vocational training courses. Psychosocial stress was assessed with the Siegrist questionnaire. The subjects included 706 HKs, 1,565 NAs and 378 Ns, and the findings showed confusion of tasks and responsibilities in the study population. Verbal abuse by residents was reported by 60.9% of HKs (versus 76.2% of NAs and 76.7% of Ns, pstress related to insufficient ability, nursing home workers should be encouraged to attend job training courses, which should cover knowledge of the specific care needs of elderly patients and of the authority/responsibility required to do their job.

  13. Home-care nursing staff in self-directed teams are more satisfied with their job and feel they have more autonomy over patient care: a nationwide survey.

    Science.gov (United States)

    Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

    2017-10-01

    The aims of this study were: (1) To examine whether working in a self-directed team is related to home-care nursing staff's job satisfaction; (2) To assess the mediating effect of self-perceived autonomy over patient care; (3) To investigate the moderating effect of educational level on the association between autonomy over patient care and job satisfaction. Self-directed teams are being introduced in home care in several countries. It is unknown whether working in a self-directed team is related to nursing staff's job satisfaction. It is important to gain insight into this association since self-directed teams may help in retaining nursing staff. A cross-sectional study based on two questionnaire surveys in 2014 and 2015. The study involved 191 certified nursing assistants and registered nurses employed in Dutch home-care organizations (mean age of 50). These were members of the Dutch Nursing Staff Panel, a nationwide panel of nursing staff working in various healthcare settings. Self-direction is positively related to nursing staff's job satisfaction. This relationship is partly mediated by autonomy over patient care. For certified nursing assistants and registered nurses with a bachelor's degree, a greater sense of autonomy over patient care in self-directed teams is positively related to job satisfaction. No significant association was found between autonomy over patient care and job satisfaction for registered nurses with an associate degree. This study suggests that home-care organizations should consider the use of self-directed teams as this increases nursing staff's job satisfaction and may therefore help to retain nursing staff in home care. © 2017 John Wiley & Sons Ltd.

  14. A game-based strategy for the staff development of home health care nurses.

    Science.gov (United States)

    Popil, Inna; Dillard-Thompson, Darlene

    2015-05-01

    This article describes gaming, an interactive teaching strategy that promotes active learning. An evaluation study conducted with home health care nurses tested the use of a game as a teaching tool. The study evaluated learning outcomes and learners' level of engagement and satisfaction with an educational game as a teaching method. Copyright 2015, SLACK Incorporated.

  15. The impact of personality on person-centred care: a study of care staff in Swedish nursing homes.

    Science.gov (United States)

    Elfstrand Corlin, Tinna; Kajonius, Petri J; Kazemi, Ali

    2017-06-01

    In this study, we explore how personal and situational factors relate to the provision of person-centred care (PCC) in nursing homes. Specifically, we focus on the relationship between the care staff's personality traits and provision of PCC and to what extent perceptions of the working environment influences this relationship. The ultimate goal of elderly care is to meet the older person's needs and individual preferences (PCC). Interpersonal aspects of care and the quality of relationship between the care staff and the older person are therefore central in PCC. A cross-sectional Swedish sample of elderly care staff (N = 322) completed an electronic survey including measures of personality (Mini-IPIP) and person-centred care (Individualized Care Inventory, ICI). A principal component analysis was conducted on the ICI-data to separate the user orientation (process quality) of PCC from the preconditions (structure quality) of PCC. Among the five factors of personality, neuroticism was the strongest predictor of ICI user orientation. ICI preconditions significantly mediated this relationship, indicating the importance of a supportive working environment. In addition, stress was introduced as a potential explanation and was shown to mediate the impact of neuroticism on ICI preconditions. Personality traits have a significant impact on user orientation, and the perception of a supportive and stress free working environment is an important prerequisite for achieving high-quality person-centred elderly care. Understanding how personality is linked to the way care staff interacts with the older person adds a new perspective on provision of person-centred elderly care. © 2016 John Wiley & Sons Ltd.

  16. Training of medical staff positively influences postoperative pain management at home in children.

    Science.gov (United States)

    Sepponen, K; Kokki, H; Ahonen, R

    1999-08-01

    The aim of this study was to describe how parents manage their child's postoperative pain at home following day-case surgery. The incidence of pain, different analgesics used and problems related to administering medications were the main interests of the study. A postal questionnaire was sent to the parents of 275 children who were under 8 years of age and had undergone an ear, nose and throat (ENT) day-case operation. The questionnaire was sent to the parents a week after discharge from hospital. Altogether, the parents of 227 children answered the questionnaire (response rate 83%). The study was divided into two phases (preintervention and postintervention), and incorporated a training program for doctors and nurses between these two phases. The training program aimed to improve the treatment practices of postoperative pain in children. Seventy-eight per cent of the children in the preintervention study and 75% in the postintervention study experienced at least mild pain after discharge. The training program for doctors and nurses affected the home treatment practices of postoperative pain. The proportion of parents treating their children increased from 68% to 80% after the training program (p = 0.028). Many parents faced problems while treating their children; for example, 19% (n = 30) of the children refused to take their medicine, and suppositories were regarded to be an especially unpleasant dosage form. However, no serious adverse effects were reported. We conclude that due to the pain experienced at home by the great majority of children following day-case ENT operations, parents need information on how to manage their child's pain. A training program for doctors and nurses can improve the treatment of children's pain even at home. Since some children dislike suppositories, it would be worth considering the use of small tablets or mixtures instead.

  17. Survey of home hemodialysis patients and nursing staff regarding vascular access use and care

    OpenAIRE

    Spry, Leslie A; Burkart, John M; Holcroft, Christina; Mortier, Leigh; Glickman, Joel D

    2014-01-01

    Vascular access infections are of concern to hemodialysis patients and nurses. Best demonstrated practices (BDPs) have not been developed for home hemodialysis (HHD) access use, but there have been generally accepted practices (GAPs) endorsed by dialysis professionals. We developed a survey to gather information about training provided and actual practices of HHD patients using the NxStage System One HHD machine. We used GAP to assess training used by nurses to teach HHD access care and then ...

  18. Are nursing home survey deficiencies higher in facilities with greater staff turnover.

    Science.gov (United States)

    Lerner, Nancy B; Johantgen, Meg; Trinkoff, Alison M; Storr, Carla L; Han, Kihye

    2014-02-01

    To examine CNA and licensed nurse (RN+LPN/LVN) turnover in relation to numbers of deficiencies in nursing homes. A secondary data analysis of information from the National Nursing Home Survey (NNHS) and contemporaneous data from the Online Survey, Certification and Reporting (OSCAR) database. Data were linked by facility as the unit of analysis to determine the relationship of CNA and licensed nurse turnover on nursing home deficiencies. The 2004 NNHS used a multistage sampling strategy to generate a final sample of 1174 nursing homes, which represent 16,100 NHs in the United States. This study focused on the 1151 NNHS facilities with complete deficiency data. Turnover was defined as the total CNAs/licensed nurse full-time equivalents (FTEs) who left during the preceding 3 months (full- and part-time) divided by the total FTE. NHs with high turnover were defined as those with rates above the 75th percentile (25.3% for CNA turnover and 17.9% for licensed nurse turnover) versus all other facilities. This study used selected OSCAR deficiencies from the Quality of Care, Quality of Life, and Resident Behavior categories, which are considered to be more closely related to nursing care. We defined NHs with high deficiencies as those with numbers of deficiencies above the 75th percentile versus all others. Using SUDAAN PROC RLOGIST, we included NNHS sampling design effects and examined associations of CNA/licensed nurse turnover with NH deficiencies, adjusting for staffing, skill mix, bed size, and ownership in binomial logistic regression models. High CNA turnover was associated with high numbers of Quality of Care (OR 1.53, 95% CI 1.10-2.13), Resident Behavior (OR 1.42, 95% CI 1.03-1.97) and total selected deficiencies (OR 1.54, 95% CI 1.12-2.12). Licensed nurse turnover was significantly related to Quality of Care deficiencies (OR 2.06, 95% CI 1.50-2.82) and total selected deficiencies (OR 1.71, 95% CI 1.25-2.33). When both CNA turnover and licensed nurse turnover were

  19. Solving a More Flexible Home Health Care Scheduling and Routing Problem with Joint Patient and Nursing Staff Selection

    Directory of Open Access Journals (Sweden)

    Jamal Abdul Nasir

    2018-01-01

    Full Text Available Development of an efficient and effective home health care (HHC service system is a quite recent and challenging task for the HHC firms. This paper aims to develop an HHC service system in the perspective of long-term economic sustainability as well as operational efficiency. A more flexible mixed-integer linear programming (MILP model is formulated by incorporating the dynamic arrival and departure of patients along with the selection of new patients and nursing staff. An integrated model is proposed that jointly addresses: (i patient selection; (ii nurse hiring; (iii nurse to patient assignment; and (iv scheduling and routing decisions in a daily HHC planning problem. The proposed model extends the HHC problem from conventional scheduling and routing issues to demand and capacity management aspects. It enables an HHC firm to solve the daily scheduling and routing problem considering existing patients and nursing staff in combination with the simultaneous selection of new patients and nurses, and optimizing the existing routes by including new patients and nurses. The model considers planning issues related to compatibility, time restrictions, contract durations, idle time and workload balance. Two heuristic methods are proposed to solve the model by exploiting the variable neighborhood search (VNS approach. Results obtained from the heuristic methods are compared with a CPLEX based solution. Numerical experiments performed on different data sets, show the efficiency and effectiveness of the solution methods to handle the considered problem.

  20. Exploring Parental and Staff Perceptions of the Family-Integrated Care Model: A Qualitative Focus Group Study.

    Science.gov (United States)

    Broom, Margaret; Parsons, Georgia; Carlisle, Hazel; Kecskes, Zsuzsoka; Thibeau, Shelley

    2017-12-01

    Family-integrated care (FICare) is an innovative model of care developed at Mount Sinai Hospital, Canada, to better integrate parents into the team caring for their infant in the neonatal intensive care unit (NICU). The effects of FICare on neonatal outcomes and parental anxiety were assessed in an international multicenter randomized trial. As an Australian regional level 3 NICU that was randomized to the intervention group, we aimed to explore parent and staff perceptions of the FICare program in our dual occupancy NICU. This qualitative study took place in a level 3 NICU with 5 parent participants and 8 staff participants, using a post implementation review design. Parents and staff perceptions of FICare were explored through focus group methodology. Thematic content analysis was done on focus group transcripts. Parents and staff perceived the FICare program to have had a positive impact on parental confidence and role attainment and thought that FICare improved parent-to-parent and parent-to-staff communication. Staff reported that nurses working with families in the program performed less hands-on care and spent more time educating and supporting parents. FICare may change current NICU practice through integrating and accepting parents as active members of the infant's care team. In addition, nurse's roles may transition from bedside carer to care coordinator, educating and supporting parents during their journey through the NICU. Further research is needed to assess the long-term impact of FICare on neonates, parents, and staff.

  1. Human resource assignment and role representation mechanism with the "cascading staff-group authoring" and "relation/situation" model.

    Science.gov (United States)

    Hirose, Y; Sasaki, Y; Kinoshita, A

    2001-01-01

    We have previously reported the access control mechanism and audit strategy of the "patient-doctor relation and clinical situation at the point-of-care" model with multi-axial access control matrix (ACM). This mechanism overcomes the deficit of ACM in the aspect of data accessibility but does not resolve the representation of the staff's affiliate and/or plural membership in the complex real world. Care groups inside a department or inter-department clinical team plays significant clinical role but also spend great amount of time and money in the hospital. Therefore the impact of human resource assignment and cost of such stakeholders to the hospital management is huge, so that they should be accurately treated in the hospital information system. However multi-axial ACM has problems with the representation of staff groups due to static parameters such as department/license because staffs belong to a group rather temporarily and/or a medical staff may belong to plural groups. As a solution, we have designed and implemented "cascading staff-group authoring" method with "relation and situation" model and multi-axial ACM. In this mechanism, (i) a system administrator certifies "group chief certifying person" according to the request and authorization by the department director, (ii) the "group chief certifying person" certifies "group chief(s)", (iii) the "group chief" recruits its members from the medical staffs, and at the same time the "group chief" decides the profit distribution policy of this group. This will enable medical staff to access EMR according to the role he/she plays whether it is as a department staff or as a group member. This solution has worked successfully over the past few years. It provides end-users with a flexible and time-to-time staff-group authoring environment using a simple human-interfaced tool without security breach and without system administration cost. In addition, profit and cost distribution is clarified among departments and

  2. Job-Demands, Job Control, Social Support, Self-Efficacy, and Burnout of Staff of Residential Children's Homes

    Science.gov (United States)

    Brouwers, André; Tomic, Welko

    2016-01-01

    The aim of the current study was to examine among educational staff members of residential children's homes to what extent task demands, job control, emotional and social support from colleagues and management as well as self-efficacy beliefs concerning coping with aggressive behaviour in youngsters are associated with emotional exhaustion,…

  3. Living preference modeling of smart homes for different target groups

    NARCIS (Netherlands)

    Allameh, E.; Heidari Jozam, M.; de Vries, B.

    2018-01-01

    The smart home concept has been around for more than 30 years. It is nevertheless fair to say that it has not taken off commercially on a wider basis so far, in spite of many optimistic forecasts over the years. One of the main reasons for this, aiming to be addressed in this paper, is that the

  4. Linking Structure, Process, and Outcome to Improve Group Home Services for Foster Youth in California

    Science.gov (United States)

    Green, Rex S.; Ellis, Peter T.

    2007-01-01

    The California Youth Connection obtained funding from two foundations to evaluate the performance of group homes serving foster youth in Alameda County, California, in order to inform state policy-making. The evaluation team initially included 14 foster youth that personally experienced group home living. Three inter-related aspects of service…

  5. Promoting Health of People with Intellectual Disabilities: Views of Professionals Working in Group Homes

    Science.gov (United States)

    Wahlström, Lina; Bergström, Helena; Marttila, Anneli

    2014-01-01

    Deinstitutionalisation has influenced the life situation for people with intellectual disabilities, whilst the experiences of health promotion in group homes now are limited. This study aimed to explore aspects important to consider when promoting health amongst persons with intellectual disabilities in group homes, from the perspective of…

  6. Survey of home hemodialysis patients and nursing staff regarding vascular access use and care.

    Science.gov (United States)

    Spry, Leslie A; Burkart, John M; Holcroft, Christina; Mortier, Leigh; Glickman, Joel D

    2015-04-01

    Vascular access infections are of concern to hemodialysis patients and nurses. Best demonstrated practices (BDPs) have not been developed for home hemodialysis (HHD) access use, but there have been generally accepted practices (GAPs) endorsed by dialysis professionals. We developed a survey to gather information about training provided and actual practices of HHD patients using the NxStage System One HHD machine. We used GAP to assess training used by nurses to teach HHD access care and then assess actual practice (adherence) by HHD patients. We also assessed training and adherence where GAPs do not exist. We received a 43% response rate from patients and 76% response from nurses representing 19 randomly selected HHD training centers. We found that nurses were not uniformly instructing HHD patients according to GAP, patients were not performing access cannulation according to GAP, nor were they adherent to their training procedures. Identification of signs and symptoms of infection was commonly trained appropriately, but we observed a reluctance to report some signs and symptoms of infection by patients. Of particular concern, when aggregating all steps surveyed, not a single nurse or patient reported training or performing all steps in accordance with GAP. We also identified practices for which there are no GAPs that require further study and may or may not impact outcomes such as infection. Further research is needed to develop strategies to implement and expand GAP, measure outcomes, and ultimately develop BDP for HHD to improve infectious complications. © 2014 The Authors. Hemodialysis International published by Wiley Periodicals, Inc. on behalf of International Society for Hemodialysis.

  7. Care staff training based on person-centered care and dementia care mapping, and its effects on the quality of life of nursing home residents with dementia.

    Science.gov (United States)

    Yasuda, Mami; Sakakibara, Hisataka

    2017-09-01

    To assess the effects of care staff training based on person-centered care (PCC) and dementia care mapping (DCM) on the quality of life (QOL) of residents with dementia in a nursing home. An intervention of staff training based on PCC and DCM was conducted with 40 care staff members at a geriatric nursing home. The effects of the staff training on the QOL of residents with dementia were evaluated by the DCM measurements of 40 residents with dementia three times at about one-month intervals (first, baseline; second, pre-intervention; third, post-intervention). The well-being and ill-being values (WIB values) of the residents with dementia measured by DCM were not different between the first and second rounds before the staff training (p = 0.211). Meanwhile, the WIB values increased from the first and second rounds to the third post-intervention round (p = 0.035 and p Staff training based on PCC and DCM could effectively improve the QOL of residents with dementia.

  8. Influence of organizational context on nursing home staff burnout: A cross-sectional survey of care aides in Western Canada.

    Science.gov (United States)

    Chamberlain, Stephanie A; Gruneir, Andrea; Hoben, Matthias; Squires, Janet E; Cummings, Greta G; Estabrooks, Carole A

    2017-06-01

    Our study examined care aide characteristics, organizational context, and frequency of dementia-related resident responsive behaviours associated with burnout. Burnout is the experience of emotional exhaustion, cynicism, and professional inefficacy. Care aide burnout has implications for turnover, staff health, and quality of care. We used surveys collected from 1194 care aides from 30 urban nursing homes in three Western Canadian provinces. We used a mixed-effects regression analysis to assess care aide characteristics, dementia-related responsive behaviours, unit and facility characteristics, and organizational context predictors of care aide burnout. We measured burnout using the Maslach Burnout Inventory, Short Form. We found that care aides were at high risk for emotional exhaustion and cynicism, but report high professional efficacy. Statistically significant predictors of emotional exhaustion included English as a second language, medium facility size, organizational slack-staff, organizational slack-space, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of cynicism were care aide age, English as a second language, unit culture, evaluation (feedback of data), formal interactions, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of professional efficacy were unit culture and structural resources. Greater care aide job satisfaction was significantly associated with increased professional efficacy. This study suggests that individual care aide and organization features are both predictive of care aide burnout. Unlike care aide or structural characteristics of the facility elements of the organizational context are potentially modifiable, and therefore amenable to intervention. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. The Transition of Primary Care Group Practices to Next Generation Models: Satisfaction of Staff, Clinicians, and Patients.

    Science.gov (United States)

    Zink, Therese; Kralewski, John; Dowd, Bryan

    Restructuring primary care is essential to achieve the triple aim. This case study examines the human factors of extensive redesign on 2 midsized primary care clinics (clinics A and B) in the Midwest United States that are owned by a large health care system. The transition occurred when while the principles for patient-centered medical home were being rolled out nationally, and before the Affordable Care Act. After the transition, interviews and discussions were conducted with 5 stakeholder groups: health system leaders, clinic managers, clinicians, nurses, and reception staff. Using a culture assessment instrument, the responses of personnel at clinics A and B were compared with comparison clinics from another health system that had not undergone transition. Patient satisfaction scores are presented. Clinics A and B were similar in size and staffing. Three human factor themes emerged from interviews: responses to change, professional and personal challenges due to role redefinition, and the importance of communication. The comparison clinics had an equal or higher mean culture scores compared with the transition clinics (A and B). Patient satisfaction in improved in Clinic A. The transition took more time than expected. Health system leaders underestimated the stress and the role adjustments for clinicians and nurses. Change leaders need to anticipate the challenge of role redefinition until health profession schools graduate trainees with more experience in new models of team-based care. Incorporating experience with team based, interprofessional care into training is essential to properly prepare future health professionals. © Copyright 2017 by the American Board of Family Medicine.

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

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2014-09-01

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

  11. [Subjective hardship and training by female staff working in direct contact with the elderly in nursing homes: a cross-sectional study].

    Science.gov (United States)

    Pélissier, Carole; Fontana, Luc; Fort, Emmanuel; Charbotel, Barbara

    2015-12-01

    To describe training given and training desired and to assess the relation between training and perceived hard working conditions as experienced by female staff working in direct contact with the elderly in nursing homes. A transverse descriptive study was conducted with the involvement of 78 occupational physicians, and included staff in 105 nursing homes in the Rhône-Alpes Region of France. Data on training received during the previous 5 years and on training needs were collected from staff by self-administered questionnaire. 1,446 nursing assistants, 667 housekeepers and 348 nurses were included. The most frequent form of training during the previous 5 years was in handling. Staff most frequently desired training in palliative care and psychological approaches to residents. Part-time workers had less frequently had training during the previous 5 years. Staff with daytime hours significantly more often had training in the reception of and activities for the elderly and in hygiene than did night-staff. Almost half of respondents reported very hard working conditions related to physical handling of residents or to the physical deterioration of elderly persons. More than two-thirds reported very hard working conditions related to death. In all occupational categories, respondents who had had training in palliative care less often reported experiencing very hard working conditions related to death. Better adaptation of the training offer to the needs expressed by employees could improve the experience of working conditions in nursing homes. A longitudinal study could assess the impact of training in palliative care on reported hard working conditions related to death.

  12. Marginal Groups in Marginal Times: Gypsy and Traveller Parents and Home Education in England, UK

    Science.gov (United States)

    Bhopal, Kalwant; Myers, Martin

    2016-01-01

    This article examines the experiences of home education for Gypsy and Traveller groups in England, UK. We argue that home education is perceived in a particular historical "moment" characterised in the media and more generally throughout society by "risk". Against this backdrop this article considers Gypsy and Traveller…

  13. Justifying continuous sedation until death: a focus group study in nursing homes in Flanders, Belgium.

    Science.gov (United States)

    Rys, Sam; Deschepper, Reginald; Deliens, Luc; Mortier, Freddy; Bilsen, Johan

    2013-01-01

    Continuous Sedation until Death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, has become a common practice in nursing homes in Flanders (Belgium). Quantitative research has suggested that CSD is not always properly applied. This qualitative study aims to explore and describe the circumstances under which nursing home clinicians consider CSD to be justified. Six focus groups were conducted including 10 physicians, 24 nurses, and 14 care assistants working in either Catholic or non-Catholic nursing homes of varying size. Refractory suffering, limited life expectancy and respecting patient autonomy are considered essential elements in deciding for CSD. However, multiple factors complicate the care of nursing home residents at the end of life, and often hinder clinicians from putting these elements into practice. Nursing home clinicians may benefit from more information and instruction about managing CSD in the complex care situations which typically occur in nursing homes. Copyright © 2013 Mosby, Inc. All rights reserved.

  14. Staff Food-Related Behaviors and Children's Tastes of Food Groups during Lunch at Child Care in Oklahoma.

    Science.gov (United States)

    Anundson, Katherine; Sisson, Susan B; Anderson, Michael; Horm, Diane; Soto, Jill; Hoffman, Leah

    2017-10-04

    Young children should consume a variety of nutrient-dense foods to support growth, while limiting added fat and sugar. A majority of children between the ages of 3 and 5 years attend child care in the United States, which makes this environment and the child-care staff influential at meals. The aim was to determine the association between best-practice food-related behaviors and young children's tastes of fruit, vegetable, low-fat dairy, and high-fat/high-sugar foods at child care. This was a cross-sectional study. A community-based study with 201 children ages 3 to 5 years from 25 early care and education centers, including 11 tribally affiliated centers and two Head Start programs across Oklahoma. Data collection occurred from fall 2011 to spring 2014. Classroom observations used the Environmental Policy Assessment Observation tool to measure the staff behaviors and environment. Staff behavior was compared at three different levels: the composite score of staff nutrition behavior, each constituent staff behavior, and staff behaviors grouped into broader feeding behaviors. Tasted food was measured through the Dietary Observation in Child Care method. The children's meals were categorized into the following food groups: fruit, vegetable, low-fat dairy, fried vegetable, fried meat, high-fat meat, and high-fat/high-sugar food. Descriptive statistics were calculated for relevant variables. Relationships between the constituent staff behaviors and food groups that children tasted were compared using multilevel mixed-model analysis. The mean number of tasted fruit or vegetable items was higher and the mean number of tasted high-fat/high-sugar food items was lower when staff: 1) determined fullness before plate removal when less than half of food was eaten, 2) ate with the children, 3) and talked about healthy food. The utilization of the three staff behaviors and their association with higher mean tastes of nutrient-dense items and lower mean tastes of high

  15. Stayers, Leavers, and Switchers Among Certified Nursing Assistants in Nursing Homes: A Longitudinal Investigation of Turnover Intent, Staff Retention, and Turnover

    Science.gov (United States)

    Rosen, Jules

    2011-01-01

    Purpose: Studies of certified nursing assistant (CNA) turnover in nursing homes are typically cross-sectional and include full-time and part-time workers. We conducted a longitudinal study to evaluate the job factors and work attitudes associated with just full-time staying or leaving. For those who did not stay, we assessed reasons for leaving and satisfaction following job transition. Design and Methods: A random sample of CNAs identified through the Pennsylvania Department of Health's CNA registry, working≥30 hr weekly in a nursing facility was surveyed by telephone at baseline and 1 year later. Results: Of the 620 responding to both surveys, 532 (85.8%) remained (stayers), 52 (8.4%) switched to another facility (switchers), and 36 (5.8%) left the industry (leavers). At baseline, switchers reported higher turnover intentions and fewer benefits compared with stayers and left for new opportunities. Leavers had lower job satisfaction and emotional well-being and left for health reasons. Turnover intentions were predicted by low job satisfaction and low emotional well-being. Actual turnover was predicted only by turnover intentions and by the absence of health insurance. Pay was not a predictor of turnover intent or turnover. Implications: There are two distinct groups of CNAs contributing to turnover. Attitudinal factors, such as job satisfaction and emotional well-being, are mediated via turnover intentions to effect actual turnover. Even accounting for methodological differences, this turnover rate is lower than previous studies, which use alternative methods and include part-time workers. This study should help nursing home administrators better understand the work-related factors associated with staff turnover. PMID:21498629

  16. Comparing hospital staff and patient perceptions of customer service: a pilot study utilizing survey and focus group data.

    Science.gov (United States)

    Fottler, Myron D; Dickson, Duncan; Ford, Robert C; Bradley, Kenneth; Johnson, Lee

    2006-02-01

    The measurement of patient satisfaction is crucial to enhancing customer service and competitive advantage in the health-care industry. While there are numerous approaches to such measurement, this paper provides a case study which compares and contrasts patient and staff perceptions of customer service using both survey and focus group data. Results indicate that there is a high degree of correlation between staff and patient perceptions of customer service based on both survey and focus group data. However, the staff and patient subgroups also provided complementary information regarding patient perceptions of their service experience. Staff members tended to have more negative perceptions of service attributes than did the patients themselves. The focus group results provide complementary information to survey results in terms of greater detail and more managerially relevant information. While these results are derived from a pilot study, they suggest that diversification of data sources beyond patient surveys may enhance the utility of customer service information. If further research can affirm these findings, they create exciting possibilities for gathering valid, reliable and cost-effective customer service information.

  17. 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.

  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. Constructing the meaning of quality of life for residents in care homes in the Lebanon: perspectives of residents, staff and family.

    Science.gov (United States)

    Adra, Marina Gharibian; Hopton, John; Keady, John

    2015-12-01

    Located in two care homes in Lebanon, the study explores the perspectives of quality of life for a sample of older residents, care staff and family caregivers. Quality of life for older people living in care homes is traditionally reported in the literature as a Westernised construct and so far little is known about its meanings from an Arabic cultural perspective and context. There is also a knowledge gap about the conditions of older people living in care homes in Lebanon. The study was a qualitative exploration of perspectives of quality of life of older residents, care staff and family caregivers. Two care homes for older people situated in Beirut took part in the study. Between 2010 and 2011 semi-structured interviews were undertaken with a sample of 20 residents, eight family caregivers and 11 care staff. Data were analysed using the constant comparative method. Four categories emerged from this analytical process: (i) maintaining family connectedness; (ii) engaging in worthwhile activities; (iii) maintaining and developing significant relationships; and (iv) holding and practicing spiritual beliefs. The emergence of these categories confirmed the complex, interrelated and multidimensional nature of quality of life for residents and other stakeholders. The findings supplement an emerging body of knowledge about the composition of quality of life for older residents in Lebanon. Improving the quality of life of older residents will require action in respect of all of the domains identified in study. Moving nursing practice from task-based care to relationship-centred approaches was seen as pivotal in helping to develop quality of life for residents living in the participating care homes. The findings have implications for education, nursing practice and research in Lebanon and help start an evidence base for care. © 2015 John Wiley & Sons Ltd.

  20. Intensive care staff, the donation request and relatives' satisfaction with the decision: a focus group study

    NARCIS (Netherlands)

    Groot, J.J.A.M. de; Vernooij-Dassen, M.J.F.J.; Vries, A. de; Hoedemaekers, C.W.; Hoitsma, A.J.; Smeets, W.; Leeuwen, E. van

    2014-01-01

    BACKGROUND: Effectiveness of the donation request is generally measured by consent rates, rather than by relatives' satisfaction with their decision. Our aim was to elicit Dutch ICU staffs' views and experiences with the donation request, to investigate their awareness of (dis)satisfaction with

  1. Introduction of a child and adolescent mental health link worker: education and health staff focus group findings.

    Science.gov (United States)

    Hunter, A; Playle, J; Sanchez, P; Cahill, J; McGowan, L

    2008-10-01

    Policy guidance suggests that outcomes for adolescents with mental health problems can be improved by secondary education services (SES) and child and adolescent mental health services (CAMHS) working more closely. This study reports on staff experiences of the introduction of a mental health link worker (MHLW). The findings of two focus groups are presented, conducted with staff from CAMHS and SES. These focus groups formed part of the overall wider evaluation of the MHLW role. The groups explored staff perceptions and experiences following the introduction of the MHLW, and elicited their views on the effectiveness of this innovative role. Qualitative methods were employed, and analysis was conducted using the principles of grounded theory and the constant comparative method. The findings revealed that the MHLW was well received by both groups, despite the identification of potential barriers. A number of key themes emerged, which included the ability of the link worker to improve communication and to encourage mutual understanding between services. The issues raised by these themes are discussed and recommendations are made for future practice and research.

  2. 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,…

  3. Implementing Montessori Methods for Dementia™ in Ontario long-term care homes: Recreation staff and multidisciplinary consultants' perceptions of policy and practice issues.

    Science.gov (United States)

    Ducak, Kate; Denton, Margaret; Elliot, Gail

    2018-01-01

    Montessori-based activities use a person-centred approach to benefit persons living with dementia by increasing their participation in, and enjoyment of, daily life. This study investigated recreation staff and multidisciplinary consultants' perceptions of factors that affected implementing Montessori Methods for Dementia™ in long-term care homes in Ontario, Canada. Qualitative data were obtained during semi-structured telephone interviews with 17 participants who worked in these homes. A political economy of aging perspective guided thematic data analysis. Barriers such as insufficient funding and negative attitudes towards activities reinforced a task-oriented biomedical model of care. Various forms of support and understanding helped put Montessori Methods for Dementia™ into practice as a person-centred care program, thus reportedly improving the quality of life of residents living with dementia, staff and family members. These results demonstrate that when Montessori Methods for Dementia™ approaches are learned and understood by staff they can be used as practical interventions for long-term care residents living with dementia.

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    Military Commission Seal VWAP Login Home Go ABOUT US Organization Overview Organizational Chart Families VWAP Login CCTV Sites Travel Media MC News CCTV Sites Travel Today at OMC Home Today at OMC Daily

  5. Short-Term Impact of a Teen Pregnancy-Prevention Intervention Implemented in Group Homes.

    Science.gov (United States)

    Oman, Roy F; Vesely, Sara K; Green, Jennifer; Fluhr, Janene; Williams, Jean

    2016-11-01

    Youth living in group home settings are at significantly greater risk for sexual risk behaviors; however, there are no sexual health programs designed specifically for these youth. The study's purpose was to assess the effectiveness of a teen pregnancy-prevention program for youth living in group home foster care settings and other out-of-home placements. The study design was a cluster randomized controlled trial involving youth (N = 1,037) recruited from 44 residential group homes located in California, Maryland, and Oklahoma. Within each state, youth (mean age = 16.2 years; 82% male; 37% Hispanic, 20% African-American, 20% white, and 17% multiracial) in half the group homes were randomly assigned to the intervention group (n = 40 clusters) and the other half were randomly assigned to a control group that offered "usual care" (n = 40 clusters). The intervention (i.e., Power Through Choices [PTC]) was a 10-session, age-appropriate, and medically accurate sexual health education program. Compared to the control group, youth in the PTC intervention showed significantly greater improvements (p attitude areas, all three self-efficacy areas, and two of three behavioral intention areas. This is the first published randomized controlled trial of a teen pregnancy-prevention program designed for youth living in foster care settings and other out-of-home placements. The numerous significant improvements in short-term outcomes are encouraging and provide preliminary evidence that the PTC program is an effective pregnancy-prevention program. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  6. Effectiveness of group music therapy versus recreational group singing for depressive symptoms of elderly nursing home residents: pragmatic trial.

    Science.gov (United States)

    Werner, Jasmin; Wosch, Thomas; Gold, Christian

    2017-02-01

    Several studies have suggested positive effects of music therapy in dementia, but research on age-related depression has been limited and of insufficient quality. The aim of this study was to examine the effect of interactive group music therapy versus recreational group singing on depressive symptoms in elderly nursing home residents. Residents of two German nursing homes with sufficient length of stay who were not bedridden were invited to participate in a pragmatic trial. A total of 117 participants, grouped into four clusters (based on their wards), were randomised to interactive group music therapy (n = 62; 20 units of 40 minutes, 2×/week) or recreational group singing (n = 55; 10 units of 90 minutes, 1×/week). The level of depressive symptoms was assessed using the Montgomery-Åsberg Depression Rating Scale at baseline (47% with at least mild depression) and follow-up in the 6th and 12th weeks. There was no blinding of assessors. The level of depressive symptoms improved significantly more in those assigned to music therapy (n = 60) than in recreational singing (n = 53), both in 6th week (mean difference 3.0 scores, 95% CI 1.21 to 4.79, p = 0.001) and 12th week (mean difference 4.50 scores, 95% CI 2.51 to 6.50, p elderly people in nursing homes more effectively than recreational singing.

  7. The impact of individual and organisational factors on engagement of individuals with intellectual disability living in community group homes: a multilevel model.

    Science.gov (United States)

    Qian, X; Tichá, R; Larson, S A; Stancliffe, R J; Wuorio, A

    2015-06-01

    Being engaged in daily activities is a strong indicator of quality of life for individuals with intellectual disability (ID) who live in small community group homes. This study aimed to identify individual and organisational factors that predict high levels of engagement. Individuals with ID (n = 78), direct support professionals (DSPs; n = 174) and supervisors (n = 21) from 21 US group homes participated in the study. For each individual with ID, we conducted 80 min of observation at the person's residence. Information was also gathered regarding demographic characteristics, DSP competence, supervisor years of experience and management practices. Data were analysed using multilevel modelling. On average, individuals were engaged in social activities 12% of observed time and non-social activities 35% of the time. Individuals with greater adaptive skills who were supported by more competent staff showed significantly higher levels of social engagement. Individuals with less severe deficits in adaptive behaviours and less challenging behaviour showed higher levels of non-social engagement. Although none of the factors related to group homes were significant, 24% of the variance in non-social engagement existed among group homes. These results suggested that engagement is a dynamic construct. The extent to which an individual with ID is engaged in daily life is a result of interplay between the individual's characteristics and the group home environment. Future research is needed to investigate the influence of variables specific to the group home on the engagement level of individuals with disabilities. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  8. Effects of Group, Individual, and Home Exercise in Persons With Parkinson Disease: A Randomized Clinical Trial.

    Science.gov (United States)

    King, Laurie A; Wilhelm, Jennifer; Chen, Yiyi; Blehm, Ron; Nutt, John; Chen, Zunqiu; Serdar, Andrea; Horak, Fay B

    2015-10-01

    Comparative studies of exercise interventions for people with Parkinson disease (PD) rarely considered how one should deliver the intervention. The objective of this study was to compare the success of exercise when administered by (1) home exercise program, (2) individualized physical therapy, or (3) a group class. We examined if common comorbidities associated with PD impacted success of each intervention. Fifty-eight people (age = 63.9 ± 8 years) with PD participated. People were randomized into (1) home exercise program, (2) individual physical therapy, or (3) group class intervention. All arms were standardized and based on the Agility Boot Camp exercise program for PD, 3 times per week for 4 weeks. The primary outcome measure was the 7-item Physical Performance Test. Other measures of balance, gait, mobility, quality of life, balance confidence, depressions, apathy, self-efficacy and UPDRS-Motor, and activity of daily living scores were included. Only the individual group significantly improved in the Physical Performance Test. The individual exercise showed the most improvements in functional and balance measures, whereas the group class showed the most improvements in gait. The home exercise program improved the least across all outcomes. Several factors effected success, particularly for the home group. An unsupervised, home exercise program is the least effective way to deliver exercise to people with PD, and individual and group exercises have differing benefits. Furthermore, people with PD who also have other comorbidities did better in a program directly supervised by a physical therapist.Video Abstract available for additional insights from the authors (see Video, Supplemental Digital Content 1, http://links.lww.com/JNPT/A112).

  9. General Nutrition Knowledge among Carers at Group Homes for People with Intellectual Disability

    Science.gov (United States)

    Hamzaid, N. H.; Flood, V. M.; Prvan, T.; O'Connor, H. T.

    2018-01-01

    Background: Good nutrition knowledge among carers of people with intellectual disability (ID) living in group homes is essential as they have a primary role in food provision for residents. Research on the nutrition knowledge of carers is limited. Method: This cross-sectional study assessed the level of general nutrition knowledge in a convenience…

  10. 7 CFR 3560.69 - Supplemental requirements for congregate housing and group homes.

    Science.gov (United States)

    2010-01-01

    ... CFR part 1924, subparts A and C. (b) Design criteria. Congregate housing and group homes must be designed to accommodate all special services that will be provided. (c) Services. Congregate housing and... access to the following services will be provided or made available: (i) A common kitchen in which to...

  11. Foster Youth Evaluate the Performance of Group Home Services in California

    Science.gov (United States)

    Green, Rex S.; Ellis, Peter T.

    2008-01-01

    In 2003 foster youth employed by a foster youth advocacy organization suggested that an evaluation of group home services to foster youth be conducted in Alameda County, California. This report presents the development and conduct of this evaluation study; how funding was obtained; and how foster youth were hired, trained, and employed to produce…

  12. Healthful Eating and Physical Activity in the Home Environment: Results from Multifamily Focus Groups

    Science.gov (United States)

    Berge, Jerica M.; Arikian, Aimee; Doherty, William J.; Neumark-Sztainer, Dianne

    2012-01-01

    Objective: To explore multiple family members' perceptions of risk and protective factors for healthful eating and physical activity in the home. Design: Ten multifamily focus groups were conducted with 26 families. Setting and Participants: Community setting with primarily black and white families. Family members (n = 103) were aged 8 to 61…

  13. Resistance to group clinical supervision: A semistructured interview study of non-participating mental health nursing staff members.

    Science.gov (United States)

    Buus, Niels; Delgado, Cynthia; Traynor, Michael; Gonge, Henrik

    2018-04-01

    This present study is a report of an interview study exploring personal views on participating in group clinical supervision among mental health nursing staff members who do not participate in supervision. There is a paucity of empirical research on resistance to supervision, which has traditionally been theorized as a supervisee's maladaptive coping with anxiety in the supervision process. The aim of the present study was to examine resistance to group clinical supervision by interviewing nurses who did not participate in supervision. In 2015, we conducted semistructured interviews with 24 Danish mental health nursing staff members who had been observed not to participate in supervision in two periods of 3 months. Interviews were audio-recorded and subjected to discourse analysis. We constructed two discursive positions taken by the informants: (i) 'forced non-participation', where an informant was in favour of supervision, but presented practical reasons for not participating; and (ii) 'deliberate rejection', where an informant intentionally chose to not to participate in supervision. Furthermore, we described two typical themes drawn upon by informants in their positioning: 'difficulties related to participating in supervision' and 'limited need for and benefits from supervision'. The findings indicated that group clinical supervision extended a space for group discussion that generated or accentuated anxiety because of already-existing conflicts and a fundamental lack of trust between group members. Many informants perceived group clinical supervision as an unacceptable intrusion, which could indicate a need for developing more acceptable types of post-registration clinical education and reflective practice for this group. © 2017 Australian College of Mental Health Nurses Inc.

  14. HIV+ and HIV- youth living in group homes in South Africa need more psychosocial support.

    Science.gov (United States)

    Nestadt, D F; Alicea, S; Petersen, I; John, S; Myeza, N P; Nicholas, S W; Cohen, L G; Holst, H; Bhana, A; McKay, M M; Abrams, E J; Mellins, C A

    2013-07-01

    Orphans and vulnerable youth who live in group homes are at risk of poor mental health and sexual and drug-using behaviors that increase the risk of HIV transmission. This study explores factors related to this risk among youth living in group homes ("children's homes") for orphans and vulnerable children in South Africa, a country afflicted by high levels of parental loss due to HIV. The study explores 1) knowledge and attitudes about HIV, 2) social support, 3) communication with group home caregivers, and 4) the relevance of an existing evidence-based HIV prevention and mental health promotion program to situations where sexual and drug risk behaviors can occur. In-depth qualitative individual interviews were conducted with 20 youth (age 10 to 16 years) residing in two children's homes in Durban, South Africa. Content analysis focused on critical themes related to coping and prevention of risk activities. Respondents exhibited inconsistent and incomplete knowledge of HIV transmission and prevention. They displayed positive attitudes toward people living with HIV, but reported experiencing or witnessing HIV-related stigma. Participants witnessed substance use and romantic/sexual relationships among their peers; few admitted to their own involvement. While relationships with childcare workers were central to their lives, youth reported communication barriers related to substance use, sex, HIV, and personal history (including parental loss, abuse, and other trauma). In conclusion, these qualitative data suggest that evidence-based HIV prevention programs that bring caregivers and youth together to improve communication, HIV knowledge, social support, youth self-esteem, and health care, reduce sexual and drug risk behaviors, and strengthen skills related to negotiating situations of sexual and substance use possibility could benefit youth and childcare workers in children's homes.

  15. Group Home Energy Efficiency Retrofit for 30% Energy Savings: Washington, D.C. (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2013-11-01

    Energy efficiency retrofits (EERs) face many challenges on the path to scalability. Limited budgets, cost effectiveness, risk factors, and accessibility impact the type and the extent of measures that can be implemented feasibly to achieve energy savings goals. Group home retrofits can face additional challenges than those in single family homes - such as reduced access (occupant-in-place restrictions) and lack of incentives for occupant behavioral change. This project studies the specification, implementation, and energy savings from an EER in a group home, with an energy savings goal of 30%. This short term test report chronicles the retrofit measures specified, their projected cost-effectiveness using building energy simulations, and the short term test results that were used to characterize pre-retrofit and post-retrofit conditions. Additionally, the final report for the project will include analysis of pre- and post-retrofit performance data on whole building energy use, and an assessment of the energy impact of occupant interface with the building (i.e., window operation). Ultimately, the study's results will be used to identify cost effective EER measures that can be implemented in group homes, given constraints that are characteristic of these buildings. Results will also point towards opportunities for future energy savings.

  16. Relieving stress. A short-term support group for home attendants.

    Science.gov (United States)

    Blaine, M

    2000-01-01

    Home attendants (HAs) work in relative isolation, burdened by conflicting demands. This article details an eight-session support group for HAs, designed to explore its effects on their work life. Meeting for hour-and-a-half sessions with no fixed agenda, the group offered members an opportunity to communicate with others in similar situations. Participants reported that the group experience helped relieve stress and made them feel less alone. Other benefits included gaining strategies for coping with difficult situations and learning to set boundaries. Further investigation into the effectiveness of similar groups is suggested.

  17. 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.

  18. Group sessions with Paro in a nursing home: Structure, observations and interviews.

    Science.gov (United States)

    Robinson, Hayley; Broadbent, Elizabeth; MacDonald, Bruce

    2016-06-01

    We recently reported that a companion robot reduced residents' loneliness in a randomised controlled trial at an aged-care facility. This report aims to provide additional, previously unpublished data about how the sessions were run, residents' interactions with the robot and staff perspectives. Observations were conducted focusing on engagement, how residents treated the robot and if the robot acted as a social catalyst. In addition, 16 residents and 21 staff were asked open-ended questions at the end of the study about the sessions and the robot. Observations indicated that some residents engaged on an emotional level with Paro, and Paro was treated as both an agent and an artificial object. Interviews revealed that residents enjoyed sharing, interacting with and talking about Paro. This study supports other research showing Paro has psychosocial benefits and provides a guide for those wishing to use Paro in a group setting in aged care. © 2015 AJA Inc.

  19. Engaging Urban Parents of Early Adolescents in Parenting Interventions: Home Visits vs. Group Sessions.

    Science.gov (United States)

    Finigan-Carr, Nadine M; Copeland-Linder, Nikeea; Haynie, Denise L; Cheng, Tina L

    2014-01-01

    Interventions targeting parents of young children have shown effectiveness, but research is lacking about best practices for engaging parents of early adolescents. Low levels of enrollment and attendance in parenting interventions present major problems for researchers and clinicians. Effective and efficient ways to engage and collaborate with parents to strengthen parenting practices and to promote healthy development of early adolescents are needed. This exploratory mixed methods study examined the feasibility of three methods of engaging parents in positive parenting activities. Participants were parents of youth ages 11-13 enrolled in three urban, public middle schools in neighborhoods characterized by high rates of community violence. Families ( N = 144) were randomized into one of three interventions: six home sessions, two home sessions followed by four group sessions, or six group sessions. The majority of parents were single, non-Hispanic, African American mothers. Urban parents of middle school students were more likely to participate in home visits than in group sessions; offering a combination did not increase participation in the group sessions. As only 34% of those who consented participated in the intervention, qualitative data were examined to explain the reasons for non-participation.

  20. Psychiatric hospital nursing staff's experiences of participating in group-based clinical supervision:

    DEFF Research Database (Denmark)

    Buus, Niels; Angel, Sanne; Traynor, Michael

    2010-01-01

    Group-based clinical supervision is commonly offered as a stress-reducing intervention in psychiatric settings, but nurses often feel ambivalent about participating. This study aimed at exploring psychiatric nurses' experiences of participating in groupbased supervision and identifying psychosocial...... reasons for their ambivalence. Semi-structured interviews were conducted with 22 psychiatric nurses at a Danish university hospital. The results indicated that participation in clinical supervision was difficult for the nurses because of an uncomfortable exposure to the professional community. The sense...... of exposure was caused by the particular interactional organisation during the sessions, which brought to light pre-existing but covert conflicts among the nurses....

  1. Present Conditions and Problems of Home Care Education in Pharmaceutical Education: Through the Activities of "the Working Group to Create Home Clinical Cases for Education".

    Science.gov (United States)

    Kobuke, Yuko

    2017-01-01

    In the pharmaceutical education model core curriculums revision, "basic qualities required as a pharmacist" are clearly shown, and "the method based on learning outcomes" has been adopted. One of the 10 qualities (No. 7) is "Practical ability of the health and medical care in the community". In the large item "F. Pharmaceutical clinical" of the model core curriculums, "participation in the home (visit) medical care and nursing care" is written in "participation in the health, medical care, and welfare of the community", and it is an important problem to offer opportunities of home medical care education at university. In our university, we launched a working group to create "home clinical cases for education" from the educational point of view to pharmacy students to learn home medical care, in collaboration with university faculty members and pharmacists, who are practitioners of home care. Through its working group activities, we would like to organize the present conditions and problems of home care education in pharmaceutical education and to examine the possibility of using "home clinical case studies" in home care education at university.

  2. Impact of Group Clinical Supervision on Patient Education Process: A Comprehensive Assessment of Patients, Staff, and Organization Dimensions

    Directory of Open Access Journals (Sweden)

    Afsaneh Jafari Moghadam

    2018-04-01

    Full Text Available Background: The most important barriers to patient education are nurses’ poor motivation and training, and poor quality of managerial supervision. Clinical supervision could be a powerful tool for overcoming these barriers. However, the associated patient, staff, and organization-related outcomes still require further research. Aim: The present study aimed to evaluate the patient-, staff-, and organization-related outcomes of group clinical supervision with the goal of improving patient education. Method: This quasi-experimental study was conducted on 35 nurses and mothers of 94 children admitted to the surgery and nephrology wards of Dr. Sheikh Hospital, Mashhad, Iran, in 2016. A 3-month clinical supervision program consisting of support, education, feedback, and facilitation stages was implemented with the assistance of education facilitators. The data were collected using the questionnaire of patient’s satisfaction with nurses’ education, Herzberg’s job motivation questionnaire, and the checklists of nurses’ education performance and quality of education documentation. Data analysis was performed by Mann-Whitney U test, Fisher’s exact test, and independent-t test in SPSS, version 14. Results: The mean ages of the nurses, patients, and mothers were 30.3±6.7, 5.2±3.8, and 32.2±6.2, respectively. Mann-Whitney U test showed a significant improvement in patients’ satisfaction with nurses’ education performance (P

  3. Awareness of Stress-Reduction Interventions on Work Attitudes: The Impact of Tenure and Staff Group in Australian Universities.

    Science.gov (United States)

    Pignata, Silvia; Winefield, Anthony H; Provis, Chris; Boyd, Carolyn M

    2016-01-01

    This study explored the impact of staff group role and length of organizational tenure in the relationship between the awareness of stress interventions (termed intervention awareness: IA) and the work-related attitudinal outcomes of university employees. A two-wave longitudinal study of a sample of 869 employees from 13 universities completed a psychosocial work factors and health questionnaire. Hierarchical regression analyses examined the contribution of staff role and different lengths of organizational tenure with IA and employees' reports of job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. Employees' length of tenure affected the relation between IA and work attitudes, and there were also differences between academic and non-academic staff groups. For non-academic employees, IA predicted job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. However, for academics, IA only predicted job satisfaction and trust which identifies a need to increase the visibility of organizational interventions. Across the tenure groups, IA predicted: (1) perceived procedural justice for employees with five or less years of tenure; (2) job satisfaction for employees with 0-19 years of tenure; (3) trust in senior management for employees with 6-19 years of tenure; and (4) affective organizational commitment for employees with a tenure length of 6-10 years. Employees working at the university for an intermediate period had the most positive perceptions of their organization in terms of IA, job satisfaction, trust in senior management, and affective organizational commitment, whereas employees with 20-38 years of tenure had the least positive perceptions. Results suggest that employees in the middle of their careers report the most positive perceptions of their university. The findings highlight the need to attend to contextual issues in organizational

  4. Awareness of stress-reduction interventions on work attitudes: the impact of tenure and staff group in Australian universities

    Directory of Open Access Journals (Sweden)

    Silvia Pignata

    2016-08-01

    Full Text Available This study explored the impact of staff group role and length of organizational tenure in the relationship between the awareness of stress interventions (termed intervention awareness: IA and the work-related attitudinal outcomes of university employees. A two-wave longitudinal study of a sample of 869 employees from 13 universities completed a psychosocial work factors and health questionnaire. Hierarchical regression analyses examined the contribution of staff role and different lengths of organizational tenure with IA and employees’ reports of job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. Employees' length of tenure affected the relation between IA and work attitudes, and there were also differences between academic and non-academic staff groups. For non-academic employees, IA predicted job satisfaction, affective organizational commitment, trust in senior management, and perceived procedural justice. However, for academics, IA only predicted job satisfaction and trust which identifies a need to increase the visibility of organizational interventions. Across the tenure groups, IA predicted: (1 perceived procedural justice for employees with five or less years of tenure; (2 job satisfaction for employees with 0–19 years of tenure; (3 trust in senior management for employees with 6–19 years of tenure; and (4 affective organizational commitment for employees with a tenure length of 6–10 years. Employees working at the university for an intermediate period had the most positive perceptions of their organization in terms of IA, job satisfaction, trust in senior management, and affective organizational commitment, whereas employees with 20–38 years of tenure had the least positive perceptions. Results suggest that employees in the middle of their careers report the most positive perceptions of their university. The findings highlight the need to attend to contextual

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

    Science.gov (United States)

    Westerberg, Kristina; Tafvelin, Susanne

    2014-09-01

    Work in home help services is typically conducted by an assistant nurse or nursing aide in the home of an elderly person, and working conditions have been described as solitary with a high workload, little influence and lack of peer and leader support. Relations between leadership styles, psychosocial work environment and a number of positive and negative employee outcomes have been established in research, but the outcome in terms of quality of care has been addressed to a lesser extent. In the present study, we aimed to focus on working conditions in terms of leadership and the employee psychosocial work environment, and how these conditions are related to the quality of care. The hypothesis was that the relation between a transformational leadership style and quality of care is mediated through organisational and peer support, job control and workload. A cross-sectional survey design was used and a total of 469 questionnaires were distributed (March-April 2012) to assistant nurses in nine Swedish home help organisations, including six municipalities and one private organisation, representing both rural and urban areas (302 questionnaires were returned, yielding a 65% response rate). The results showed that our hypothesis was supported and, when indirect effects were also taken into consideration, there was no direct effect of leadership style on quality of care. The mediated model explained 51% of the variance in quality of care. These results indicate that leadership style is important not only to employee outcomes in home help services but is also indirectly related to quality of care as assessed by staff members. © 2013 John Wiley & Sons Ltd.

  6. Telehealth Interventions Delivering Home-based Support Group Videoconferencing: Systematic Review.

    Science.gov (United States)

    Banbury, Annie; Nancarrow, Susan; Dart, Jared; Gray, Leonard; Parkinson, Lynne

    2018-02-02

    Group therapy and education and support sessions are used within health care across a range of disciplines such as chronic disease self-management and psychotherapy interventions. However, there are barriers that constrain group attendance, such as mobility, time, and distance. Using videoconferencing may overcome known barriers and improve the accessibility of group-based interventions. The aim of this study was to review the literature to determine the feasibility, acceptability, effectiveness, and implementation of health professional-led group videoconferencing to provide education or social support or both, into the home setting. Electronic databases were searched using predefined search terms for primary interventions for patient education and/or social support. The quality of studies was assessed using the Mixed Methods Appraisal Tool. We developed an analysis framework using hierarchical terms feasibility, acceptability, effectiveness, and implementation, which were informed by subheadings. Of the 1634 records identified, 17 were included in this review. Home-based groups by videoconferencing are feasible even for those with limited digital literacy. Overall acceptability was high with access from the home highly valued and little concern of privacy issues. Some participants reported preferring face-to-face groups. Good information technology (IT) support and training is required for facilitators and participants. Communication can be adapted for the Web environment and would be enhanced by clear communication strategies and protocols. A range of improved outcomes were reported but because of the heterogeneity of studies, comparison of these across studies was not possible. There was a trend for improvement in mental health outcomes. Benefits highlighted in the qualitative data included engaging with others with similar problems; improved accessibility to groups; and development of health knowledge, insights, and skills. Videoconference groups were able to

  7. Home

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    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

  8. 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

  9. Pseudomonas putida and Pseudomonas fluorescens Species Group Recovery from Human Homes Varies Seasonally and by Environment.

    Directory of Open Access Journals (Sweden)

    Susanna K Remold

    Full Text Available By shedding light on variation in time as well as in space, long-term biogeographic studies can help us define organisms' distribution patterns and understand their underlying drivers. Here we examine distributions of Pseudomonas in and around 15 human homes, focusing on the P. putida and P. fluorescens species groups. We describe recovery from 10,941 samples collected during up to 8 visits per home, occurring on average 2.6 times per year. We collected a mean of 141 samples per visit, from sites in most rooms of the house, from the surrounding yards, and from human and pet occupants. We recovered Pseudomonas in 9.7% of samples, with the majority of isolates being from the P. putida and P. fluorescens species groups (approximately 62% and 23% of Pseudomonas samples recovered respectively. Although representatives of both groups were recovered from every season, every house, and every type of environment sampled, recovery was highly variable across houses and samplings. Whereas recovery of P. putida group was higher in summer and fall than in winter and spring, P. fluorescens group isolates were most often recovered in spring. P. putida group recovery from soils was substantially higher than its recovery from all other environment types, while higher P. fluorescens group recovery from soils than from other sites was much less pronounced. Both species groups were recovered from skin and upper respiratory tract samples from healthy humans and pets, although this occurred infrequently. This study indicates that even species that are able to survive under a broad range of conditions can be rare and variable in their distributions in space and in time. For such groups, determining patterns and causes of stochastic and seasonal variability may be more important for understanding the processes driving their biogeography than the identity of the types of environments in which they can be found.

  10. Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

    Science.gov (United States)

    Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

    2012-01-01

    Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

  11. '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

  12. Internet-enabled pulmonary rehabilitation and diabetes education in group settings at home: a preliminary study of patient acceptability.

    Science.gov (United States)

    Burkow, Tatjana M; Vognild, Lars K; Østengen, Geir; Johnsen, Elin; Risberg, Marijke Jongsma; Bratvold, Astrid; Hagen, Tord; Brattvoll, Morten; Krogstad, Trine; Hjalmarsen, Audhild

    2013-03-05

    The prevalence of major chronic illnesses, such as chronic obstructive pulmonary disease (COPD) and diabetes, is increasing. Pulmonary rehabilitation and diabetes self-management education are important in the management of COPD and diabetes respectively. However, not everyone can participate in the programmes offered at a hospital or other central locations, for reasons such as travel and transport. Internet-enabled home-based programmes have the potential to overcome these barriers.This study aims to assess patient acceptability of the delivery form and components of Internet-enabled programmes based on home groups for comprehensive pulmonary rehabilitation and for diabetes self-management education. We have developed Internet-enabled home programmes for comprehensive pulmonary rehabilitation and for diabetes self-management education that include group education, group exercising (COPD only), individual consultations, educational videos and a digital health diary. Our prototype technology platform makes use of each user's own TV at home, connected to a computer, and a remote control. We conducted a six-week home trial with 10 participants: one group with COPD and one with diabetes. The participants were interviewed using semi-structured interviews. Both home-based programmes were well accepted by the participants. The group setting at home made it possible to share experiences and to learn from questions raised by others, as in conventional group education. In the sessions, interaction and discussion worked well, despite the structure needed for turn taking. The thematic educational videos were well accepted although they were up to 40 minutes long and their quality was below TV broadcasting standards. Taking part in group exercising at home under the guidance of a physiotherapist was also well accepted by the participants. Participants in the COPD group appreciated the social aspect of group education sessions and of exercising together, each in their own home

  13. Effect of physical training on urinary incontinence: a randomized parallel group trial in nursing homes

    Directory of Open Access Journals (Sweden)

    Vinsnes AG

    2012-02-01

    Full Text Available Anne G Vinsnes1, Jorunn L Helbostad2, Signe Nyrønning3, Gene E Harkless1,4, Randi Granbo5, Arnfinn Seim61Faculty of Nursing, Sør-Trøndelag University College, 2Department of Neuroscience, Norwegian University of Science and Technology, 3Søbstad Community Hospital and Teaching Nursing Home, Trondheim, Norway; 4University of New Hampshire, College of Health and Social Services, Nursing Faculty, Durham, New Hampshire, USA; 5Department of Physiotherapy, Sør-Trøndelag University College, 6Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, NorwayBackground: Residents in nursing homes (NHs are often frail older persons who have impaired physical activity. Urinary incontinence (UI is a common complaint for residents in NHs. Reduced functional ability and residence in NHs are documented to be risk factors for UI.Objective: To investigate if an individualized training program designed to improve activity of daily living (ADL and physical capacity among residents in nursing homes has any impact on UI.Materials and methods: This randomized controlled trial was a substudy of a Nordic multicenter study. Participants had to be >65 years, have stayed in the NH for more than 3 months and in need of assistance in at least one ADL. A total of 98 residents were randomly allocated to either a training group (n = 48 or a control group (n = 50 after baseline registrations. The training program lasted for 3 months and included accommodated physical activity and ADL training. Personal treatment goals were elicited for each subject. The control group received their usual care. The main outcome measure was UI as measured by a 24-hour pad-weighing test. There was no statistically significant difference between the groups on this measure at baseline (P = 0.15. Changes were calculated from baseline to 3 months after the end of the intervention.Results: Altogether, 68 participants were included in the analysis

  14. EnviroAtlas - Commute Modes and Working from Home by Block Group for the Conterminous United States

    Data.gov (United States)

    U.S. Environmental Protection Agency — This EnviroAtlas dataset portrays the percent of workers who commute to work using various modes, and the percent who work from home within each Census Block Group...

  15. Cold homes, fuel poverty and energy efficiency improvements: A longitudinal focus group approach.

    Science.gov (United States)

    Grey, Charlotte N B; Schmieder-Gaite, Tina; Jiang, Shiyu; Nascimento, Christina; Poortinga, Wouter

    2017-08-01

    Cold homes and fuel poverty have been identified as factors in health and social inequalities that could be alleviated through energy efficiency interventions. Research on fuel poverty and the health impacts of affordable warmth initiatives have to date primarily been conducted using quantitative and statistical methods, limiting the way how fuel poverty is understood. This study took a longitudinal focus group approach that allowed exploration of lived experiences of fuel poverty before and after an energy efficiency intervention. Focus group discussions were held with residents from three low-income communities before (n = 28) and after (n = 22) they received energy efficiency measures funded through a government-led scheme. The results show that improving the energy efficiency of homes at risk of fuel poverty has a profound impact on wellbeing and quality of life, financial stress, thermal comfort, social interactions and indoor space use. However, the process of receiving the intervention was experienced by some as stressful. There is a need for better community engagement and communication to improve the benefits delivered by fuel poverty programmes, as well as further qualitative exploration to better understand the wider impacts of fuel poverty and policy-led intervention schemes.

  16. Late group-based rehabilitation has no advantages compared with supervised home-exercises after total knee arthroplasty

    DEFF Research Database (Denmark)

    Madsen, Majbritt; Larsen, Kristian; Madsen, Inger Kirkegård

    2013-01-01

    This study aimed to test whether group-based rehabilitation focusing on strength training, education and self-management is more effective than individual, supervised home-training after fast-track total knee arthroplasty (TKA).......This study aimed to test whether group-based rehabilitation focusing on strength training, education and self-management is more effective than individual, supervised home-training after fast-track total knee arthroplasty (TKA)....

  17. Perspectives on multidrug-resistant organisms at the end of life : A focus group study of staff members and institutional stakeholders.

    Science.gov (United States)

    Herbst, Franziska A; Heckel, Maria; Tiedtke, Johanna M; Adelhardt, Thomas; Sturm, Alexander; Stiel, Stephanie; Ostgathe, Christoph

    2018-03-16

    There is a lack of research into how hospital staff and institutional stakeholders (i. e. institutional representatives from public health authorities, hospital hygiene, and the departments of microbiology, palliative care, and geriatrics) engage with patients who are carriers of multidrug-resistant organisms and receiving end-of-life care. Knowledge of their experiences, workload, and needs should be considered in dealing with hospitalized carriers of multidrug-resistant organisms as well as staff education. This study explored and compared staff members' and stakeholders' perspectives on multidrug-resistant organisms and on provision of end-of-life care to carrier patients. In this study four focus groups consisting of hospital staff members and institutional stakeholders were formed within a mixed-methods parent study in a palliative care unit at a university clinic and a geriatric ward of a Catholic and academic teaching hospital. Participants discussed results from staff and stakeholder interviews from a former study phase. Data were analyzed according to Grounded Theory and perspectives of staff members and institutional stakeholders were compared and contrasted. Key issues debated by staff members (N = 19) and institutional stakeholders (N = 10) were 1) the additional workload, 2) reasons for uncertainty about handling carrier patients, 3) the format of continuing education, and 4) the preferred management approach for dealing with multidrug-resistant organism carrier patients. Although similar barriers (e. g. colleagues' ambiguous opinions) were identified, both groups drew different conclusions concerning the management of these barriers. While institutional stakeholders recommended making decisions on hygiene measures under consideration of the specific patient situation, staff members preferred the use of standardized hygiene measures which should be applied uniformly to all patients. Staff members and institutional stakeholders

  18. Implementation of the patient-centered medical home in the Veterans Health Administration: associations with patient satisfaction, quality of care, staff burnout, and hospital and emergency department use.

    Science.gov (United States)

    Nelson, Karin M; Helfrich, Christian; Sun, Haili; Hebert, Paul L; Liu, Chuan-Fen; Dolan, Emily; Taylor, Leslie; Wong, Edwin; Maynard, Charles; Hernandez, Susan E; Sanders, William; Randall, Ian; Curtis, Idamay; Schectman, Gordon; Stark, Richard; Fihn, Stephan D

    2014-08-01

    In 2010, the Veterans Health Administration (VHA) began implementing the patient-centered medical home (PCMH) model. The Patient Aligned Care Team (PACT) initiative aims to improve health outcomes through team-based care, improved access, and care management. To track progress and evaluate outcomes at all VHA primary care clinics, we developed and validated a method to assess PCMH implementation. To create an index that measures the extent of PCMH implementation, describe variation in implementation, and examine the association between the implementation index and key outcomes. We conducted an observational study using data on more than 5.6 million veterans who received care at 913 VHA hospital-based and community-based primary care clinics and 5404 primary care staff from (1) VHA clinical and administrative databases, (2) a national patient survey administered to a weighted random sample of veterans who received outpatient care from June 1 to December 31, 2012, and (3) a survey of all VHA primary care staff in June 2012. Composite scores were constructed for 8 core domains of PACT: access, continuity, care coordination, comprehensiveness, self-management support, patient-centered care and communication, shared decision making, and team-based care. Patient satisfaction, rates of hospitalization and emergency department use, quality of care, and staff burnout. Fifty-three items were included in the PACT Implementation Progress Index (Pi2). Compared with the 87 clinics in the lowest decile of the Pi2, the 77 sites in the top decile exhibited significantly higher patient satisfaction (9.33 vs 7.53; P hospitalization rates for ambulatory care-sensitive conditions (4.42 vs 3.68 quarterly admissions for veterans 65 years or older per 1000 patients; P < .001), and lower emergency department use (188 vs 245 visits per 1000 patients; P < .001). The extent of PCMH implementation, as measured by the Pi2, was highly associated with important outcomes for both

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

    Science.gov (United States)

    Yoshitake, Taketo

    2017-01-01

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

  20. Attractiveness of working in home care: an online focus group study among nurses.

    NARCIS (Netherlands)

    Groot, K. de; Maurits, E.E.M.; Francke, A.L.

    2018-01-01

    Many western countries are experiencing a substantial shortage of home-care nurses due to the increasing numbers of care-dependent people living at home. In-depth knowledge is needed about what home-care nurses find attractive about their work in order to make recommendations for the recruitment and

  1. An Analysis of the Relationship between the Organizational Culture and the Performance of Staff Work Groups in Schools and the Development of an Explanatory Model

    Science.gov (United States)

    James, Chris; Connolly, Michael

    2009-01-01

    This article analyses the concept of organizational culture and the relationship between the organizational culture and the performance of staff work groups in schools. The article draws upon a study of 12 schools in Wales, UK, which despite being in disadvantaged settings have high levels of pupil attainment. A model is developed linking the…

  2. Differences between early and late involvement of palliative home care in oncology care: A focus group study with palliative home care teams.

    Science.gov (United States)

    Dhollander, Naomi; Deliens, Luc; Van Belle, Simon; De Vleminck, Aline; Pardon, Koen

    2018-05-01

    To date, no randomised controlled trials on the integration of specialised palliative home care into oncology care have been identified. Information on whether existing models of integrated care are applicable to the home care system and how working procedures and skills of the palliative care teams might require adaptation is missing. To gain insight into differences between early and late involvement and the effect on existing working procedures and skills as perceived by palliative home care teams. Qualitative study - focus group interviews. Six palliative home care teams in Flanders, Belgium. Participants included physicians, nurses and psychologists. Differences were found concerning (1) reasons for initiation, (2) planning of care process, (3) focus on future goals versus problems, (4) opportunity to provide holistic care, (5) empowerment of patients and (6) empowerment of professional caregivers. A shift from a medical approach to a more holistic approach is the most noticeable. Being involved earlier also results in a more structured follow-up and in empowering the patient to be part of the decision-making process. Early involvement creates the need for transmural collaboration, which leads to the teams taking on more supporting and coordinating tasks. Being involved earlier leads to different tasks and working procedures and to the need for transmural collaboration. Future research might focus on the development of an intervention model for the early integration of palliative home care into oncology care. To develop this model, components of existing models might need to be adapted or extended.

  3. CBE Faculty and Staff

    Science.gov (United States)

    About Us Research Staff Edward Arens Fred Bauman Gail Brager Darryl Dickerhoff Ali Ghahramani Partners Facilities Graduate Programs Visiting Scholar Program Careers CBE Faculty and Staff CBE is an performance of buildings. The core research group for CBE includes faculty and research staff members

  4. Sex Education and Young People in Group Homes: Balancing Risks, Rights and Resilience in Sexual Health Promotion

    Science.gov (United States)

    Lindroth, Malin

    2014-01-01

    This paper presents findings from focus group interviews conducted in Swedish government group homes for young people with a history of psychosocial problems, substance misuse and criminal behaviour. Participants were asked to reflect on a newly developed sex education curriculum located within a harm-reduction paradigm prior to its…

  5. Parkinson's disease as community health problem: study in Norwegian nursing homes. The Norwegian Study Group of Parkinson's Disease in the Elderly.

    OpenAIRE

    Larsen, J P

    1991-01-01

    OBJECTIVE--To examine the extent of under-diagnosis and overdiagnosis of Parkinson's disease and to determine quality of treatment in a defined population. DESIGN--Clinical evaluation of an elderly population. SETTING--40 Norwegian nursing homes. SUBJECTS--3322 residents of nursing homes, of whom 500 were selected by nursing staff for evaluation on the basis of a structured information programme on Parkinson's disease and 269 were examined in detail by neurologists. MAIN OUTCOME MEASURES--Pat...

  6. Symptoms of burnout among staff of direct service care

    OpenAIRE

    ZICHOVÁ, Eliška

    2017-01-01

    This dissertation was focused on burnout syndrome among the staff of direct service care. The degree of burnout was estimated using Copenhagen Burnout Inventory questionnaire which was completed by the respondents from six Prague homes for seniors. The burnout incidence in this group was 30-45 %, whereas it was only 18-32 % among Czech Army employees who were studied for comparison. The staff of direct service care had significantly higher degree of personal, work-related, client-related and ...

  7. Effects of Group Reminiscence Therapy on Disability of Nursing Home Residents in Mashhad –Iran 1390

    Directory of Open Access Journals (Sweden)

    Hadi Kooshyar

    2012-10-01

    Full Text Available Objectives: Examine the effects of group reminiscence therapy on disability of nursing home residents in Mashhad -Iran. Methods & Materials: In this semi-experimental study, 56 residents of nursing homes in Mashhad –Iran were selected by convenience sampling. Subjects in each nursing home randomly assigned to reminiscence group therapy (30 and control group (26. Thus six groups with 4-8 members were made. Reminiscence group therapy was done one hour weekly for eight weeks. Disability, depression, cognitive function, and pain were measured by World Health Organization Disability Assessment Schedule II (WHODAS II, 15-Item Geriatric Depression Scale (GDS-15, Mini Mental State Examination (MMSE and Visual Analogue Scale (VAS respectively. SPSS version 11.5 and parametric and non-parametric tests were used for data analysis. Results: The result of ANOVA and Mann-Whitney tests showed there was no significant difference about total disability score (P=0.94 and its subscales: communication and understanding (P=0.20, getting around (P=0.20, self-care (P=0.92, dealing with other (P=0.72, and participation (P=0.88 between experimental and control group. Conclusion: One hour weekly group reminiscence therapy for eight weeks can't reduce disability and its subdivisions in nursing home residents. Therefore we advise further studies in this field.

  8. 75 FR 10318 - Briggs & Stratton Power Products Group, LLC., Home Power Division, a Subsidiary of Briggs...

    Science.gov (United States)

    2010-03-05

    ... portable generators, home stand-by generators and pressure washers. New findings show that worker... portable generators, home stand-by generators and pressure washers. The amended notice applicable to TA-W... 1974, as amended. Signed in Washington, DC, this 22nd day of February 2010. Elliott S. Kushner...

  9. Autonomous home-care nursing staff are more engaged in their work and less likely to consider leaving the healthcare sector: A questionnaire survey

    NARCIS (Netherlands)

    Maurits, E.E.M.; de Veer, A.J.E.; van der Hoek, L.S.; Francke, A.L.

    2015-01-01

    Background: The need for home care is rising in many Western European countries, due to the ageing population and governmental policies to substitute institutional care with home care. At the same time, a general shortage of qualified home-care staffexists or is expected in many countries. It is

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

    Science.gov (United States)

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

    2017-10-01

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

  11. Changes in the Self-Rated Well-Being of People Who Move from Congregated Settings to Personalized Arrangements and Group Home Placements

    Science.gov (United States)

    McConkey, Roy; Keogh, Fiona; Bunting, Brendan; Iriarte, Edurne Garcia

    2018-01-01

    A natural experiment contrasted the self-rated well-being of people with intellectual disabilities (n = 75) and those with enduring mental health problems (n = 44) after they moved to new accommodation and support options, while others remained in congregated settings or living in the family home. Most support staff also provided well-being…

  12. About the Joint Chiefs of Staff

    Science.gov (United States)

    Skip to main content (Press Enter). Toggle navigation Joint Chiefs of Staff Joint Chiefs of Staff Joint Chiefs of Staff Facebook Twitter YouTube Flickr Blog Instagram Search JCS: Search Search Search JCS: Search Home Media News Photos Videos Publications About The Joint Staff Chairman Vice Chairman

  13. The effects of group reminiscence therapy on depression, self esteem, and life satisfaction of elderly nursing home residents.

    Science.gov (United States)

    Chao, Shu-Yuan; Liu, Hsing-Yuan; Wu, Chiu-Yen; Jin, Suh-Fen; Chu, Tsung-Lan; Huang, Tzu-Shin; Clark, Mary Jo

    2006-03-01

    The need to provide quality mental health care for elders in nursing home settings has been a critical issue, as the aging population grows rapidly and institutional care becomes a necessity for some elders. The purpose of this quasi-experimental study was to describe the effect of participation in reminiscence group therapy on older nursing home residents' depression, self-esteem, and life satisfaction. Purposive sampling was used to recruit participants who met the study criteria. Residents of one ward were assigned to the reminiscence therapy group intervention, while residents of the other ward served as controls. Nine weekly one-hour sessions were designed to elicit reminiscence as group therapy for 12 elders in the experimental group. Another 12 elders were recruited for a control group matched to experimental subjects on relevant criteria. Depression, self-esteem, and life satisfaction were measured one week before and after the therapy. The Statistical Package for the Social Sciences (SPSS, Version 10.0) was used to analyze data. Results indicated that group reminiscence therapy significantly improved self-esteem, although effects on depression and life satisfaction were not significant. Reminiscence groups could enhance elders' social interaction with one another in nursing home settings and become support groups for participants. The model we created here can serve as a reference for future application in institutional care.

  14. City Kids in the Wilderness: A Pilot-Test of Outward Bound for Foster Care Group Home Youth.

    Science.gov (United States)

    Fischer, Robert L.; Attah, E. B.

    2001-01-01

    A study examined perceptions of a 7-day Outward Bound program among 23 urban youths, foster parents, and foster care workers from group homes in Atlanta (Georgia). Foster parents reported improved self-esteem and behavior among the teens, but foster care workers reported worse behavior. Negative program impressions lessened among male youths but…

  15. 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.

  16. Nursing documentation in inpatient psychiatry: The relevance of nurse-patient interactions in progress notes-A focus group study with mental health staff.

    Science.gov (United States)

    Myklebust, Kjellaug K; Bjørkly, Stål; Råheim, Målfrid

    2018-02-01

    To gain insight into mental health staff's perception of writing progress notes in an acute and subacute psychiatric ward context. The nursing process structures nursing documentation. Progress notes are intended to be an evaluation of a patient's nursing diagnoses, interventions and outcomes. Within this template, a patient's status and the care provided are to be recorded. The therapeutic nurse-patient relationship is recognised as a key component of psychiatric care today. At the same time, the biomedical model remains strong. Research literature exploring nursing staff's experiences with writing progress notes in psychiatric contexts, and especially the space given to staff-patient relations, is sparse. Qualitative design. Focus group interviews with mental health staff working in one acute and one subacute psychiatric ward were conducted. Systematic text condensation, a method for transverse thematic analysis, was used. Two main categories emerged from the analysis: the position of the professional as an expert and distant observer in the progress notes, and the weak position of professional-patient interactions in progress notes. The participants did not perceive that the current recording model, which is based on the nursing process, supported a focus on patients' resources or reporting professional-patient interactions. This model appeared to put ward staff in an expert position in relation to patients, which made it challenging to involve patients in the recording process. Essential aspects of nursing care related to recovery and person-centred care were not prioritised for documentation. This study contributes to the critical examination of the documentation praxis, as well as to the critical examination of the documentation tool as to what is considered important to document. © 2017 John Wiley & Sons Ltd.

  17. Comparing the Effects of Group and Home-based Physical Activity on Mental Health in the Elderly.

    Science.gov (United States)

    Mortazavi, Seyede Salehe; Shati, Mohsen; Ardebili, Hassan Eftekhar; Mohammad, Kazem; Beni, Reza Dorali; Keshteli, A H

    2013-11-01

    The present study focuses on comparing the effects of home-based (HB) and group-based (GB) physical activity on mental health in a sample of older adults in Shahr-e-kord. In this quasi-experimental study, a twice-weekly physical activity program for 2 months was provided either individually at home or in a group format for 181 people who were divided into two groups (HB and GB). The outcome, mental health, was measured with the 28-item General Health Questionnaire (GHQ-28). Mental health status improved after participation in the physical activity program. The decrease in GHQ-28 total score in GB group, 3 months after intervention, was 3.61 ± 2.28 (P effects of GB physical activity on mental health compared with HB physical activity, adjusted for related baseline variables, were significant. These findings reveal the probable effects of GB rather than HB physical activity on mental health among the elderly.

  18. [An Integrative Review of Home Care Service for Pregnant Women, Mothers, Infants, and Toddlers in Vulnerable Group].

    Science.gov (United States)

    Kim, Dasom; Lee, Insook

    2017-10-01

    This study was intended to integrate the evidence of home care service intervention for mothers and children in vulnerable groups through an integrative literature review. We searched the MEDLINE (PubMED), EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, DBpia databases. The quality of the articles was assessed by one doctoral researcher and verified by one professor of community health nursing who had participated in the systematic review of literature. A framework was developed to identify the intervention patterns in the selected papers and categorize various elements. The extracted intervention elements were grouped into potential themes, which were verified by assessors on whether they clearly reflected the interventions in the papers. Among 878 searched papers, we selected 16 papers after excluding literature that does not satisfy the selection criteria and quality evaluation. The intervention elements of 16 selected papers were categorized into six themes. The extracted intervention elements were divided into the themes of Patient-specific/Situation-specific care planning and intervention, Emphasis on self care competency, Intense home visit by developmental milestone, Reinforcing and modeling mother-child attachment, Communication and interaction across the intervention, Linkage with community resource and multidisciplinary approach. As a result of the analysis of proper interventions of home care services for mothers and children in vulnerable groups, it was found that it is necessary to consider indispensable intervention elements that can standardize the quality of home care services, and conduct studies on developing intervention programs based on the elements. © 2017 Korean Society of Nursing Science

  19. Existing Whole-House Solutions Case Study: Group Home Energy Efficiency Retrofit for 30% Energy Savings, Washington, D.C.

    Energy Technology Data Exchange (ETDEWEB)

    None

    2013-11-01

    Energy efficiency retrofits (EERs) face many challenges on the path to scalability. Limited budgets, cost effectiveness, risk factors, and accessibility impact the type and the extent of measures that can be implemented feasibly to achieve energy savings goals. Group home retrofits can face additional challenges than those in single family homes – such as reduced access (occupant-in-place restrictions) and lack of incentives for occupant behavioral change. This project studies the specification, implementation, and energy savings from an EER in a group home, with an energy savings goal of 30%. This short term test report chronicles the retrofit measures specified, their projected cost-effectiveness using building energy simulations, and the short term test results that were used to characterize pre-retrofit and post-retrofit conditions. Additionally, the final report for the project will include analysis of pre- and post-retrofit performance data on whole building energy use, and an assessment of the energy impact of occupant interface with the building (i.e., window operation). Ultimately, the study’s results will be used to identify cost effective EER measures that can be implemented in group homes, given constraints that are characteristic of these buildings. Results will also point towards opportunities for future energy savings.

  20. Occupant-in-Place Energy Efficiency Retrofit in a Group Home for 30% Energy Savings in Climate Zone 4

    Energy Technology Data Exchange (ETDEWEB)

    Moore, M.

    2013-08-01

    Energy efficiency retrofits (EERs) face many challenges on the path to scalability. Limited budgets, cost effectiveness, risk factors, and accessibility impact the type and the extent of measures that can be implemented feasibly to achieve energy savings goals. Group home retrofits can face additional challenges than those in single family homes - such as reduced access (occupant-in-place restrictions) and lack of incentives for occupant behavioral change. This project studies the specification, implementation, and energy savings from an EER in a group home, with an energy savings goal of 30%. This short term test report chronicles the retrofit measures specified, their projected cost-effectiveness using building energy simulations, and the short term test results that were used to characterize pre-retrofit and post-retrofit conditions. Additionally, the final report for the project will include analysis of pre- and post-retrofit performance data on whole building energy use, and an assessment of the energy impact of occupant interface with the building (i.e., window operation). Ultimately, the study's results will be used to identify cost effective EER measures that can be implemented in group homes, given constraints that are characteristic of these buildings. Results will also point towards opportunities for future energy savings.

  1. Occupant-in-Place Energy Efficiency Retrofit in a Group Home for 30% Energy Savings in Climate Zone 4

    Energy Technology Data Exchange (ETDEWEB)

    Moore, Mike [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States)

    2013-08-01

    Energy efficiency retrofits (EERs) face many challenges on the path to scalability. Limited budgets, cost effectiveness, risk factors, and accessibility impact the type and the extent of measures that can be implemented feasibly to achieve energy savings goals. Group home retrofits can face additional challenges than those in single family homes – such as reduced access (occupant-in-place restrictions) and lack of incentives for occupant behavioral change. This project studies the specification, implementation, and energy savings from an EER in a group home, with an energy savings goal of 30%. This short term test report chronicles the retrofit measures specified, their projected cost effectiveness using building energy simulations, and the short term test results that were used to characterize pre-retrofit and post-retrofit conditions. Additionally, the final report for the project will include analysis of pre- and post-retrofit performance data on whole building energy use, and an assessment of the energy impact of occupant interface with the building (i.e., window operation). Ultimately, the study’s results will be used to identify cost-effective EER measures that can be implemented in group homes, given constraints that are characteristic of these buildings. Results will also point towards opportunities for future energy savings.

  2. THE HIDDEN POWER IN GAPS: COMMUNITY HOME CARE VOLUNTEER GROUP PARTICIPANT OF A CATHOLIC CHURCH IN CARIACICA – ES - BRAZIL

    Directory of Open Access Journals (Sweden)

    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.

  3. Effects of using nursing home residents to serve as group activity leaders: lessons learned from the RAP project.

    Science.gov (United States)

    Skrajner, Michael J; Haberman, Jessica L; Camp, Cameron J; Tusick, Melanie; Frentiu, Cristina; Gorzelle, Gregg

    2014-03-01

    Previous research has demonstrated that persons with early to moderate stage dementia are capable of leading small group activities for persons with more advanced dementia. In this study, we built upon this previous work by training residents in long-term care facilities to fill the role of group activity leaders using a Resident-Assisted Programming (RAP) training regimen. There were two stages to the program. In the first stage, RAP training was provided by researchers. In the second stage, RAP training was provided to residents by activities staff members of long-term care facilities who had been trained by researchers. We examine the effects of RAP implemented by researchers and by activities staff member on long-term care resident with dementia who took part in these RAP activities. We also examined effects produced by two types of small group activities: two Montessori-based activities and an activity which focuses on persons with more advanced dementia, based on the work of Jitka Zgola. Results demonstrate that levels of positive engagement seen in players during RAP (resident-led activities) were typically higher than those observed during standard activities programming led by site staff. In general, Montessori-Based Dementia Programming® produced more constructive engagement than Zgola-based programming (ZBP), though ZBP did increase a positive form of engagement involving observing activities with interest. In addition, RAP implemented by activities staff members produced effects that were, on the whole, similar to those produced when RAP was implemented by researchers. Implications of these findings for providing meaningful social roles for persons with dementia residing in long-term care, and suggestions for further research in this area, are discussed.

  4. Psychotropic medication in a randomly selected group of citizens receiving residential or home care

    DEFF Research Database (Denmark)

    Futtrup, Tina Bergmann; Schultz, Hanne; Jensen, Margit Bak

    2014-01-01

    INTRODUCTION: Treatment with one or more psychotropic medications (PMs), especially in the elderly, is associated with risk, and the effects of treatment are poorly validated. The aim of this article was to describe the use of PM in a population of citizens receiving either residential care or home...... care with focus on the prevalence of drug use, the combination of different PMs and doses in relation to current recommendations. METHODS: The medication lists of 214 citizens receiving residential care (122) and home care (92) were collected together with information on age, gender and residential...

  5. Detecting depression in the aged: is there concordance between screening tools and the perceptions of nursing home staff and residents? A pilot study in a rural aged care facility.

    Science.gov (United States)

    Johnston, Luke; Reid, Alexander; Wilson, Jessica; Levesque, Janelle; Driver, Brian

    2007-08-01

    Recognition of depression in the elderly is exacerbated in rural and remote regions by a lack of mental health specialists. In nursing homes, screening tools have been advocated to circumvent the variable reliability of both nursing staff and residents in recognising depression. Debate concerning the utility of screening tools abounds. Previous research has neglected concordance between screening tools, nursing staff and residents in recognising depression. The present study aimed to determine if there was a significant difference in the proportion of depressed residents identified by recognition sources, and assessed the level of chance corrected agreement between sources. One hundred and two residents of aged care facilities in Wagga Wagga, Australia, mean age of 85.19 +/- 7.09 years. Residents were interviewed within their residential aged care facility. Cross-sectional, between-subjects design. Residents, nursing staff, Geriatric Depression Scale (GDS-12R) and Hamilton Depression Rating Scale. Hamilton Depression Rating Scale and nursing staff professional opinion were not significantly different; however, both measures were significantly different to the resident measures (GDS-12R and resident opinion). Kappa statistic analysis of outcome measures revealed, at best, no more than a moderate level of chance corrected agreement between said sources. It is tentatively argued that the different sources might correspond to qualitatively different 'depression' constructs, and that health professionals who are concerned with depression in the elderly be aware of the disparity between, and subsequently consider, a variety of recognition sources.

  6. Justifying continuous sedation until death: A focus group study in nursing homes in Flanders, Belgium

    NARCIS (Netherlands)

    Rys, S.; Deschepper, R.; Deliens, L.; Mortier, F.; Bilsen, J.

    2013-01-01

    Continuous Sedation until Death (CSD), the act of reducing or removing the consciousness of an incurably ill patient until death, has become a common practice in nursing homes in Flanders (Belgium). Quantitative research has suggested that CSD is not always properly applied. This qualitative study

  7. Joint Chiefs of Staff > About > The Joint Staff > Senior Enlisted Advisor

    Science.gov (United States)

    Skip to main content (Press Enter). Toggle navigation Joint Chiefs of Staff Joint Chiefs of Staff Joint Chiefs of Staff Facebook Twitter YouTube Flickr Blog Instagram Search JCS: Search Search Search JCS: Search Home Media News Photos Videos Publications About The Joint Staff Chairman Vice Chairman

  8. Staff's person-centredness in dementia care in relation to job characteristics and job-related well-being: a cross-sectional survey in nursing homes.

    Science.gov (United States)

    Willemse, Bernadette M; De Jonge, Jan; Smit, Dieneke; Visser, Quirijn; Depla, Marja F I A; Pot, Anne Margriet

    2015-02-01

    To explore the role of nursing staff's person-centredness caring for people with dementia in relation to their work environment and job-related well-being. Given the development towards person-centred care and labour force issues, research has recently focused on the effect of person-centredness on nursing staff's well-being. Findings from occupational stress research suggest that employees' personal characteristics, such as person-centredness, can moderate the impact particular job characteristics have on their job-related well-being. Cross-sectional survey. A national survey was conducted among healthcare staff (n = 1147) in 136 living arrangements for people with dementia in the Netherlands (2008-2009). Hierarchical regression analyses were used. Person-centredness moderates the relationship between coworker support and three outcomes of job-related well-being and between supervisor support and two of these outcomes. For highly person-centred nursing staff, coworker support was found to have a weaker impact and supervisor support to have a stronger impact on their job-related well-being. In addition, direct effects showed that person-centredness was weakly associated with more job satisfaction, more emotional exhaustion and more strongly with more personal accomplishment. Nursing staff's person-centredness does play a modest role in relation to job characteristics and job-related well-being. Findings indicate that person-centredness is not only beneficial to residents with dementia as found earlier, but also for nursing staff themselves; specifically, in case nursing staff members feel supported by their supervisor. Since a more person-centred workforce feels more competent, further implementation of person-centred care might have a positive impact on the attractiveness of the profession. © 2014 John Wiley & Sons Ltd.

  9. An Evaluative Look Behind the Curtain : World Bank Group Staff's Early Experience with the Shared Prosperity Goal

    OpenAIRE

    Smets, Lodewijk; Bogetic, Zeljko

    2018-01-01

    In 2013, the Board of Executive Directors of the World Bank Group endorsed two ambitious goals: eliminating extreme poverty in the world by 2030 and boosting shared prosperity. The latter is defined as fostering the growth in the income of the poorest 40 percent of the population in each country. In 2016-17, the World Bank's Independent Evaluation Group conducted an evaluation on how well ...

  10. Palliative sedation challenging the professional competency of health care providers and staff: a qualitative focus group and personal written narrative study.

    Science.gov (United States)

    Leboul, Danièle; Aubry, Régis; Peter, Jean-Michel; Royer, Victor; Richard, Jean-François; Guirimand, Frédéric

    2017-04-11

    Despite recent advances in palliative medicine, sedating a terminally ill patient is regarded as an indispensable treatment to manage unbearable suffering. With the prospect of widespread use of palliative sedation, the feelings and representations of health care providers and staff (carers) regarding sedation must be carefully explored if we are to gain a better understanding of its impact and potential pitfalls. The objective of the study was to provide a comprehensive description of the opinions of carers about the use of sedation practices in palliative care units (PCU), which have become a focus of public attention following changes in legislation. Data were collected using a qualitative study involving multi-professional focus groups with health care providers and staff as well as personal narratives written by physicians and paramedical staff. A total of 35 medical and paramedical providers volunteered to participate in focus group discussions in three Palliative Care Units in two French hospitals and to write personal narratives. Health care provider and staff opinions had to do with their professional stance and competencies when using midazolam and practicing sedation in palliative care. They expressed uncertainty regarding three aspects of the comprehensive care: biomedical rigour of diagnosis and therapeutics, quality of the patient/provider relationship and care to be provided. Focusing on the sedative effect of midazolam and continuous sedation until death, the interviewed health care providers examined the basics of their professional competency as well as the key role played by the health care team in terms of providing support and minimizing workplace suffering. Nurses were subject to the greatest misgivings about their work when they were called upon to sedate patients. The uncertainty experienced by the carers with regard to the medical, psychosocial and ethical justification for sedation is a source of psychological burden and moral distress

  11. Staff's person-centredness in dementia care in relation to job characteristics and job-related well-being: a cross-sectional survey in nursing homes

    NARCIS (Netherlands)

    Willemse, Bernadette M.; Jonge, de J.; Smit, D.; Visser, Q.; Depla, M.F.I.A.; Pot, Anne Margriet

    2015-01-01

    Aim: To explore the role of nursing staff's person-centredness caring for people with dementia in relation to their work environment and job-related well-being. Background: Given the development towards person-centred care and labour force issues, research has recently focused on the effect of

  12. Staff working in hospital units with greater social capital experience less work-home conflict: Secondary analysis of a cross-sectional study.

    Science.gov (United States)

    Nitzsche, Anika; Kuntz, Ludwig; Miedaner, Felix

    2017-10-01

    When the interplay between work and private life does not function correctly (work-home conflict), this constitutes a well-known risk factor for poorer health, increased absenteeism and lower work performance. Information about influencing factors of work-home conflict is therefore indispensable in order to avoid it. In this study, we analyse whether a good working atmosphere that fosters mutual trust, support and a 'sense of unity' (organizational social capital) can reduce an employee's conflict between work and private life. This study investigates the link between organizational social capital and work-home conflict in health professionals. This issue was investigated using a cross-sectional study conducted in 2013. Data from questionnaires completed by physicians and nurses (n=1733) were linked with structural data from 66 neonatal intensive care units in Germany. Using multi-level analyses, we investigated associations between organizational social capital at the ward level and work-home conflict at the level of individual employees, taking into account additional structural and individual characteristics. Employees on wards with greater social capital reported significantly less work-home conflict. Our results support the hypothesis that organizational social capital is an important collective resource. As such, more attention should be given to establishing a good working atmosphere that fosters mutual trust, support and a 'sense of unity', and this should be encouraged in a targeted fashion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. 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.

  14. The diagnostic suitability of a xerostomia questionnaire and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents

    NARCIS (Netherlands)

    Putten, Gerard van der; Brand, H.S.; Schols, J.M.; Baat, C. de

    2011-01-01

    The study objective was to explore the diagnostic suitability of the Xerostomia Inventory and the association between xerostomia, hyposalivation and medication use in a group of nursing home residents. A cross-sectional study was carried out in 50 physically impaired nursing home residents (20 men)

  15. Stayers, Leavers, and Switchers among Certified Nursing Assistants in Nursing Homes: A Longitudinal Investigation of Turnover Intent, Staff Retention, and Turnover

    Science.gov (United States)

    Rosen, Jules; Stiehl, Emily M.; Mittal, Vikas; Leana, Carrie R.

    2011-01-01

    Purpose: Studies of certified nursing assistant (CNA) turnover in nursing homes are typically cross-sectional and include full-time and part-time workers. We conducted a longitudinal study to evaluate the job factors and work attitudes associated with just full-time staying or leaving. For those who did not stay, we assessed reasons for leaving…

  16. Defective homing is associated with altered Cdc42 activity in cells from patients with Fanconi anemia group A

    Science.gov (United States)

    Zhang, Xiaoling; Shang, Xun; Guo, Fukun; Murphy, Kim; Kirby, Michelle; Kelly, Patrick; Reeves, Lilith; Smith, Franklin O.; Williams, David A.

    2008-01-01

    Previous studies showed that Fanconi anemia (FA) murine stem cells have defective reconstitution after bone marrow (BM) transplantation. The mechanism underlying this defect is not known. Here, we report defective homing of FA patient BM progenitors transplanted into mouse models. Using cells from patients carrying mutations in FA complementation group A (FA-A), we show that when transplanted into nonobese diabetic/severe combined immunodeficiency (NOD/SCID) recipient mice, FA-A BM cells exhibited impaired homing activity. FA-A cells also showed defects in both cell-cell and cell-matrix adhesion. Complementation of FA-A deficiency by reexpression of FANCA readily restored adhesion of FA-A cells. A significant decrease in the activity of the Rho GTPase Cdc42 was found associated with these defective functions in patient-derived cells, and expression of a constitutively active Cdc42 mutant was able to rescue the adhesion defect of FA-A cells. These results provide the first evidence that FA proteins influence human BM progenitor homing and adhesion via the small GTPase Cdc42-regulated signaling pathway. PMID:18565850

  17. Nutritional self-care among a group of older home-living people in rural Southern Norway

    Directory of Open Access Journals (Sweden)

    Dale B

    2015-01-01

    Full Text Available Bjørg Dale, Ulrika SöderhamnCentre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, NorwayBackground: Older home-living people are an at-risk group for undernutrition, particularly those who are living alone. Lack of knowledge about healthy dietary habits, altered taste sensation, and declined health status are shown to be some of the factors related to undernutrition. The aims of this study were to explore how a small group of older people in Southern Norway perceived their nutritional self-care.Methods: An exploratory qualitative approach, combined with a simple self-report questionnaire, was used. Five persons living in rural areas in Southern Norway, who in a former study were screened and found to be at risk for undernutrition, participated. Qualitative data assessed by means of individual self-care talks in the persons' own homes were analyzed using directed content analysis. A simple self-report questionnaire containing demographic variables, two health-related questions, and the Nutritional Form For the Elderly (NUFFE-NO instrument was filled out at baseline and 6 months after the self-care talks.Results: The qualitative data showed that the participants had adequate knowledge about healthy and nutritious diets. They were aware of and motivated to adapt their diet to their current state of health and to perform the necessary actions to maintain an optimal nutritional status and nutritional self-care.Conclusion: Older people living at home are a diverse group. However, this study showed that they may have sufficient knowledge, willingness, and ability to perform nutritional self-care, even if they live alone and have several chronic illnesses and impaired health.Keywords: adapting, decision-making, knowledge, self-care talks

  18. Staff Association

    CERN Multimedia

    Staff Association

    2014-01-01

    Remove of the staff association office   The Staff Association offices are going to be renovated during the coming four months, February to May 2014. The physical move from our current premises 64/R-002 to our temporary office in  510/R-010 will take place on Friday January 31st, so the Secretariat will be closed on that day. Hence, from Monday February 3rd until the end of May 2014 the Staff Association Secretariat will be located in 510/R-010 (entrance just across the CERN Printshop).    

  19. Effectiveness of Gestalt Group Therapy on Loneliness of Women Caregivers of Alzheimer Patients at Home

    Directory of Open Access Journals (Sweden)

    Hemn Saadati

    2014-12-01

    Full Text Available Objectives: Loneliness is a common experience of people, regardless of gender, age, socio economic and cultural experience in the course of its life. The aim of this study was to examine the effectiveness of Gestalt group therapy on the loneliness of Alzheimer’s caregivers. Methods: In an experimental study with a pre-post test design and control group, women participants were selected from Alzheimer Association of Iran. Total number of 50 women members was evaluated according to inclusion/ exclusion criteria. 28 participants selected and were divided into two equal groups randomly. Loneliness Scale was administered to both groups at the beginning. Gestalt therapy sessions were applied to the intervention group, each session 90 minutes weekly and continued for 12 successive weeks. The post-test data collected after the last session by administering Loneliness Scale. Data was analyzed by using t-test for independent group. Results: The results showed that the mean differences between the two groups were significant and gestalt therapy decreased the loneliness of member of intervention group significantly. Loneliness scores of intervention group in two sub-scales were also significantly lower in post-test compared to control group. Discussion: Gestalt therapy can be helpful in enhancing positive emotions and decreasing loneliness in Alzheimer caregivers which is one of the hardest emotions that these women threatens reduced and the introduction of enhanced quality of life of the caregivers and hence increase the quality of care for patients increased.

  20. Long-Term Improvements in Knowledge and Psychosocial Factors of a Teen Pregnancy Prevention Intervention Implemented in Group Homes.

    Science.gov (United States)

    Green, Jennifer; Oman, Roy F; Lu, Minggen; Clements-Nolle, Kristen D

    2017-06-01

    Youth in out-of-home care have higher rates of sexual risk behaviors and pregnancy than youth nationally. This study aimed to determine if Power Through Choices (PTC), a teen pregnancy prevention program developed for youth in out-of-home care, significantly improves knowledge and psychosocial outcomes regarding HIV and sexually transmitted infections (STIs), sexual activity and contraception methods, long term. A cluster randomized controlled trial was conducted with 1,036 ethnically diverse youths (aged 13-18 years) recruited from 44 residential group homes in three states. Intervention participants received the 10-session PTC intervention; control participants received usual care. Participants were administered self-report surveys at baseline, after intervention, 6 and 12 months after the intervention. Survey items assessed knowledge, attitudes, self-efficacy, and behavioral intentions regarding HIV and STIs, sexual activity and contraception methods. Random intercept logistic regression analyses were used to assess differences between the intervention and control groups. Compared with youth in the control group, youth in the PTC intervention demonstrated significant improvements in knowledge about anatomy and fertility (adjusted odds ratio [AOR] = 1.07, 95% confidence interval [CI] = 1.03-1.11), HIV and STIs (AOR = 1.03, 95% CI = 1.002-1.07), and methods of protection (AOR = 1.06, 95% CI = 1.03-1.09), as well as self-efficacy regarding self-efficacy to communicate with a partner (AOR = 1.14, 95% CI = 1.04-1.26), plan for protected sex and avoid unprotected sex (AOR = 1.16, 95% CI = 1.04-1.28), and where to get methods of birth control (AOR = 1.13, 95% CI = 1.01-1.26) 12 months after the intervention. Findings suggest that the PTC intervention can have positive long-term knowledge and psychosocial effects regarding contraception methods on youth in out-of-home care. Copyright © 2017 Society for Adolescent Health and Medicine. Published by

  1. Automated recording of home cage activity and temperature of individual rats housed in social groups: The Rodent Big Brother project.

    Science.gov (United States)

    Redfern, William S; Tse, Karen; Grant, Claire; Keerie, Amy; Simpson, David J; Pedersen, John C; Rimmer, Victoria; Leslie, Lauren; Klein, Stephanie K; Karp, Natasha A; Sillito, Rowland; Chartsias, Agis; Lukins, Tim; Heward, James; Vickers, Catherine; Chapman, Kathryn; Armstrong, J Douglas

    2017-01-01

    Measuring the activity and temperature of rats is commonly required in biomedical research. Conventional approaches necessitate single housing, which affects their behavior and wellbeing. We have used a subcutaneous radiofrequency identification (RFID) transponder to measure ambulatory activity and temperature of individual rats when group-housed in conventional, rack-mounted home cages. The transponder location and temperature is detected by a matrix of antennae in a baseplate under the cage. An infrared high-definition camera acquires side-view video of the cage and also enables automated detection of vertical activity. Validation studies showed that baseplate-derived ambulatory activity correlated well with manual tracking and with side-view whole-cage video pixel movement. This technology enables individual behavioral and temperature data to be acquired continuously from group-housed rats in their familiar, home cage environment. We demonstrate its ability to reliably detect naturally occurring behavioral effects, extending beyond the capabilities of routine observational tests and conventional monitoring equipment. It has numerous potential applications including safety pharmacology, toxicology, circadian biology, disease models and drug discovery.

  2. A group randomized controlled trial integrating obesity prevention and control for postpartum adolescents in a home visiting program.

    Science.gov (United States)

    Haire-Joshu, Debra L; Schwarz, Cynthia D; Peskoe, Sarah B; Budd, Elizabeth L; Brownson, Ross C; Joshu, Corinne E

    2015-06-26

    Adolescence represents a critical period for the development of overweight that tracks into adulthood. This risk is significantly heightened for adolescents that become pregnant, many of whom experience postpartum weight retention. The aim of this study was to evaluate Balance Adolescent Lifestyle Activities and Nutrition Choices for Energy (BALANCE), a multicomponent obesity prevention intervention targeting postpartum adolescents participating in a national home visiting child development-parent education program. A group randomized, nested cohort design was used with 1325 adolescents, 694 intervention and 490 control, (mean age = 17.8 years, 52 % underrepresented minorities) located across 30 states. Participatory methods were used to integrate lifestyle behavior change strategies within standard parent education practice. Content targeted replacement of high-risk obesogenic patterns (e.g. sweetened drink and high fat snack consumption, sedentary activity) with positive behaviors (e.g. water intake, fruit and vegetables, increased walking). Parent educators delivered BALANCE through home visits, school based classroom-group meetings, and website activities. Control adolescents received standard child development information. Phase I included baseline to posttest (12 months); Phase II included baseline to follow-up (24 months). When compared to the control group, BALANCE adolescents who were ≥12 weeks postpartum were 89 % more likely (p = 0.02) to maintain a normal BMI or improve an overweight/obese BMI by 12 months; this change was not sustained at 24 months. When compared to the control group, BALANCE adolescents significantly improved fruit and vegetable intake (p = .03). In stratified analyses, water intake improved among younger BALANCE teens (p = .001) and overweight/obese BALANCE teens (p = .05) when compared to control counterparts. There were no significant differences between groups in sweetened drink and snack consumption

  3. Using Group II Introns for Attenuating the In Vitro and In Vivo Expression of a Homing Endonuclease.

    Directory of Open Access Journals (Sweden)

    Tuhin Kumar Guha

    Full Text Available In Chaetomium thermophilum (DSM 1495 within the mitochondrial DNA (mtDNA small ribosomal subunit (rns gene a group IIA1 intron interrupts an open reading frame (ORF encoded within a group I intron (mS1247. This arrangement offers the opportunity to examine if the nested group II intron could be utilized as a regulatory element for the expression of the homing endonuclease (HEase. Constructs were generated where the codon-optimized ORF was interrupted with either the native group IIA1 intron or a group IIB type intron. This study showed that the expression of the HEase (in vivo in Escherichia coli can be regulated by manipulating the splicing efficiency of the HEase ORF-embedded group II introns. Exogenous magnesium chloride (MgCl2 stimulated the expression of a functional HEase but the addition of cobalt chloride (CoCl2 to growth media antagonized the expression of HEase activity. Ultimately the ability to attenuate HEase activity might be useful in precision genome engineering, minimizing off target activities, or where pathways have to be altered during a specific growth phase.

  4. Safe start at home: what parents of newborns need after early discharge from hospital - a focus group study.

    Science.gov (United States)

    Kurth, Elisabeth; Krähenbühl, Katrin; Eicher, Manuela; Rodmann, Susanne; Fölmli, Luzia; Conzelmann, Cornelia; Zemp, Elisabeth

    2016-03-08

    The length of postpartum hospital stay is decreasing internationally. Earlier hospital discharge of mothers and newborns decreases postnatal care or transfers it to the outpatient setting. This study aimed to investigate the experiences of new parents and examine their views on care following early hospital discharge. Six focus group discussions with new parents (n = 24) were conducted. A stratified sampling scheme of German and Turkish-speaking groups was employed. A 'playful design' method was used to facilitate participants communication wherein they used blocks and figurines to visualize their perspectives on care models The visualized constructions of care models were photographed and discussions were audio-recorded and transcribed verbatim. Text and visual data was thematically analyzed by a multi-professional group and findings were validated by the focus group participants. Following discharge, mothers reported feeling physically strained during recuperating from birth and initiating breastfeeding. The combined requirements of infant and self-care needs resulted in a significant need for practical and medical support. Families reported challenges in accessing postnatal care services and lacking inter-professional coordination. The visualized models of ideal care comprised access to a package of postnatal care including monitoring, treating and caring for the health of the mother and newborn. This included home visits from qualified midwives, access to a 24-h helpline, and domestic support for household tasks. Participants suggested that improving inter-professional networks, implementing supervisors or a centralized coordinating center could help to remedy the current fragmented care. After hospital discharge, new parents need practical support, monitoring and care. Such support is important for the health and wellbeing of the mother and child. Integrated care services including professional home visits and a 24-hour help line may help meet the needs of

  5. Pain management for older persons living in nursing homes: a pilot study.

    Science.gov (United States)

    Tse, Mimi M Y; Ho, Suki S K

    2013-06-01

    Because the prevalence of chronic pain among the elderly in nursing homes is high and decreases their quality of life, effective nonpharmacologic pain management should be promoted. The purpose of this quasiexperimental pretest and posttest control design was to enhance pain management in nursing homes via an integrated pain management program (IPMP) for staff and residents. Nursing staff and residents from the experimental nursing home were invited to join the 8-week IPMP, whereas staff and residents from the control nursing home did not receive the IPMP. Baseline data were collected from nursing staff and residents in both groups before and after the IPMP. The IPMP consisted of eight lectures on pain assessment, drug knowledge,and nondrug strategies for the nursing staff, and 8 weeks of activities, including gardening therapy and physiotherapy exercise, for the residents. There were 48 and 42 older people in the experimental and control groups, respectively. No significant differences were found in their educational level, sleep quality, bowel habits, past and present health conditions, pain conditions and psychologic well-being parameters (p > .05) at baseline. After the IPMP, the experimental nursing staff showed a significant improvement in their knowledge of and attitudes to pain management (p pain scores and used more nondrug strategies for pain relief compared with the control group (p nursing staff, as well as reducing pain conditions and enhancing psychologic well-being for older persons in nursing homes. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  6. Prevalence and antimicrogram of Staphylococcus intermedius group isolates from veterinary staff, companion animals, and the environment in veterinary hospitals in Korea.

    Science.gov (United States)

    Youn, Jung-Ho; Yoon, Jang Won; Koo, Hye Cheong; Lim, Suk-Kyung; Park, Yong Ho

    2011-03-01

    The Staphylococcus intermedius bacterial group (SIG) includes 3 distinct genetically heterogenous species: S. intermedius, S. pseudintermedius, and S. delphini. This pathogen group is associated with many opportunistic skin and ear infections in companion animals. Human infections with S. intermedius and S. pseudintermedius isolates and the emergence of methicillin-resistant isolates have been recently reported, which emphasizes the importance of nationwide identification of SIG isolate prevalence and antibiotic resistance in veterinary clinics. In the present study, a total of 178 SIG isolates were obtained from veterinary staff (n  =  40), companion animals (n  =  115), and the local environment (n  =  23) in 8 Korean veterinary hospitals. Isolates were differentiated into 167 S. pseudintermedius (93.8%) and 11 S. intermedius (6.2%) isolates; S. delphini isolates were not identified. The most effective antibiotics against these isolates included amoxicillin-clavulanic acid, amikacin, nitrofloxacin, imipenem, and vancomycin; whereas ampicillin, penicillin, tetracycline, erythromycin, and trimethoprim-sulfamethoxazole were not effective. Surprisingly, the 128 SIG isolates (71.9%) displayed multiple drug resistance (MDR) against 3 or more antibiotic classes. Out of 52 SIG isolates carrying the methicillin-resistance gene (mecA), only 34 (65.4%) were oxacillin-resistant, and 49 (94.2%) methicillin-resistant SIG were multidrug resistant. This finding suggests the presence of greater numbers of MDR phenotypes than other isolates (P < 0.05).

  7. Online information for parents caring for their premature baby at home: A focus group study and systematic web search.

    Science.gov (United States)

    Alderdice, Fiona; Gargan, Phyl; McCall, Emma; Franck, Linda

    2018-01-30

    Online resources are a source of information for parents of premature babies when their baby is discharged from hospital. To explore what topics parents deemed important after returning home from hospital with their premature baby and to evaluate the quality of existing websites that provide information for parents post-discharge. In stage 1, 23 parents living in Northern Ireland participated in three focus groups and shared their information and support needs following the discharge of their infant(s). In stage 2, a World Wide Web (WWW) search was conducted using Google, Yahoo and Bing search engines. Websites meeting pre-specified inclusion criteria were reviewed using two website assessment tools and by calculating a readability score. Website content was compared to the topics identified by parents in the focus groups. Five overarching topics were identified across the three focus groups: life at home after neonatal care, taking care of our family, taking care of our premature baby, baby's growth and development and help with getting support and advice. Twenty-nine sites were identified that met the systematic web search inclusion criteria. Fifteen (52%) covered all five topics identified by parents to some extent and 9 (31%) provided current, accurate and relevant information based on the assessment criteria. Parents reported the need for information and support post-discharge from hospital. This was not always available to them, and relevant online resources were of varying quality. Listening to parents needs and preferences can facilitate the development of high-quality, evidence-based, parent-centred resources. © 2018 The Authors Health Expectations published by John Wiley & Sons Ltd.

  8. Mobilizing Older Adults: Harnessing the Potential of Smart Home Technologies. Contribution of the IMIA Working Group on Smart Homes and Ambient Assisted Living.

    Science.gov (United States)

    Demiris, G; Thompson, H J

    2012-01-01

    This paper highlights the potential of smart home applications to not only assess mobility determinants for older adults in the home environment but also provide the opportunity for tailored interventions. We present a theoretical framework for assessing mobility parameters and utilizing this information to enable behavior change based on the Health Belief Model. We discuss examples that showcase the potential of smart home systems to not only measure but also improve mobility for community dwelling older adults. Mobility is a complex construct that cannot be addressed with a single monitoring approach or a single intervention. Instead, tailored interventions that address specific needs and behaviors of individuals and take into consideration preferences of older adults and potentially their social network are needed to effectively enforce positive behavior change. Smart home systems have the ability to capture details of one's daily living that could otherwise not be easily obtained; however, such data repositories alone are not sufficient to improve clinical outcomes if appropriate mechanisms for data mining and analysis, as well as tailored response systems are not in place. Unleashing the potential of smart home applications to measure and improve mobility has the potential of transforming elder care and providing potentially cost-effective tools to support independence for older adults. A technologically driven smart home application can maximize its clinical relevance by pursuing interactive features that can lead to behavior change.

  9. Official Website of the Joint Chiefs of Staff

    Science.gov (United States)

    Skip to main content (Press Enter). Toggle navigation Joint Chiefs of Staff Joint Chiefs of Staff Joint Chiefs of Staff Facebook Twitter YouTube Flickr Blog Instagram Search JCS: Search Search Search JCS: Search Home Media News Photos Videos Publications About The Joint Staff Chairman Vice Chairman

  10. A pilot trial of body weight reduction for nonalcoholic fatty liver disease with a home-based lifestyle modification intervention delivered in collaboration with interdisciplinary medical staff

    International Nuclear Information System (INIS)

    Oza, Noriko; Eguchi, Yuichiro; Mizuta, Toshihiko

    2009-01-01

    Nonalcoholic fatty liver disease (NAFLD) is a hepatic manifestation of the metabolic syndrome. The aim of this study was to evaluate a 6-month home-based lifestyle modification intervention delivered in collaboration with physicians, hygienists, registered dietitians, and nurses. Outpatients with NAFLD diagnosed by abdominal ultrasonography were eligible for this study. Abdominal computed tomography (CT) scan evaluated liver fat deposition by the liver-spleen ratio (L/S ratio) and visceral fat accumulation as the visceral fat area (VFA; cm 2 ). During the 6-month home-based lifestyle modification intervention, each patient was examined by physicians, nurses, hygienists, and registered dietitians, who provided individualized advice to the patients. Patients recorded their daily weight for self-control of weight with recommended diet and exercise regimens. Sixty-seven NAFLD patients were enrolled in this study and 22 patients (32.8%) completed the 6-month intervention. Nineteen of the 22 patients achieved significant improvements in body weight, body mass index (BMI), waist circumference, VFA, L/S ratio, and systolic blood pressure, with improved laboratory data. Overall, 39 patients withdrew from the intervention. The mean age of the patients who withdrew was 50.0±11.0 years, which was significantly younger than that of the patients who were followed up (60.1±10.1 years; P<0.01). The reduction in body weight achieved by NAFLD patients during the 6-month intervention was associated with improved fat deposition and liver function. This intervention offers a practical approach for treating a large number of NAFLD patients with lifestyle modification therapy. (author)

  11. Medium-sized Universities Connect to Their Libraries: Links on University Home Pages and User Group Pages

    Directory of Open Access Journals (Sweden)

    Pamela Harpel-Burk

    2006-03-01

    Full Text Available From major tasks—such as recruitment of new students and staff—to the more mundane but equally important tasks—such as providing directions to campus—college and university Web sites perform a wide range of tasks for a varied assortment of users. Overlapping functions and user needs meld to create the need for a Web site with three major functions: promotion and marketing, access to online services, and providing a means of communication between individuals and groups. In turn, college and university Web sites that provide links to their library home page can be valuable assets for recruitment, public relations, and for helping users locate online services.

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

    Science.gov (United States)

    McConkey, R; Collins, S

    2010-08-01

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

  13. Determination of staphylococcal exotoxins, SCCmec types, and genetic relatedness of Staphylococcus intermedius group isolates from veterinary staff, companion animals, and hospital environments in Korea

    Science.gov (United States)

    Youn, Jung-Ho; Ahn, Kuk Ju; Lim, Suk-Kyung

    2011-01-01

    The Staphylococcus (S.) intermedius group (SIG) has been a main research subject in recent years. S. pseudintermedius causes pyoderma and otitis in companion animals as well as foodborne diseases. To prevent SIG-associated infection and disease outbreaks, identification of both staphylococcal exotoxins and staphylococcal cassette chromosome mec (SCCmec) types among SIG isolates may be helpful. In this study, it was found that a single isolate (one out of 178 SIG isolates examined) harbored the canine enterotoxin SEC gene. However, the S. intermedius exfoliative toxin gene was found in 166 SIG isolates although the S. aureus-derived exfoliative toxin genes, such as eta, etb and etd, were not detected. SCCmec typing resulted in classifying one isolate as SCCmec type IV, 41 isolates as type V (including three S. intermedius isolates), and 10 isolates as non-classifiable. Genetic relatedness of all S. pseudintermedius isolates recovered from veterinary staff, companion animals, and hospital environments was determined by pulsed-field gel electrophoresis. Strains having the same band patterns were detected in S. pseudintermedius isolates collected at 13 and 18 months, suggesting possible colonization and/or expansion of a specific S. pseudintermedius strain in a veterinary hospital. PMID:21897094

  14. At-home and in-group delivery of constraint-induced movement therapy in children with hemiparesis: A systematic review.

    Science.gov (United States)

    Durand, Emilie; Plante, Pascale; Pelletier, Andrey-Anne; Rondeau, Johanie; Simard, Frédérique; Voisin, Julien

    2018-07-01

    Constraint-induced movement therapy (CIMT) is increasingly recognized as an effective therapy for children with hemiparesis. However, the effectiveness of CIMT outside the standard rehabilitation protocol in clinical settings is less known. The aim of this systematic review was to investigate the effectiveness of CIMT conducted at home or in a group. We searched CINAHL, PubMed and ScienceDirect in August 2017 to select articles of studies investigating the impact of CIMT performed at home and in a group on affected upper-limb ability, occupational performance, and quality of life of children. Quality was evaluated with the PEDro scale. Among 374 reports of studies, 30 met the criteria; 15 examined CIMT at home and 15 in a group. CIMT with the 2 delivery models, at home or in a group, had a positive effect on the affected upper-limb ability and occupational performance. The quality of evidence was high for both these outcomes. However, the evidence was weaker and the results too limited to conclude on the impact on quality of life. The data also suggested that the glove may not be the best type of constraint. CIMT performed at home or in a group may be a promising intervention for rehabilitation for children with hemiparesis, but more studies on the impact on quality of life are warranted. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  15. Labeling and advertising of home insulation. Final staff report to the Federal Trade Commission and proposed trade regulation rule (16 CFR Part 460)

    Energy Technology Data Exchange (ETDEWEB)

    1978-07-01

    Insulation can save significant amounts of fuel and money, and has therefore captured public attention as a desirable energy conservation measure. Because insulation is a very difficult product for uninformed consumers to evaluate, there was broad support for a rule requiring the disclosure of information facilitating choices among insulation products. With the information that the Recommended Rule will require, consumers will be able to compare the thermal properties of varous types of insulation and make the best purchases for their needs. In order to provide consumers, as quickly as possible, with information aiding their purchase of this major conservation measure, and to protect consumers from the abuses that rising demand has brought, the Commission undertook this rulemaking proceeding on an expedited schedule. The Rule was proposed on November 18, 1977. The tests mandated by the Rule will provide reproducible and accurate R-values, permitting comparisons of thermal performance. As a result of the testing and required disclosures of R-values and related information, consumers should be able to make sound choices for their needs, without being uninformed or misinformed about the relative values of different types of insulation. The Recommended Rule covers the testing, advertising, and labeling of thermal insulation products. It includes organic, fibrous, cellular, and reflective insulations sold for use in homes, apartments, and other residential dwellings. Insulation sold directly to consumers for do-it-yourself installation is covered, as well as insulation installed by professionals.

  16. Long-term care planning study: strengths and learning needs of nursing staff.

    Science.gov (United States)

    Cruttenden, Kathleen E

    2006-01-01

    This planning study was designed and conducted in a predominantly rural Canadian province to examine the strengths and learning needs of four categories of nursing staff practising in New Brunswick nursing homes. Participants included directors of care, registered nurses, licensed practical nurses, and resident attendants. The nursing homes ranged in size from 38 to 196 beds and were located throughout the province. In health and planning studies, ethnography conveys a coherent statement of peoples' local knowledge as culture-sharing groups (Muecke, 1994). The study derived information from the Nursing Home Act, reports, the literature, key informants, and direct observations of and interviews with participants. Leadership strengths defined the roles for categories of staff and supported the capacity of each category to identify their learning needs. In conclusion, nurses practising in nursing homes can and must take an active role in decision making for their learning.

  17. Management of group b streptococcus-positive pregnant women at maternity homes in JAPAN: a questionnaire survey of compliance among midwives.

    Science.gov (United States)

    Yamaguchi, Kotomi; Ohashi, Kazutomo

    2018-01-01

    Per the 2014 Japanese Midwives Association (JMA) guidelines, midwives were allowed to manage the deliveries for group B streptococcus (GBS)-positive pregnant women in labour at maternity homes without the supervision of a medical doctor if they complied with the guidelines of the Japan Society of Obstetrics and Gynecology (JSOG), wherein midwives working for maternity homes are expected to cooperate with commissioned obstetricians and paediatricians in cooperative medical facilities. We examined the rate of compliance with these JMA and JSOG guidelines regarding the management of GBS-positive pregnant women among midwives at maternity homes in Japan. Between October and December 2015, an anonymous questionnaire was distributed to 337 maternity homes registered with the JMA by mail. The questionnaire obtained information regarding the timing of GBS screening, specimen collection, transfer of GBS-positive pregnant women from a maternity home to a hospital, administration of intrapartum antibiotic prophylaxis, and collaboration between midwives and commissioned obstetricians. Data were analysed using descriptive statistics. We used frequency distribution as the statistical test. Responses were received from 246 (73.0%) maternity homes, of which complete responses from 204 maternity homes (valid response rate, 60.5%) were analysed. Of these 204 maternity homes, only 97 (47.5%) conducted a GBS screening test during 33-37 weeks of gestation as recommended by the JSOG guidelines. Although midwives alone managed GBS-positive pregnant women in labour at 135 maternity homes (66.2%), intrapartum antibiotic prophylaxis, as recommended by the JSOG guidelines, was conducted in only 111 (54.4%). Moreover, only 37.0% (50/135) and 82.2% (111/135) of maternity homes ensured that GBS-positive pregnant women in labour with an elapse of ≥18 h after PROM and a body temperature of ≥38.0 °C, respectively, were transferred to a hospital by ambulance. Only at 58.3% (119/204) of

  18. Hierarchy in the home cage affects behaviour and gene expression in group-housed C57BL/6 male mice.

    Science.gov (United States)

    Horii, Yasuyuki; Nagasawa, Tatsuhiro; Sakakibara, Hiroyuki; Takahashi, Aki; Tanave, Akira; Matsumoto, Yuki; Nagayama, Hiromichi; Yoshimi, Kazuto; Yasuda, Michiko T; Shimoi, Kayoko; Koide, Tsuyoshi

    2017-08-01

    Group-housed male mice exhibit aggressive behaviour towards their cage mates and form a social hierarchy. Here, we describe how social hierarchy in standard group-housed conditions affects behaviour and gene expression in male mice. Four male C57BL/6 mice were kept in each cage used in the study, and the social hierarchy was determined from observation of video recordings of aggressive behaviour. After formation of a social hierarchy, the behaviour and hippocampal gene expression were analysed in the mice. Higher anxiety- and depression-like behaviours and elevated gene expression of hypothalamic corticotropin-releasing hormone and hippocampal serotonin receptor subtypes were observed in subordinate mice compared with those of dominant mice. These differences were alleviated by orally administering fluoxetine, which is an antidepressant of the selective serotonin reuptake inhibitor class. We concluded that hierarchy in the home cage affects behaviour and gene expression in male mice, resulting in anxiety- and depression-like behaviours being regulated differently in dominant and subordinate mice.

  19. Preparación del equipo básico de salud en temas de violencia doméstica, perspectiva de género Training of basic health staff on subjects related to home violence, genre perspective

    Directory of Open Access Journals (Sweden)

    Victoria Guadalupe Baró Jiménez

    2011-06-01

    , shows its domestic side as a problem with repercussion mainly on health's women and the health staff is lack of training to treat it. Objective: to characterize the training on home violence of the basic health staff. Methods: this is a research, qualitative, descriptive project including a universe of 20 persons, physicians and nurses working in consulting rooms of Family Physicians and emergency rooms in 2007 from the health area of the "Aleida Fernández Chardiet" polyclinic. The following methods were used: historical-logical, systemic approach, specialized literature study, modeling, interviews, and questionnaire as well as the expert consultations. Results: more than 60 % of study health staff showed a lack of knowledge with relation to the type of care must to be offered, the attitude to be followed, existence of the methodology and improvement in care in face of cases of home violence. Conclusions: training of physicians and nurses of basic health staff on home violence, is scarce in cognitive and procedural dimensions although less insufficient in the axiological dimension, since they are identified with the existence and affection degree that this problem causes mainly on the population health, but also they recognize the need of training in this respect for patients and for the staff care them. This insufficiency lies in the lack of a developing and integral diagnosis of this phenomenon falling into population health, the quality of professional performance and the impact of mission of university polyclinic on the community included, suggesting the need of to include subjects of this type in the study plans of health sciences careers.

  20. Labeling and advertising of home insulation. Final staff report to the Federal Trade Commission and proposed trade regulation rule (16 CFR Part 460)

    Energy Technology Data Exchange (ETDEWEB)

    1978-07-01

    Because insulation is a very difficult product for uniformed consumers to evaluate, there has been broad support for a rule requiring disclosure of information facilitating choices among insulation products. With information that the Recommended Rule will require, consumers will be able to compare the thermal properties of various types of insulation and make the best purchases. The FTC undertook this rulemaking effort and proposed a Rule on November 18, 1977. Hearings were conducted. Approximately 50 witnesses representing insulation manufacturers, contractors, trade associations, consumer and environmental groups, and state and Federal government agencies attended. As the record shows, without the Rule, some insulation industry members have failed to base R-value claims on tests or have extrapolated values from too-thin samples. Neither labels nor ads disclose R values; most do not explain R value; and the industry is not telling consumers about factors that often reduce insulation R values. Consumers are seldom told about performance characteristics of individual types of insulation. They are not advised that insulation is not always a good investment, or that their money might be more wisely spent on other conservation measures. The Rule addresses all of these problems. All aspects of the insulation industry and some consumer characteristics are summarized. (MCW)

  1. Teaching a Model of Social Skills Training to Child Care Workers at a Group Home for Adolescents, for Improvement of Treatment Planning.

    Science.gov (United States)

    Gramling, Lyle T.

    This practicum study implemented a training program in the teaching of social skills for 4 child care workers at a group home for 12 adolescents having moderate to severe emotional and behavioral problems. The inservice training program involved teaching concepts, techniques, and social skills terminology during the first four sessions, with…

  2. Bridging the Gap Between Continuous Sedation Until Death and Physician-Assisted Death: A Focus Group Study in Nursing Homes in Flanders, Belgium

    NARCIS (Netherlands)

    Rys, S.; Deschepper, R.; Mortier, F.; Deliens, L.; Bilsen, J.

    2015-01-01

    The distinction between continuous sedation until death (CSD) and physician-assisted death (PAD) has become a topic of medical ethical debate. We conducted 6 focus groups to examine how nursing home clinicians perceive this distinction. For some, the difference is clear whereas others consider CSD a

  3. Complex group-I introns in nuclear SSU rDNA of red and green algae: evidence of homing-endonuclease pseudogenes in the Bangiophyceae

    DEFF Research Database (Denmark)

    Haugen, P; Huss, V A; Nielsen, Henrik

    1999-01-01

    on the complementary strand. A comparison between related group-I introns in the Bangiophyceae revealed homing-endonuclease-like pseudogenes due to frame-shifts and deletions in Porphyra and Bangia. The Scenedesmus and Porphyra introns provide new insights into the evolution and possible novel functions of nuclear...

  4. Evaluating the systematic implementation of the 'Let Me Decide' advance care planning programme in long term care through focus groups: staff perspectives.

    LENUS (Irish Health Repository)

    Cornally, Nicola

    2015-11-01

    The \\'Let Me Decide\\' Advance Care Planning (LMD-ACP) programme offers a structured approach to End-of-Life (EoL) care planning in long-term care for residents with and without capacity to complete an advance care directive\\/plan. The programme was implemented in three homes in the South of Ireland, with a view to improving quality of care at end of life. This paper will present an evaluation of the systematic implementation of the LMD-ACP programme in the homes.

  5. Building Back Wards in a 'Post' Institutional Era: Hospital Confinement, Group Home Eviction, and Ontario's Treatment of People Labelled with Intellectual Disabilities

    Directory of Open Access Journals (Sweden)

    Natalie Spagnuolo

    2016-12-01

    Full Text Available Although Ontario has closed the regional centres that were intended for people labelled with intellectual disabilities and apologized to survivors, the institutionalization of disabled people persists in other forms in the province. This article demonstrates that the eligibility criteria established by privately-operated and publically-funded group homes contributes to the use of what will be termed 'back ward' placements in institutions such as hospitals and nursing homes. While group homes themselves have been – quite rightly – criticized as neo-institutional forms of residential support, they also play a role in shaping more overt forms of confinement by refusing to tailor their services to the needs of certain individuals. What follows is an analysis of residential support systems that builds upon case studies and reports to expose how impairment hierarchies, based on ranked support needs, determine who will end up in these 'back wards' and who will be offered a place in a group home.

  6. Phage T4 endonuclease SegD that is similar to group I intron endonucleases does not initiate homing of its own gene.

    Science.gov (United States)

    Sokolov, Andrey S; Latypov, Oleg R; Kolosov, Peter M; Shlyapnikov, Michael G; Bezlepkina, Tamara A; Kholod, Natalia S; Kadyrov, Farid A; Granovsky, Igor E

    2018-02-01

    Homing endonucleases are a group of site-specific endonucleases that initiate homing, a nonreciprocal transfer of its own gene into a new allele lacking this gene. This work describes a novel phage T4 endonuclease, SegD, which is homologous to the GIY-YIG family of homing endonucleases. Like other T4 homing endonucleases SegD recognizes an extended, 16bp long, site, cleaves it asymmetrically to form 3'-protruding ends and digests both unmodified DNA and modified T-even phage DNA with similar efficiencies. Surprisingly, we revealed that SegD cleavage site was identical in the genomes of segD - and segD + phages. We found that segD gene was expressed during the T4 developmental cycle. Nevertheless, endonuclease SegD was not able to initiate homing of its own gene as well as genetic recombination between phages in its site inserted into the rII locus. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. STAFF NEEDED

    CERN Multimedia

    2001-01-01

    The English National Programme, part of the Lycée International de Ferney-Voltaire (France) needs the following staff for September 2001: A part-time teacher of primary English The post involves teaching the English curriculum to pupils who are within the French educational system: Classes take place on Tuesday afternoons at the Lycée, Team spirit necessary as teachers work as a team, Induction & training are offered. A part time teacher of senior secondary history-geography in English A part time teacher of secondary mathematics in English Teachers must be mother-tongue English speakers and have a relevant degree and/or teaching qualification. For the history-geography post, either history or geography degrees are acceptable. Please send your c.v. and a letter of application to Peter Woodburn, Head, English National Programme, Lycée International, 01216 Ferney-Voltaire, France. (Email: engnat@hotmail.com) Telephone 04 50 40 82 66 for further details of posts. Ple...

  8. Staff - Kenneth R. Papp | Alaska Division of Geological & Geophysical

    Science.gov (United States)

    Surveys Home About Us Director's Office Alaska Statutes Annual Reports Employment Staff Directory and Facilities Staff Seismic and Well Data Data Reports Contact Us Frequently Asked Questions Ask a Facebook DGGS News Natural Resources Geological & Geophysical Surveys Staff - Kenneth R. Papp main

  9. Children's sugar-sweetened beverages consumption: associations with family and home-related factors, differences within ethnic groups explored.

    Science.gov (United States)

    van de Gaar, V M; van Grieken, A; Jansen, W; Raat, H

    2017-02-14

    The consumption of sugar-sweetened beverages (SSB) may contribute to the development of overweight among children. The present study aimed to evaluate associations between family and home-related factors and children's SSB consumption. We explored associations within ethnic background of the child. Cross-sectional data from the population-based 'Water Campaign' study were used. Parents (n = 644) of primary school children (6-13 years) completed a questionnaire on socio-demographic characteristics, family and home-related factors and child's SSB intake. The family and home-related factors under study were: cognitive variables (e.g. parental attitude, subjective norm), environmental variables (e.g. availability of SSB, parenting practices), and habitual variables (e.g. habit strength, taste preference). Regression analyses were used to evaluate the associations between family and home-related factors and child's SSB intake (p ethnic background, with the explained variance of the full models ranging from 8.7% for children from Moroccan or Turkish ethnic background to 44.4% for children with Dutch ethnic background. Our results provide support for interventions targeting children's SSB intake focussing on the identified family and home-related factors, with active participation of parents. Also, the relationships between these factors and the child's SSB intake differed for children with distinct ethnic backgrounds. Therefore, we would recommend to tailor interventions taking into account the ethnic background of the family. Number NTR3400 ; date April 4th 2012; retrospectively registered.

  10. Evaluating family function in caring for a geriatric group: Family APGAR applied for older adults by home care nurses.

    Science.gov (United States)

    Wang, Mei-Wen; Huang, Yi-Yu

    2016-06-01

    Family function is an essential factor affecting older adults' health. However, there has been no appropriate method to assess the family function of most older adults with fragility or poor health status. The present study aimed to explore the differences and relevance of family function estimated by home care nurses and the older adults, and to determine if nurses could represent older adults to provide the estimation. Study participants were 50 older adults who were aged older 65 years and were taken care of at home by well-trained nurses. The present study used the Family APGAR as the questionnaire. We compared the results evaluated by the older adults and their home care nurses. The results included the level of dysfunction and the total scores of the questionnaire. The paired t-test and McNemar-Bowker test were used for the analysis. Family function could be leveled as "good," "moderate dysfunction" and "severe dysfunction" according to the scores. The family function levels estimated by nurses showed no significant differences to the patients' condition (P = 0.123 > 0.05). Comparing the total scores of the older adults with those of their own home care nurses, the results showed a moderate to nearly high correlation (R = 0.689/P older adults' family problems much earlier and to improve the their health status by enhancing family support. Geriatr Gerontol Int 2015; ●●: ●●-●●. © 2015 Japan Geriatrics Society.

  11. Perspectives and expectations for telemedicine opportunities from families of nursing home residents and caregivers in nursing homes.

    Science.gov (United States)

    Chang, Jun-Yih; Chen, Liang-Kung; Chang, Chia-Ching

    2009-07-01

    This study assessed current perspectives and expectations for telemedicine by nursing home caregivers and families of nursing home patients in Taipei, Taiwan. A total of 116 interviews were conducted with family members (n=37) and caregivers (n=79) using an original, four-part questionnaire devised to assess the expectations and concerns related to prospective telemedicine opportunities, including consumer attitude, knowledge of and interest in medicine, concerns and worries about telemedicine, and anticipated benefits of telemedicine. Statistical significance between the two groups was observed in sex, age, and educational level (all pexpectations concerning benefits of telemedicine. More than 60% of family members or caregivers expected improved efficiency and quality of hospital and nursing home health care, greater rapport between nursing homes and either staff or patients, reduced overall medical costs of caregiving, and reduced staff/caregiver working hours. The acceptable cost was anything up to $15.30 USD per month. Nursing home caregivers and families of nursing home patients are highly interested in telemedicine; however, they are only willing to pay a slightly higher cost of nursing care for this service. The challenge for the future in this industry is to balance peoples' demands and telemedicine's associated costs. Results of this study suggest that caregivers and families of nursing home residents favour telemedicine implementation to provide enhanced care coordination in nursing homes when economic circumstances are favourable.

  12. Bridging the gap between continuous sedation until death and physician-assisted death: a focus group study in nursing homes in Flanders, Belgium.

    Science.gov (United States)

    Rys, Sam; Deschepper, Reginald; Mortier, Freddy; Deliens, Luc; Bilsen, Johan

    2015-06-01

    The distinction between continuous sedation until death (CSD) and physician-assisted death (PAD) has become a topic of medical ethical debate. We conducted 6 focus groups to examine how nursing home clinicians perceive this distinction. For some, the difference is clear whereas others consider CSD a form of euthanasia. Another group situates CSD between pain relief and ending life. Arguments for these perspectives refer to the following themes: intention, dosage of sedative drugs, unconsciousness, and the pace of the dying process. Generally, CSD is considered emotionally easier to deal with since it entails a gradual dying process. Nursing home clinicians have diverging perceptions of the relation between CSD and PAD; some consider CSD to be more than a purely palliative measure, that is, also as a means to hasten death. © The Author(s) 2014.

  13. Home is to be understood

    DEFF Research Database (Denmark)

    Buhl, Mie; Werner Hansen, Siv

    2018-01-01

    , and involved artists with refugee status (mainly from Syria), a group of local volunteers, and members of the museum staff. The project derived from the annual theme “ON THE MOVE” and culminated in an art exhibition and event on June 4th 2016. Up until then the museum had invited the artists to create artworks...... for the exhibition, while including the volunteers in the process, facilitating the meeting of those who are at home and those who are on the run. In this sense, the MFSK situates themselves as a social-political activist; a contemporary institution dealing with contemporary societal issues. The migrant and refugee...... of engaging with themes of refuge, home and exile? What are the implications of volunteering in such project? The paper’s discussions are framed by the theories of gallery education (Bishop, 2006; Mörsch, 2009), co-creation in museums (Simon, 2010), community arts (Kester, 2013), and draws on fieldwork...

  14. Personal Staff - Joint Staff - The National Guard

    Science.gov (United States)

    the ARNG Deputy Director of the ARNG Chief of Staff of the ARNG Command Chief Warrant Officer of the Site Maintenance Battle Focused Training Strategy Battle Staff Training Resources News Publications March Today in Guard History Leadership CNGB VCNGB SEA DANG DARNG Joint Staff J-1 J-2 J-3 J-4 J-5 J-6 J

  15. Early home-based group education to support informed decision-making among patients with end-stage renal disease: a multi-centre randomized controlled trial.

    Science.gov (United States)

    Massey, Emma K; Gregoor, Peter J H Smak; Nette, Robert W; van den Dorpel, Marinus A; van Kooij, Anthony; Zietse, Robert; Zuidema, Willij C; Timman, Reinier; Busschbach, Jan J; Weimar, Willem

    2016-05-01

    The aim was to test the effectiveness of early home-based group education on knowledge and communication about renal replacement therapy (RRT). We conducted a randomized controlled trial using a cross-over design among 80 end-stage renal disease (ESRD) patients. Between T0 and T1 (weeks 1-4) Group 1 received the intervention and Group 2 received standard care. Between T1 and T2 (weeks 5-8) Group 1 received standard care and Group 2 received the intervention. The intervention was a group education session on RRT options held in the patient's home given by social workers. Patients invited members from their social network to attend. Self-report questionnaires were used at T0, T1 and T2 to measure patients' knowledge and communication, and concepts from the Theory of Planned Behaviour such as attitude. Comparable questionnaires were completed pre-post intervention by 229 attendees. Primary RRT was registered up to 2 years post-intervention. Multilevel linear modelling was used to analyse patient data and paired t-tests for attendee data. Statistically significant increases in the primary targets knowledge and communication were found among patients and attendees after receiving the intervention. The intervention also had a significant effect in increasing positive attitude toward living donation and haemodialysis. Of the 80 participants, 49 underwent RRT during follow-up. Of these, 34 underwent a living donor kidney transplant, of which 22 were pre-emptive. Early home-based group education supports informed decision-making regarding primary RRT for ESRD patients and their social networks and may remove barriers to pre-emptive transplantation. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  16. Impact of Managers' Coaching Conversations on Staff Knowledge Use and Performance in Long-Term Care Settings.

    Science.gov (United States)

    Cummings, Greta G; Hewko, Sarah J; Wang, Mengzhe; Wong, Carol A; Laschinger, Heather K Spence; Estabrooks, Carole A

    2018-02-01

    Extended lifespans and complex resident care needs have amplified resource demands on nursing homes. Nurse managers play an important role in staff job satisfaction, research use, and resident outcomes. Coaching skills, developed through leadership skill-building, have been shown to be of value in nursing. To test a theoretical model of nursing home staff perceptions of their work context, their managers' use of coaching conversations, and their use of instrumental, conceptual and persuasive research. Using a two-group crossover design, 33 managers employed in seven Canadian nursing homes were invited to attend a 2-day coaching development workshop. Survey data were collected from managers and staff at three time points; we analyzed staff data (n = 333), collected after managers had completed the workshop. We used structural equation modeling to test our theoretical model of contextual characteristics as causal variables, managers' characteristics, and coaching behaviors as mediating variables and staff use of research, job satisfaction, and burnout as outcome variables. The theoretical model fit the data well (χ 2 = 58, df = 43, p = .06) indicating no significant differences between data and model-implied matrices. Resonant leadership (a relational approach to influencing change) had the strongest significant relationship with manager support, which in turn influenced frequency of coaching conversations. Coaching conversations had a positive, non-significant relationship with staff persuasive use of research, which in turn significantly increased instrumental research use. Importantly, coaching conversations were significantly, negatively related to job satisfaction. Our findings add to growing research exploring the role of context and leadership in influencing job satisfaction and use of research by healthcare practitioners. One-on-one coaching conversations may be difficult for staff not used to participating in such conversations. Resonant leadership, as

  17. Ethical challenges related to next of kin - nursing staffs' perspective.

    Science.gov (United States)

    Tønnessen, Siri; Solvoll, Betty-Ann; Brinchmann, Berit Støre

    2016-11-01

    Patients in clinical settings are not lonely islands; they have relatives who play a more or less active role in their lives. The purpose of this article is to elucidate the ethical challenges nursing staff encounter with patients' next of kin and to discuss how these challenges affect clinical practice. The study is based on data collected from ethical group discussions among nursing staff in a nursing home. The discussions took place in 2011 and 2012. The data were analysed and interpreted by using hermeneutic methodology. All the data have been anonymised and handled with confidentiality. Written informed consent was obtained from all participants. Ethical challenges relating to patients' next of kin were found to be an issue frequently discussed in the groups. Our findings indicate that next of kin have different characteristics, categorised as 'the professionals' and 'the shadows'. In this article, we will describe the next of kin's characteristics and the ethical challenges and practical implications that nursing staff experience in this connection. We will discuss the findings in the light of the four basic principles of medical ethics and propose interventions to help nurses manage ethical challenges related to next of kin. The study reveals the need to enhance nursing staffs' communicative and ethical skills on an individual level, but most importantly, to establish routines in clinical settings for informing and following up next of kin in a systematic and structured way. © The Author(s) 2015.

  18. Collaborative survey of perinatal loss in planned and unplanned home births. Northern Region Perinatal Mortality Survey Coordinating Group.

    OpenAIRE

    1996-01-01

    OBJECTIVE: To document the outcome of planned and unplanned births outside hospital. DESIGN: Confidential review of every pregnancy ending in stillbirth or neonatal death in which plans had been made for home delivery, irrespective of where delivery eventually occurred. The review was part of a sustained collaborative survey of all perinatal deaths. SETTING: Northern Regional Health Authority area. SUBJECTS: All 558,691 registered births to women normally resident in the former Northern Regio...

  19. Collaborative survey of perinatal loss in planned and unplanned home births. Northern Region Perinatal Mortality Survey Coordinating Group.

    Science.gov (United States)

    1996-11-23

    To document the outcome of planned and unplanned births outside hospital. Confidential review of every pregnancy ending in stillbirth or neonatal death in which plans had been made for home delivery, irrespective of where delivery eventually occurred. The review was part of a sustained collaborative survey of all perinatal deaths. Northern Regional Health Authority area. All 558,691 registered births to women normally resident in the former Northern Regional Health Authority area during 1981-94. Perinatal death. The estimated perinatal mortality during 1981-94 among women booked for a home birth was 14 deaths in 2888 births. This was less than half that among all women in the region. Only three of the 14 women delivered outside hospital. Independent review suggested that two of the 14 deaths might have been averted by different management. Both births occurred in hospital, and in only one was management before admission of the mother judged inappropriate. Perinatal loss to the 64 women who booked for hospital delivery but delivered outside and to the 67 women who delivered outside hospital without ever making arrangements to receive professional care during labour accounted for the high perinatal mortality (134 deaths in 3466 deliveries) among all births outside hospital. The perinatal hazard associated with planned home birth in the few women who exercised this option (unplanned delivery outside hospital.

  20. Communication skills training in a nursing home: effects of a brief intervention on residents and nursing aides

    Science.gov (United States)

    Sprangers, Suzan; Dijkstra, Katinka; Romijn-Luijten, Anna

    2015-01-01

    Effective communication by nursing home staff is related to a higher quality of life and a decrease in verbal and physical aggression and depression in nursing home residents. Several communication intervention studies have been conducted to improve communication between nursing home staff and nursing home residents with dementia. These studies have shown that communication skills training can improve nursing aides’ communication with nursing home residents. However, these studies tended to be time-consuming and fairly difficult to implement. Moreover, these studies focused on the communicative benefits for the nursing home residents and their well-being, while benefits and well-being for the nursing aides were neglected. The current study focused on implementing a brief communication skills training program to improve nursing aides’ (N=24) communication with residents with dementia (N=26) in a nursing home. The effects of the training on nursing aides’ communication, caregiver distress, and job satisfaction and residents’ psychopathology and agitation were assessed relative to a control group condition. Nursing aides in the intervention group were individually trained to communicate effectively with residents during morning care by using short instructions, positive speech, and biographical statements. Mixed ANOVAs showed that, after training, nursing aides in the intervention group experienced less caregiver distress. Additionally, the number of short instructions and instances of positive speech increased. Providing nursing aides with helpful feedback during care aids communication and reduces caregiver burden, even with a brief intervention that requires limited time investments for nursing home staff. PMID:25653513

  1. The feasibility of a train-the-trainer approach to end of life care training in care homes: an evaluation.

    Science.gov (United States)

    Mayrhofer, Andrea; Goodman, Claire; Smeeton, Nigel; Handley, Melanie; Amador, Sarah; Davies, Sue

    2016-01-22

    The ABC End of Life Education Programme trained approximately 3000 care home staff in End of Life (EoL) care. An evaluation that compared this programme with the Gold Standards Framework found that it achieved equivalent outcomes at a lower cost with higher levels of staff satisfaction. To consolidate this learning, a facilitated peer education model that used the ABC materials was piloted. The goal was to create a critical mass of trained staff, mitigate the impact of staff turnover and embed EoL care training within the organisations. The aim of the study was to evaluate the feasibility of using a train the trainer (TTT) model to support EoL care in care homes. A mixed method design involved 18 care homes with and without on-site nursing across the East of England. Data collection included a review of care home residents' characteristics and service use (n = 274), decedents' notes n = 150), staff interviews (n = 49), focus groups (n = 3), audio diaries (n = 28) and observations of workshops (n = 3). Seventeen care homes participated. At the end of the TTT programme 28 trainers and 114 learners (56% of the targeted number of learners) had been trained (median per home 6, range 0-13). Three care homes achieved or exceeded the set target of training 12 learners. Trainers ranged from senior care staff to support workers and administrative staff. Results showed a positive association between care home stability, in terms of leadership and staff turnover, and uptake of the programme. Care home ownership, type of care home, size of care home, previous training in EoL care and resident characteristics were not associated with programme completion. Working with facilitators was important to trainers, but insufficient to compensate for organisational turbulence. Variability of uptake was also linked to management support, programme fit with the trainers' roles and responsibilities and their opportunities to work with staff on a daily basis. When

  2. The mitochondrial LSU rRNA group II intron of Ustilago maydis encodes an active homing endonuclease likely involved in intron mobility.

    Directory of Open Access Journals (Sweden)

    Anja Pfeifer

    Full Text Available BACKGROUND: The a2 mating type locus gene lga2 is critical for uniparental mitochondrial DNA inheritance during sexual development of Ustilago maydis. Specifically, the absence of lga2 results in biparental inheritance, along with efficient transfer of intronic regions in the large subunit rRNA gene between parental molecules. However, the underlying role of the predicted LAGLIDADG homing endonuclease gene I-UmaI located within the group II intron LRII1 has remained unresolved. METHODOLOGY/PRINCIPAL FINDINGS: We have investigated the enzymatic activity of I-UmaI in vitro based on expression of a tagged full-length and a naturally occurring mutant derivative, which harbors only the N-terminal LAGLIDADG domain. This confirmed Mg²⁺-dependent endonuclease activity and cleavage at the LRII1 insertion site to generate four base pair extensions with 3' overhangs. Specifically, I-UmaI recognizes an asymmetric DNA sequence with a minimum length of 14 base pairs (5'-GACGGGAAGACCCT-3' and tolerates subtle base pair substitutions within the homing site. Enzymatic analysis of the mutant variant indicated a correlation between the activity in vitro and intron homing. Bioinformatic analyses revealed that putatively functional or former functional I-UmaI homologs are confined to a few members within the Ustilaginales and Agaricales, including the phylogenetically distant species Lentinula edodes, and are linked to group II introns inserted into homologous positions in the LSU rDNA. CONCLUSIONS/SIGNIFICANCE: The present data provide strong evidence that intron homing efficiently operates under conditions of biparental inheritance in U. maydis. Conversely, uniparental inheritance may be critical to restrict the transmission of mobile introns. Bioinformatic analyses suggest that I-UmaI-associated introns have been acquired independently in distant taxa and are more widespread than anticipated from available genomic data.

  3. Work satisfaction, stress, quality of care and morale of older people in a nursing home.

    Science.gov (United States)

    Redfern, Sally; Hannan, Shirina; Norman, Ian; Martin, Finbarr

    2002-11-01

    The aim in the present study, which was carried out in one nursing home for older people, was to determine the feasibility of working with care workers and very frail service users to investigate links between the levels of work satisfaction and stress of the staff, and the quality of care and morale of the residents. Most of the 44 care staff (70%) and 22 cognitively intact residents (82%) participated willingly in completing rating scales through self-completion questionnaire or by interview. Well-validated scales were used to measure job satisfaction, work stress, organisational commitment, perceived quality of care, and morale and mental health. The findings revealed a staff group with a fairly high level of job dissatisfaction and stress, who were, nevertheless, very committed to the nursing home. The morale of the residents was good although the residents rated the home atmosphere lower than the staff did. Significant correlations emerged, in the expected direction, between satisfaction, commitment, stress and quality of care perceived by staff. The correlations between home atmosphere perceived by residents, and their morale and mental health were low; further investigation is needed with a larger sample. This feasibility study supports the need for further research using a case-study approach in a small number of homes because of the labour-intensive nature of the data collection and the importance of triangulating data from many sources.

  4. Work-Related Stressors Among Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Home Visitors: A Qualitative Study.

    Science.gov (United States)

    Alitz, Paige J; Geary, Shana; Birriel, Pamela C; Sayi, Takudzwa; Ramakrishnan, Rema; Balogun, Omotola; Salloum, Alison; Marshall, Jennifer T

    2018-05-31

    Background The Florida Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program delivers evidence-based home visiting services to over 1400 families each year. Home visitors are integral in providing resources for families to promote healthy pregnancy, child development, family wellness, and self-sufficiency. Due to the nature of this work, home visitors experience work-related pressures and stressors that can impact staff well-being and retention. Objectives The purpose of this study was to understand primary sources of work-related stress experienced by home visitors, subsequent effects on their engagement with program participants, and to learn of coping mechanisms used to manage stress. Methods In 2015, Florida MIECHV program evaluators conducted ten focus groups with 49 home visitors during which they ranked and discussed their top sources of work-related stress. Qualitative analysis was conducted to identify emergent themes in work-related stressors and coping/supports. Results Across all sites, the burden of paperwork and data entry were the highest ranked work-related stressors perceived as interfering with home visitors' engagement with participants. The second-highest ranked stressors included caseload management, followed by a lack of resources for families, and dangerous environments. Home visitors reported gratification in their helping relationships families, and relied on coworkers or supervisors as primary sources of workplace support along with self-care (e.g. mini-vacations, recreation, and counseling). Conclusions for practice Florida MIECHV home visitors across all ten focus groups shared similar work-related stressors that they felt diminished engagement with program participants and could impact participant and staff retention. In response, Florida MIECHV increased resources to support home visitor compensation and reduce caseloads, and obtained a competitive award from HRSA to implement a mindfulness-based stress reduction

  5. Communication, advice exchange and job satisfaction of nursing staff: a social network analyses of 35 long-term care units.

    Science.gov (United States)

    van Beek, Adriana P A; Wagner, Cordula; Spreeuwenberg, Peter P M; Frijters, Dinnus H M; Ribbe, Miel W; Groenewegen, Peter P

    2011-06-01

    The behaviour of individuals is affected by the social networks in which they are embedded. Networks are also important for the diffusion of information and the influence of employees in organisations. Yet, at the moment little is known about the social networks of nursing staff in healthcare settings. This is the first study that investigates informal communication and advice networks of nursing staff in long-term care. We examine the structure of the networks, how they are related to the size of units and characteristics of nursing staff, and their relationship with job satisfaction. We collected social network data of 380 nursing staff of 35 units in group projects and psychogeriatric units in nursing homes and residential homes in the Netherlands. Communication and advice networks were analyzed in a social network application (UCINET), focusing on the number of contacts (density) between nursing staff on the units. We then studied the correlation between the density of networks, size of the units and characteristics of nursing staff. We used multilevel analyses to investigate the relationship between social networks and job satisfaction of nursing staff, taking characteristics of units and nursing staff into account. Both communication and advice networks were negatively related to the number of residents and the number of nursing staff of the units. Communication and advice networks were more dense when more staff worked part-time. Furthermore, density of communication networks was positively related to the age of nursing staff of the units. Multilevel analyses showed that job satisfaction differed significantly between individual staff members and units and was influenced by the number of nursing staff of the units. However, this relationship disappeared when density of communication networks was added to the model. Overall, communication and advice networks of nursing staff in long-term care are relatively dense. This fits with the high level of cooperation

  6. Research staff and public engagement

    DEFF Research Database (Denmark)

    Davies, Sarah Rachael

    2013-01-01

    focuses on one staff group, contract researchers, to explore the perceived challenges and opportunities of public engagement. Qualitative and quantitative data-from a web-based survey and three focus groups-are used to show that, while engagement activities are often seen as rewarding, the challenges...

  7. Understanding organizational and cultural premises for quality of care in nursing homes: an ethnographic study.

    Science.gov (United States)

    Nakrem, Sigrid

    2015-11-13

    Internationally, there are concerns about the quality of care in nursing homes. The concept of 'corporate culture' as an internal variable could be seen as the means to improve quality of care and quality of life for the residents. The aim of this article was to describe the nursing home culture from the staff's perspective and to include how the residents describe quality of care. An ethnographic design was employed. A purposive sample of four municipal public nursing homes in Norway with long-term care residents was included in the study. Data were collected by participant observation including informal conversation with the staff, and in-depth interviews with 15 residents using a narrative approach. The main findings were that organizational cultures could be seen as relatively stable corporate cultures described as 'personalities' with characteristics that were common for all nursing homes (conformity) and typical traits that were present in some nursing homes, but that they were also like no other nursing home (distinctiveness). Conformity ('Every nursing home is like all other nursing homes') meant that nursing home organizations formed their services according to a perception of what residents in general need and expect. Trait ('Every nursing home is like some other nursing homes') expressed typologies of nursing homes: residency, medical, safeguard or family orientation. The distinctness of each nursing home ('Every nursing home is like no other nursing home') was expressed in unique features of the nursing home; the characteristics of the nursing home involved certain patterns of structure, cultural assumptions and interactions that were unique in each nursing home. Nursing home residents experienced quality of care as 'The nursing home as my home' and 'Interpersonal care quality'. The resident group in the different types of nursing homes were unique, and the experience of quality of care seemed to depend on whether their unique needs and expectations

  8. Staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in quality improvement: a focus group discussion study at two hospital settings in Sweden.

    Science.gov (United States)

    Hvitfeldt-Forsberg, Helena; Mazzocato, Pamela; Glaser, Daniel; Keller, Christina; Unbeck, Maria

    2017-06-06

    To explore healthcare staffs' and managers' perceptions of how and when discrete event simulation modelling can be used as a decision support in improvement efforts. Two focus group discussions were performed. Two settings were included: a rheumatology department and an orthopaedic section both situated in Sweden. Healthcare staff and managers (n=13) from the two settings. Two workshops were performed, one at each setting. Workshops were initiated by a short introduction to simulation modelling. Results from the respective simulation model were then presented and discussed in the following focus group discussion. Categories from the content analysis are presented according to the following research questions: how and when simulation modelling can assist healthcare improvement? Regarding how, the participants mentioned that simulation modelling could act as a tool for support and a way to visualise problems, potential solutions and their effects. Regarding when, simulation modelling could be used both locally and by management, as well as a pedagogical tool to develop and test innovative ideas and to involve everyone in the improvement work. Its potential as an information and communication tool and as an instrument for pedagogic work within healthcare improvement render a broader application and value of simulation modelling than previously reported. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  9. Relationship between speaking English as a second language and agitation in people with dementia living in care homes: Results from the MARQUE (Managing Agitation and Raising Quality of life) English national care home survey.

    Science.gov (United States)

    Cooper, C; Rapaport, P; Robertson, S; Marston, L; Barber, J; Manela, M; Livingston, G

    2018-03-01

    As not speaking English as a first language may lead to increased difficulties in communication with staff and other residents, we (1) tested our primary hypotheses that care home residents with dementia speaking English as a second language experience more agitation and overall neuropsychiatric symptoms, and (2) explored qualitatively how staff consider that residents' language, ethnicity, and culture might impact on how they manage agitation. We interviewed staff, residents with dementia, and their family carers from 86 care homes (2014-2015) about resident's neuropsychiatric symptoms, agitation, life quality, and dementia severity. We qualitatively interviewed 25 staff. Seventy-one out of 1420 (5%) of care home residents with dementia interviewed spoke English as a second language. After controlling for dementia severity, age, and sex, and accounting for care home and staff proxy clustering, speaking English as a second language compared with as a first language was associated with significantly higher Cohen-Mansfield Agitation Inventory (adjusted difference in means 8.3, 95% confidence interval 4.1 to 12.5) and Neuropsychiatric inventory scores (4.1, 0.65 to 7.5). Staff narratives described how linguistic and culturally isolating being in a care home where no residents or staff share your culture or language could be for people with dementia, and how this sometimes caused or worsened agitation. Considering a person with dementia's need to be understood when selecting a care home and developing technology resources to enable dementia-friendly translation services could be important strategies for reducing distress of people with dementia from minority ethnic groups who live in care homes. © 2017 The Authors. International Journal of Geriatric Psychiatry Published by John Wiley & Sons Ltd.

  10. Consequences from use of reminiscence - a randomised intervention study in ten Danish nursing homes

    Directory of Open Access Journals (Sweden)

    Sørensen Jan

    2010-06-01

    Full Text Available Abstract Background Reminiscence is the systematic use of memories and recollections to strengthen self-identity and self-worth. The study aim was to investigate the consequences for nursing home residents and staff of integrating reminiscence into daily nursing care. Methods In this randomised study, ten nursing homes were matched into two groups on the basis of location, type and size. In the period August 2006 - August 2007, staff in the Intervention Group were trained and supported in the use of reminiscence, involving individual and group sessions with residents as well as reminiscence boxes, posters and exhibitions. At baseline and again 6 and 12 months after the intervention start, data were collected on residents' cognitive level, agitated behaviour, general functioning and proxy-assessed quality of life, as well as on staff well-being and job satisfaction. Mixed linear modelling was used to analyse differences in outcome between the intervention and control groups. Results Project drop-out rates were 32% for residents and 38% for nursing staff. Most staff in the Intervention Group considered reminiscence a useful tool that improved their communication with residents, and that they would recommend to other nursing homes. There were no significant differences between residents in the Intervention and the Control Group in cognitive level, agitated behaviour or general functioning. Residents in the Intervention Group showed significant higher score at 6 months in quality of life subscale 'Response to surroundings', but there was no significant difference at 12 months. Positive effects of reminiscence were observed for all staff outcome measures, the only exception being SF-12 self-rated physical health. At 6 months after start of reminiscence, staff in the Intervention Group had significantly better scores than those in the Control Group for Personal accomplishment, Emotional exhaustion, Depersonalisation, 'Attitude towards individual

  11. Developing relationships between care staff and people with dementia through Music Therapy and Dance Movement Therapy: A preliminary phenomenological study.

    Science.gov (United States)

    Melhuish, Ruth; Beuzeboc, Catherine; Guzmán, Azucena

    2017-04-01

    Background There is an increasing focus on providing effective psychosocial interventions to improve quality of life in dementia care. This study aims to explore the attitudes and perceptions of staff who participated regularly in Music Therapy (MT) and Dance Movement Therapy (DMT) groups for residents with dementia in a nursing home. Method In-depth interviews were conducted with seven members of care home staff. Data were analysed using interpretative phenomenological analysis. Results A representation modelling the impact of MT and DMT in a nursing care home. Three main themes were identified. 1) Discovering residents' skills and feelings; 2) Learning from the therapists to change approaches to care practice with subthemes: time, space and pace, choice, following the residents' lead; 3) Connection between staff and residents. Conclusion The model indicated that both interventions performed in parallel helped staff to discover residents' skills and feelings. Although it is a small sample size, this study strongly suggests that MT and DMT can have a positive influence in helping care staff to provide a meaningful care environment.

  12. Returning home

    DEFF Research Database (Denmark)

    Agergaard, Jytte; Brøgger, Ditte

    2016-01-01

    flows. By focusing on these educational migrants, this paper explores how they connect to their rural homes. Guided by a critical reading of the migration-development scholarship, the paper examines how migrants and their relatives make sense of educational migrants’ remitting and returning practices......, and by comparing three groups of educational migrants, the migrants’ reasons for staying connected and sending remittances are scrutinized. The paper finds that although educational migrants do not generate extensive economic remittances for local development in Nepal, they stay connected to their rural homes...

  13. Perception of library staff on the preservation and conservation of ...

    African Journals Online (AJOL)

    Perception of library staff on the preservation and conservation of library resources in the Federal ... Journal Home > Vol 48, No 1-2 (2015) > ... of preservation policy as well as lack of funding to purchase preservation equipment in the library.

  14. The utilization of formal and informal home care by older patients with cancer: a Belgian cohort study with two control groups.

    Science.gov (United States)

    Baitar, Abdelbari; Buntinx, Frank; De Burghgraeve, Tine; Deckx, Laura; Bulens, Paul; Wildiers, Hans; van den Akker, Marjan

    2017-09-12

    The purpose of this paper is to analyse the utilization of formal and informal home care among older patients with cancer (OCP) and to compare this with middle-aged patients with cancer (MCP) and older patients without cancer (ONC). Additionally, we examined predictors of transitions towards formal care one year after a cancer diagnosis. OCP and MCP had to be recruited within three months after a cancer diagnosis and have an estimated life expectancy over six months. ONC consisted of patients without known cancer, seen by the general practitioner. Formal and informal care were compared between the patient groups at baseline, i.e. shortly after a cancer diagnosis and changes in care were studied after one year. A total of 844 patients were evaluable for formal care at baseline and 469 patients (56%) at follow-up. At baseline, about half of older adults and 18% of MCP used formal care, while about 85% of cancer patients and 57% ONC used informal care. Formal care increased for all groups after one year though not significantly in OCP. The amount of informal care only changed in MCP which decreased after one year. Cancer-related factors and changes in need factors predict a transition towards formal care after a cancer diagnosis. A cancer diagnosis has a different impact on the use of formal and informal care than ageing as such. The first year after a cancer diagnosis is an important time to follow-up on the patients' needs for home care.

  15. Supported Conversation for hospital staff

    DEFF Research Database (Denmark)

    Forchhammer, Hysse B; Løvholt, Annelise P.; Mathiesen, Lone Lundbak

    in communication and interaction, Supported Conversation for Adults with Aphasia (SCA) was adapted and implemented in a large neurological department at Rigshospitalet-Glostrup in Copenhagen. Method 152 staff members representing different health professionals were assigned to one of eleven courses during a six...... month period. Each course had 10-12 participants and lasted 6 hours, including instruction in the SCA principles, video analysis, interdisciplinary group work, and practice sessions with PWAs. Self-assessed learning outcomes were evaluated with a brief questionnaire filled out by staff members...... in communication, also showed significant improvements across all staff groups. After the course, more time to spend with patients was perceived as the most important factor to further increase communication success with PWA. Conclusion The results show that interdisciplinary SCA-courses successfully increase...

  16. Research Staff | Buildings | NREL

    Science.gov (United States)

    Research Staff Research Staff Photo of Roderick Jackson Roderick Jackson Laboratory Program Manager -related research at NREL. He works closely with senior laboratory management to set the strategic agenda for NREL's buildings portfolio, including all research, development, and market implementation

  17. E3 Staff Database

    Data.gov (United States)

    US Agency for International Development — E3 Staff database is maintained by E3 PDMS (Professional Development & Management Services) office. The database is Mysql. It is manually updated by E3 staff as...

  18. Adopt a Care Home: An intergenerational initiative bringing children into care homes.

    Science.gov (United States)

    Di Bona, Laura; Kennedy, Sheila; Mountain, Gail

    2017-01-01

    Dementia friendly communities, in which people living with dementia actively participate and those around them are educated about dementia, may improve the wellbeing of those living with dementia and reduce the associated stigma. The Adopt a Care Home scheme aims to contribute towards this by teaching schoolchildren about dementia and linking them with people living with dementia in a local care home. Forty-one children, 10 people living with dementia and 8 school/care home staff participated in a mixed methods (questionnaires, observations, interviews and focus groups) evaluation to assess the scheme's feasibility and impact. Data were analysed statistically and thematically. The scheme was successfully implemented, increased children's dementia awareness and appeared enjoyable for most participants. Findings, therefore, demonstrate the scheme's potential to contribute towards dementia friendly communities by increasing children's knowledge and understanding of dementia and engaging people living with dementia in an enjoyable activity, increasing their social inclusion.

  19. Mind Map: a new way to teach patients and staff.

    Science.gov (United States)

    Michelini, C A

    2000-05-01

    As home care agencies look for new ways to achieve patient outcomes and staff competencies in a cost-effective manner, Mind Map is a method that can be used to quickly organize patient and staff education while evaluating the learner's comprehension of critical information.

  20. Research Staff | Wind | NREL

    Science.gov (United States)

    Research Staff Research Staff Learn more about the expertise and technical skills of the wind power research team and staff at NREL. Name Position Email Phone Anstedt, Sheri Professional III-Writer/Editor /Web Content Sheri.Anstedt@nrel.gov 303-275-3255 Baker, Donald Research Technician V-Electrical

  1. Delinquency and Crime Prevention: Overview of Research Comparing Treatment Foster Care and Group Care

    Science.gov (United States)

    Osei, Gershon K.; Gorey, Kevin M.; Jozefowicz, Debra M. Hernandez

    2016-01-01

    Background: Evidence of treatment foster care (TFC) and group care's (GC) potential to prevent delinquency and crime has been developing. Objectives: We clarified the state of comparative knowledge with a historical overview. Then we explored the hypothesis that smaller, probably better resourced group homes with smaller staff/resident ratios have…

  2. Eldercare at Home: Problems of Daily Living

    Science.gov (United States)

    ... suggestions and provide education or other support. A social worker with the home health agency may make a few visits to discuss options ... carry out needed medical procedures. They often have social workers and ... When home health agency staff are visiting the home because of physical ...

  3. Building Emotion and Affect Regulation (BEAR): Preliminary Evidence from an Open Trial in Children's Residential Group Homes in Singapore

    Science.gov (United States)

    Pat-Horenczyk, R.; Shi, C. Sim Wei; Schramm-Yavin, S.; Bar-Halpern, M.; Tan, L. J.

    2015-01-01

    Background: The Building Emotion and Affect Regulation (BEAR) program is a theory-based group intervention for enhancing resilience in children, with a focus on strengthening emotion regulation. The BEAR is a 6-session protocol for children aged 7-12 who have been subject to traumatic life events. Objective: This paper presents the guiding…

  4. Characteristics and health conditions of a group of nursing home patients with mental-physical multimorbidity - the MAPPING study

    NARCIS (Netherlands)

    van den Brink, Anne M. A.; Gerritsen, Debby L.; de Valk, Miranda M. H.; Oude Voshaar, Richard C.; Koopmans, Raymond T. C. M.

    Background: Long-term care facilities have partly taken over the traditional asylum function of psychiatric hospitals and house an increasing group of patients with mental-physical multimorbidity (MPM). Little is known about the characteristics, behavior, and care dependency of these patients. This

  5. Improving socially constructed cross-cultural communication in aged care homes: A critical perspective.

    Science.gov (United States)

    Xiao, Lily Dongxia; Willis, Eileen; Harrington, Ann; Gillham, David; De Bellis, Anita; Morey, Wendy; Jeffers, Lesley

    2018-01-01

    Cultural diversity between residents and staff is significant in aged care homes in many developed nations in the context of international migration. This diversity can be a challenge to achieving effective cross-cultural communication. The aim of this study was to critically examine how staff and residents initiated effective cross-cultural communication and social cohesion that enabled positive changes to occur. A critical hermeneutic analysis underpinned by Giddens' Structuration Theory was applied to the study. Data were collected by interviews with residents or their family and by focus groups with staff in four aged care homes in Australia. Findings reveal that residents and staff are capable of restructuring communication via a partnership approach. They can also work in collaboration to develop communication resources. When staff demonstrate cultural humility, they empower residents from culturally and linguistically diverse backgrounds to engage in effective communication. Findings also suggest that workforce interventions are required to improve residents' experiences in cross-cultural care. This study challenges aged care homes to establish policies, criteria and procedures in cross-cultural communication. There is also the challenge to provide ongoing education and training for staff to improve their cross-cultural communication capabilities. © 2017 John Wiley & Sons Ltd.

  6. Elections to Staff Council

    CERN Multimedia

    Saff Association

    2013-01-01

    2013 Elections to Staff Council   Vote! Make your voice heard and be many to elect the new Staff Council. More details on the elections can be found on the Staff Association web site (https://ap-vote.web.cern.ch/elections-2013).   Timetable elections Monday 28 October to Monday 11 November, 12:00 am voting Monday 18 and Monday 25 November, publication of the results in Echo Tuesday 19 November, Staff Association Assizes Tuesday 3 December, first meeting of the new Staff Council and election of the new Executive Committee The voting procedure is monitored by the Election Committee.

  7. Innovative public library services - staff-less or staff-intensive?

    DEFF Research Database (Denmark)

    Johannsen, Carl Gustav Viggo

    2014-01-01

    Purpose – Several recent library innovations seem to make professional and clerical staff superfluous such as automated loan and delivery equipment, staff-less libraries open in 80 hours a week, and virtual services, enabling users to search the library catalogue and make reservations of library...... materials from their home address. The purpose of this paper is to examine whether such developments will necessarily lead to a situation where public libraries become self-service institutions or to what extent self-service and innovative staff-intensive library services can develop and co......-exist. Furthermore, the paper will examine what challenges library leaders face and what they can do, and actually have done, to handle staff resistance and other related problems to the benefit of both the users, the local communities, and also, the staff, in particular, when introducing new and innovative services...

  8. End uses of electric energy in homes of a group of dwellings; Usos finales de la energia electrica en hogares de un conjunto habitacional

    Energy Technology Data Exchange (ETDEWEB)

    Campero Littlewood, E.; Romero Cortes, J.; Alarcon Maldonado, E.; Silva Oliver, J.; Ortiz Segura, J.; Vargas Rubio, J. [Departamento de Energia, Universidad Autonoma Metropolitana - Unidad Azcapotzalco, Mexico, D. F. (Mexico)

    1997-12-31

    This paper reports the results of an inquiry conducted to a sample of homes of a group of dwellings. The objective of this inquiry was to know the number of dwellers, the electric household appliances and the type of artificial lighting characteristic of a three-bed room apartment of approximately 65 square meters. In the Introduction is given the information related to the distribution of the monthly consumption of the entire group of dwellings for two separate periods for more than six years, which allows to determine the yearly average rates of growth. The information collected in the inquiry is presented in graphical form of frequency of electric household appliances and the light bulb rating of the more typical electric appurtenances. The results correspond to the answers in 188 inquiries judged reliable (230 questionnaires were delivered to the homes). The analysis of the information allows the knowledge of the electricity consumption capacity that the sampled homes have and to infer the consumption capacity of the entire group of dwellings. [Espanol] En este trabajo se reportan los resultados de una encuesta aplicada a una muestra de hogares en un conjunto habitacional. El objetivo de la encuesta es conocer el numero de habitantes, el equipamiento en electrodomesticos y la iluminacion artificial que caracteriza a un departamento de tres recamaras de aproximadamente 65 m{sup 2}. En la introduccion se suministra la informacion de la distribucion del consumo mensual promedio de toda la unidad habitacional para dos periodos separados por mas de seis anos, lo que permite determinar las tasas promedio anuales de crecimiento. La informacion recopilada en la encuesta se presenta a manera de graficas de frecuencias de los electrodomesticos, de las capacidades de los focos o de las caracteristicas mas importantes de los aparatos electricos. Los resultados corresponden a las respuestas de 188 encuestas declaradas confiables (se entregaron cuestionarios a 230 hogares

  9. End uses of electric energy in homes of a group of dwellings; Usos finales de la energia electrica en hogares de un conjunto habitacional

    Energy Technology Data Exchange (ETDEWEB)

    Campero Littlewood, E; Romero Cortes, J; Alarcon Maldonado, E; Silva Oliver, J; Ortiz Segura, J; Vargas Rubio, J [Departamento de Energia, Universidad Autonoma Metropolitana - Unidad Azcapotzalco, Mexico, D. F. (Mexico)

    1998-12-31

    This paper reports the results of an inquiry conducted to a sample of homes of a group of dwellings. The objective of this inquiry was to know the number of dwellers, the electric household appliances and the type of artificial lighting characteristic of a three-bed room apartment of approximately 65 square meters. In the Introduction is given the information related to the distribution of the monthly consumption of the entire group of dwellings for two separate periods for more than six years, which allows to determine the yearly average rates of growth. The information collected in the inquiry is presented in graphical form of frequency of electric household appliances and the light bulb rating of the more typical electric appurtenances. The results correspond to the answers in 188 inquiries judged reliable (230 questionnaires were delivered to the homes). The analysis of the information allows the knowledge of the electricity consumption capacity that the sampled homes have and to infer the consumption capacity of the entire group of dwellings. [Espanol] En este trabajo se reportan los resultados de una encuesta aplicada a una muestra de hogares en un conjunto habitacional. El objetivo de la encuesta es conocer el numero de habitantes, el equipamiento en electrodomesticos y la iluminacion artificial que caracteriza a un departamento de tres recamaras de aproximadamente 65 m{sup 2}. En la introduccion se suministra la informacion de la distribucion del consumo mensual promedio de toda la unidad habitacional para dos periodos separados por mas de seis anos, lo que permite determinar las tasas promedio anuales de crecimiento. La informacion recopilada en la encuesta se presenta a manera de graficas de frecuencias de los electrodomesticos, de las capacidades de los focos o de las caracteristicas mas importantes de los aparatos electricos. Los resultados corresponden a las respuestas de 188 encuestas declaradas confiables (se entregaron cuestionarios a 230 hogares

  10. The economics of dementia-care mapping in nursing homes: a cluster-randomised controlled trial.

    Directory of Open Access Journals (Sweden)

    Geertje van de Ven

    Full Text Available BACKGROUND: Dementia-care mapping (DCM is a cyclic intervention aiming at reducing neuropsychiatric symptoms in people with dementia in nursing homes. Alongside an 18-month cluster-randomized controlled trial in which we studied the effectiveness of DCM on residents and staff outcomes, we investigated differences in costs of care between DCM and usual care in nursing homes. METHODS: Dementia special care units were randomly assigned to DCM or usual care. Nurses from the intervention care homes received DCM training, a DCM organizational briefing day and conducted the 4-months DCM-intervention twice during the study. A single DCM cycle consists of observation, feedback to the staff, and action plans for the residents. We measured costs related to health care consumption, falls and psychotropic drug use at the resident level and absenteeism at the staff level. Data were extracted from resident files and the nursing home records. Prizes were determined using the Dutch manual of health care cost and the cost prices delivered by a pharmacy and a nursing home. Total costs were evaluated by means of linear mixed-effect models for longitudinal data, with the unit as a random effect to correct for dependencies within units. RESULTS: 34 units from 11 nursing homes, including 318 residents and 376 nursing staff members participated in the cost analyses. Analyses showed no difference in total costs. However certain changes within costs could be noticed. The intervention group showed lower costs associated with outpatient hospital appointments over time (p = 0.05 than the control group. In both groups, the number of falls, costs associated with the elderly-care physician and nurse practitioner increased equally during the study (p<0.02. CONCLUSIONS: DCM is a cost-neutral intervention. It effectively reduces outpatient hospital appointments compared to usual care. Other considerations than costs, such as nursing homes' preferences, may determine whether they

  11. Implementing Home Health Standards in Clinical Practice.

    Science.gov (United States)

    Gorski, Lisa A

    2016-02-01

    In 1986, the American Nurses Association (ANA) published the first Standards of Home Health Practice. Revised in 1992 and expanded in 1999 to become Home Health Nursing: Scope and Standards of Practice, it was revised in 2008 and again in 2014. In the 2014 edition, there are 6 standards of home healthcare nursing practice and 10 standards of professional performance for home healthcare nursing. The focus of this article is to describe the home healthcare standards and to provide guidance for implementation in clinical practice. It is strongly encouraged that home healthcare administrators, educators, and staff obtain a copy of the standards and fully read this essential home healthcare resource.

  12. Chief of staff finance | Lillie | Scientia Militaria: South African Journal ...

    African Journals Online (AJOL)

    Scientia Militaria: South African Journal of Military Studies. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 12, No 2 (1982) >. Log in or Register to get access to full text downloads. Username, Password, Remember me, or Register. Chief of staff finance. Ashley C ...

  13. The effectiveness of staff training focused on increasing emotional intelligence and improving interaction between support staff and clients.

    Science.gov (United States)

    Zijlmans, L J M; Embregts, P J C M; Gerits, L; Bosman, A M T; Derksen, J J L

    2015-07-01

    Recent research addressed the relationship between staff behaviour and challenging behaviour of individuals with an intellectual disability (ID). Consequently, research on interventions aimed at staff is warranted. The present study focused on the effectiveness of a staff training aimed at emotional intelligence and interactions between staff and clients. The effects of the training on emotional intelligence, coping style and emotions of support staff were investigated. Participants were 214 support staff working within residential settings for individuals with ID and challenging behaviour. The experimental group consisted of 76 staff members, 138 staff members participated in two different control groups. A pre-test, post-test, follow-up control group design was used. Effectiveness was assessed using questionnaires addressing emotional intelligence, coping and emotions. Emotional intelligence of the experimental group changed significantly more than that of the two control groups. The experimental group showed an increase in task-oriented coping, whereas one control group did not. The results with regard to emotions were mixed. Follow-up data revealed that effects within the experimental group were still present four months after the training ended. A staff training aimed at emotional intelligence and staff-client interactions is effective in improving emotional intelligence and coping styles of support staff. However, the need for more research aiming at the relationship between staff characteristics, organisational factors and their mediating role in the effectiveness of staff training is emphasised. © 2014 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

  14. Implementing the patient-centered medical home model for chronic disease care in small medical practices: practice group characteristics and physician understanding.

    Science.gov (United States)

    Baxter, Louisa; Nash, David B

    2013-01-01

    Strengthening primary care may improve health outcomes and restrain spending. The patient-centered medical home (PCMH) model is endorsed as a tool to achieve this. Early evaluations in large group practices demonstrate improvements in some health outcomes. Evidence is lacking from small medical practices that deliver the majority of primary health care. This was a national survey of 200 physicians that explored perceptions of PCMH. There was considerable interest in adoption of the model; however, providing PCMH care was seen as an extension of traditional roles that requires additional reimbursement. No differentiation was made among a variety of payment models to do this. All joint principle components of the model were identified as important: extending access and information technology were the most contentious. There was consensus that PCMH might improve the quality of primary care; however, tension between wider societal benefits and rising costs for individual practices was a challenge to implementation.

  15. Participatory women's groups and counselling through home visits to improve child growth in rural eastern India: protocol for a cluster randomised controlled trial.

    Science.gov (United States)

    Nair, Nirmala; Tripathy, Prasanta; Sachdev, Harshpal S; Bhattacharyya, Sanghita; Gope, Rajkumar; Gagrai, Sumitra; Rath, Shibanand; Rath, Suchitra; Sinha, Rajesh; Roy, Swati Sarbani; Shewale, Suhas; Singh, Vijay; Srivastava, Aradhana; Pradhan, Hemanta; Costello, Anthony; Copas, Andrew; Skordis-Worrall, Jolene; Haghparast-Bidgoli, Hassan; Saville, Naomi; Prost, Audrey

    2015-04-15

    Child stunting (low height-for-age) is a marker of chronic undernutrition and predicts children's subsequent physical and cognitive development. Around one third of the world's stunted children live in India. Our study aims to assess the impact, cost-effectiveness, and scalability of a community intervention with a government-proposed community-based worker to improve growth in children under two in rural India. The study is a cluster randomised controlled trial in two rural districts of Jharkhand and Odisha (eastern India). The intervention tested involves a community-based worker carrying out two activities: (a) one home visit to all pregnant women in the third trimester, followed by subsequent monthly home visits to all infants aged 0-24 months to support appropriate feeding, infection control, and care-giving; (b) a monthly women's group meeting using participatory learning and action to catalyse individual and community action for maternal and child health and nutrition. Both intervention and control clusters also receive an intervention to strengthen Village Health Sanitation and Nutrition Committees. The unit of randomisation is a purposively selected cluster of approximately 1000 population. A total of 120 geographical clusters covering an estimated population of 121,531 were randomised to two trial arms: 60 clusters in the intervention arm receive home visits, group meetings, and support to Village Health Sanitation and Nutrition Committees; 60 clusters in the control arm receive support to Committees only. The study participants are pregnant women identified in the third trimester of pregnancy and their children (n = 2520). Mothers and their children are followed up at seven time points: during pregnancy, within 72 hours of delivery, and at 3, 6, 9, 12 and 18 months after birth. The trial's primary outcome is children's mean length-for-age Z scores at 18 months. Secondary outcomes include wasting and underweight at all time points, birth weight, growth

  16. An Epidemiological Approach to Staff Burnout.

    Science.gov (United States)

    Kamis, Edna

    This paper describes a conceptual model of staff burnout in terms of independent, intervening and dependent variables. Staff burnout is defined, symptoms are presented, and the epidemiological approach to burnout is descussed. Components of the proposed model, which groups determinants of mental health into three domains, consist of: (1)…

  17. Depression in nursing homes.

    Science.gov (United States)

    Snowdon, John

    2010-11-01

    Although studies have shown the prevalence of depression in nursing homes to be high, under-recognition of depression in these facilities is widespread. Use of screening tests to enhance detection of depressive symptoms has been recommended. This paper aims to provoke discussion about optimal management of depression in nursing homes. The utility of the Cornell Scale for Depression in Dementia (CSDD) is considered. CSDD data relating to residents assessed in 2008-2009 were collected from three Sydney nursing homes. CSDD scores were available from 162 residents, though raters stated they were unable to score participants on at least one item in 47 cases. Scores of 13 or more were recorded for 23% of residents in these facilities, but in most of these cases little was documented in case files to show that the results had been discussed by staff, or that they led to interventions, or that follow-up testing was arranged. Results of CSDD testing should prompt care staff (including doctors) to consider causation of depression in cases where residents are identified as possibly depressed. In particular, there needs to be discussion of how to help residents to cope with disability, losses, and feelings of powerlessness. Research is needed, examining factors that might predict response to antidepressants, and what else helps. Accreditation of nursing homes could be made to depend partly on evidence that staff regularly search for, and (if found) ensure appropriate responses to, depression.

  18. Oral histories of HIV/AIDS support group members, NGO workers and home-based carers in KwaZulu-Natal.

    Science.gov (United States)

    Denis, Philippe

    2016-01-01

    The purpose of this paper is to bring to the attention of the AIDS research community the existence of an oral history project known as the Memories of AIDS Project. The project focused on HIV/AIDS support group members, non-governmental organisation (NGO) workers and home-based carers in the Umgungundlovu (Pietermaritzburg) District Municipality, South Africa. The project was carried out by the Sinomlando Centre for Oral History and Memory Work, a research and community development centre of the University of KwaZulu-Natal, over a period of three years (2011-2013). Sixty-five individual oral history interviews of 1 to 4 hours duration and 11 focus group sessions were recorded, transcribed and translated from isiZulu into English when necessary. The life stories of community workers and support group members documented in the interviews show, on the part of the informants, a remarkable degree of agency and assertiveness in matters of sexuality, gender relations and religious beliefs. They found innovative ways of navigating through the conflicting claims of biomedicine, Christianity and African traditional religion. As much as the epidemic caused grief and suffering, it opened the door to new knowledge and new opportunities.

  19. At Home in the Office. A Guide for the Home Worker.

    Science.gov (United States)

    Thomas, Neil; And Others

    This guide provides information to persons interested in establishing a work-at-home program, specifically those in clerical or support staff positions who use modern automated office equipment. The text is divided into two sections. The Home Worker section provides a summary of the At Home in the Office Project, personality characteristics…

  20. Development of the Intervention Materials for the HomeStyles Obesity Prevention Program for Parents of Preschoolers

    Directory of Open Access Journals (Sweden)

    Jennifer Martin-Biggers

    2015-08-01

    Full Text Available Home environment is key to the development of obesity-preventing behaviors during childhood, yet few resources help preschool parents address factors at home associated with obesity risk. This paper describes creation of materials for an in-home intervention (HomeStyles with this population. An advisory group of stakeholders and target audience members determined salient factors affecting childhood obesity to address in-home and developed program materials. The Social Cognitive Theory, Faith’s Core Behavior Change Strategies to Treat Childhood Obesity, Adult Learning Theory and motivational interviewing techniques guided development of 12 guides targeting strategies parents can use to shape the home environment. Interviews were conducted to determine effectiveness of the guides. Cognitive testing of guide design (n = 251 and content (n = 261 occurred in English and Spanish in New Jersey and Arizona with parents and home visitation staff who would present the guides. Interviews investigated perceptions of content usefulness and parent comprehension. Findings were also examined in light of theoretical underpinnings. Both home visitation staff and parents felt the guides were very readable and useful. Parents appreciated use of motivational interviewing techniques and Adult Learning Theory. Current research is testing these guides through an in-home, randomized control trial.

  1. Nurses' knowledge and attitudes toward aged sexuality in Flemish nursing homes.

    Science.gov (United States)

    Mahieu, Lieslot; de Casterlé, Bernadette Dierckx; Acke, Jolien; Vandermarliere, Hanne; Van Elssen, Kim; Fieuws, Steffen; Gastmans, Chris

    2016-09-01

    Admission to a nursing home does not necessarily diminish an older person's desire for sexual expression and fulfillment. Given that nursing staff directly and indirectly influence the range of acceptable sexual expressions of nursing home residents, their knowledge and attitudes toward aged sexuality can have far-reaching effects on both the quality of care they provide to residents and the self-image and well-being of these residents. To investigate nursing staff's knowledge and attitudes toward aged sexuality, to determine whether certain sociodemographic factors of the nursing staff relate to their knowledge and attitudes toward later-life sexuality, and to examine the relationship between knowledge and attitudes. Descriptive cross-sectional survey study. The administered questionnaire collected sociodemographic data and data from an adapted, Dutch version of the Aging Sexual Knowledge and Attitudes Scale. Data were collected from November 2011 through April 2012. A total of 43 geographically dispersed nursing homes in Flanders, Belgium, participated. Out of a potential research sample of 2228 nursing staff respondents, 1166 participated. The study protocol was approved by the Ethics Committee of the Faculty of Medicine of the KU Leuven. Nursing staff appeared to be moderately knowledgeable about aged sexuality and displayed a rather positive attitude toward sexuality in older people. Significant relationships between various variables were found both at univariable and multivariable levels. Knowledge and attitudes proved to be positively related, indicating that a higher level of knowledge of aged sexuality is associated with a more positive attitude toward sexuality in later life. Research findings are discussed within a broader international context. There is room for improvement for both nursing staff's knowledge and attitudes toward aged sexuality. This might be aided by appropriate educational interventions. Our results identified different target groups

  2. 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.

  3. Comparison of Walking, Muscle Strength, Balance, and Fear of Falling Between Repeated Fall Group, One-time Fall Group, and Nonfall Group of the Elderly Receiving Home Care Service.

    Science.gov (United States)

    Jeon, MiYang; Gu, Mee Ock; Yim, JongEun

    2017-12-01

    The purpose of this study was to provide information to develop a program to prevent repeated falls by analyzing the difference in gait, muscle strength, balance, and fear of falling according to their fall experience. The study subjects were 110 elderly individuals aged over 60 years who agreed to their participation in this research. The study participants were categorized into a repeated fall group (n = 40), a one-time fall group (n = 15), and a nonfall group (n = 46) of the elderly. Measurements of gait, muscle strength, balance, and fear of falling were taken in each group. With regard to gait, there were significant differences among three groups in gait cycle (F = 3.50, p = .034), speed (F = 13.06, p balance, the nonfall group had significantly greater results than the one-time fall group and repeated fall group in dynamic balance (F = 10.80, p balance (F = 8.20, p = .001). In the case of the fear of falling, the repeated fall group had significantly higher score than other two groups (F = 20.62, p fall risk factors to enhance gait and balance and lower body muscle strength and reduce the fear of falling to prevent repeated incidences of falls in this population. Copyright © 2017. Published by Elsevier B.V.

  4. Use of mental health services by nursing home residents after hurricanes.

    Science.gov (United States)

    Brown, Lisa M; Hyer, Kathryn; Schinka, John A; Mando, Ahed; Frazier, Darvis; Polivka-West, Lumarie

    2010-01-01

    A growing body of research supports the value of mental health intervention to treat people affected by disasters. This study used a mixed-methods approach to evaluate pre- and posthurricane mental health service use in Florida nursing homes. A questionnaire was administered to 258 directors of nursing, administrators, and owners of nursing homes, representing two-thirds of Florida's counties, to identify residents' mental health needs and service use. In four subsequent focus group meetings with 22 nursing home administrators, underlying factors influencing residents' use of services were evaluated. Although most nursing homes provided some type of mental health care during normal operations, disaster-related mental health services were not routinely provided to residents. Receiving facilities were more likely than evacuating facilities to provide treatment to evacuated residents. Nursing home staff should be trained to deliver disaster-related mental health intervention and in procedures for making referrals for follow-up evaluation and formal intervention.

  5. Optimal healthcare delivery to care homes in the UK: a realist evaluation of what supports effective working to improve healthcare outcomes.

    Science.gov (United States)

    Gordon, Adam L; Goodman, Claire; Davies, Sue L; Dening, Tom; Gage, Heather; Meyer, Julienne; Schneider, Justine; Bell, Brian; Jordan, Jake; Martin, Finbarr C; Iliffe, Steve; Bowman, Clive; Gladman, John R F; Victor, Christina; Mayrhofer, Andrea; Handley, Melanie; Zubair, Maria

    2018-01-05

    care home residents have high healthcare needs not fully met by prevailing healthcare models. This study explored how healthcare configuration influences resource use. a realist evaluation using qualitative and quantitative data from case studies of three UK health and social care economies selected for differing patterns of healthcare delivery to care homes. Four homes per area (12 in total) were recruited. A total of 239 residents were followed for 12 months to record resource-use. Overall, 181 participants completed 116 interviews and 13 focus groups including residents, relatives, care home staff, community nurses, allied health professionals and General Practitioners. context-mechanism-outcome configurations were identified explaining what supported effective working between healthcare services and care home staff: (i) investment in care home-specific work that legitimises and values work with care homes; (ii) relational working which over time builds trust between practitioners; (iii) care which 'wraps around' care homes; and (iv) access to specialist care for older people with dementia. Resource use was similar between sites despite differing approaches to healthcare. There was greater utilisation of GP resource where this was specifically commissioned but no difference in costs between sites. activities generating opportunities and an interest in healthcare and care home staff working together are integral to optimal healthcare provision in care homes. Outcomes are likely to be better where: focus and activities legitimise ongoing contact between healthcare staff and care homes at an institutional level; link with a wider system of healthcare; and provide access to dementia-specific expertise. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Geriatrics Society.

  6. Research Staff | Bioenergy | NREL

    Science.gov (United States)

    Research Staff Research Staff Photo of Adam Bratis, Ph.D. Adam Bratis Associate Lab Director-Bio research to accomplish the objectives of the Department of Energy's Bioenergy Technologies Office, and to serve as a spokesperson for the bioenergy research effort at NREL, both internally and externally. This

  7. Elections to Staff Council

    CERN Multimedia

    Staff Association

    2011-01-01

    Elections to fill all seats in the Staff Council are being organized this month. The voting takes place from the 31st of October to the 14th of November, at noon. As you may have noted when reading Echo, many issues concerning our employment conditions are on the agenda of the coming months and will keep the next Staff Council very busy. So, make your voice heard and take part in the elections for a new Staff Council. By doing so, you will be encouraging the men and women who will be representing you over the next two years and they will doubtless appreciate your gratitude. Every member of the Staff Association will have received an email containing a link to the webpage which will allow voting. If you are a member of the Staff Association and you did not receive such an email, please contact the Staff Association secretariat (staff.association@cern.ch). Do not forget to vote * * * * * * * Vote Make your voice heard and be many to elect the new Staff Council. More details on the election...

  8. Nursing Homes

    Science.gov (United States)

    ... Home › Aging & Health A to Z › Nursing Homes Font size A A A Print Share Glossary Basic ... Reason For Living in A Nursing Home Some type of disability with activities of daily living (ADLs) ...

  9. Home Care

    Science.gov (United States)

    ... are part of home healthcare agencies. You may benefit from home care if you are dealing with ... it will trigger an emergency response or checkup phone call. Newer technologies ... or mobile testing technology (home diagnostics), including x-rays and ...

  10. Working in clients' homes: the impact on the mental health and well-being of visiting home care workers.

    Science.gov (United States)

    Denton, Margaret A; Zeytinoğlu, Işk Urla; Davies, Sharon

    2002-01-01

    The purpose of this paper is to examine the effects of working in clients' homes on the mental health and well-being of visiting home care workers. This paper reports the results of a survey of 674 visiting staff from three non-profit home care agencies in a medium-sized city in Ontario, Canada. Survey results are also complimented by data from 9 focus groups with 50 employees. For purposes of this study, home care workers include visiting therapists, nurses, and home support workers. Mental health and well-being is measured by three dependent variables: stress; job stress; and intrinsic job satisfaction. Multiple least squared regression analyses show several structural, emotional, physical, and organizational working conditions associated with the health and well-being of visiting home care workers. Overall, results show that workload, difficult clients, clients who take advantage of workers, sexual harassment, safety hazards, a repetitious job, and work-related injuries are associated with poorer health. Being fairly paid, having good benefits, emotional labour, organizational support, control over work, and peer support are associated with better health. Results suggest that policy change is needed to encourage healthier work environments for employees who work in clients' homes.

  11. Decentralized Ground Staff Scheduling

    DEFF Research Database (Denmark)

    Sørensen, M. D.; Clausen, Jens

    2002-01-01

    scheduling is investigated. The airport terminal is divided into zones, where each zone consists of a set of stands geographically next to each other. Staff is assigned to work in only one zone and the staff scheduling is planned decentralized for each zone. The advantage of this approach is that the staff...... work in a smaller area of the terminal and thus spends less time walking between stands. When planning decentralized the allocation of stands to flights influences the staff scheduling since the workload in a zone depends on which flights are allocated to stands in the zone. Hence solving the problem...... depends on the actual stand allocation but also on the number of zones and the layout of these. A mathematical model of the problem is proposed, which integrates the stand allocation and the staff scheduling. A heuristic solution method is developed and applied on a real case from British Airways, London...

  12. New staff contract policy

    CERN Document Server

    HR Department

    2006-01-01

    Following discussion at TREF and on the recommendation of the Finance Committee, Council approved a new staff contract policy, which became effective on 1 January 2006. Its application is covered by a new Administrative Circular No. 2 (Rev. 3) 'Recruitment, appointment and possible developments regarding the contractual position of staff members'. The revised circular replaces the previous Circulars No. 9 (Rev. 3) 'Staff contracts' and No. 2 (Rev. 2) 'Guidelines and procedures concerning recruitment and probation period for staff members'. The main features of the new contract policy are as follows: The new policy provides chances for long-term employment for all staff recruits staying for four years without distinguishing between those assigned to long-term or short-term activities when joining CERN. In addition, it presents a number of simplifications for the award of ICs. There are henceforth only 2 types of contract: Limited Duration (LD) contracts for all recruitment and Indefinite Contracts (IC) for...

  13. A Pilot Study Evaluating the Feasibility of Psychological First Aid for Nursing Home Residents.

    Science.gov (United States)

    Brown, Lisa M; Bruce, Martha L; Hyer, Kathryn; Mills, Whitney L; Vongxaiburana, Elizabeth; Polivka-West, Lumarie

    2009-07-01

    OBJECTIVES: The objectives of the pilot study were to modify existing psychological first aid (PFA) materials so they would be appropriate for use with institutionalized elders, evaluate the feasibility of using nursing home staff to deliver the intervention to residents, and solicit feedback from residents about the intervention. The STORM Study, an acronym for "services for treating older residents' mental health", is the first step in the development of an evidence-based disaster mental health intervention for this vulnerable and underserved population. METHOD: Demographic characteristics were collected on participating residents and staff. Program evaluation forms were completed by staff participants during the pilot test and nurse training session. Staff and resident discussion groups were conducted during the pilot test to collect qualitative data on the use of PFA in nursing homes. RESULTS: Results demonstrate the feasibility of the PFA program to train staff to provide residents with PFA during disasters. CONCLUSIONS: Future research should focus on whether PFA improves coping and reduces stress in disaster exposed nursing home residents.

  14. Replicating the Family: The Biopolitics of Involvement Discourses Concerning Relatives in Nursing Home Institutions

    Directory of Open Access Journals (Sweden)

    Jessica Holmgren

    2014-10-01

    Full Text Available The aim of this study was to describe the biopolitics of involvement discourses articulated by nursing staff concerning relatives in nursing home institutions, using a Foucault-inspired discourse analytical approach. Previous research has described how relatives have not been involved in nursing homes on their own terms. This is partly due to a lack of communication and knowledge, but it is also a consequence of an unclear organizational structure. Results from a discourse analysis of six focus group interviews with nursing staff show that the “involvement discourse” in nursing homes can be described as a “new” vs “old” family rhetoric. This rhetoric can be said to uphold, legitimize and provide different subject positions for both nursing staff and relatives concerning the conditions for involvement in nursing homes. As part of a “project of possibility” in elderly care, it may be possible to adopt a critical pedagogical approach among nursing staff in order to educate, strengthen and support them in reflecting on their professional norming and how it conditions the involvement of relatives.

  15. Working in small-scale, homelike dementia care: effects on staff burnout symptoms and job characteristics. A quasi-experimental, longitudinal study.

    Science.gov (United States)

    Zwakhalen, Sandra Mg; Hamers, Jan Ph; van Rossum, Erik; Ambergen, Ton; Kempen, Gertrudis Ijm; Verbeek, Hilde

    2018-05-01

    This paper reports on a quasi-experimental, longitudinal study on the effects of working in a new type of dementia care facility (i.e. small-scale living facilities) on staff burnout symptoms and job characteristics (job autonomy, social support, physical demands and workload). It is hypothesised that nursing staff working in small-scale facilities experience fewer burnout symptoms, more autonomy and social support, and fewer symptoms of physical demands and workload compared with staff in regular wards. Two types of long-term institutional nursing care settings were included: 28 houses in small-scale living facilities and 21 regular psychogeriatric wards in nursing homes. At baseline and at follow-ups after 6 and 12 months nursing staff were assessed by means of self-report questionnaires. In total, 305 nursing staff members were included in the study, 114 working in small-scale living facilities (intervention group) and 191 in regular wards (control group). No overall effects on burnout symptoms were detected. Significantly fewer physical demands and lower workload were experienced by staff working in small-scale living facilities compared with staff in regular wards. They also experienced more job autonomy. No significant effect was found for overall social support in the total group. This study suggests positive effects of the work environment on several work characteristics. Organisational climate differs in the two conditions, which might account for our results. This may influence nursing staff well-being and has important implications for nursing home managers and policy makers. Future studies should enhance our understanding of the influence of job characteristics on outcomes.

  16. Qualitative analysis and conceptual mapping of patient experiences in home health care.

    Science.gov (United States)

    Lines, Lisa M; Anderson, Wayne L; Blackmon, Brian D; Pronier, Cristalle R; Allen, Rachael W; Kenyon, Anne E

    2018-01-01

    This study explored patient experiences in home health care through a literature review, focus groups, and interviews. Our goal was to develop a conceptual map of home health care patient experience domains. The conceptual map identifies technical and personal spheres of care, relating prior studies to new focus group and interview findings and identifying the most important domains of care. Study participants (n = 35) most frequently reported the most important domain as staff who are caring, supportive, patient, empathetic, respectful, and considerate (endorsed by 29% of participants). The conceptual map includes 114 discrete domains.

  17. Optimisation of staff protection

    International Nuclear Information System (INIS)

    Faulkner, K.; Marshall, N.W.; Rawlings, D.J.

    1997-01-01

    It is important to minimize the radiation dose received by staff, but it is particularly important in interventional radiology. Staff doses may be reduced by minimizing the fluoroscopic screening time and number of images, compatible with the clinical objective of the procedure. Staff may also move to different positions in the room in an attempt to reduce doses. Finally, staff should wear appropriate protective clothing to reduce their occupational doses. This paper will concentrate on the optimization of personal shielding in interventional radiology. The effect of changing the lead equivalence of various protective devices on effective dose to staff has been studied by modeling the exposure of staff to realistic scattered radiation. Both overcouch x-ray tube/undercouch image intensified and overcouch image intensifier/undercouch x-ray tube geometries were simulated. It was deduced from this simulation that increasing the lead apron thickness from 0.35 mm lead to 0.5 mm lead had only a small reducing effect. By contrast, wearing a lead rubber thyroid shield or face mask is a superior means of reducing the effective dose to staff. Standing back from the couch when the x-ray tube is emitting radiation is another good method of reducing doses, being better than exchanging a 0.35 mm lead apron for a 0.5 mm apron. In summary, it is always preferable to shield more organs than to increase the thickness of the lead apron. (author)

  18. Elections to Staff Council

    CERN Multimedia

    Staff Association

    2013-01-01

    Elections to fill all seats in the Staff Council are being organized this month. The voting takes place from the 28 of October to the 11th of November, at noon. As you may have noted when reading Echo, many issues concerning our employment conditions are on the agenda of the coming months, and in particular the Five-yearly-Review 2015, subject of the questionnaire that you probably recently filled out. All this will keep the next Staff Council very busy indeed. So, make your voice heard and take part in the elections for a new Staff Council. By doing so, you will be encouraging the men and women who will be representing you over the next two years and they will doubtless appreciate your gratitude. Every member of the Staff Association will have received an email containing a link to the webpage which will allow voting. If you are a member of the Staff Association and you did not receive such an email, please contact the Staff Association secretariat (staff.association@cern.ch). Do not forget to v...

  19. Management of Patients Who Receive an Organ Transplant Abroad and Return Home for Follow-up Care: Recommendations From the Declaration of Istanbul Custodian Group.

    Science.gov (United States)

    Domínguez-Gil, Beatriz; Danovitch, Gabriel; Martin, Dominique E; López-Fraga, Marta; Van Assche, Kristof; Morris, Michele L; Lavee, Jacob; Erlich, Gilad; Fadhil, Riadh; Busic, Mirela; Rankin, Glynn; Al-Rukhaimi, Mona; OʼConnell, Philip; Chin, Jacqueline; Norman, Triona; Massari, Pablo; Kamel, Refaat; Delmonico, Francis L

    2018-01-01

    Eradicating transplant tourism depends on complex solutions that include efforts to progress towards self-sufficiency in transplantation. Meanwhile, professionals and authorities are faced with medical, legal, and ethical problems raised by patients who return home after receiving an organ transplant abroad, particularly when the organ has been obtained through illegitimate means. In 2016, the Declaration of Istanbul Custodian Group convened an international, multidisciplinary workshop in Madrid, Spain, to address these challenges and provide recommendations for the management of these patients, which are presented in this paper. The core recommendations are grounded in the belief that principles of transparency, traceability, and continuity of care applied to patients who receive an organ domestically should also apply to patients who receive an organ abroad. Governments and professionals are urged to ensure that, upon return, patients are promptly referred to a transplant center for evaluation and care, not cover the costs of transplants resulting from organ or human trafficking, register standardized information at official registries on patients who travel for transplantation, promote international exchange of data for traceability, and develop a framework for the notification of identified or suspected cases of transnational transplant-related crimes by health professionals to law enforcement agencies.

  20. A prospective study of factors associated with risk of turnover among care workers in group homes for elderly individuals with dementia.

    Science.gov (United States)

    Suzumura, Miwa; Fushiki, Yasuhiro; Kobayashi, Kota; Oura, Asae; Suzumura, Shigeo; Yamashita, Masafumi; Mori, Mitsuru

    2013-01-01

    A prospective study was conducted to assess factors associated with risk of turnover among care workers in group homes (GHs) for elderly individuals with dementia. In January, 2010, 51 out of 238 GHs in Sapporo City responded to our request for participation in a survey. During February and March of 2010, 438 out of 700 care workers (62.6%) in the GHs returned a completed questionnaire to us. They were followed up with until March of 2012, and 395 subjects (90.1%) responded to our survey, which was conducted twice. Over the course of 2 years, 91 subjects left their jobs. Cox's proportional hazards model was used for analysis, adjusting for gender and age. Less provision of social support by supervisors, colleagues, family or friends was significantly associated with increased risk of turnover. Financial aids for off-the-job training was marginally significantly associated with reduced risk of turnover. Longer duration of working for frail elderly care was significantly associated with decreased risk of turnover. Habitual smoking was significantly associated with increased risk of turnover. Social support in the workplace may be important to reduce the risk of turnover in care workers at GHs. Further prospective studies are required in other areas in Japan.

  1. Perceptions of health and risk management among home care workers in Sweden.

    Science.gov (United States)

    Larsson, A; Karlqvist, L; Westerberg, M; Gard, G

    2013-10-01

    Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. This study aims to examine home care workers' perceptions of health, risks, working conditions, and risk management within their organization. The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides ( n  = 133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations.

  2. Homing oneself

    DEFF Research Database (Denmark)

    Winther, Ida Wentzel

    2009-01-01

    What is home? A building, a physical and mental phenomenon, or a concept?  There are many homes and ways `to home oneself´. Many of us quite often dwell in other places than at home (as professional commuters between two places, as travellers staying in hotels, as children of divorced parents...

  3. Staff rules and regulations

    CERN Multimedia

    HR Department

    2007-01-01

    The 11th edition of the Staff Rules and Regulations, dated 1 January 2007, adopted by the Council and the Finance Committee in December 2006, is currently being distributed to departmental secretariats. The Staff Rules and Regulations, together with a summary of the main modifications made, will be available, as from next week, on the Human Resources Department's intranet site: http://cern.ch/hr-web/internal/admin_services/rules/default.asp The main changes made to the Staff Rules and Regulations stem from the five-yearly review of employment conditions of members of the personnel. The changes notably relate to: the categories of members of the personnel (e.g. removal of the local staff category); the careers structure and the merit recognition system; the non-residence, installation and re-installation allowances; the definition of family, family allowances and family-related leave; recognition of partnerships; education fees. The administrative circulars, some of which are being revised following the ...

  4. Staff Association Cocktail

    CERN Multimedia

    Staff Association

    2017-01-01

    The Staff Association has been organising for many years a cocktail with delegates of the Member States participating in Finance Committees of March and September. This cocktail is held at the end of the day, after the Finance Committee meeting. This direct and regular communication helps establish an ongoing contact between the Staff Association and CERN Member States and, more recently, the Associate Member States. Ambassadors of the CERN Staff Association, who are Members of the Personnel, have the opportunity to meet their national delegation in an informal and friendly atmosphere. These exchanges, facilitated by the use of the national language, allow the personnel via the Staff Association to express its ideas and positions on current affairs and fundamental issues, and also to hear about those of the delegations in return.

  5. Staff Performance Analysis: A Method for Identifying Brigade Staff Tasks

    National Research Council Canada - National Science Library

    Ford, Laura

    1997-01-01

    ... members of conventional mounted brigade staff. Initial analysis of performance requirements in existing documentation revealed that the performance specifications were not sufficiently detailed for brigade battle staffs...

  6. Creating a new home

    DEFF Research Database (Denmark)

    Gram-Hanssen, Kirsten; Bech-Danielsen, Claus

    2012-01-01

    Housing research is increasingly focusing on how different groups of residents use their dwelling and transform it into a home. In this article, we look at the homes of immigrants in Danish social housing. The article is based on qualitative interviews with Somali, Iraqi and Turkish immigrants, a...

  7. Home, Smart Home

    DEFF Research Database (Denmark)

    Hansen, Ellen Kathrine; Olesen, Gitte Gylling Hammershøj; Mullins, Michael

    2013-01-01

    The article places focus on how smart technologies integrated in a one family- home and particular the window offer unique challenges and opportunities for designing buildings with the best possible environments for people and nature. Toward an interdisciplinary approach, we address the interaction...... between daylight defined in technical terms and daylight defined in aesthetic, architectural terms. Through field-tests of a Danish carbon-neutral home and an analysis of five key design parameters, we explore the contradictions and potentials in smart buildings, using the smart window as example of how...... to the energy design is central. The study illuminates an approach of the design of smart houses as living organisms by connecting technology with the needs of the occupants with the power and beauty of daylight....

  8. Study protocol of a cluster randomized controlled trial evaluating the efficacy of a comprehensive pressure ulcer prevention programme for private for-profit nursing homes.

    Science.gov (United States)

    Kwong, Enid Wai-yung; Lee, Paul Hong; Yeung, Kwan-mo

    2016-01-18

    Because the demand for government-subsidized nursing homes in Hong Kong outstrips the supply, the number of for-profit private nursing homes has been increasing rapidly. However, the standard of care in such homes is always criticized. Pressure ulcers are a major long-term care issue that is closely associated with the quality of care delivered in nursing home settings. The aim of this study is to evaluate the effectiveness of a pressure ulcer prevention programme for residents in private for-profit nursing homes. This is a two-arm cluster randomized controlled trial with an estimated sample size of 1088 residents and 74 care staff from eight for-profit private nursing homes. Eligible nursing homes will be those classified as category A2 homes in the Enhanced Bought Place Scheme (EBPS), having a capacity of around 130-150 beds, and no structured PU prevention protocol and/or programmes in place. Care staff will be health workers, personal care workers, and nurses who are front-line staff providing direct care to residents. Eight nursing homes will be randomly assigned to either an experimental or control group. The experimental group will be provided with an intensive training programme and will be involved in the implementation of a 16-week pressure ulcer prevention protocol, while the control group will deliver the usual pressure ulcer prevention care. The study outcomes are the pressure ulcer prevention knowledge and skills of the care staff and the prevalence and incidence of pressure ulcers. Data on the knowledge and skills of care staff, and prevalence of pressure ulcer will be collected at the base line, and then at the 8(th) week and at completion of the implementation of the protocol. The assessment of the incidence of pressures will start from before the commencement of the intensive training course to the end of the implementation of the protocol. In view of the negative impact of pressure ulcers, it is important to have an effective and evidence

  9. OA35 Shared humanity, shared mortality - spiritual care in care homes.

    Science.gov (United States)

    Thomas, Mark

    2015-04-01

    Currently a fifth of the population die in care homes and most residents are in the final year of life. Spiritual care is recognised as important (The National Institute for Health and Care Excellence [NICE] Quality Standards, Leadership Alliance) yet there is little teaching for care homes' staff in this vital area. Spiritual care is intrinsic in the Gold Standards Framework (GSF) programmes, it is one of the standards for GSF accreditation, yet often health and social care professionals are unaware or unconfident in this area, with a tendency to confuse spirituality with religion. To develop a Spiritual Care course to supplement the range of GSF programmes, especially for care homes, to increase confidence and ability of staff caring for people nearing the end of life. While we need to bring professional expertise to bear in our caring, we must also bring our humanity, our lack of answers and our ability to listen with mindfulness and compassion. Working in collaboration with Staffordshire University, blending academic and practical expertise, we developed a one day workshop and filmed a four-module distance-learning course. Evaluations have shown a broadening of awareness and perspective, increased confidence in assessing and meeting spiritual needs, greater self-care and resilience amongst staff and a more creative interpretation of spiritual care helping to meet the needs of care homes' residents. Early use of this spiritual care workshop and course for care homes' staff has been well received and encouraging. Sharing our common human experience of loss and mortality leads to greater resilience through inner transformation. © 2015, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  10. Individualized tracking of self-directed motor learning in group-housed mice performing a skilled lever positioning task in the home cage.

    Science.gov (United States)

    Silasi, Gergely; Boyd, Jamie D; Bolanos, Federico; LeDue, Jeff M; Scott, Stephen H; Murphy, Timothy H

    2018-01-01

    Skilled forelimb function in mice is traditionally studied through behavioral paradigms that require extensive training by investigators and are limited by the number of trials individual animals are able to perform within a supervised session. We developed a skilled lever positioning task that mice can perform within their home cage. The task requires mice to use their forelimb to precisely hold a lever mounted on a rotary encoder within a rewarded position to dispense a water reward. A Raspberry Pi microcomputer is used to record lever position during trials and to control task parameters, thus making this low-footprint apparatus ideal for use within animal housing facilities. Custom Python software automatically increments task difficulty by requiring a longer hold duration, or a more accurate hold position, to dispense a reward. The performance of individual animals within group-housed mice is tracked through radio-frequency identification implants, and data stored on the microcomputer may be accessed remotely through an active internet connection. Mice continuously engage in the task for over 2.5 mo and perform ~500 trials/24 h. Mice required ~15,000 trials to learn to hold the lever within a 10° range for 1.5 s and were able to further refine movement accuracy by limiting their error to a 5° range within each trial. These results demonstrate the feasibility of autonomously training group-housed mice on a forelimb motor task. This paradigm may be used in the future to assess functional recovery after injury or cortical reorganization induced by self-directed motor learning. NEW & NOTEWORTHY We developed a low-cost system for fully autonomous training of group-housed mice on a forelimb motor task. We demonstrate the feasibility of tracking both end-point, as well as kinematic performance of individual mice, with each performing thousands of trials over 2.5 mo. The task is run and controlled by a Raspberry Pi microcomputer, which allows for cages to be

  11. Group I introns and associated homing endonuclease genes reveals a clinal structure for Porphyra spiralis var. amplifolia (Bangiales, Rhodophyta along the Eastern coast of South America

    Directory of Open Access Journals (Sweden)

    Matioli Sergio R

    2008-11-01

    Full Text Available Abstract Background Group I introns are found in the nuclear small subunit ribosomal RNA gene (SSU rDNA of some species of the genus Porphyra (Bangiales, Rhodophyta. Size polymorphisms in group I introns has been interpreted as the result of the degeneration of homing endonuclease genes (HEG inserted in peripheral loops of intron paired elements. In this study, intron size polymorphisms were characterized for different Porphyra spiralis var. amplifolia (PSA populations on the Southern Brazilian coast, and were used to infer genetic relationships and genetic structure of these PSA populations, in addition to cox2-3 and rbcL-S regions. Introns of different sizes were tested qualitatively for in vitro self-splicing. Results Five intron size polymorphisms within 17 haplotypes were obtained from 80 individuals representing eight localities along the distribution of PSA in the Eastern coast of South America. In order to infer genetic structure and genetic relationships of PSA, these polymorphisms and haplotypes were used as markers for pairwise Fst analyses, Mantel's test and median joining network. The five cox2-3 haplotypes and the unique rbcL-S haplotype were used as markers for summary statistics, neutrality tests Tajima's D and Fu's Fs and for median joining network analyses. An event of demographic expansion from a population with low effective number, followed by a pattern of isolation by distance was obtained for PSA populations with the three analyses. In vitro experiments have shown that introns of different lengths were able to self-splice from pre-RNA transcripts. Conclusion The findings indicated that degenerated HEGs are reminiscent of the presence of a full-length and functional HEG, once fixed for PSA populations. The cline of HEG degeneration determined the pattern of isolation by distance. Analyses with the other markers indicated an event of demographic expansion from a population with low effective number. The different degrees of

  12. Group I introns and associated homing endonuclease genes reveals a clinal structure for Porphyra spiralis var. amplifolia (Bangiales, Rhodophyta) along the Eastern coast of South America

    Science.gov (United States)

    2008-01-01

    Background Group I introns are found in the nuclear small subunit ribosomal RNA gene (SSU rDNA) of some species of the genus Porphyra (Bangiales, Rhodophyta). Size polymorphisms in group I introns has been interpreted as the result of the degeneration of homing endonuclease genes (HEG) inserted in peripheral loops of intron paired elements. In this study, intron size polymorphisms were characterized for different Porphyra spiralis var. amplifolia (PSA) populations on the Southern Brazilian coast, and were used to infer genetic relationships and genetic structure of these PSA populations, in addition to cox2-3 and rbcL-S regions. Introns of different sizes were tested qualitatively for in vitro self-splicing. Results Five intron size polymorphisms within 17 haplotypes were obtained from 80 individuals representing eight localities along the distribution of PSA in the Eastern coast of South America. In order to infer genetic structure and genetic relationships of PSA, these polymorphisms and haplotypes were used as markers for pairwise Fst analyses, Mantel's test and median joining network. The five cox2-3 haplotypes and the unique rbcL-S haplotype were used as markers for summary statistics, neutrality tests Tajima's D and Fu's Fs and for median joining network analyses. An event of demographic expansion from a population with low effective number, followed by a pattern of isolation by distance was obtained for PSA populations with the three analyses. In vitro experiments have shown that introns of different lengths were able to self-splice from pre-RNA transcripts. Conclusion The findings indicated that degenerated HEGs are reminiscent of the presence of a full-length and functional HEG, once fixed for PSA populations. The cline of HEG degeneration determined the pattern of isolation by distance. Analyses with the other markers indicated an event of demographic expansion from a population with low effective number. The different degrees of degeneration of the HEG

  13. Effect of participatory women's groups and counselling through home visits on children's linear growth in rural eastern India (CARING trial): a cluster-randomised controlled trial.

    Science.gov (United States)

    Nair, Nirmala; Tripathy, Prasanta; Sachdev, H S; Pradhan, Hemanta; Bhattacharyya, Sanghita; Gope, Rajkumar; Gagrai, Sumitra; Rath, Shibanand; Rath, Suchitra; Sinha, Rajesh; Roy, Swati Sarbani; Shewale, Suhas; Singh, Vijay; Srivastava, Aradhana; Costello, Anthony; Copas, Andrew; Skordis-Worrall, Jolene; Haghparast-Bidgoli, Hassan; Saville, Naomi; Prost, Audrey

    2017-10-01

    Around 30% of the world's stunted children live in India. The Government of India has proposed a new cadre of community-based workers to improve nutrition in 200 districts. We aimed to find out the effect of such a worker carrying out home visits and participatory group meetings on children's linear growth. We did a cluster-randomised controlled trial in two adjoining districts of Jharkhand and Odisha, India. 120 clusters (around 1000 people each) were randomly allocated to intervention or control using a lottery. Randomisation took place in July, 2013, and was stratified by district and number of hamlets per cluster (0, 1-2, or ≥3), resulting in six strata. In each intervention cluster, a worker carried out one home visit in the third trimester of pregnancy, monthly visits to children younger than 2 years to support feeding, hygiene, care, and stimulation, as well as monthly women's group meetings to promote individual and community action for nutrition. Participants were pregnant women identified and recruited in the study clusters and their children. We excluded stillbirths and neonatal deaths, infants whose mothers died, those with congenital abnormalities, multiple births, and mother and infant pairs who migrated out of the study area permanently during the trial period. Data collectors visited each woman in pregnancy, within 72 h of her baby's birth, and at 3, 6, 9, 12, and 18 months after birth. The primary outcome was children's length-for-age Z score at 18 months of age. Analyses were by intention to treat. Due to the nature of the intervention, participants and the intervention team were not masked to allocation. Data collectors and the data manager were masked to allocation. The trial is registered as ISCRTN (51505201) and with the Clinical Trials Registry of India (number 2014/06/004664). Between Oct 1, 2013, and Dec 31, 2015, we recruited 5781 pregnant women. 3001 infants were born to pregnant women recruited between Oct 1, 2013, and Feb 10, 2015

  14. Staff rosters for 1979: environmental programs

    Energy Technology Data Exchange (ETDEWEB)

    1979-12-01

    The roster of the scientific and professional staffs of the Environmental Programs of the Department of Energy and Environment has been compiled as of December 1979. Staff members have been listed according to their organizational units, i.e., the Atmospheric Sciences Division, the Environmental Chemistry Division, the Oceanographic Sciences Division, and the Land and Freshwater Environmental Sciences Group. Educational background, research interests, professional activities, summary of experience at BNL, and selected publications have been included for each member listed.

  15. Action research in nursing homes

    DEFF Research Database (Denmark)

    Andersen, John; Bilfeldt, Annette

    2016-01-01

    quality in a joint effort between care workers, residents at the nursing home, and researchers. It concludes that the project led to empowerment of the residents and staff and played an important role in the development of democratic knowledge building about better quality and ethics in elder care....

  16. COSMOS--improving the quality of life in nursing home patients: protocol for an effectiveness-implementation cluster randomized clinical hybrid trial.

    Science.gov (United States)

    Husebo, Bettina S; Flo, Elisabeth; Aarsland, Dag; Selbaek, Geir; Testad, Ingelin; Gulla, Christine; Aasmul, Irene; Ballard, Clive

    2015-09-15

    Nursing home patients have complex mental and physical health problems, disabilities and social needs, combined with widespread prescription of psychotropic drugs. Preservation of their quality of life is an important goal. This can only be achieved within nursing homes that offer competent clinical conditions of treatment and care. COmmunication, Systematic assessment and treatment of pain, Medication review, Occupational therapy, Safety (COSMOS) is an effectiveness-implementation hybrid trial that combines and implements organization of activities evidence-based interventions to improve staff competence and thereby the patients' quality of life, mental health and safety. The aim of this paper is to describe the development, content and implementation process of the COSMOS trial. COSMOS includes a 2-month pilot study with 128 participants distributed among nine Norwegian nursing homes, and a 4-month multicenter, cluster randomized effectiveness-implementation clinical hybrid trial with follow-up at month 9, including 571 patients from 67 nursing home units (one unit defined as one cluster). Clusters are randomized to COSMOS intervention or current best practice (control group). The intervention group will receive a 2-day education program including written guidelines, repeated theoretical and practical training (credited education of caregivers, physicians and nursing home managers), case discussions and role play. The 1-day midway evaluation, information and interviews of nursing staff and a telephone hotline all support the implementation process. Outcome measures include quality of life in late-stage dementia, neuropsychiatric symptoms, activities of daily living, pain, depression, sleep, medication, cost-utility analysis, hospital admission and mortality. Despite complex medical and psychosocial challenges, nursing home patients are often treated by staff possessing low level skills, lacking education and in facilities with a high staff turnover

  17. Effectiveness of locomotion training in a home visit preventive care project: one-group pre-intervention versus post-intervention design study.

    Science.gov (United States)

    Ito, Shinya; Hashimoto, Mari; Aduma, Saori; Yasumura, Seiji

    2015-11-01

    Locomotion training in a home visit-type preventive-care program has been reported elsewhere. However, continuation of appropriate exercises in a home setting is difficult, and few reports are available on locomotion training in a home setting. The objective of this study was to evaluate the effectiveness of locomotion training over 3 months in a home visit-type preventive-care program for improvement of motor function among elderly people. Nine hundred and fifty-eight elderly people in Tendo City in Japan who were not currently attending any preventive-care program were invited to participate in the study, and 87 were enrolled. In the pre-intervention and post-intervention assessments, we administered an interview survey (the Kihon Checklist), the timed one-leg standing test with eyes open and the sit-to-stand test, at the participants' homes. The intervention involved one set of training exercises with the participants standing on each leg for 1 min and squatting five or six times. The participants were asked to repeat one set of the exercises three times a day at home. In addition, the participants were regularly asked over the telephone about their performance of the exercises. Physical strength, cognitive function, and total scores of the Kihon Checklist were significantly lower after the intervention than before. In addition, the one-leg standing test time was significantly longer after the intervention (mean ± SD, 23.9 ± 35.4) than before (15.7 ± 20.5), and the sit-to-stand test time was significantly shorter after the intervention (13.0 ± 6.2) than before (14.8 ± 8.3). Locomotion training in a home-visit preventive-care program with telephone support effectively improved the motor function of elderly people who were not currently attending any preventive-care program organized by the long-term care insurance system.

  18. A natural fit: home healthcare and biomedical engineering.

    Science.gov (United States)

    Damasco, Nestor; Abe, Chris

    2010-01-01

    The involvement of Biomed in management of home care equipment has become a natural fit for Rady Children's Hospital. Managing all aspects of home care equipment through an in-house biomedical engineering department is cost-effective, efficient, provides excellent customer service, and enhances the relationship with the clinical staff and patients. It develops a sense of security for patients and staff that home care equipment is tested and maintained in a stringent manner that promotes safety.

  19. Job and task analysis for technical staff

    International Nuclear Information System (INIS)

    Toline, B.C.

    1991-01-01

    In September of 1989 Cooper Nuclear Station began a project to upgrade the Technical Staff Training Program. This project's roots began by performing job and Task Analysis for Technical Staff. While the industry has long been committed to Job and Task Analysis to target performance based instruction for single job positions, this approach was unique in that it was not originally considered appropriate for a group as diverse as Tech Staff. Much to his satisfaction the Job and Task Analysis Project was much less complicated for Technical Staff than the author had imagined. The benefits of performing the Job and Task Analysis for Technical Staff have become increasingly obvious as he pursues lesson plan development and course revisions. The outline for this presentation will be as follows: philosophy adopted; preparation of the job survey document; performing the job analysis; performing task analysis for technical staff and associated pitfalls; clustering objectives for training and comparison to existing program; benefits now and in the future; final phase (comparison to INPO guides and meeting the needs of non-degreed engineering professionals); and conclusion. By focusing on performance based needs for engineers rather than traditional academics for training the author is confident the future Technical Staff Program will meet the challenges ahead and will exceed requirements for accreditation

  20. Research Staff | Photovoltaic Research | NREL

    Science.gov (United States)

    Research Staff Research Staff desc Greg Wilson Center Director Dr. Greg Wilson is the Director of @nrel.gov 303-384-6649 Bosco, Nicholas Staff Scientist Nick.Bosco@nrel.gov 303-384-6337 Braunecker, Wade IV-Physics Michael.Deceglie@nrel.gov 303-384-6104 Deline, Chris Staff Engineer Chris.Deline@nrel.gov

  1. Home hemodialysis

    DEFF Research Database (Denmark)

    Agar, John W; Perkins, Anthony; Heaf, James G

    2015-01-01

    We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use.......We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use....

  2. Correlates and management of nonmalignant pain in the nursing home. SAGE Study Group. Systematic Assessment of Geriatric drug use via Epidemiology.

    Science.gov (United States)

    Won, A; Lapane, K; Gambassi, G; Bernabei, R; Mor, V; Lipsitz, L A

    1999-08-01

    Nonmalignant pain is a common problem among older people. The prevalence of pain in the nursing home is not well studied. We looked at the association between nonmalignant pain, psychological and functional health, and the practice patterns for pain management in the nursing home. A cross-sectional study. Nursing Home in four US states. A total of 49,971 nursing home residents from 1992 to 1995. We used the SAGE database (Systematic Assessment of Geriatric drug use via Epidemiology), which linked information from the Minimum Data Set and nursing home drug utilization data. The MDS items measured included pain, activities of daily living (ADL) function, mood, and time involved in activities. The use of analgesics, anxiolytics, and antidepressants was also documented. Daily pain was reported in 26% of nursing home residents. The prevalence was lower among men, persons more than age 85, and racial minorities. Persons suffering pain daily were more likely to have severe ADL impairment, odds ratio (OR) (2.47 (95% CI, 2.34-2.60)), more depressive signs and symptoms (OR 1.66 (95% CI, 1.57-1.75)), and less frequent involvement in activities (OR 1.35 (95% CI, 1.29-1.40)). Approximately 25% of persons with daily pain received no analgesics. Residents who were more than 85 years old (OR 1.15 (95% CI 1.02-1.28)), cognitively impaired, (OR 1.44 (95% CI, 1.29-1.61)), of male gender (OR 1.17 (95% CI, 1.06-1.29)), or a racial minority (OR 1.69 (95% CI, 1.40-2.05) and OR 1.56 (95% CI, 0.70-1.04) for blacks and Hispanics, respectively) were at greater risk of not receiving analgesics. Approximately 50% of those in pain used physical and occupational therapies, which was more than two times higher (OR 2.44 (95% CI, 2.34-2.54)), than use for those not in pain. Daily nonmalignant pain is prevalent among nursing home residents and is often associated with impairments in ADL, mood, and decreased activity involvement. Even when pain was recognized, men, racial minorities, and cognitively

  3. Leisure Activities of University College Staff

    Science.gov (United States)

    Biernat, Elzbieta; Roguski, Karol

    2009-01-01

    Study aim: To determine the participation of academic teachers in leisure activities for that group contribute to shaping habits of a large percentage of young people. Material and methods: A group of 52 staff members (about 30%) of a private university college, aged 25-70 years, were interviewed with respect to their participation in sports,…

  4. Pilot study to investigate the feasibility of the Home Falls and Accidents Screening Tool (HOME FAST) to identify older Malaysian people at risk of falls.

    Science.gov (United States)

    Romli, Muhammad Hibatullah; Mackenzie, Lynette; Lovarini, Meryl; Tan, Maw Pin

    2016-08-16

    The relationship between home hazards and falls in older Malaysian people is not yet fully understood. No tools to evaluate the Malaysian home environment currently exist. Therefore, this study aimed to pilot the Home Falls and Accidents Screening Tool (HOME FAST) to identify hazards in Malaysian homes, to evaluate the feasibility of using the HOME FAST in the Malaysian Elders Longitudinal Research (MELoR) study and to gather preliminary data about the experience of falls among a small sample of Malaysian older people. A cross-sectional pilot study was conducted. An urban setting in Kuala Lumpur. 26 older people aged 60 and over were recruited from the control group of a related research project in Malaysia, in addition to older people known to the researchers. The HOME FAST was applied with the baseline survey for the MELoR study via a face-to-face interview and observation of the home by research staff. The majority of the participants were female, of Malay or Chinese ethnicity and living with others in a double-storeyed house. Falls were reported in the previous year by 19% and 80% of falls occurred at home. Gender and fear of falling had the strongest associations with home hazards. Most hazards were detected in the bathroom area. A small number of errors were detected in the HOME FAST ratings by researchers. The HOME FAST is feasible as a research and clinical tool for the Malaysian context and is appropriate for use in the MELoR study. Home hazards were prevalent in the homes of older people and further research with the larger MELoR sample is needed to confirm the validity of using the HOME FAST in Malaysia. Training in the use of the HOME FAST is needed to ensure accurate use by researchers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  5. STAFF MARKETING IN MODERN RUSSIAN CONDITIONS

    Directory of Open Access Journals (Sweden)

    Nataliya N. Kretova

    2017-09-01

    Full Text Available The conception of staff marketing, which was developed abroad, is effectively used in the developed countries for a long time. Its main advantage consists in the possibility of organizing some planning for the implementation of staff strategy: staff marketing provides the enterprise on the long-term basis with human resources capable of forming strategic potential, which would allow to implement the planned activities. Numerous problems of formation and development of civilized market relations in our country do not allow to fully implement the detailed models of staff marketing in domestic realities. On the basis of the analysis of theoretical developments and factors that have a practical impact on the implementation of marketing personnel in modern Russian conditions, the authors describe the essential elements of the conception. The primary purposes of staff marketing for domestic enterprises, grouped into the internal and external marketing are substantiated and disclosed. The special attention is paid to increasing the staff loyalty, which has dominant influence on business outcomes. The algorithm of events for the development of motivation system is proposed; at the stage of studying job satisfaction it is recommend to apply analytical calculations with the use of Shewhart control charts. Unlike traditional statistical tools based on the inspection of already implemented results, this approach is aimed at preventing negative tendencies and avoids losses associated with dissatisfaction with difficulty, as the individual employee and the team as a whole. Modern Russian enterprises can fully realize the conception of staff marketing only through rethinking of the consequences for all directions of work with the staff, as reflected in the definition of objectives, motivating staff and ensuring social responsibility of the enterprise.

  6. What Consumers Say About Nursing Homes in Online Reviews.

    Science.gov (United States)

    Kellogg, Caitlyn; Zhu, Yujun; Cardenas, Valeria; Vazquez, Katalina; Johari, Kayla; Rahman, Anna; Enguidanos, Susan

    2018-04-20

    Although patient-centered care is an expressed value of our healthcare system, no studies have examined what consumers say in online reviews about nursing homes (NHs). Insight into themes addressed in these reviews could inform improvement efforts that promote patient-centered NH care. We analyzed nursing home (NH) Yelp reviews. From a list of all NHs in California, we drew a purposeful sample of 51 NHs, selecting facilities representing a range of geographical areas and occupancy rates. Two research teams analyzed the reviews using grounded theory to identify codes and tracked how frequently each code was mentioned. We evaluated 264 reviews, identifying 24 codes, grouped under five categories: quality of staff care and staffing; physical facility and setting; resident safety and security; clinical care quality; and financial issues. More than half (53.41%) of Yelp reviewers posted comments related to staff attitude and caring and nearly a third (29.2%) posted comments related to staff responsiveness. Yelp reviewers also often posted about NHs' physical environment. Infrequently mentioned were the quality of health care provided and concerns about resident safety and security. Our results are consistent with those from related studies. Yelp reviewers focus on NH aspects that are not evaluated in most other NH rating systems. The federal Nursing Home Compare website, for instance, does not report measures of staff attitudes or the NH's physical setting. Rather, it reports measures of staffing levels and clinical processes and outcomes. We recommend that NH consumers consult both types of rating systems because they provide complementary information.

  7. Meeting staff representatives of the European Agencies

    CERN Multimedia

    Staff Association

    2014-01-01

      The AASC (Assembly of Agency Staff Committee) held its 27th Meeting of the specialized European Agencies on 26 and 27 May on the premises of the OHIM (Office for Harmonization in the Internal Market) in Alicante, Spain. Two representatives of the CERN Staff Association, in charge of External Relations, attended as observers. This participation is a useful complement to regular contacts we have with FICSA (Federation of International Civil Servants' Associations), which groups staff associations of the UN Agencies, and the annual CSAIO conferences (Conference of Staff Associations of International Organizations), where each Autumn representatives of international organizations based in Europe meet to discuss themes of common interest to better promote and defend the rights of the international civil servants. All these meetings allow us to remain informed on items that are directly or indirectly related to employment and social conditions of our colleagues in other international and Europ...

  8. Conflict resolution styles: a comparison of assisted living and nursing home facilities.

    Science.gov (United States)

    Small, Jeff A; Montoro-Rodriguez, Julian

    2006-01-01

    In this exploratory study, the authors investigated how interpersonal conflict is resolved in assisted living and nursing home facilities. In particular, the authors examined whether conflict resolution styles differed between type of facility and between residents and staff in each type of facility. Four focus groups were conducted--two with residents and two with staff from each type of facility. The focus groups centered on discussing the occurrence of conflict and how each participant handled it. Discourse analysis was employed to identify participants' use of three styles of conflict resolution: controlling, solution-oriented, and non-confrontational. The results indicate that staff in each care context showed a preference for the solution-oriented approach. Residents in each setting reported equal use of the non-confrontational and solution-oriented styles. The findings suggest that preferred conflict resolution styles may vary more as a function of the role of each communicator than the context of the care setting.

  9. The contribution of gender-role orientation, work factors and home stressors to psychological well-being and sickness absence in male- and female-dominated occupational groups.

    Science.gov (United States)

    Evans, Olga; Steptoe, Andrew

    2002-02-01

    The associations of work stress, types of work and gender-role orientation with psychological well-being and sickness absence were investigated in a questionnaire survey of 588 male and female nurses and 387 male and female accountants. We hypothesised that health might be impaired among women working in the male-dominated occupation (accountancy), and men in the female-dominated occupation (nursing), but that effects might be moderated by job strain (perceptions of high demand and low control), work and home hassles, and traditional male (instrumentality) and female (expressivity) psychological characteristics. Responses were analysed from 172 female and 61 male nurses, and from 53 female and 81 male commercial accountants. Female accountants were more likely than other groups to have high anxiety scores on the Hospital Anxiety and Depression Scales, while male nurses had the highest rates of sickness absence. Male nurses and female accountants also reported more work-related hassles than did female nurses and male accountants. Men and women in the same occupation did not differ in job strain or job social support, but nurses reported greater job strain than accountants, due to higher ratings of demands and lower skill utilisation. After adjusting for age, sex, occupation, paid work hours and a measure of social desirability bias, risk of elevated anxiety was independently associated with higher job strain, lower job social support, more work hassles, more domestic responsibility, lower instrumentality and higher expressivity. The association between sex and anxiety was no longer significant after instrumentality had been entered into the regression model. Sickness absence of more than three days over the past 12 months was independently associated with higher job strain, more work hassles, lower instrumentality and higher expressivity. The results suggest that when men and women occupy jobs in which they are in the cultural and numerical minority, there may be

  10. Staff rules and regulations

    CERN Multimedia

    HR Department

    2007-01-01

    The 11th edition of the Staff Rules and Regulations, dated 1 January 2007, adopted by the Council and the Finance Committee in December 2006, is currently being distributed to departmental secretariats. The Staff Rules and Regulations, together with a summary of the main modifications made, will be available, as from next week, on the Human Resources Department's intranet site: http://cern.ch/hr-web/internal/admin_services/rules/default.asp The main changes made to the Staff Rules and Regulations stem from the five-yearly review of employment conditions of members of the personnel. The changes notably relate to: the categories of members of the personnel (e.g. removal of the local staff category); the careers structure and the merit recognition system; the non-residence, installation and re-installation allowances; the definition of family, family allowances and family-related leave; recognition of partnerships; education fees. The administrative circulars, some of which are being revised following the m...

  11. CHIEF OF STAFF FINANCE

    African Journals Online (AJOL)

    The fifth Chief of Staff Division, namely Finance, is the end result of ... 1946 was able to report in 1948 that there had ... the same time however, the Secretary referred ... mended that because 'the existing dual arrange- ... tigate the division of functions in the Department. ... randum discussing the different arguments sur-.

  12. Staff Development Redesigned.

    Science.gov (United States)

    Lambert, Linda

    1988-01-01

    Contends that staff development, supposedly designed to assist teachers, has instead colluded with forces to continue their colonization. Since teachers are not taking charge of their profession and participating actively in educational change, certain actions must be taken to lighten their nonprofessional workload and to build a professional…

  13. Integration of CERN staff

    CERN Multimedia

    CERN PhotoLab

    1965-01-01

    An example of the integration of CERN staff in the neighbouring communes is provided by the hamlet of Bugnon at St-Genis-Pouilly (Ain), France. The CERN installation on the Swiss site are visible on the left in the background. Behind them the Saleve mountain in Haute-Savoie.

  14. Institutionalizing Staff Development.

    Science.gov (United States)

    Shawl, William F.

    Three years ago, Golden West College (GWC) decided to make a major commitment to staff development as a means of revitalizing the college. This commitment was evidenced through the creation of the position of Dean of Educational Development, who is responsible solely for serving faculty needs; the Educational Development Center, which houses the…

  15. The Staff of Life.

    Science.gov (United States)

    Jones, Rebecca

    1994-01-01

    Some children have chronic illnesses that require diet modifications as part of their medical treatment. Advises school districts to hire a registered dietitian or look for resources at a local hospital or public health office. In addition, schools should work with parents, improve staff training, and conduct spot checks of school cafeterias. (MLF)

  16. Home health care agency staffing patterns before and after the Balanced Budget Act of 1997, by rural and urban location.

    Science.gov (United States)

    McAuley, William J; Spector, William; Van Nostrand, Joan

    2008-01-01

    The Balanced Budget Act (BBA) of 1997 and other recent policies have led to reduced Medicare funding for home health agencies (HHAs) and visits per beneficiary. We examine the staffing characteristics of stable Medicare-certified HHAs across rural and urban counties from 1996 to 2002, a period encompassing the changes associated with the BBA and related policies. Data were drawn from Medicare Provider of Service files and the Area Resource File. The unit of analysis was the 3,126 counties in the United States, grouped into 5 categories: metropolitan, nonmetropolitan adjacent, and 3 nonmetropolitan nonadjacent groups identified by largest town size. Only relatively stable HHAs were included. We generated summary HHA staff statistics for each county group and year. All staff categories, other than therapists, declined from 1997 to 2002 across the metropolitan and nonmetropolitan county groupings. There were substantial population-adjusted decreases in stable HHA-based home health aides in all counties, including remote counties. The limited presence of stable HHA staff in certain nonmetropolitan county types has been exacerbated since implementation of the BBA, especially in the most rural counties. The loss of aides in more rural counties may limit the availability of home-based long-term care in these locations, where the need for long-term care is considerable. Future research should examine the degree to which the presence of HHA staff influences actual access and whether other paid and unpaid sources of care substitute for Medicare home health care in counties with limited supplies of HHA staff.

  17. "We do as well as we can". The experiences of staff assisting disabled people in community residential homes "Við gerum bara eins og við getum" - Þjónusta við fólk með fjölþættar skerðingar

    Directory of Open Access Journals (Sweden)

    Guðný Jónsdóttir

    2013-06-01

    Full Text Available Staff supporting young people and adults with complex and severe neurological impairments are the key to their communication, quality of life and participation. This study reports the knowledge and experiences of staff members supporting disabled people living in community residential homes, as well as their perceived needs for information and support. Furthermore, the study aimed to reveal staff´s views on their possibilities to support service users´ wellbeing, participation and quality of life. Participants were twelve experienced staff members. Qualitative methods were used and data were collected through semi-structured interviews. The results of the study reveal that services provided in community residential homes for people with complex and severe impairments are not in line with human rights treaties, including the right to health. Further, it does not mirror the social approach to disability which today is the focus of policy frameworks. The staff were positive toward service users, tried to do their best but lacked resources. Their knowledge of service user´s health-related needs was scarce and little was done to prevent further impairments or increasing health problems. Staff reported lack of human resources, high staff turnover and lack of information, training and support. Recent governmental changes, provide possibilities for revised emphasis in the service provided, on cooperation between different sectors as well as for the development of transdisciplinary services.Aðstoðarfólk á heimilum fólks með fjölþættar skerðingar er mikilvægur hlekkur í lífi þess og lykill að samskiptum, lífsgæðum og þátttöku. Rannsóknin varpar ljósi á sýn þessa starfsfólks á megináherslur í þjónustu við fólk með flóknar stuðningsþarfir og þörf fyrir fræðslu og stuðning í starfi. Ennfremur var leitað eftir skilningi á heilsutengdum þörfum þjónustunotenda og möguleikum til að styðja við velferð

  18. Improving care in care homes: a qualitative evaluation of the Croydon care home support team.

    Science.gov (United States)

    Lawrence, Vanessa; Banerjee, Sube

    2010-05-01

    The Croydon care home support team (CHST) was developed in response to reports of patient abuse within long-term care. It presents a novel strategy for improving standards of care within care homes. A qualitative methodology was used to assess the perceived impact of the CHST. In-depth interviews were conducted with 14 care home managers and 24 members of care home staff across 14 care homes. Grounded theory principles guided the collection and analysis of the data. Reports of improved communication between staff, improved staff development and confidence, and improved quality of care point towards the effectiveness of the CHST model. The collaborative approach of the CHST was considered pivotal to its success and presented as an effective method of engaging care home managers and staff. The CHST adopted a systemic approach that placed an equal emphasis on the social, mental health and nursing needs of residents and aimed to address the whole culture of care within the individual homes. The data demonstrate the potential for specialist multi-disciplinary teams to raise standards of care across long-term care settings. Increased awareness of safeguarding issues, improved staff morale and communication and ongoing opportunities for discussion and problem solving promised to sustain improvements. Such services could be instrumental in meeting the government priority of preventing abuse among vulnerable adults.

  19. Staff satisfaction and its components in residential aged care.

    Science.gov (United States)

    Chou, Shu-Chiung; Boldy, Duncan P; Lee, Andy H

    2002-06-01

    The purpose of this study was to assess the direction and magnitude of the effects among the components of staff satisfaction in residential aged care and to examine whether the relationships among satisfaction components vary according to facility type (i.e. nursing homes and hostels). A hostel is a low care facility in which residents are more independent, have a lower level of care needs, and receive personal but not nursing care. A cross-sectional survey design was adopted to collect the required information, and a stratified random sampling approach was utilized to select facilities. Structural equation modeling was used to examine relationships among satisfaction components. Seventy residential aged care facilities in Western Australia. The sample includes 610 nursing home and 373 hostel care staff. The relationships among satisfaction components are different for nursing home and hostel staff. Professional support is found to have a strong and positive effect on all other aspects of staff satisfaction. The findings lead to an improved understanding of the interrelationship among staff satisfaction components, which has important implications through enhancing professional support. This needs to be recognized and emphasized by managers, care providers, and policy makers so as to maintain stable personnel and continuity of care.

  20. Children’s sugar-sweetened beverages consumption: associations with family and home-related factors, differences within ethnic groups explored

    Directory of Open Access Journals (Sweden)

    V. M. van de Gaar

    2017-02-01

    Full Text Available Abstract Background The consumption of sugar-sweetened beverages (SSB may contribute to the development of overweight among children. The present study aimed to evaluate associations between family and home-related factors and children’s SSB consumption. We explored associations within ethnic background of the child. Methods Cross-sectional data from the population-based ‘Water Campaign’ study were used. Parents (n = 644 of primary school children (6-13 years completed a questionnaire on socio-demographic characteristics, family and home-related factors and child’s SSB intake. The family and home-related factors under study were: cognitive variables (e.g. parental attitude, subjective norm, environmental variables (e.g. availability of SSB, parenting practices, and habitual variables (e.g. habit strength, taste preference. Regression analyses were used to evaluate the associations between family and home-related factors and child’s SSB intake (p < 0.05. Results Mean age of the children was 9.4 years (SD: 1.8 and 54.1% were girls. The child’s average SSB intake was 0.9 litres (SD: 0.6 per day. Child’s age, parents’ subjective norm, parenting practices, and parental modelling were positively associated with the child’s SSB intake. The availability of SSB at home and school and parental attitude were negatively associated with the child’s SSB intake. The associations under study differed according to the child’s ethnic background, with the explained variance of the full models ranging from 8.7% for children from Moroccan or Turkish ethnic background to 44.4% for children with Dutch ethnic background. Conclusions Our results provide support for interventions targeting children’s SSB intake focussing on the identified family and home-related factors, with active participation of parents. Also, the relationships between these factors and the child’s SSB intake differed for children with distinct ethnic backgrounds

  1. Medical home characteristics and the pediatric patient experience.

    Science.gov (United States)

    Burnet, Deborah; Gunter, Kathryn E; Nocon, Robert S; Gao, Yue; Jin, Janel; Fairchild, Paige; Chin, Marshall H

    2014-11-01

    The patient-centered medical home (PCMH) has roots in pediatrics, yet we know little about the experience of pediatric patients in PCMH settings. To examine the association between clinic PCMH characteristics and pediatric patient experience as reported by parents. We assessed the cross-sectional correlation between clinic PCMH characteristics and pediatric patient experience in 24 clinics randomly selected from the Safety Net Medical Home Initiative, a 5-state PCMH demonstration project. PCMH characteristics were measured with surveys of randomly selected providers and staff; surveys generated 0 (worst) to 100 (best) scores for 5 subscales, and a total score. Patient experience was measured through surveying parents of pediatric patients. Questions from the Consumer Assessment of Healthcare Providers and Systems-Clinician and Group instrument produced 4 patient experience measures: timeliness, physician communication, staff helpfulness, and overall rating. To investigate the relationship between PCMH characteristics and patient experience, we used generalized estimating equations with an exchangeable correlation structure. We included 440 parents and 214 providers and staff in the analysis. Total PCMH score was not associated with parents' assessment of patient experience; however, PCMH subscales were associated with patient experience in different directions. In particular, quality improvement activities undertaken by clinics were strongly associated with positive ratings of patient experience, whereas patient care management activities were associated with more negative reports of patient experience. Future work should bolster features of the PCMH that work well for patients while investigating which PCMH features negatively impact patient experience, to yield a better patient experience overall.

  2. Implementing Culture Change in Nursing Homes: An Adaptive Leadership Framework.

    Science.gov (United States)

    Corazzini, Kirsten; Twersky, Jack; White, Heidi K; Buhr, Gwendolen T; McConnell, Eleanor S; Weiner, Madeline; Colón-Emeric, Cathleen S

    2015-08-01

    To describe key adaptive challenges and leadership behaviors to implement culture change for person-directed care. The study design was a qualitative, observational study of nursing home staff perceptions of the implementation of culture change in each of 3 nursing homes. We conducted 7 focus groups of licensed and unlicensed nursing staff, medical care providers, and administrators. Questions explored perceptions of facilitators and barriers to culture change. Using a template organizing style of analysis with immersion/crystallization, themes of barriers and facilitators were coded for adaptive challenges and leadership. Six key themes emerged, including relationships, standards and expectations, motivation and vision, workload, respect of personhood, and physical environment. Within each theme, participants identified barriers that were adaptive challenges and facilitators that were examples of adaptive leadership. Commonly identified challenges were how to provide person-directed care in the context of extant rules or policies or how to develop staff motivated to provide person-directed care. Implementing culture change requires the recognition of adaptive challenges for which there are no technical solutions, but which require reframing of norms and expectations, and the development of novel and flexible solutions. Managers and administrators seeking to implement person-directed care will need to consider the role of adaptive leadership to address these adaptive challenges. © The Author 2014. 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.

  3. [For the betterment of home palliative care].

    Science.gov (United States)

    Midorikawa, Yasuhiko; Iiduka, Masashi

    2010-12-01

    The problems we have identified to overcome for a betterment of home palliative care were as follows:(1) Staffs' low level of knowledge and a lack of interest in home care, (2) Lack of cooperation between hospital and clinic, (3) Hard to keep the medical and caregiver staffs employed in the home care settings and a technical training is behind, (4) Insufficient cooperative networks for elderly care and welfare in the region, and (5) Misunderstanding of home palliative care by patient, family and people in the region. It is important to solve these problems one by one for a betterment of home palliative care. In this paper, we reported these problems through actual activities of our hospital and Iwaki city, and we propose to deal with them.

  4. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

    2016-01-01

    participatory design and qualitative methods. Data were collected from observational studies, individual interviews, and focus group interviews. Two neonatal units participated. One unit was experienced in providing neonatal home care with home visits, and the other planned to offer neonatal home care......BACKGROUND: For the majority of preterm infants, the last weeks of hospital admission mainly concerns tube feeding and establishment of breastfeeding. Neonatal home care (NH) was developed to allow infants to remain at home for tube feeding and establishment of breastfeeding with regular home...... visits from neonatal nurses. For hospitals covering large regions, home visits may be challenging, time consuming, and expensive and alternative approaches must be explored. OBJECTIVE: To identify parental needs when wanting to provide neonatal home care supported by telemedicine. METHODS: The study used...

  5. A review of NRC staff uses of probabilistic risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    1994-03-01

    The NRC staff uses probabilistic risk assessment (PRA) and risk management as important elements its licensing and regulatory processes. In October 1991, the NRC`s Executive Director for Operations established the PRA Working Group to address concerns identified by the Advisory Committee on Reactor Safeguards with respect to unevenness and inconsistency in the staff`s current uses of PRA. After surveying current staff uses of PRA and identifying needed improvements, the Working Group defined a set of basic principles for staff PRA use and identified three areas for improvements: guidance development, training enhancements, and PRA methods development. For each area of improvement, the Working Group took certain actions and recommended additional work. The Working Group recommended integrating its work with other recent PRA-related activities the staff completed and improving staff interactions with PRA users in the nuclear industry. The Working Group took two key actions by developing general guidance for two uses of PRA within the NRC (that is, screening or prioritizing reactor safety issues and analyzing such issues in detail) and developing guidance on basic terms and methods important to the staff`s uses of PRA.

  6. Job satisfaction among emergency department staff.

    Science.gov (United States)

    Suárez, M; Asenjo, M; Sánchez, M

    2017-02-01

    To compare job satisfaction among nurses, physicians and administrative staff in an emergency department (ED). To analyse the relationship of job satisfaction with demographic and professional characteristics of these personnel. We performed a descriptive, cross-sectional study in an ED in Barcelona (Spain). Job satisfaction was evaluated by means of the Font-Roja questionnaire. Multivariate analysis determined relationship between the overall job satisfaction and the variables collected. Fifty-two nurses, 22 physicians and 30 administrative staff were included. Administrative staff were significantly more satisfied than physicians and nurses: 3.42±0.32 vs. 2.87±0.42 and 3.06±0.36, respectively. Multivariate analysis showed the following variables to be associated with job satisfaction: rotation among the different ED acuity levels (OR: 2.34; 95%CI: 0.93-5.89) and being an administrative staff (OR: 0.27; 95%CI: 0.09-0.80). Nurses and physicians reported greater stress and work pressure than administrative staff and described a worse physical working environment. Interpersonal relationships obtained the highest score among the three groups of professionals. Job satisfaction of nurses and physicians in an ED is lower than that of administrative staff with the former perceiving greater stress and work pressure. Conversely, interpersonal relationships are identified as strength. Being nurse or physician and not rotating among the different ED acuity levels increase dissatisfaction. Copyright © 2016 College of Emergency Nursing Australasia. Published by Elsevier Ltd. All rights reserved.

  7. The Quality of Life of Palliative Care Staff: A Personal Construct Approach.

    Science.gov (United States)

    Viney, Linda L.; And Others

    1994-01-01

    Compared palliative care staff with staff from burn and neonatal units and with mature age general nursing trainees at end of training. Found that palliative care staff expressed better quality of life, in terms of significantly less anxiety and depression, as well as more good feelings than other staff groups. (Author/NB)

  8. Policy for home or hospice as the preferred place of death from cancer: Scottish Health and Ethnicity Linkage Study population cohort shows challenges across all ethnic groups in Scotland.

    Science.gov (United States)

    Sharpe, Katharine H; Cezard, Genevieve; Bansal, Narinder; Bhopal, Raj S; Brewster, David H

    2015-12-01

    Place of cancer death varies ethnically and internationally. Palliative care reviews highlight limited ability to demonstrate equal access due to incomplete or unreliable ethnicity data. To establish place of cancer death by ethnicity and describe patient characteristics. We linked census, hospital episode and mortality data for 117 467 persons dying of cancer, 2001-2009. With White Scottish population as reference, prevalence ratios (PR), 95% CIs and p values of death in hospital, home or hospice adjusted for sex and age were calculated by ethnic group. White Scottish group and minority ethnic groups combined constituted 91% and 0.4% of cancer deaths, respectively. South Asian, Chinese and African Origin patients were youngest at death (66, 66 and 65.9 years). Compared with the Scottish White reference, the White Irish (1.15 (1.10 to 1.22), pScottish White patients were less likely to die in hospital and more likely to die at home or in a hospice regardless of socioeconomic indicator used. Cancer deaths occur most often in hospital (52.3%) for all ethnic groups. Regardless of the socioeconomic indicator used, more affluent Scottish White patients were less likely to die in hospital; existing socioeconomic indicators detected no clear trend for the non-White population. Regardless of ethnic group, significant work is required to achieve more people dying at home or the setting of their choice. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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

    Science.gov (United States)

    NGB Official March Today in Guard History Leadership CNGB VCNGB SEA DANG DARNG Joint Staff J-1 J-2 J-3 J-4 J-5 J-6 J-7 J-8 Personal Staff Inspector General Judge Advocate General Officer Management Public Affairs Executive Support Services Legislative Liaison Special Staff Directorate of Management

  10. Special Staff - Joint Staff - Leadership - The National Guard

    Science.gov (United States)

    the ARNG Deputy Director of the ARNG Chief of Staff of the ARNG Command Chief Warrant Officer of the Site Maintenance Battle Focused Training Strategy Battle Staff Training Resources News Publications March Today in Guard History Leadership CNGB VCNGB SEA DANG DARNG Joint Staff J-1 J-2 J-3 J-4 J-5 J-6 J

  11. Attributions of Agency and the Construction of Moral Order: Dementia, Death, and Dignity in Nursing-Home Care

    Science.gov (United States)

    Rodriquez, Jason

    2009-01-01

    Using evidence gathered during 18 months of participant-observation in 2 nursing homes and 65 interviews with staff, this article examines how nursing-home staff use agency as a rhetorical resource to construct a dignified workplace. Staff attribute agency to dying residents, saying they choose the timing and conditions of their death. Staff…

  12. Fall prevention in nursing homes

    DEFF Research Database (Denmark)

    Andresen, Mette; Hauge, Johnny

    2014-01-01

    that the number of hospitalization after a fall injury will become an even greater task for the Danish hospitals, The aim of the study was to show if there is a relationship between physically frail elderly nursing home resident’s subjective evaluation of fall-risk and an objective evaluation of their balance....... Further, to suggest tools for fall prevention in nursing home settings on the basis of the results of this study and the literature. A quantitative method inspired by the survey method was used to give an overview of fall patterns, subjective and objective evaluations of fallrisk. Participants were 16...... physically frail elderly nursing home residents from three different nursing homes. Measures: a small staff-questionnaire about incidences and places where the participants had falling-episodes during a 12 month period, The Falls Effi cacy Scale Swedish version (FES(S)) and Berg Balance Scale (BBS) Results...

  13. Unimaginable homes

    DEFF Research Database (Denmark)

    Møller, Kristian; Klausen, Maja

    2018-01-01

    The chapter draw from critical mediatization theory, critical intimacy theory, and cultural gerontology and asks: How do elderly people practice their mediatized homes? Which roles do media play in constituting and disturbing the flows of bodies into the home? Moreover: how do dominant...... in the making of the mediatized home space. We conclude by returning to the research questions and making explicit how researching flows of bodies that in many ways inhabit homes of the in-between contributes to both gerontological and geomediatization research agendas....

  14. Evaluation of the 'Ladder to the Moon, Culture Change Studio Engagement Programme' staff training: Two quasi-experimental case studies.

    Science.gov (United States)

    Guzmán, Azucena; Wenborn, Jennifer; Swinson, Tom; Orrell, Martin

    2017-09-01

    To evaluate the impact of the CCSEP on care home staff in two care settings for older people in one nursing home and one residential home. Care homes provide personal care and accommodation for older people. The English Dementia Strategy aims to improve the quality of service provision for people with dementia. This includes specific mention of improving the quality of life in care homes and as such includes objectives related to developing the workforce knowledge and skills. The Ladder to the Moon Culture Change Studio Engagement Programme (CCSEP) is a staff training approach based on the Positive Psychology framework that uses theatre- and film-based activities. This study used a wait-list controlled design. However, the data analysis plan was amended to reflect difficulties in data collection, and a quasi-experimental case study approach was consequently utilised. Outcome measures for staff attitudes and beliefs were as follows: Sense of Competence in Dementia Care Staff; Approaches to Dementia Questionnaire; Job Satisfaction Index; Brief Learning Transfer System Inventory; and Scale of Positive and Negative Experience. The Quality of Interaction Schedule (QUIS) was used to observe changes in staff-resident interaction. Fifty staff in two care homes completed the questionnaires and forty-one undertook formal CCSEP training. In Home A (nursing home), there was no significant change in any of the measures. In Home B (residential home), the QUIS showed an increase in positive interactions post intervention; a significant increase in the Building Relationship subscale of Sense of Competence; and a significant increase in staff sense of hopefulness towards people with dementia. The Brief Learning Transfer System Inventory showed a significant decrease post-intervention. The intervention did not significantly affect the happiness or job satisfaction of care home staff. The results of this study provide tentative evidence about the efficacy of this staff training

  15. Prescribing of psychotropic medication for nursing home residents with dementia: a general practitioner survey

    Directory of Open Access Journals (Sweden)

    Cousins JM

    2017-10-01

    Full Text Available Justin M Cousins, Luke RE Bereznicki, Nick B Cooling, Gregory M Peterson School of Medicine, Faculty of Health, University of Tasmania, Hobart, TAS, Australia Objective: The aim of this study was to identify factors influencing the prescribing of psychotropic medication by general practitioners (GPs to nursing home residents with dementia.Subjects and methods: GPs with experience in nursing homes were recruited through professional body newsletter advertising, while 1,000 randomly selected GPs from south-eastern Australia were invited to participate, along with a targeted group of GPs in Tasmania. An anonymous survey was used to collect GPs’ opinions.Results: A lack of nursing staff and resources was cited as the major barrier to GPs recommending non-pharmacological techniques for behavioral and psychological symptoms of dementia (BPSD; cited by 55%; 78/141, and increasing staff levels at the nursing home ranked as the most important factor to reduce the usage of psychotropic agents (cited by 60%; 76/126.Conclusion: According to GPs, strategies to reduce the reliance on psychotropic medication by nursing home residents should be directed toward improved staffing and resources at the facilities. Keywords: dementia, nursing homes, general practitioners, antipsychotic agents, benzodiazepines

  16. The Relationship between Reciprocity and the Emotional and Behavioural Responses of Staff

    Science.gov (United States)

    Thomas, Cathryn; Rose, John

    2010-01-01

    Background: The current study examines a model relating to the concept of reciprocity and burnout in staff, incorporating previous research findings based upon Weiner's (1980, 1986) cognitive-emotional model linking emotions, optimism and helping behaviour, with the aim of testing the model. Materials: Staff working in community homes within the…

  17. Research Staff | Water Power | NREL

    Science.gov (United States)

    Research Staff Research Staff Learn more about the expertise and technical skills of the water power research team and staff at NREL. Name Position Email Phone Anstedt, Sheri Professional III-Writer /Editor/Web Content Sheri.Anstedt@nrel.gov 303-275-3255 Baker, Donald Research Technician V-Electrical

  18. Autonomy among physically frail older people in nursing home settings

    DEFF Research Database (Denmark)

    Andresen, Mette; Puggaard, Lis

    2008-01-01

    BACKGROUND: Experiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings...... participants aged 65 years or older were included in the study. All the participants were restricted in performing at least one P-ADL activity unassisted and had a Mini Mental State Examination-score above 16. Perceived autonomy was measured at baseline, after 12 weeks and after 24 weeks by The Autonomy Sub......-dimension in the Measure of Actualisation of Potential test. Programmes were based on participants' individual assessment of their most important daily activities. Staff at all nursing homes who usually organize physical training, social or creative activities carried out individually tailored programmes using their usual...

  19. Mental Health staff views on improving burnout and mental toughness

    OpenAIRE

    Posner, Zoe; Janssen, Jessica; Roddam, Hazel

    2017-01-01

    Purpose- Burnout in mental health staff is acknowledged as a major problem. The purpose of this paper is to gain an understanding of mental health staff views on improving burnout and mental toughness in mental health staff.\\ud Design/methodology/approach-Ten participants from two mental health rehabilitation units across the North West of England took part in a Nominal Group Technique (NGT). Participants consisted of mental health workers from varied roles in order to\\ud capture views from a...

  20. Information for contractors' staff

    CERN Multimedia

    The Dosimetry Service

    2005-01-01

    We have observed a significant decrease in the number of completed Certificates for Work in Controlled Radiation Areas being submitted with applications for dosimeters for your staff. Henceforth, we shall no longer be able to issue dosimeters without a certificate, which must be signed by the employee and the contractor's radiation-protection expert. You can obtain the certificate form from the Dosimetry Service at Building 24/E-011 or from our Website: http://service-rp-dosimetry.web.cern.ch/service-rp-dosimetry/. Thank you for your understanding. The Dosimetry Service

  1. STAFF VACANCY LIST

    CERN Document Server

    Human Resources Division

    2002-01-01

    For economy reasons, it has been decided to stop printing and distributing this list to Staff Members. It can be found on the Web (LIST). Divisional Administrative Officers will receive an updated printed copy on a monthly basis and are asked to display this in a public place in their division. Copies will also be posted on the notice boards of the Administration Building (No. 60) in the glass-fronted cabinet (close to the lifts) and also on the notice board close to the Post Office. A copy will also be given to the Reception (Building No. 33). Human Resources Division Tel. 74606

  2. The Staff Association and you

    CERN Multimedia

    Association du personnel

    2013-01-01

    The Staff Association, your representative with the Management and the Member States The article VII 1.01 of the Staff Rules and Regulations (SR&R) provides that “the relations between the Director-General and the personnel shall be established either on an individual basis or on a collective basis with the Staff Association as intermediary”. This essential role of the Staff representatives, of being the spokesperson of the entire staff of the Organization vis-à-vis the Director-General and the Members States, is achieved through regular participation in the various joint advisory committees defined in the SR&R. The most important are the Standing Concertation Committee and the TREF, tripartite forum where your representatives meet with the Member States delegates, in the presence of the Management, to explain the position of the staff on the various issues concerning employment conditions. The Finance Committee also gives the opportunity to the Staff Association to ...

  3. Fostering Resilience in Children Exposed to Domestic Violence: Practical Strategies EC Staff Can Put into Action

    Science.gov (United States)

    Stephens, Karen

    2010-01-01

    Children enmeshed in violence don't experience a relaxed, predictable, or trusting home life. In fact, children exposed to home violence often experience symptoms of post-traumatic stress disorder (PTSD) just as adults do after enduring violence. Domestic violence robs children of their childhood. And while early childhood staff can't erase the…

  4. Crèche and School of the Staff Association: a programme for children from 2 to 4 year old

    CERN Multimedia

    Staff Association

    2018-01-01

    Find out how children between the ages of two to four and their families can benefit from the Staff Association Crèche and School programme. Classes for children aged between two and four years have been set-up to ensure the initial transition from home to school is as smooth as possible. Children attend mornings only and are welcomed by the same group of teaching staff throughout the week, allowing the children to establish a link between their home life and the crèche/school. The challenge of these classes is to offer the children a happy environment where they can feel emotionally secure, and the teaching staff can create a harmonious atmosphere allowing them to learn by moving, manipulating, exchanging, making mistakes… playing. Creativity takes a central role as it enables the child to express him or herself and increase their ability to handle their emotions constructively. According to Albert Einstein ‘Play is the highest form of research’. &nbs...

  5. Smart homes and ambient assisted living applications: from data to knowledge-empowering or overwhelming older adults? Contribution of the IMIA Smart Homes and Ambiant Assisted Living Working Group.

    Science.gov (United States)

    Demiris, G; Thompson, H

    2011-01-01

    As health care systems face limited resources and workforce shortages to address the complex needs of older adult populations, innovative approaches utilizing information technology can support aging. Smart Home and Ambient Assisted Living (SHAAL) systems utilize advanced and ubiquitous technologies including sensors and other devices that are integrated in the residential infrastructure or wearable, to capture data describing activities of daily living and health related events. This paper highlights how data from SHAAL systems can lead to information and knowledge that ultimately improves clinical outcomes and quality of life for older adults as well as quality of health care services. We conducted a review of personal health record applications specifically for older adults and approaches to using information to improve elder care. We present a framework that showcases how data captured from SHAAL systems can be processed to provide meaningful information that becomes part of a personal health record. Synthesis and visualization of information resulting from SHAAL systems can lead to knowledge and support education, delivery of tailored interventions and if needed, transitions in care. Such actions can involve multiple stakeholders as part of shared decision making. SHAAL systems have the potential to support aging and improve quality of life and decision making for older adults and their families. The framework presented in this paper demonstrates how emphasis needs to be placed into extracting meaningful information from new innovative systems that will support decision making. The challenge for informatics designers and researchers is to facilitate an evolution of SHAAL systems expanding beyond demonstration projects to actual interventions that will improve health care for older adults.

  6. Joint Chiefs of Staff > About > Joint Staff Inspector General

    Science.gov (United States)

    ., discrimination, sexual harassment or conditions of employment) must be addressed by agencies other than the IG Service & Reserve Links DOD IG: Home Page Army: Home Page | IG | Reserve National Guard | IG School

  7. Exploring a motivation of medical staff.

    Science.gov (United States)

    Goncharuk, Anatoliy G

    2018-06-08

    This paper aims to identify the true motivators (needs) of medical staff, compare them with the current labor incentives, and detect possible differences in motivators for main groups of medical staff. Observing personnel of 5 hospitals and students of the medical institute by special questionnaires, the author confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author used special questionnaires to collect the data. Study results confirmed the hypothesis of different motivators for groups of medical staff with different ages, professions, and gender. The author also found significant differences between the motivation of Ukrainian health workers and their colleagues from other countries. The main conclusion is that no matter how we would like to satisfy gender and age equality, all people are individual and what is good for an elderly male doctor cannot be acceptable for a young female nurse. Therefore, forming the motivation system for employees of medical institutions, it is necessary to take into account the age, gender, professions, and other characteristics of each employee. In this way, we can achieve the highest health-care performance. Copyright © 2018 John Wiley & Sons, Ltd.

  8. Radiation Safety Awareness Among Medical Staff

    International Nuclear Information System (INIS)

    Szarmach, Arkadiusz; Piskunowicz, Maciej; Świętoń, Dominik; Muc, Adam; Mockałło, Gabor; Dzierżanowski, Jarosław; Szurowska, Edyta

    2015-01-01

    The common access to imaging methods based on ionizing radiation requires also radiation protection. The knowledge of ionizing radiation exposure risks among the medical staff is essential for planning diagnostic procedures and therapy. Evaluation of the knowledge of radiation safety during diagnostic procedures among the medical staff. The study consisted of a questionnaire survey. The questionnaire consisted of seven closed-ended questions concerning the knowledge of the effects of exposure to ionizing radiation as well as questions related to responder’s profession and work experience. The study group included a total of 150 individuals from four professional groups: nurses, doctors, medical technicians, support staff. The study was carried out in the three largest hospitals in Gdańsk between July and October 2013. The highest rates of correct answers to questions related to the issue of radiation protection were provided by the staff of radiology facilities and emergency departments with 1–5 years of professional experience. The most vulnerable group in terms of the knowledge of these issues consisted of individuals working at surgical wards with 11–15 years of professional experience. Education in the field of radiological protection should be a subject of periodic training of medical personnel regardless of position and length of service

  9. Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study.

    Science.gov (United States)

    Kwong, Enid Wy; Hung, Maria Sy; Woo, Kevin

    2016-11-25

    A need exits to develop a protocol for preventing pressure ulcers (PUs) in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes. A total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning), changing (action), and refreezing (results) were carried out. During each cycle, focus group interviews, field observations of the care staff's practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results. The following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the revised risk assessment method, the timely and appropriate

  10. Nursing Home - Pain - Percentage of Residents Reporting Pain

    Data.gov (United States)

    U.S. Department of Health & Human Services — Adequate pain management is an important indicator of quality of care and quality of life. Nursing home staff should check patients regularly to see if they are...

  11. THE STAFF ASSOCIATION'S INTERNAL COMMISSIONS A source of innovative ideas

    CERN Multimedia

    STAFF ASSOCIATION

    2010-01-01

    In the heart of the Staff Association, internal commissions carry out preparatory work which is indispensable for productive discussions in Staff Council and Executive Committee meetings. These working groups, composed of staff delegates and interested staff members, are think tanks for all subjects in the area assigned to them. Five commissions are active in 2010 : The “In-Form-Action” Commission develops a communication strategy (Information), organizes staff mobilization and action (Action) and promotes delegate training (Formation [training]), in order to enhance, support and professionalize the activities of the Staff Association. The Commission for “Employment Conditions” deals with remuneration, the advancement system, working hours, recruitment, and retention, among other things. It gives its opinion on proposals by the Management or elaborates its own proposals. The Commission for “Health and Safety” examines all aspec...

  12. Proposta de modelo para dimensionamento do pessoal de enfermagem em assistência domiciliária Propuesta de modelo para la provisión de personal de enfermería en asistencia domiciliaria Proposal for a model for calculating the size of nursing staff in home care

    Directory of Open Access Journals (Sweden)

    Luiza Watanabe Dal Ben

    2007-03-01

    previstas y de ausencias no previstas. A partir de esas variables propusimos un modelo para calcular el cuadro de profesionales de enfermería en AD, agilizando el proceso de toma de decisiones.Home care brings up issues related to the number of daily hours and days of nursing service from users of these services. This study was carried out in order to identify the criteria adopted by managers and nurses for calculating the nursing staff needed in home care services. Data were collected through semi-structured interviews and analyzed according to the method of content analysis. Three categories were identified: patient's eligibility, time spent in care, and professional competency profile. The steps considered were: identification of daily average work load, choice of the proportion of professional categories, nursing workers' daily journey, and identification of the technical safety index for covering planned and unplanned absences. From these variables a model for calculating nursing personnel needed in home care is proposed in order to speed up the decision making process.

  13. Collaborating for oral health in support of vulnerable older people: co-production of oral health training in care homes.

    Science.gov (United States)

    Patel, Rakhee; Robertson, Claire; Gallagher, Jennifer E

    2017-11-23

    In recent years, the value of co-production has become embedded in the social care agenda. Care home residents are at significantly higher risk of dental diseases and often rely on the care team for support. It is therefore vital that staff are trained and confident in delivering evidence based oral care to their clients. Three London care homes co-produced a pilot oral health training programme, informed by in-depth interviews and group discussions. The initiative was evaluated using pre/post-questionnaires of carers and semi-structured interviews of managers and the dental teams. Two care homes were available for delivery of the programme, which resulted in training of 64% (n = 87) of care staff. The training programme involved videos and resources and was delivered flexibly with the support of an oral health educator and a dental therapist. There was an improvement in knowledge and self-reported confidence post-training; however, only 54% (n = 45) completed the post-training questionnaire. This study suggests that co-production of an oral care training package for care home staff, is possible and welcome, but challenging in this complex and changing environment. Further work is needed to explore the feasibility, sustainability and impact of doing so. © The Author 2017. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  14. Development and validation of a screening instrument to assess the types and quality of foods served at home meals

    Directory of Open Access Journals (Sweden)

    Fulkerson Jayne A

    2012-02-01

    Full Text Available Abstract Background Although there is growing interest in assessing the home food environment, no easy-to-use, low cost tools exist to assess the foods served at home meals, making it difficult to assess the meal component of the food environment. The aim of this study was to develop and validate a user-friendly screener to assess the types of foods served at home meals. Methods Primary food preparing adults (n = 51 participated in a validation study in their own homes. Staff and participants independently completed a screener as participants cooked dinner. The screener assessed the types of foods offered, method(s of preparation, and use of added fats. Two scale scores were created: 1 to assess offerings of foods in five food groups (meat and other protein, milk, vegetables, fruit, grains, 2 to assess the relative healthfulness of foods based on types offered, preparation method, and added fats. Criterion validity was assessed comparing staff and participant reports of individual foods (kappa (k and scale scores (Spearman correlations. Results Criterion validity was high between participants' and staffs' record of whether major food categories (meat and other protein, bread and cereal, salad, vegetables, fruits, dessert were served (k = 0.79-1.0, moderate for reports of other starches (e.g., rice being served (k = 0.52, and high for the Five Food Group and Healthfulness scale scores (r = 0.75-0.85, p Conclusions This new meal screening tool has high validity and can be used to assess the types of foods served at home meals allowing a more comprehensive assessment of the home food environment.

  15. A randomized clinical trial of the anti-caries efficacy of 5,000 compared to 1,450 ppm fluoridated toothpaste on root caries lesions in elderly disabled nursing home residents

    DEFF Research Database (Denmark)

    Ekstrand, K.R.; Poulsen, J.E.; Hede, B.

    2013-01-01

    Root caries is prevalent in elderly disabled nursing home residents in Denmark. This study aimed to compare the effectiveness of tooth brushing with 5,000 versus 1,450 ppm of fluoridated toothpaste (F-toothpaste) for controlling root caries in nursing home residents. The duration of the study was 8...... months. Elderly disabled residents (n = 176) in 6 nursing homes in the Copenhagen area consented to take part in the study. They were randomly assigned to use one of the two toothpastes. Both groups had their teeth brushed twice a day by the nursing staff. A total of 125 residents completed the study...

  16. Assessing the skills of home care workers in helping older people take their prescribed medications.

    Science.gov (United States)

    Smyth, Elizabeth E J

    2015-08-01

    The Southern Health and Social Care Trust in Northern Ireland applied a modified version of the Objective Structured Clinical Examination (OSCE) to assess the skills of home care workers in assisting older people taking prescribed medications. In Northern Ireland, home care workers are care workers employed by health and social care trusts or private agencies. The application of the model has developed the skills of this staff group, improved the relationship between the commissioner and provider, significantly reduced the time spent by community nurses in individual training and assessment, and enhanced the patient experience for those taking medication. Overall, the application of this model has provided assurances to the Trust board, the executive director of nursing, and operational directors that home care workers are competent in assisting older people in this high-risk activity.

  17. Food Allergy Knowledge and Attitudes of Restaurant Managers and Staff: An EHS-Net Study

    Science.gov (United States)

    Radke, Taylor J.; Brown, Laura G.; Hoover, E. Rickamer; Faw, Brenda V.; Reimann, David; Wong, Melissa R.; Nicholas, David; Barkley, Jonathan; Ripley, Danny

    2016-01-01

    Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers’ food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant’s ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction. PMID:28221943

  18. Food Allergy Knowledge and Attitudes of Restaurant Managers and Staff: An EHS-Net Study.

    Science.gov (United States)

    Radke, Taylor J; Brown, Laura G; Hoover, E Rickamer; Faw, Brenda V; Reimann, David; Wong, Melissa R; Nicholas, David; Barkley, Jonathan; Ripley, Danny

    2016-09-01

    Dining outside of the home can be difficult for persons with food allergies who must rely on restaurant staff to properly prepare allergen-free meals. The purpose of this study was to understand and identify factors associated with food allergy knowledge and attitudes among restaurant managers, food workers, and servers. This study was conducted by the Environmental Health Specialists Network (EHS-Net), a collaborative forum of federal, state, and local environmental health specialists working to understand the environmental factors associated with food safety issues. EHS-Net personnel collected data from 278 randomly selected restaurants through interviews with restaurant managers, food workers, and servers. Results indicated that managers, food workers, and servers were generally knowledgeable and had positive attitudes about accommodating customers' food allergies. However, we identified important gaps, such as more than 10% of managers and staff believed that a person with a food allergy can safely consume a small amount of that allergen. Managers and staff also had lower confidence in their restaurant's ability to properly respond to a food allergy emergency. The knowledge and attitudes of all groups were higher at restaurants that had a specific person to answer food allergy questions and requests or a plan for answering questions from food allergic customers. However, food allergy training was not associated with knowledge in any of the groups but was associated with manager and server attitudes. Based on these findings, we encourage restaurants to be proactive by training staff about food allergies and creating plans and procedures to reduce the risk of a customer having a food allergic reaction.

  19. Job strain in nursing homes-Exploring the impact of leadership.

    Science.gov (United States)

    Backman, Annica; Sjögren, Karin; Lövheim, Hugo; Edvardsson, David

    2018-04-01

    To explore the association between nursing home managers' leadership, job strain and social support as perceived by direct care staff in nursing homes. It is well known that aged care staff experience high levels of job strain, and that aged care staff experiencing job strain are exposed to increased risk for adverse health effects. Leadership styles have been associated with job strain in the literature; however, the impact of perceived leadership on staff job strain and social support has not been clarified within nursing home contexts. This study had a cross-sectional design. Participating staff (n = 3,605) completed surveys which included questions about staff characteristics, valid and reliable measures of nursing home managers' leadership, perceived job strain and social support. Statistical analyses of correlations and multiple regression analysis with interaction terms were conducted. Nursing home managers' leadership were significantly associated with lower level of job strain and higher level of social support among direct care staff. A multiple regression analysis including an interaction term indicated individual and joint effects of nursing home managers' leadership and social support on job strain. Nursing home managers' leadership and social support were both individually and in combination associated with staff perception of lesser job strain. Thus, nursing home managers' leadership are beneficial for the working situation and strain of staff. Promoting a supporting work environment through leadership is an important implication for nursing home managers as it can influence staff perception of job strain and social support within the unit. By providing leadership, offering support and strategies towards a healthy work environment, nursing home managers can buffer adverse health effects among staff. © 2017 John Wiley & Sons Ltd.

  20. Focus on Dementia Care: Continuing Education Preferences, Challenges, and Catalysts among Rural Home Care Providers

    Science.gov (United States)

    Kosteniuk, Julie G.; Morgan, Debra G.; O'Connell, Megan E.; Dal Bello-Haas, Vanina; Stewart, Norma J.

    2016-01-01

    Home care staff who provide housekeeping and personal care to individuals with dementia generally have lower levels of dementia care training compared with other health care providers. The study's purposes were to determine whether the professional role of home care staff in a predominantly rural region was associated with preferences for delivery…

  1. A European multicenter study on systematic ethics work in nursing homes.

    Science.gov (United States)

    Bollig, Georg; Rosland, Jan Henrik; Gjengedal, Eva; Schmidt, Gerda; May, Arnd T; Heller, Andreas

    2017-09-01

    There are many existing ethical challenges in nursing homes. Although different methods and approaches to discussing the ethical challenges have been established, systematic ethics work is not yet a standard in all nursing homes. The aim of the present study was to explore ethical challenges and approaches to implementing systematic ethics work in nursing homes. Data from five institutions in Austria, Germany and Norway were collected, and a mixed-methods two-tiered study approach was chosen. Documentation of ethics discussions was combined with qualitative focus group interviews with staff members regarding the implementation of systematic ethics work in nursing homes. One hundred and five ethics meetings were documented. The main topics were advance care planning, ethical challenges associated with artificial nutrition, hospitalisation and end-of-life decision-making. Of the meetings, 33% focused mainly on everyday ethical challenges. In 76% of prospective case discussions, agreements about a solution were reached; however, in 29% of these no residents or relatives participated. The advantages of systematic ethics work described by the staff were enhanced openness and dialogue, overall, and a greater ethical awareness. Many voiced a need for structure and support from the administration. Systematic ethics work is greatly appreciated by the staff and helps to reach a consensus in the majority of case discussions. It should be implemented in all nursing homes. Attention to everyday ethical challenges is important. The participation of relatives and physicians could be improved. The participation of the residents' in ethics discussions should be encouraged to strengthen their autonomy and dignity. © 2016 The Authors. Scandinavian Journal of Caring Sciences published by John Wiley & Sons Ltd on behalf of Nordic College of Caring Science.

  2. Twitter accounts followed by Congressional health staff.

    Science.gov (United States)

    Grande, David; Meisel, Zachary F; Merchant, Raina M; Seymour, Jane; Gollust, Sarah E

    2017-07-01

    Although health policy research should inform policy making, the communication gap between researchers and policy makers limits successful translation. Social media represents a new opportunity to connect researchers and policy makers. Our objective was to assess who Congressional health policy staff follow on a major social media platform. Cross-sectional study. Our study measured Congressional health policy staff's use of Twitter and the types of individuals and organizations they follow. To focus on more influential Twitter accounts, we restricted our sample to those followed by at least 3 individual Congressional staff members. Of the 30,843 accounts followed by the 115 Congressional health policy staff, 1273 were potentially policy-related and followed by 3 or more staff. Of these, few were academically affiliated (2.4%) or explicitly health-related (5.6%) sites; many were general news media sources (50.9%) and political and governmental sources (36.4%). Health-focused accounts were frequently connected to the news media or government rather than academia. Top accounts followed (ie, highest quintile) were most likely to be national news organizations (odds ratio [OR], 5.88; 95% confidence interval [CI], 1.75-19.7) and elected officials (OR, 8.22; 95% CI, 1.75-38.6) compared with advocacy and interest groups. Health-related and academic sources are largely absent from the Twitter conversations with US Congressional health policy staff. Even within social media, traditional and political news media are important information intermediaries that researchers and journals should target to disseminate health policy evidence.

  3. Introducing a model incorporating early integration of specialist palliative care: A qualitative research study of staff's perspectives.

    Science.gov (United States)

    Michael, Natasha; O'Callaghan, Clare; Brooker, Joanne E; Walker, Helen; Hiscock, Richard; Phillips, David

    2016-03-01

    Palliative care has evolved to encompass early integration, with evaluation of patient and organisational outcomes. However, little is known of staff's experiences and adaptations when change occurs within palliative care services. To explore staff experiences of a transition from a service predominantly focused on end-of-life care to a specialist service encompassing early integration. Qualitative research incorporating interviews, focus groups and anonymous semi-structured questionnaires. Data were analysed using a comparative approach. Service activity data were also aggregated. A total of 32 medical, nursing, allied health and administrative staff serving a 22-bed palliative care unit and community palliative service, within a large health service. Patients cared for within the new model were significantly more likely to be discharged home (7.9% increase, p = 0.003) and less likely to die in the inpatient unit (10.4% decrease, p management was considered valuable, nurses particularly found additional skill expectations challenging, and perceived patients' acute care needs as detracting from emotional and end-of-life care demands. Staff views varied on whether they regarded the new model's faster-paced work-life as consistent with fundamental palliative care principles. Less certainty about care goals, needing to prioritise care tasks, reduced shared support rituals and other losses could intensify stress, leading staff to develop personalised coping strategies. Services introducing and researching innovative models of palliative care need to ensure adequate preparation, maintenance of holistic care principles in faster work-paced contexts and assist staff dealing with demands associated with caring for patients at different stages of illness trajectories. © The Author(s) 2015.

  4. A review of NRC staff uses of probabilistic risk assessment

    International Nuclear Information System (INIS)

    1994-03-01

    The NRC staff uses probabilistic risk assessment (PRA) and risk management as important elements its licensing and regulatory processes. In October 1991, the NRC's Executive Director for Operations established the PRA Working Group to address concerns identified by the Advisory Committee on Reactor Safeguards with respect to unevenness and inconsistency in the staff's current uses of PRA. After surveying current staff uses of PRA and identifying needed improvements, the Working Group defined a set of basic principles for staff PRA use and identified three areas for improvements: guidance development, training enhancements, and PRA methods development. For each area of improvement, the Working Group took certain actions and recommended additional work. The Working Group recommended integrating its work with other recent PRA-related activities the staff completed and improving staff interactions with PRA users in the nuclear industry. The Working Group took two key actions by developing general guidance for two uses of PRA within the NRC (that is, screening or prioritizing reactor safety issues and analyzing such issues in detail) and developing guidance on basic terms and methods important to the staff's uses of PRA

  5. A randomized controlled trial of a senior centre group programme for increasing social support and preventing depression in elderly people living at home in Norway

    Directory of Open Access Journals (Sweden)

    Bøen Hege

    2012-05-01

    Full Text Available Abstract Background Late-life depression is a common condition and a challenging public health problem. A lack of social support is strongly associated with psychological distress. Senior centres seem to be suitable arenas for community-based health promotion interventions, although few studies have addressed this subject. The objectives were to examine the effect of a preventive senior centre group programme consisting of weekly meetings, on social support, depression and quality of life. Methods A questionnaire was sent to a random sample of 4,000 persons over 65 in Oslo, and a total of 2,387 completed questionnaires were obtained. These subjects served as a basis for recruitment of participants for a trial, with scores on HSCL-10 being used as a main inclusion criterion. A total of 138 persons were randomized into an intervention group (N = 77 and control group (N = 61. Final analyses included 92 persons. Social support (OSS-3, depression (BDI, life satisfaction and health were measured in interviews at baseline and after 12 months (at the end of the intervention programme. Perceptions of benefits from the intervention were also measured. Mean scores, SD, SE and CI were used to describe the changes in outcomes. Effect sizes were calculated based on the original scales and as Cohen’s d. Paired sample tests and ANOVA were used to test group differences. Results There was an increase in social support in both groups, but greatest in the intervention group. The level of depression increased for both groups, but more so in the control than the intervention group. There was a decrease in life satisfaction, although the decrease was largest among controls. There were almost no differences in reported health between groups. However, effect sizes were small and differences were not statistically significant. In contrast, most of the participants said the intervention meant much to them and led to increased use of the centre. Conclusions In

  6. [Development of an evaluation instrument for service quality in nursing homes].

    Science.gov (United States)

    Lee, Jia; Ji, Eun Sun

    2011-08-01

    The purposes of this study were to identify the factors influencing service quality in nursing homes, and to develop an evaluation instrument for service quality. A three-phase process was employed for the study. 1) The important factors to evaluate the service quality in nursing homes were identified through a literature review, panel discussion and focus group interview, 2) the evaluation instrument was developed, and 3) validity and reliability of the study instrument were tested by factor analysis, Pearson correlation coefficient, Cronbach's α and Cohen's Kappa. Factor analysis showed that the factors influencing service quality in nursing homes were healthcare, diet/assistance, therapy, environment and staff. To improve objectivity of the instrument, quantitative as well as qualitative evaluation approaches were adopted. The study instrument was developed with 30 items and showed acceptable construct validity. The criterion-related validity was a Pearson correlation coefficient of .85 in 151 care facilities. The internal consistency was Cronbach's α=.95. The instrument has acceptable validity and a high degree of reliability. Staff in nursing homes can continuously improve and manage their services using the results of the evaluation instrument.

  7. 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 ...

  8. [Home births].

    Science.gov (United States)

    Welffens, K; Kirkpatrick, C; Daelemans, C; Derisbourg, S

    In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.

  9. Greater gains from smoke-free legislation for non-smoking bar staff in Belfast.

    Science.gov (United States)

    Bannon, Finian; Devlin, Anne; McElwee, Gerry; Gavin, Anna

    2009-12-01

    In April 2007, smoke-free legislation was enacted in workplaces throughout N. Ireland. The effects of this legislation on bar workers' health and their exposure to second-hand smoke at home, work and social environment, and their attitudes to the legislation before and after its implementation remain to be documented. A self-completed questionnaire of bar staff in 35 Belfast bars, before (March 2007, n = 110) and after the legislation (July 2007, n = 110). Smokers (excluding 'social smokers') made up 41.6% of respondents. After the introduction of the smoke-free legislation, the reductions in the proportion of bar workers reporting various respiratory symptoms ranged from 1.3% to 18.6% for smokers and from 21.9% to 33.2% for non-smokers. Likewise, the reductions for various sensory symptoms ranged from 7.3% to 17.7% for smokers and from 29.6% to 46.8% for non-smokers. Reduction in wheeze, cough and throat symptoms after the legislation were much greater for non-smokers than smokers. The proportion of bar staff who reported satisfaction with the legislation remained unchanged across the surveys. Decreases in perceived exposure to second-hand smoke occurred at work, home and in social settings. After the legislation's enactment, a majority of bar workers felt the workplace was healthier (98%). These first findings show reduced reported symptoms among bar workers, both smokers and non-smokers, after the introduction of smoke-free legislation in N. Ireland, though greater among non-smokers. There was also a reported fall in the hours of second-hand smoke exposure in the home for this group of workers which has a high prevalence of smokers.

  10. Multidisciplinary, Nurse-Led Psychiatric Consultation in Nursing Homes: A Pilot Study in Clinical Practice.

    Science.gov (United States)

    Koekkoek, Bauke; van Baarsen, Carlijn; Steenbeek, Mirella

    2016-07-01

    To determine the effects of multidisciplinary, nurse-led psychiatric consultation on behavioral problems of nursing home residents. Residents often suffer from psychiatric symptoms, while staff psychiatric expertise varies. A pre-post study was conducted in seven homes using the Neuropsychiatric Inventory Nursing Home version (NPI-NH). In 71 consultations during 18 months, 56-75% of residents suffered from agitation/aggression, depression, anxiety, and disinhibition. Post-intervention (n = 54), frequency, and severity of psychiatric symptoms were significantly and clinically meaningfully reduced. Also, staff suffered from less work stress. Nurse-led psychiatric consultation is valuable to both nursing home residents and staff. © 2015 Wiley Periodicals, Inc.

  11. Quality of care in Norwegian nursing homes - typology of family perceptions.

    Science.gov (United States)

    Vinsnes, Anne G; Nakrem, Sigrid; Harkless, Gene E; Seim, Arnfinn

    2012-01-01

    This study aimed to elucidate the understandings and beliefs about quality held by family members of residents of Norwegian nursing homes. The objective reported in the study considers how family member judge factors that enhance or hamper high care quality. The percentage of those who will require care in a nursing home some time before the end of their lives will increase dramatically in the next 20 years. Therefore, anticipating this pressure to expand nursing home availability, it is urgent that these services are developed from a keen understanding of what creates the best value. Care quality from the family's perspective is just one piece of the nursing home experience that must be understood for optimal value in care to be realised. Qualitative methodology. Three focus group interviews; purposive sampling was used to recruit the 16 family members of residents in nursing homes. Three domains emerged that served as anchors for a typology of family perceptions of the quality care continuum: resident contentment, suitability of staff and environmental context. Each domain was developed with categories describing high- to low-quality markers, which were then clarified by enhancing and hindering factors. This typology provides a family perspective framework that may be useful to nursing leadership at all levels of the nursing home organisation to identify important quality of care strengths as well as markers of poor care. Overall, the typology is offered to expand nurses' understanding of quality, both practically and conceptually, to provide the best value in nursing care. © 2011 Blackwell Publishing Ltd.

  12. Chief of Staff, Office of the President | IDRC - International ...

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

    Maintaining fluid communications in between the President's Office and all ... Prepares the President for important meetings and events. ... at the request of the President, ad-hoc working groups of staff as needed to solve any internal issues.

  13. 2011 Elections to Staff Council

    CERN Multimedia

    Staff Association

    2011-01-01

    Vote Elections to fill all seats in the Staff Council are being organized this month. Voting will begin on Monday 31 October. Make your voice heard and be many to elect the new Staff Council. By doing so, you will be encouraging the men and women who will  represent you over the next two years and they will doubtless appreciate your gratitude. More details on the elections can be found on the Staff Association web site. (http://association.web.cern.ch) Elections Timetable Monday 31 October, at noon start date for voting Monday 14 November, at noon closing date for voting Monday 21 November, publication of the results in Echo Tuesday 22 and Wednesday 29 November Staff Association Assizes Tuesday 6 December, at 10.00 a.m. first meeting of the new Staff Council and election of the new Executive Committee The voting procedure is monitored by the Election Committee. 

  14. Predictive Factors associated with Death of Elderly in Nursing Homes

    Directory of Open Access Journals (Sweden)

    Kiwol Sung, PhD, RN

    2014-06-01

    Conclusion: Dyspnea, problematic behaviors, and ADL data were identified as the key factors associated with death among nursing home residents. Future plans for the prediction of death among nursing home residents can be made by nursing staff, factoring in these identified variables, to ensure more comfortable conditions and more responsive care.

  15. Study of information needs of juveniles in Asero remand home ...

    African Journals Online (AJOL)

    The study examines the information needs of juveniles in Asero remand home, Abeokuta, Ogun State, Nigeria. A structured questionnaire was used to obtain data for the study. Interviews were also conducted with the staff of the home to supplement the data. Of the respondents 100% revealed that their major information ...

  16. Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study

    Directory of Open Access Journals (Sweden)

    Enid WY Kwong

    2016-11-01

    Full Text Available Abstract Background A need exits to develop a protocol for preventing pressure ulcers (PUs in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes. Methods A total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning, changing (action, and refreezing (results were carried out. During each cycle, focus group interviews, field observations of the care staff’s practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results. Results The following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the

  17. The home range of a recently established group of Southern ground-hornbill (Bucorvus leadbeateri in the Limpopo Valley, South Africa

    Directory of Open Access Journals (Sweden)

    Nicholas Theron

    2013-10-01

    Conservation implications: The Limpopo Valley SGH population is one of the most significant outside protected areas in South Africa. This population is especially vulnerable to threats such as poisoning, persecution for window breaking and drought, as shown by their near extirpation from the area. Conservation efforts need to focus on awareness amongst local farmers, provision of artificial nests and continued monitoring of groups.

  18. Introducing Psychiatric Care into Nursing Homes.

    Science.gov (United States)

    Sakauye, Kenneth M.; Camp, Cameron J.

    1992-01-01

    Consultation-liaison psychiatry program in teaching nursing home helped implement six guiding principles, including make patient human to the staff; assume no behavior is random; look for depression or psychosis as source of problems; reduce medications and medication doses; create more homelike environment; and use conditions in which learning…

  19. Human resources in home care in Europe.

    NARCIS (Netherlands)

    Genet, N.; Lamura, G.; Boerma, W.; Hutchinson, A.; Garms-Homolova, V.; Naiditch, M.; Chlabicz, S.; Ersek, K.; Gulácsi, L.; Fagerstrom, C.; Bolibar, B.

    2010-01-01

    Introduction: The increasing old-age dependency ratio implies future reduction of human resources available to provide services. Little information is available about the level of qualification, contractual aspects, payment and working conditions of home care workers and the existence of staff

  20. Improving person-centred care in nursing homes through dementia-care mapping: design of a cluster-randomised controlled trial

    Science.gov (United States)

    2012-01-01

    Background The effectiveness and efficiency of nursing-home dementia care are suboptimal: there are high rates of neuropsychiatric symptoms among the residents and work-related stress among the staff. Dementia-care mapping is a person-centred care method that may alleviate both the resident and the staff problems. The main objective of this study is to evaluate the effectiveness and cost-effectiveness of dementia-care mapping in nursing-home dementia care. Methods/Design The study is a cluster-randomised controlled trial, with nursing homes grouped in clusters. Studywise minimisation is the allocation method. Nursing homes in the intervention group will receive a dementia-care-mapping intervention, while the control group will receive usual care. The primary outcome measure is resident agitation, to be assessed with the Cohen-Mansfield Agitation Inventory. The secondary outcomes are resident neuropsychiatric symptoms, assessed with the Neuropsychiatric Inventory - Nursing Homes and quality of life, assessed with Qualidem and the EQ-5D. The staff outcomes are stress reactions, job satisfaction and job-stress-related absenteeism, and staff turnover rate, assessed with the Questionnaire about Experience and Assessment of Work, the General Health Questionnaire-12, and the Maastricht Job Satisfaction Scale for Health Care, respectively. We will collect the data from the questionnaires and electronic registration systems. We will employ linear mixed-effect models and cost-effectiveness analyses to evaluate the outcomes. We will use structural equation modelling in the secondary analysis to evaluate the plausibility of a theoretical model regarding the effectiveness of the dementia-care mapping intervention. We will set up process analyses, including focus groups with staff, to determine the relevant facilitators of and barriers to implementing dementia-care mapping broadly. Discussion A novelty of dementia-care mapping is that it offers an integral person

  1. Improving person-centred care in nursing homes through dementia-care mapping: design of a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    van de Ven Geertje

    2012-01-01

    Full Text Available Abstract Background The effectiveness and efficiency of nursing-home dementia care are suboptimal: there are high rates of neuropsychiatric symptoms among the residents and work-related stress among the staff. Dementia-care mapping is a person-centred care method that may alleviate both the resident and the staff problems. The main objective of this study is to evaluate the effectiveness and cost-effectiveness of dementia-care mapping in nursing-home dementia care. Methods/Design The study is a cluster-randomised controlled trial, with nursing homes grouped in clusters. Studywise minimisation is the allocation method. Nursing homes in the intervention group will receive a dementia-care-mapping intervention, while the control group will receive usual care. The primary outcome measure is resident agitation, to be assessed with the Cohen-Mansfield Agitation Inventory. The secondary outcomes are resident neuropsychiatric symptoms, assessed with the Neuropsychiatric Inventory - Nursing Homes and quality of life, assessed with Qualidem and the EQ-5D. The staff outcomes are stress reactions, job satisfaction and job-stress-related absenteeism, and staff turnover rate, assessed with the Questionnaire about Experience and Assessment of Work, the General Health Questionnaire-12, and the Maastricht Job Satisfaction Scale for Health Care, respectively. We will collect the data from the questionnaires and electronic registration systems. We will employ linear mixed-effect models and cost-effectiveness analyses to evaluate the outcomes. We will use structural equation modelling in the secondary analysis to evaluate the plausibility of a theoretical model regarding the effectiveness of the dementia-care mapping intervention. We will set up process analyses, including focus groups with staff, to determine the relevant facilitators of and barriers to implementing dementia-care mapping broadly. Discussion A novelty of dementia-care mapping is that it offers an

  2. Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

    Science.gov (United States)

    Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

    2018-01-01

    Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

  3. Understanding organizational and cultural premises for quality of care in nursing homes: an ethnographic study

    OpenAIRE

    Nakrem, Sigrid

    2015-01-01

    Background Internationally, there are concerns about the quality of care in nursing homes. The concept of ?corporate culture? as an internal variable could be seen as the means to improve quality of care and quality of life for the residents. The aim of this article was to describe the nursing home culture from the staff?s perspective and to include how the residents describe quality of care. Methods An ethnographic design was employed. A purposive sample of four municipal public nursing home...

  4. The competencies of Registered Nurses working in care homes: a modified Delphi study.

    Science.gov (United States)

    Stanyon, Miriam Ruth; Goldberg, Sarah Elizabeth; Astle, Anita; Griffiths, Amanda; Gordon, Adam Lee

    2017-07-01

    registered Nurses (RNs) working in UK care homes receive most of their training in acute hospitals. At present the role of care home nursing is underdeveloped and it is seen as a low status career. We describe here research to define core competencies for RNs working in UK care homes. a two-stage process was adopted. A systematic literature review and focus groups with stakeholders provided an initial list of competencies. The competency list was modified over three rounds of a Delphi process with a multi-disciplinary expert panel of 28 members. twenty-two competencies entered the consensus process, all competencies were amended and six split. Thirty-one competencies were scored in round two, eight were agreed as essential, one competency was split into two. Twenty-four competencies were submitted for scoring in round three. In total, 22 competencies were agreed as essential for RNs working in care homes. A further 10 competencies did not reach consensus. the output of this study is an expert-consensus list of competencies for RNs working in care homes. This would be a firm basis on which to build a curriculum for this staff group. © The Author 2017. Published by Oxford University Press on behalf of the British Geriatrics Society.All rights reserved. For permissions, please email: journals.permissions@oup.com

  5. Genetics Home Reference: Waardenburg syndrome

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Waardenburg syndrome Waardenburg syndrome Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Waardenburg syndrome is a group of genetic conditions that can ...

  6. Genetics Home Reference: Bartter syndrome

    Science.gov (United States)

    ... Email Facebook Twitter Home Health Conditions Bartter syndrome Bartter syndrome Printable PDF Open All Close All Enable Javascript to view the expand/collapse boxes. Description Bartter syndrome is a group of very similar kidney disorders ...

  7. Safety assessment of a home-based telecare system for adults with developmental disabilities in Indiana: a multi-stakeholder perspective.

    Science.gov (United States)

    Brewer, Jeffrey L; Taber-Doughty, Teresa; Kubik, Sara

    2010-01-01

    We investigated the perceptions of people about the safety, security and privacy of a telecare monitoring system for adults with developmental disabilities living in residential settings. The telecare system was used by remote caregivers overnight, when staff were not present in the homes. We surveyed 127 people from different stakeholder groups in the state of Indiana. The people surveyed included those with knowledge or experience of telecare, and those without. The stakeholders were clients, their advocates, service provider administrators and independent case coordinators. The responses in each category for every group were positive except one: only 4 of the 11 telecare case coordinators agreed that the telecare system provided a secure environment. Overall, the telecare system was perceived to be as safe, secure and private as the conventional alternative of having staff in the home.

  8. Fermilab | Home

    Science.gov (United States)

    Industry Students and teachers Media ... Five (more) fascinating facts about DUNE Engineering the Mathematics in Music June 2 10 a.m. Get to Know the Lederman Science Center June 3 1 p.m. Ask a Scientist Security, Privacy, Legal Use of Cookies Quick Links Home Contact Phone Book Fermilab at Work For Industry

  9. Home Automation

    OpenAIRE

    Ahmed, Zeeshan

    2010-01-01

    In this paper I briefly discuss the importance of home automation system. Going in to the details I briefly present a real time designed and implemented software and hardware oriented house automation research project, capable of automating house's electricity and providing a security system to detect the presence of unexpected behavior.

  10. Home Education, School, Travellers and Educational Inclusion

    Science.gov (United States)

    D'Arcy, Kate

    2014-01-01

    The difficulties Traveller pupils experience in school are well documented. Yet those in home educating go unreported. Monk suggests this is because some groups are overlooked; that gypsies and Travellers are often not perceived as home educators. This article highlights how the move to home education is seldom a free choice for Traveller…

  11. Caring for Young Children in the Home.

    Science.gov (United States)

    Birckmayer, Jennifer; And Others

    Group leaders of 10- to 13-year-olds may use this program guide to help the preteens interact with young children through six discussion meetings and five visits with a preschool child at home. Discussion topics concern (1) the family environment of young children, (2) children's play; (3) children's play areas at home, (4) safety at home, (5)…

  12. Mapping Staff Competencies for Information Literacy Interventions

    Directory of Open Access Journals (Sweden)

    Sheila Corrall

    2010-09-01

    Full Text Available Information literacy (IL is a key strategic objective for academic libraries. Many academic librarians are involved in designing, developing and delivering IL programmes, using both classroom teaching and e-learning methods. IL has also become a priority at institutional level and some universities and colleges have formal policies and strategies to integrate and embed IL in the curriculum. IL interventions also happen informally at enquiry points and reference desks, when queries offer ‘teachable moments’ for library staff to help students develop information skills and understanding while solving their information problems. Research shows that such instruction features strongly in both face-to-face and virtual reference transactions, but few IL policies and strategies cover this frontline personalised IL support. Similarly, most discussion of staff training and development for IL education has centred on the teaching roles and pedagogical knowledge of professional librarians, with limited discussion of the competencies needed for frontline interventions by paraprofessionals or assistants. This workshop promotes an inclusive holistic model of IL education and library workforce development. It will investigate the skills and knowledge needed by frontline staff to contribute effectively to the IL mission of academic libraries. It will focus on the learning support needed by students from different educational, social, ethnic and cultural backgrounds, with particular reference to postgraduate students, as a group typifying this diversity. The facilitator will review IL interventions and library staff competencies discussed in the literature. Participants will discuss typical queries or problems presented by different categories of postgraduate students and then identify the skills, knowledge and understanding required by frontline staff to provide an appropriate service response. The skillsets identified will be compared with those of teaching

  13. Staff management, training and knowledge management

    International Nuclear Information System (INIS)

    Makino, Hitoshi; Umeki, Hiroyuki; Capouet, M.; Depaus, C.; Berckmans, A.

    2014-01-01

    Staff management/training and knowledge management are organisational issues that are particularly sensitive in long-term projects stretching over decades like the development and operation of a geological repository. The IAEA has already issued several publications that deal with this issue (IAEA, 2006, 2008). Organisational aspects were also discussed in the framework of a topical session organised by the Integration Group for the Safety Case (IGSC) at its annual meeting in 2009 and were regarded as a topic deserving future attention (NEA, 2009a). More recently, the Forum on Stakeholder Confidence (FSC) identified organisational, mission and behavioural features as attributes of confidence and trust (NEA, 2013). They also identified that aspects such as structural learning capacity, high levels of skill and competence in relevant areas, specific management plan, good operating records, transparency and consistency are associated with confidence building in a safety case. These aspects are considerably related to staff training/management and knowledge management. The IGSC has initiated a proposal of study dedicated to staff training/management and knowledge management with the objective to highlight how these recent concerns and the requirements issued by the IAEA are concretely implemented in the national programmes. The goal of this study is to acknowledge the differences of views and needs for staff management and knowledge management at different stages of individual programmes and between implementer and regulator. As a starting point to this study, the JAEA and ONDRAF/NIRAS prepared a draft questionnaire in order to succinctly capture processes and tools that the national organisations have implemented to meet the requirements and address the issues set out in the field of staff and knowledge management. For the purpose of this study, a questionnaire is now under development, which will be presented on the occasion of this symposium with guidance based on a

  14. Enabling ICU patients to die at home.

    Science.gov (United States)

    Battle, Emma; Bates, Lucy; Liderth, Emma; Jones, Samantha; Sheen, Sheryl; Ginty, Andrew; Northmore, Melanie

    2014-10-07

    There is often an overlap between intensive care medicine and palliative medicine. When all curative treatment options have been explored, keeping the patient comfortable and free from pain is the main concern for healthcare practitioners. Patient autonomy in end of life decisions has not been encouraged in the intensive care unit (ICU), until now, because of its specialised and technical nature. Staff at the Royal Bolton Hospital have broken down the barriers to enabling ICU patients to die in their own homes, and have developed a system of collaborative working that can help to fulfil a patient's final wish to go home. This article describes how ICU staff developed a process that enabled two ventilated patients to be transferred home for end of life care.

  15. 32 CFR 270.5 - Staff.

    Science.gov (United States)

    2010-07-01

    ... 32 National Defense 2 2010-07-01 2010-07-01 false Staff. 270.5 Section 270.5 National Defense... Staff. (a) The Commission will have a support staff, which will include staff members sufficient to expeditiously and efficiently process the applications for payments under this part. All members of the staff...

  16. Maori in Partnership: A Peer Mentoring Model for Tertiary Indigenous Staff in New Zealand

    Science.gov (United States)

    Kensington-Miller, Barbara; Ratima, Matiu

    2015-01-01

    This article presents a professional development programme which brought an indigenous minority group of tertiary staff together. We describe a peer-mentoring model, piloted in 2009 at The University of Auckland, New Zealand with university staff in order to promote staff advancement. The participants were all Maori, the indigenous people of New…

  17. Pay-for-performance policy and data-driven decision making within nursing homes: a qualitative study.

    Science.gov (United States)

    Abrahamson, Kathleen; Miech, Edward; Davila, Heather Wood; Mueller, Christine; Cooke, Valerie; Arling, Greg

    2015-05-01

    Health systems globally and within the USA have introduced nursing home pay-for-performance (P4P) programmes in response to the need for improved nursing home quality. Central to the challenge of administering effective P4P is the availability of accurate, timely and clinically appropriate data for decision making. We aimed to explore ways in which data were collected, thought about and used as a result of participation in a P4P programme. Semistructured interviews were conducted with 232 nursing home employees from within 70 nursing homes that participated in P4P-sponsored quality improvement (QI) projects. Interview data were analysed to identify themes surrounding collecting, thinking about and using data for QI decision making. The term 'data' appeared 247 times in the interviews, and over 92% of these instances (228/247) were spontaneous references by nursing home staff. Overall, 34% of respondents (79/232) referred directly to 'data' in their interviews. Nursing home leadership more frequently discussed data use than direct care staff. Emergent themes included using data to identify a QI problem, gathering data in new ways at the local level, and measuring outcomes in response to P4P participation. Alterations in data use as a result of policy change were theoretically consistent with the revised version of the Promoting Action on Research Implementation in Health Services framework, which posits that successful implementation is a function of evidence, context and facilitation. Providing a reimbursement context that facilitates the collection and use of reliable local evidence may be an important consideration to others contemplating the adaptation of P4P policies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. Care home design for people with dementia: What do people with dementia and their family carers value?

    Science.gov (United States)

    Innes, Anthea; Kelly, Fiona; Dincarslan, Ozlem

    2011-07-01

    To report on the views of people with dementia who live in care homes and their family carers on aspects of design that are important to them, and discuss these in relation to developing physical care environments that respond to the wishes of people with dementia and their family carers. Six focus groups were held: two in Northern Ireland and four in Scotland. A total of 40 people participated in the focus groups. Twenty nine people were with dementia (24 female and five male), and 11 were family carers (10 female and one male). Carers discussed the features of a building they took into account when selecting a care home, and discussed this in relation to 'bricks and mortar versus people'. Key themes reported by people with dementia and their family carers included how the space in the environment is used, for example, what happens in the building and the presence or absence of certain design features. Outside space and wayfinding aids were identified as positive features of the home, along with a general lack of concern about ensuite provision. The results demonstrate the complexity of building design as it must provide living space acceptable to people with dementia living there and family members who visit, as well as provide a workable environment for staff. The findings highlight areas that should be considered by care home teams involved in the build of a new home or the redevelopment of an existing care home.

  19. Owning, letting and demanding second homes

    DEFF Research Database (Denmark)

    Bloze, Gintautas; Skak, Morten

    register data and presents estimations of the probability of owning a second home, the decision to let the second home and the number of let weeks per year. Also income elasticities for primary and second housing demand are estimated. We find a conventional monotonic increase in demand elasticities...... for primary housing demand for non-owners of second homes; however, owners of second homes have the highest income elasticity in the middle income group....

  20. Home care, hospitalizations and doctor visits

    OpenAIRE

    Gonçalves Judite; Weaver France

    2014-01-01

    This study estimates the effects of formal home care on hospitalizations and doctor visits. We compare the effects of medically- and non-medically-related home care and investigate heterogeneous effects by age group and informal care availability. Two-part models are estimated, using data from Switzerland. In this federal country, home care policy is decentralized into cantons (i.e. states). The endogeneity of home care is addressed by using instrumental variables, canton and time fixed effec...

  1. Dual-energy x-ray absorptiometry to measure the effects of a thirteen-week moderate to vigorous aquatic exercise and nutritional education intervention on percent body fat in adults with intellectual disabilities from group home settings.

    Science.gov (United States)

    Casey, Amanda; Boyd, Colin; Mackenzie, Sasho; Rasmussen, Roy

    2012-05-01

    People with intellectual disability are more likely to be obese and extremely obese than people without intellectual disability with rates remaining elevated among adults, women and individuals living in community settings. Dual-energy X-ray absorptiometry measured the effects of a 13-week aquatic exercise and nutrition intervention on percent body fat in eight adults with intellectual disabilities (aged 41.0 ± 13.7 yrs) of varying fat levels (15%-39%) from two group homes. A moderate to vigorous aquatic exercise program lasted for the duration of 13 weeks with three, one-hour sessions held at a 25m pool each week. Nutritional assistants educated participants as to the importance of food choice and portion size. A two-tailed Wilcoxon matched-pairs signed-ranks test determined the impact of the combined intervention on body fat percentage and BMI at pre and post test. Median body fat percentage (0.8 %) and BMI (0.3 kg/m(2)) decreased following the exercise intervention, but neither were statistically significant, p = .11 and p = .55, respectively. The combined intervention was ineffective at reducing percent body fat in adults with intellectual disability according to dual-energy X-ray absorptiometry. These results are in agreement with findings from exercise alone interventions and suggest that more stringent nutritional guidelines are needed for this population and especially for individuals living in group home settings. The study did show that adults with intellectual disability may participate in moderate to vigorous physical activity when given the opportunity.

  2. Study protocol: cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care: cluster randomized controlled trial.

    Science.gov (United States)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe; Damsbo-Svendsen, Signe; Kreinfeldt Skovgaard Møller, Tina; Boll Hansen, Eigil; Keiding, Hans

    2014-08-28

    support.Furthermore, interviews with nursing home and home-care management, nursing staff and nutrition coordinators in both the control and intervention groups, participants in the intervention group and the involved multidisciplinary team will be performed. In this study we will evaluate in a randomized controlled trial whether multidisciplinary nutritional support is cost-effective, in undernourished older adults in home-care and nursing home and contribute to important research. ClinicalTrials.gov 2013 NCT01873456.

  3. Hygiene Knowledge of Food Staff in Catering Industry

    Directory of Open Access Journals (Sweden)

    Hülya Yardımcı

    2015-04-01

    Full Text Available This study, designed as a cross-sectional study, was carried out to determine the hygiene knowledge of the staff (N = 317 employed in kitchen and service departments of catering firms in Ankara. It was found that the mean scores of the staff with regard to personal hygiene, food hygiene, and kitchen and equipment hygiene were 10.7 ± 1.6, 19.8 ± 4.0, and 13.6 ± 2.0, respectively. Male staff achieved higher mean scores in personal hygiene knowledge test compared with female staff (p < .01. The staff receiving a hygiene training were determined to have higher mean scores in terms of hygiene knowledge tests compared with those who have not received, and the production staff had higher knowledge as to hygiene than the other groups (p < .01. The mean scores for hygiene knowledge tests were found to be increasing with age. Hygiene knowledge scores of the staff were quite lower than what must be taken. For that reason, periodical training programs should be organized to increase the awareness of the staff about hygiene.

  4. [Job stress of nursing aides in Swiss nursing homes : Nonlinear canonical analysis].

    Science.gov (United States)

    Ziegler, A; Bernet, M; Metzenthin, P; Conca, A; Hahn, S

    2016-08-01

    Due to demographic changes, the demand for care in nursing homes for the elderly and infirmed is growing. At the same time nursing staff shortages are also increasing. Nursing aides are the primary care providers and comprise the largest staff group in Swiss nursing homes. They are exposed to various forms of job stress, which threaten job retention. The aim of this study was to discover which features of the work situation and which personal characteristics of the nursing aides were related to the workload. Data from nursing aides in Swiss nursing homes were investigated through a secondary analysis of a national quantitative cross-sectional study, using descriptive statistics and a nonlinear canonical correlation analysis. A total of 1054 nursing aides were included in the secondary analysis, 94.6 % of whom were women between the ages of 42 and 61 years. The job stress most frequently mentioned in the descriptive analysis, almost 60 % of the participants referred to it, was staff shortage. The nonlinear canonical correlation analysis revealed that many job strains are caused by social and organizational issues. In particular, a lack of support from supervisors was associated with staff not feeling appreciated. These job strains correlated with a high level of responsibility, the feeling of being unable to work independently and a feeling of being exploited. These strains were predominant in the nursing aides between 32 and 51 years old who had part time jobs but workloads of 80-90 %. Middle-aged nursing aides who worked to 80-90 % are particularly at risk to resign from the position prematurely. Measures need to be mainly implemented in the social and organizational areas. It can be assumed that a targeted individual support, recognition and promotion of nursing aides may decrease the level of job strain.

  5. Checklist for Staff Technology Training.

    Science.gov (United States)

    Anderson, Mary Alice

    1997-01-01

    Presents a planning checklist for staff technology training. Includes forming a committee and developing proposals, contacting pertinent people, handling publicity, sending invitations, distributing schedules/registration information, arranging for equipment, purchasing prizes, conducting preliminary checks on equipment and software, ordering…

  6. Managing Custodial and Maintenance Staffs.

    Science.gov (United States)

    Fickes, Michael

    2001-01-01

    Presents some basic maintenance management techniques that can help schools meet their budgets, preserve staffing levels, meet productivity needs, and sustain quality services. Tips for staff recruitment, training, and retention are explored. (GR)

  7. Rational-Emotive Staff Development.

    Science.gov (United States)

    Forman, Susan G.; Forman, Bruce D.

    1980-01-01

    The application of Rational-Emotive Therapy principles and techniques in in-service education for school personnel is discussed. Teacher and counselor participation in a staff development program is described. (Author)

  8. A pressure ulcer prevention programme specially designed for nursing homes: does it work?

    Science.gov (United States)

    Kwong, Enid W-Y; Lau, Ada T-Y; Lee, Rainbow L-P; Kwan, Rick Y-C

    2011-10-01

    The aim of this study was to evaluate a pressure ulcer prevention programme for nursing homes to ascertain the feasibility of its implementation, impact on care staff and outcomes for pressure ulcer knowledge and skills and pressure ulcer reduction. No pressure ulcer prevention protocol for long-term care settings has been established to date. The first author of this study thus developed a pressure ulcer prevention programme for nursing homes. A quasi-experimental pretest and post-test design was adopted. Forty-one non-licensed care providers and eleven nurses from a government-subsidised nursing home voluntarily participated in the study. Knowledge and skills of the non-licensed care providers were assessed before, immediately after and six weeks after the training course, and pressure ulcer prevalence and incidence were recorded before and during the protocol implementation. At the end of the programme implementation, focus group interviews with the subjects were conducted to explore their views on the programme. A statistically significant improvement in knowledge and skills scores amongst non-licensed care providers was noted. Pressure ulcer prevalence and incidence rates dropped from 9-2·5% and 2·5-0·8%, respectively, after programme implementation. The focus group findings indicated that the programme enhanced the motivation of non-licensed care providers to improve their performance of pressure ulcer prevention care and increased communication and cooperation amongst care staff, but use of the modified Braden scale was considered by nurses to increase their workload. A pressure ulcer prevention programme for nursing homes, which was feasible and acceptable, with positive impact and outcome in a nursing home was empirically developed. The study findings can be employed to modify the programme and its outcomes for an evaluation of effectiveness of the programme through a randomised controlled trial. © 2011 Blackwell Publishing Ltd.

  9. SENIOR STAFF ADVANCEMENT COMMITTEE (SSAC)

    CERN Document Server

    2000-01-01

    Composition and mandateThe Senior Staff Advancement Committee is composed of members nominated ad persona by the Director-General.The Committee examines proposals from Divisions concerning promotions to grade 13 in Career Path IX, changes of career path to Career Path IX and advancements to the exceptional grade in Career path VIII.The Director-General may consult the Committee on any matter related to senior staff careers.The Committee makes its recommendations to the Director-General.

  10. A staff shortage in Canada?

    International Nuclear Information System (INIS)

    Stoll, P.

    1995-01-01

    Attrition of experienced staff, falling student enrolments and closure of university courses are symptoms of the contraction of the Canadian nuclear industry over the last two decades. It is not alone. A study carried out by Human Resources Development Canada, a government department, to forecast the demand for qualified nuclear staff in Canada over the next 15 years has reached similar conclusions to an OECD/NEA study of its members' future personnel requirements. (author)

  11. Bringing Your Baby Home

    Science.gov (United States)

    ... for Educators Search English Español Bringing Your Baby Home KidsHealth / For Parents / Bringing Your Baby Home What's ... recall your baby's seemingly endless crying episodes. The Home Front Introducing your baby to others at home ...

  12. The Medical Home

    Science.gov (United States)

    ... Videos for Educators Search English Español The Medical Home KidsHealth / For Parents / The Medical Home What's in ... for your child. What Does the Term "Medical Home" Mean? A medical home isn't a place ...

  13. Why join the Staff Association

    CERN Multimedia

    Association du personnel

    2011-01-01

    Becoming a member of the Staff Association (SA) is above all a personal choice, showing that the joining person’s commitment and adherence to values such as solidarity, social cohesion, etc.In September, the SA launches a membership campaign to convince a maximum number to join, to inform, arouse interest and support. Posters, emails and individual contacts are part of the campaign programme, just like this editorial. As far as individual contacts are concerned, we ask you to give time and lend an ear to the delegates of your department in the Staff Council, who will approach you, in order to make an open and constructive discussion possible. Do not hesitate to ask questions and let them know your thoughts about the SA, as (constructive) criticism enables us to progress. The Staff Association and its role of collective representation The Staff Association, via its delegates, represents collectively all staff of the Organization before the Director-General and Member States. To do this, staff rep...

  14. Home care robot for socially supporting the elderly: focus group studies in three European countries to screen user attitudes and requirements.

    Science.gov (United States)

    Zsiga, Katalin; Edelmayer, Georg; Rumeau, Pierre; Péter, Orsolya; Tóth, András; Fazekas, Gábor

    2013-12-01

    The growing number of elderly individuals presents new challenges for society. Many elderly individuals have physical or cognitive impairments and require support from caregivers. An attempt to overcome the limitations caused by the lack of human caregivers is the inclusion of assistive technology such as socially active robots. The Domeo-project of the Ambient Assisted Living Joint Programme of the European Union aims to develop a new companion robotic system that would allow assistance to the elderly. The requirements and attitude of the potential users and caregivers have been assessed in Austria, France and Hungary. The robot functions were demonstrated to the participants. Three focus groups were formed: potential end users, older caregivers and younger caregivers. The discussions were recorded and processed according to six aspects: (i) acceptability and privacy, (ii) pertinence of services, (iii) possible obstacles, (iv) motivation level to use the proposed services, (v) organizational issues and (vi) recommendations. Minor differences were observed between the countries, but there were considerable differences regarding the age of the participants. The younger caregivers want to be assured of the safety of their client and to receive immediate notification in case of an emergency. As for the elderly, the most important aspect is to gain a companion and a physical helper. Many of the recommendations can be taken into consideration during robot development, but some of them are not realistic at present.

  15. [Transversal study on the prevalence of Metabolic Bone Disease (MBD) and Home Parenteral Nutrition (HPN) in Spain: data from NADYA group].

    Science.gov (United States)

    Martínez, C; Virgili, N; Cuerda, C; Chicharro, L; Gómez, P; Moreno, J M; Álvarez, J; Martí, E; Matía, P; Penacho, M A; Garde, C; De Luis, D; Gonzalo, M; Lobo, G

    2010-01-01

    Patients with intestinal failure who receive HPN are at high risk of developing MBD. The origin of this bone alteration is multifactorial and depends greatly on the underlying disease for which the nutritional support is required. Data on the prevalence of this disease in our environment is lacking, so NADYA-SEMPE group has sponsored this transversal study with the aim of knowing the actual MBD prevalence. Retrospective data from 51 patients from 13 hospitals were collected. The questionnaire included demographic data as well as the most clinically relevant for MBD data. Laboratory data (calciuria, PTH, 25 -OH -vitamin D) and the results from the first and last bone densitometry were also registered. Bone mineral density had only been assessed by densitometry in 21 patients at the moment HPN was started. Bone quality is already altered before HPN in a significant percentage of cases (52%). After a mean follow up of 6 years, this percentage increases up to 81%. Due to retrospective nature of the study and the low number of subjects included it has not been possible to determine the role that HPN plays in MBD etiology. Only 35% of patients have vitamin D levels above the recommended limits and the majority of them is not on specific supplementation. HPN is associated with very high risk of MBD, therefore, management protocols that can lead to early detection of the problem as well as guiding for follow up and treatment of these patients are needed.

  16. Decontamination of breast pump milk collection kits and related items at home and in hospital: guidance from a Joint Working Group of the Healthcare Infection Society and Infection Prevention Society.

    Science.gov (United States)

    Price, E; Weaver, G; Hoffman, P; Jones, M; Gilks, J; O'Brien, V; Ridgway, G

    2016-03-01

    A variety of methods are in use for decontaminating breast pump milk collection kits and related items associated with infant feeding. This paper aims to provide best practice guidance for decontamination of this equipment at home and in hospital. It has been compiled by a Joint Working Group of the Healthcare Infection Society and the Infection Prevention Society. The guidance has been informed by a search of the literature in Medline, the British Nursing Index, the Cumulative Index to Nursing and Allied Health Literature, Midwifery and Infant Care, and the results of two surveys of UK neonatal units in 2002/3 and 2006, and of members of the Infection Prevention Society in 2014. Since limited good quality evidence was available from these sources, much of the guidance represents good practice based on the consensus view of the Working Group. This guidance provides practical recommendations to support the safe decontamination of breast pump milk collection kits for healthcare professionals to use and communicate to other groups such as parents and carers. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Acquiring taste in home economics?

    DEFF Research Database (Denmark)

    Stenbak Larsen, Christian

    Objective: To explore how home economics was taught in Denmark before the recent Danish school reform, which also revised the objectives and content of home economics, naming it Food Knowledge (Madkundskab) Methods: Participant observation was done in home economic lessons in two case schools...... appreciated by the group of boys, and others again learned to stick with their idiosyncrasies when pressured by the teacher. Conclusions: Children were acquiring taste in the home economic lessons, but not only the kind of tastes that the teacher had planned for. This leads to reflections on the very complex...... process of taste acquiring and to a call for further research into taste acquiring in complex real life contexts as home economics lessons....

  18. Exploring the Synergic Effects of Nursing Home Work on Work-Related Musculoskeletal Disorders Among Nursing Assistants.

    Science.gov (United States)

    Ching, Shirley S Y; Szeto, Grace; Lai, Godfrey Kin Bun; Lai, Xiao Bin; Chan, Ying Tung; Cheung, Kin

    2018-03-01

    Little is known about how nursing assistants (NAs) perceive the nature of their work and how their work contributes to work-related musculoskeletal disorders (WMSDs). This qualitative study addressed these gaps. Twenty-four NAs with WMSDs working in four nursing homes participated in semistructured focus group interviews. Their WMSDs were not limited to the lower back but involved several body parts. The risk factors for WMSDs included physical, psychosocial, organizational, and personal factors as well as coworkers and clients. However, it is the synergistic effects of long work hours without sufficient rest, work even with musculoskeletal pain because of staff shortages, ineffective management with insufficient prework training and inadequate equipment maintenance, and an aging workforce with strong commitment to resident care that play a crucial role in WMSDs among NAs working in nursing homes. The study found that multidimensional intervention strategies using engineering, administrative, and personal controls should be developed to reduce WMSDs among NAs working in nursing homes.

  19. Ethics and gender issues in palliative care in nursing homes: an Austrian participatory research project.

    Science.gov (United States)

    Reitinger, Elisabeth; Heimerl, Katharina

    2014-06-01

    The development of palliative care in nursing homes in German-speaking countries has gained in importance within the past 15-20 years. Ethical and gender issues are core aspects of a palliative care culture and should therefore be better understood. The aim of this study was to highlight insights regarding ethical and gender issues, based on the experiences of professionals in nursing homes. A 2-year participatory action research study was performed in collaboration with three nursing homes in Austria. The article focusses on 10 group discussions with interdisciplinary professional teams that were conducted to generate ethical narratives. Thematic and narrative analysis was undertaken both individually and within the interdisciplinary research team. Findings and interpretations were validated with practitioners and researchers. A total of 36 narratives were collected and summarised within eight themes concerning the theoretical journey of a nursing home resident with relatives from entry into the house until death. The most burdensome ethical dilemmas are not the ones around death and dying but rather those relating to small-scale everyday work/life issues. Sharing experiences and feelings in ethical discussions provides relief. Emotions are important facilitators of insight into ethical dilemmas. Gender issues can be observed in care situations as well as in the organisational structure of nursing homes. Opportunities to share experiences and perspectives around ethical questions in interdisciplinary group discussions help professionals to better understand difficult issues and find appropriate ways of managing them. There is a need for communication structures such as facilitated ethical discussions that enable nursing home staff to reflect their everyday decisions. Expression of emotions should be encouraged in ethical decision-making processes in nursing homes. Gender-sensitive reflection supports the development of palliative care as organisational culture.

  20. Theoretical and hands-on guidance from dental hygienists promotes good oral health in elderly people living in nursing homes, a pilot study.

    Science.gov (United States)

    Seleskog, B; Lindqvist, L; Wårdh, I; Engström, A; von Bültzingslöwen, I

    2018-04-12

    Oral health in nursing homes for elderly is often unsatisfactory, and oral health education to nursing staff has not shown sufficient results why there is need for novel approaches. The aim of the study was to trial a new oral healthcare educational programme and to evaluate the effects on residents' oral health. In addition, attitudes among the nursing staff in the intervention nursing home were explored. In a controlled clinical trial, two comparable nursing homes were randomly assigned for intervention or control. Interventions included weekly theoretical and hands-on guidance from dental hygienists on oral hygiene procedures and discussions on oral care routines. The residents' oral health, measured by the Revised Oral Assessment Guide (ROAG), dental plaque and gingival bleeding were evaluated at baseline and after 3 months. Attitudes among the staff to oral health care were measured at the intervention nursing home. Revised Oral Assessment Guide gums and lips scores showed a tendency to decrease in the intervention group, but remained high in the control group. Plaque levels improved significantly after intervention, and a trend towards less gingival bleeding was observed. The intervention nursing staff seemed to be more aware of their own limitations concerning oral health care after intervention and valued more frequent contact with dental services to a greater extent. The oral healthcare situation for elderly people today is so complex that theoretical education at the group level regarding different aspects of oral health is not sufficient. Individual hands-on guidance by dental hygienists on a regular basis in everyday care may be a new approach. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. A Home Away from Home

    DEFF Research Database (Denmark)

    McIlvenny, Paul

    2008-01-01

    The House of Tiny Tearaways (HTT) first appeared on British television in May 2005. Over a six-day period, three families are invited to reside in a specially designed house together with a resident clinical psychologist. The house is to be “a home away from home” for the resident families...... in order to analyze excerpts from the program and to explore how the affordances and constraints of the specially designed house—its architecture and spatial configuration, as well as the surveillance technology embedded within its walls—are assembled within particular familial activities, and how...... the relationships between family members are reshaped as a result. The analysis focuses on several key phenomena: 1) practices of video observation in relation to the domestic sphere; 2) use of inscription devices, such as video displays, to capture and visualize behavior and action in the “home;” 3) practicing...

  2. Dementia-Related Work Activities of Home Care Nurses and Aides: Frequency, Perceived Competence, and Continuing Education Priorities

    Science.gov (United States)

    Morgan, Debra G.; Kosteniuk, Julie G.; O'Connell, Megan E.; Dal Bello-Haas, Vanina; Stewart, Norma J.; Karunanayake, Chandima

    2016-01-01

    An understanding of the specific dementia learning needs of home care staff is needed to plan relevant continuing education (CE) programs and supports. The study's objective was to examine frequency and perceived competence in performing 20 dementia-related work activities, and identify CE priorities among home care staff. A cross-sectional survey…

  3. Implications of staff 'churn' for nurse managers, staff, and patients.

    Science.gov (United States)

    Duffield, Christine; Roche, Michael; O'Brien-Pallas, Linda; Catling-Paull, Christine

    2009-01-01

    In this article, the term "churn" is used not only because of the degree of change to staffing, but also because some of the reasons for staff movement are not classified as voluntary turnover. The difficulties for the nurse managing a unit with the degree of "churn" should not be under-estimated. Changes to skill mix and the proportions of full-time, agency, and temporary staff present challenges in providing clinical leadership, scheduling staff, performance management, and supervision. Perhaps more importantly, it is likely that there is an impact on the continuity of care provided in the absence of continuity of staffing. A greater understanding of the human and financial costs and consequences, and a willingness to change established practices at the institutional and ward level, are needed.

  4. EIROStaff serving the staff of the European scientific organizations

    CERN Multimedia

    Association du personnel

    2009-01-01

    By analogy with the EIROforum meetings, where the administrations of seven European scientific organizations (CERN, EFDA, EMBL, ESA, ESO, ESRF, ILL) have been meeting since 2002, the staff associations of these same organizations grouped under the name “EIROStaff” met on Thursday 27 and Friday 28 May 2009 at CERN. Staff representatives of GSI, which is not a member of EIROforum at present, also attended.

  5. Public involvement in research within care homes: benefits and challenges in the APPROACH study.

    Science.gov (United States)

    Froggatt, Katherine; Goodman, Claire; Morbey, Hazel; Davies, Sue L; Masey, Helen; Dickinson, Angela; Martin, Wendy; Victor, Christina

    2016-12-01

    Public involvement in research (PIR) can improve research design and recruitment. Less is known about how PIR enhances the experience of participation and enriches the data collection process. In a study to evaluate how UK care homes and primary health-care services achieve integrated working to promote older people's health, PIR was integrated throughout the research processes. This paper aims to present one way in which PIR has been integrated into the design and delivery of a multisite research study based in care homes. A prospective case study design, with an embedded qualitative evaluation of PIR activity. Data collection was undertaken in six care homes in three sites in England. Six PIR members participated: all had prior personal or work experience in care homes. Qualitative data collection involved discussion groups, and site-specific meetings to review experiences of participation, benefits and challenges, and completion of structured fieldwork notes after each care home visit. PIR members supported recruitment, resident and staff interviews and participated in data interpretation. Benefits of PIR work were resident engagement that minimized distress and made best use of limited research resources. Challenges concerned communication and scheduling. Researcher support for PIR involvement was resource intensive. Clearly defined roles with identified training and support facilitated involvement in different aspects of the data collection process. This can also ensure that vulnerable older people who participate in research have a positive experience that reinforces the value of their views. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2015-01-01

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

  7. Challenges to conducting research with older people living in nursing homes

    Directory of Open Access Journals (Sweden)

    Higginson Irene J

    2009-08-01

    Full Text Available Abstract Background Although older people are increasingly cared for in nursing homes towards the end of life, there is a dearth of research exploring the views of residents. There are however, a number of challenges and methodological issues involved in doing this. The aim of this paper is to discuss some of these, along with residents' views on taking part in a study of the perceptions of dignity of older people in care homes and make recommendations for future research in these settings. Methods Qualitative interviews were used to obtain the views on maintaining dignity of 18 people aged 75 years and over, living in two private nursing homes in South East London. Detailed field notes on experiences of recruiting and interviewing participants were kept. Results Challenges included taking informed consent (completing reply slips and having a 'reasonable' understanding of their participation; finding opportunities to conduct interviews; involvement of care home staff and residents' families and trying to maintain privacy during the interviews. Most residents were positive about their participation in the study, however, five had concerns either before or during their interviews. Although 15 residents seemed to feel free to air their views, three seemed reluctant to express their opinions on their care in the home. Conclusion Although we experienced many challenges to conducting this study, they were not insurmountable, and once overcome, allowed this often unheard vulnerable group to express their views, with potential long-term benefits for future delivery of care.

  8. Training of technical staff and technical staff managers

    International Nuclear Information System (INIS)

    Moody, G.F.

    1991-01-01

    The purpose of Technical Staff and Technical Staff Managers training is to provide job skills enhancement to individuals selected to fill key technical positions within a nuclear utility. This training is unique in that unlike other training programs accredited by the National Academy for Nuclear Training, it does not lead to specific task qualification. The problems encountered when determining the student population and curriculum are a direct result of this major difference. Major problems encountered are determining who should attend the training, what amount of training is necessary and sufficient, and how to obtain the best feedback in order to effect substantive program improvements. These topics will be explored and possible solutions discussed

  9. Radiation monitoring of PET staff

    International Nuclear Information System (INIS)

    Trang, A.

    2004-01-01

    Full text: Positron emission tomography (PET) is becoming a common diagnostic tool in hospitals, often located in and employing staff from the Nuclear Medicine or Radiology departments. Although similar in some ways, staff in PET departments are commonly found to have the highest radiation doses in the hospital environment due to unique challenges which PET tracers present in administration as well as production. The establishment of a PET centre with a dedicated cyclotron has raised concerns of radiation protection to the staff at the WA PET Centre and the Radiopharmaceutical Production and Development (RAPID) team. Since every PET centre has differing designs and practices, it was considered important to closely monitor the radiation dose to our staff so that improvements to practices and design could be made to reduce radiation dose. Electronic dosimeters (MGP DMC 2000XB), which have a facility to log time and dose at 10 second intervals, were provided to three PET technologists and three PET nurses. These were worn in the top pocket of their lab coats throughout a whole day. Each staff member was then asked to note down their duties throughout the day and also note the time they performed each duty. The duties would then correlate with the dose with which the electronic monitor recorded and an estimate of radiation dose per duty could be given. Also an estimate of the dose per day to each staff member could be made. PET nurses averaged approximately 20 μ8v per day getting their largest dose from caring for occasional problematic patients. Smaller doses of a 1-2 μ8v were recorded for injections and removing cannulas. PET technologists averaged approximately 15 μ8v per day getting their largest dose of 1-5μ8v mainly from positioning of patients and sometimes larger doses due to problematic patients. Smaller doses of 1-2 μ5v were again recorded for injections and removal of cannulas. Following a presentation given to staff, all WA PET Centre and RAPID staff

  10. Group dynamics.

    Science.gov (United States)

    Scandiffio, A L

    1990-12-01

    Group dynamics play a significant role within any organization, culture, or unit. The important thing to remember with any of these structures is that they are made up of people--people with different ideas, motivations, background, and sometimes different agendas. Most groups, formal or informal, look for a leader in an effort to maintain cohesiveness of the unit. At times, that cultural bond must be developed; once developed, it must be nurtured. There are also times that one of the group no longer finds the culture comfortable and begins to act out behaviorally. It is these times that become trying for the leader as she or he attempts to remain objective when that which was once in the building phase of group cohesiveness starts to fall apart. At all times, the manager must continue to view the employee creating the disturbance as an integral part of the group. It is at this time that it is beneficial to perceive the employee exhibiting problem behaviors as a special employee, as one who needs the benefit of your experience and skills, as one who is still part of the group. It is also during this time that the manager should focus upon her or his own views in the area of power, communication, and the corporate culture of the unit that one has established before attempting to understand another's point of view. Once we understand our own motivation and accept ourselves, it is then that we may move on to offer assistance to another. Once we understand our insecurities recognizing staff dysfunction as a symptom of system dysfunction will not be so threatening to the concept of the manager that we perceive ourselves to be. It takes a secure person to admit that she or he favors staff before deciding to do something to change things. The important thing to know is that it can be done. The favored staff can find a new way of relating to others, the special employee can find new modes of behavior (and even find self-esteem in the process), the group can find new ways

  11. NO to sacrificing future staff!

    CERN Multimedia

    Staff Association

    2011-01-01

    During our public meetings last week, we reviewed several subjects. However, the most urgent one today is the 2nd package of measures for our Pension Fund. In our previous issue, we devoted a long article to the Management’s plan for staff recruited from January 2012. A disaster! As we announced at our meetings, the Staff Association will organize a referendum at the beginning of April. For the message to be heard it is vital that as many staff as possible take part. By voting you will express your support to your staff representatives to stand in the way of these unacceptable measures. It is a matter of urgency that the staff makes their voice heard. Time is short, the decisions will be made in June. The future of our Organization is as stake. This is our future colleagues we are talking about. We must prevent this sacrifice. They must be welcomed in such a manner that there is no uneasiness between us. They must be made to feel welcome in their new family, CERN, our CERN. That they should pay an ...

  12. 2017 Elections to Staff Council

    CERN Multimedia

    Staff Association

    2017-01-01

    Make your voice heard, support your candidates! After verification by the Electoral Commission, all candidates for the elections to the Staff Council have been registered. It is now up to you, members of the Staff Association, to vote for the candidate(s) of your choice. We hope that you will be many to vote and to elect the new Staff Council! By doing so, you can support and encourage the women and men, who will represent you over the next two years. We are using an electronic voting system; all you need to do is click the link below and follow the instructions on the screen. https://ap-vote.web.cern.ch/elections-2017 The deadline for voting is Monday, 13 November at midday (12 pm). Elections Timetable Monday 13 November, at noon Closing date for voting Tuesday 21 November and Tuesday 5 December Publication of the results in Echo Monday 27 and Tuesday 28 November Staff Association Assizes Tuesday 5 December (afternoon) First meeting of the new Staff Council and election of the new Executive Committee The ...

  13. 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

  14. [Regional geriatric team--a model for cooperation between nursing homes and hospitals].

    Science.gov (United States)

    Sellaeg, Wenche Frogn

    2005-04-21

    Few studies describe and evaluate the use of ambulatory geriatric teams in nursing homes. This article gives an account of a model in which a multidisciplinary group from the local hospital has been visiting 17 communities in Norway twice a year for 11 years. The ambulatory geriatric team includes a geriatrician, a geriatric nurse, a physiotherapist and an occupational therapist. Their aim is to raise the quality of geriatric assessment and care and to enhance the cooperation between the hospital and the nursing homes in the communities. The team members are doing a comprehensive geriatric assessment of some of the patients; they assess cases for further referral, and examine patients with declining functioning with a view to rehabilitation. The team provides instruction in various aspects of geriatrics to community care professionals. Much time is devoted to discussions on problems raised by the staff, such as management of patients with dementia-related behavioural problems, and to provide feedback to staff-members. The team liaise between hospitals, nursing homes and community care services in the communities in order to enhance communication between the professionals involved. An evaluation of the team was done on behalf of the National Institute of Health through a postal questionnaire which was returned by 223 doctors, nurses and allied health care professionals. The results indicate that visits by the ambulatory team improve the knowledge of doctors and allied professionals about diseases in the elderly; 92% reported that they now felt they were doing a better job.

  15. The effects of humor therapy on nursing home residents measured using observational methods: the SMILE cluster randomized trial.

    Science.gov (United States)

    Low, Lee-Fay; Goodenough, Belinda; Fletcher, Jennifer; Xu, Kenny; Casey, Anne-Nicole; Chenoweth, Lynn; Fleming, Richard; Spitzer, Peter; Bell, Jean-Paul; Brodaty, Henry

    2014-08-01

    To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment. Single-blind cluster randomized controlled trial. A to