WorldWideScience

Sample records for monthly home visits

  1. The Impact on Child Developmental Status at 12 Months of Volunteer Home-Visiting Support

    Directory of Open Access Journals (Sweden)

    Jacqueline Barnes

    2012-01-01

    Full Text Available Home-visiting support during pregnancy or soon after the birth of an infant can be advantageous for maternal well-being and infant development. The best results have been identified when home visitors are professionals, especially nurses, and if a theoretically driven curriculum is followed with fidelity. Some suggest that disadvantaged families, who may avoid professional services, respond well to support from community volunteers, but there is less evidence about their impact. This study identified potentially vulnerable mothers during pregnancy in randomly allocated neighbourhoods where local volunteer home-visiting schemes agreed to offer proactive volunteer support and control areas where the local home-visiting schemes did not offer this proactive service. Taking demographic, child, and family factors into account, there were no significant differences in infant cognitive development at 12 months of age between families who had been supported by a volunteer and those who had not. Better cognitive development was predicted by less reported parenting stress when infants were 2 months and a more stimulating and responsive home environment at 12 months. The results suggest that unstructured proactive volunteer support for potentially vulnerable families is not likely to enhance infant development. Limitations of the cluster-randomised design are discussed.

  2. Predictors of Better Self-Care in Patients with Heart Failure after Six Months of Follow-Up Home Visits

    Science.gov (United States)

    Trojahn, Melina Maria; Ruschel, Karen Brasil; Nogueira de Souza, Emiliane; Mussi, Cláudia Motta; Naomi Hirakata, Vânia; Nogueira Mello Lopes, Alexandra; Rabelo-Silva, Eneida Rejane

    2013-01-01

    This study aimed to examine the predictors of better self-care behavior in patients with heart failure (HF) in a home visiting program. This is a longitudinal study nested in a randomized controlled trial (ISRCTN01213862) in which the home-based educational intervention consisted of a six-month followup that included four home visits by a nurse, interspersed with four telephone calls. The self-care score was measured at baseline and at six months using the Brazilian version of the European Heart Failure Self-Care Behaviour Scale. The associations included eight variables: age, sex, schooling, having received the intervention, social support, income, comorbidities, and symptom severity. A simple linear regression model was developed using significant variables (P ≤ 0.20), followed by a multivariate model to determine the predictors of better self-care. One hundred eighty-eight patients completed the study. A better self-care behavior was associated with patients who received intervention (P < 0.001), had more years of schooling (P = 0.016), and had more comorbidities (P = 0.008). Having received the intervention (P < 0.001) and having a greater number of comorbidities (P = 0.038) were predictors of better self-care. In the multivariate regression model, being in the intervention group and having more comorbidities were a predictor of better self-care. PMID:24083023

  3. [Nurse home visits in France].

    Science.gov (United States)

    Monguillon, Dominique; Gracia, Pierre-Benjamin

    2011-10-01

    Nurse home visits in France. More and more nurses carry out home visits, either as freelance nurses or employees of a nurse home visits service, a home hospital care structure or a nursing care centre. These home visits are both demanded by patients and encouraged by the health authorities. As a consequence, the service is expanding every year.

  4. Home Visiting in Two Cultures

    Science.gov (United States)

    Lamorey, Suzanne

    2017-01-01

    The home visiting component of early childhood education programs provides an important portal through which to observe family interactions as well as gain insights about the ethnotheories of the home visitor. Home visits were videotaped in the United States and in Turkey to analyze training and program effectiveness. One striking feature of this…

  5. Home Visits: Shortening the Path between Home and School.

    Science.gov (United States)

    Acosta, Dolores; Keith, Joe; Patin, Debra

    1997-01-01

    Describes the Home Visit Initiative at Socorro Middle School in Texas. Discusses the purpose of home visits; selection of families for teacher home visits; the visiting team; parents', students', and teachers' reactions to visits, and the results of an evaluation of the home visits, especially the impact on parent volunteerism and schooling,…

  6. Case Study of Home-School Visits

    Science.gov (United States)

    Aguerrebere, Yolanda

    2009-01-01

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

  7. Creating a national home visiting research network.

    Science.gov (United States)

    Duggan, Anne; Minkovitz, Cynthia S; Chaffin, Mark; Korfmacher, Jon; Brooks-Gunn, Jeanne; Crowne, Sarah; Filene, Jill; Gonsalves, Kay; Landsverk, John; Harwood, Robin

    2013-11-01

    Home visiting can play a key role in the early childhood system of services. For home visiting to achieve its potential, decision-makers must make informed choices regarding adoption, adaptation, coordination, scale-up, and sustainment. We need a coordinated, focused, and theory-based home visiting research infrastructure to inform such decisions. The transdisciplinary Home Visiting Research Network (HVRN) was established in July 2012 with funding from the Health Resources and Services Administration. Its goal is to promote the translation of research findings into policy and practice. Its objectives are to (1) develop a national home visiting research agenda, (2) advance the use of innovative research methods; and (3) provide a research environment that is supportive of the professional development of emerging researchers interested in home visiting. A Management Team designs and directs activities to achieve these objectives through Work Teams. A Steering Committee of national leaders representing stakeholder groups oversees progress. HVRN's Coordinating Center supports the Work Teams and HVRN's Home visiting Applied Research Collaborative, a practice-based research network of home visiting programs. This article describes HVRN's rationale, approach, and anticipated products. We use home visiting-primary care coordination as an illustration, noting potential roles for pediatric practices and pediatric researchers and research educators in HVRN activities. HVRN creates the infrastructure for a rigorous program of research to inform policy and practice on home visiting as part of the system of services to improve family functioning, parenting, and child outcomes.

  8. Piloting a Statewide Home Visiting Quality Improvement Learning Collaborative.

    Science.gov (United States)

    Goyal, Neera K; Rome, Martha G; Massie, Julie A; Mangeot, Colleen; Ammerman, Robert T; Breckenridge, Jye; Lannon, Carole M

    2017-02-01

    Objective To pilot test a statewide quality improvement (QI) collaborative learning network of home visiting agencies. Methods Project timeline was June 2014-May 2015. Overall objectives of this 8-month initiative were to assess the use of collaborative QI to engage local home visiting agencies and to test the use of statewide home visiting data for QI. Outcome measures were mean time from referral to first home visit, percentage of families with at least three home visits per month, mean duration of participation, and exit rate among infants learning. A statewide data system was used to generate monthly run charts. Results Mean time from referral to first home visit was 16.7 days, and 9.4% of families received ≥3 visits per month. Mean participation was 11.7 months, and the exit rate among infants learning network, agencies tested and measured changes using statewide and internal data. Potential next steps are to develop and test new metrics with current pilot sites and a larger collaborative.

  9. Assessing Quality in Home Visiting Programs

    Science.gov (United States)

    Korfmacher, Jon; Laszewski, Audrey; Sparr, Mariel; Hammel, Jennifer

    2013-01-01

    Defining quality and designing a quality assessment measure for home visitation programs is a complex and multifaceted undertaking. This article summarizes the process used to create the Home Visitation Program Quality Rating Tool (HVPQRT) and identifies next steps for its development. The HVPQRT measures both structural and dynamic features of…

  10. A clinical trial of in-home CBT for depressed mothers in home visitation.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Altaye, Mekibib; Stevens, Jack; Teeters, Angelique R; Van Ginkel, Judith B

    2013-09-01

    Despite negative outcomes for depressed mothers and their children, no treatment specifically designed to address maternal depression in the context of home visitation has emerged. In-Home Cognitive Behavioral Therapy (IH-CBT) is an adapted treatment that is delivered in the home, focuses on the needs of new mothers, and leverages ongoing home visiting to optimize engagement and outcomes. This study examined the efficacy of IH-CBT using a randomized clinical trial. Subjects were 93 new mothers in a home visiting program. Mothers with major depressive disorder identified at 3months postpartum were randomized into IH-CBT and ongoing home visitation (n=47) or standard home visitation (SHV; n=46) in which they received home visitation alone and could obtain treatment in the community. Depression was measured at pre- and posttreatment, and 3-month follow-up using interviews, clinician ratings, and self-report. Mothers receiving IH-CBT showed improvements in all indicators of depression relative to the SHV condition and these gains were maintained at follow-up. For example, 70.7% of mothers receiving IH-CBT were no longer depressed at posttreatment in terms of meeting criteria for major depressive disorder compared to 30.2% in the SHV group. These findings suggest that IH-CBT is an efficacious treatment for depressed mothers in home visitation programs. Copyright © 2013. Published by Elsevier Ltd.

  11. Home visits: why do rates vary so much?

    LENUS (Irish Health Repository)

    Stewart, P

    2012-03-01

    Data including information on patient age, gender, who initiated the visit and call classification was collected during office hours from 12 G.P. rural teaching practices with a combined GMS patient population of 24,720, over a 2 month period. There were a total of 603 home visits, giving an annual visiting rate of 143\\/1000. Visiting rates varied between practices from 45 to 305\\/1000 per year. When high visiting practices (>210\\/1000\\/year) were compared to low visiting rate practices (>90\\/1000\\/year), patients tended to be older (79.7 v. 74.5 years) and calls were 12 times more likely to be doctor initiated (16.6% v. 1.4%) or classified as routine( 50.7% v. 44.9%). The variation between practices was related in part to patient age but appears largely due to differences in doctor home visiting behaviour. There are no recent figures on home visiting in Ireland.

  12. PTSD in Depressed Mothers in Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Chard, Kathleen M.; Stevens, Jack; Van Ginkel, Judith B.

    2013-01-01

    Recent research has suggested that mothers participating in home visitation programs have a high incidence of mental health problems, particularly depression. Posttraumatic stress disorder (PTSD) is a common comorbidity with depression, yet its prevalence among home visiting populations and implications for parenting and maternal functioning have not been examined. This study contrasted depressed mothers with (n = 35) and without PTSD (n = 55) who were enrolled in a home visitation program. Results indicated that depressed mothers with comorbid PTSD were more likely to have experienced childhood sexual abuse, had greater severity of depressive symptoms, increased social isolation, and lower overall functioning than their counterparts without PTSD. Among PTSD mothers, greater severity of PTSD symptoms, in particular avoidance and emotional numbness, were associated with increased maternal psychopathology and parenting deficits even after controlling for depression severity. These findings add to the literature documenting the negative impacts of PTSD on maternal functioning and parenting. Implications for screening and treatment in the context of home visitation are discussed. PMID:24307928

  13. Effects of home visiting on adolescent mothers' parenting attitudes.

    Science.gov (United States)

    McKelvey, Lorraine M; Burrow, Nicola A; Balamurugan, Appathurai; Whiteside-Mansell, Leanne; Plummer, Pamela

    2012-10-01

    We examined the impact of a home visiting intervention on 227 adolescent mothers' parenting attitudes. At enrollment, half of mothers were at risk for child maltreatment. Mothers assigned to intervention (n = 161) received home visits and case management. Intervention and comparison mothers (n = 66) participated in monthly peer group meetings. Regression analyses controlling for enrollment differences indicated that intervention group mothers had significant improvements in 3 of 5 subscales and in total Adult-Adolescent Parenting Inventory-2 scores relative to the comparison group.

  14. Collaborative relationship in preventive home visits to older people

    DEFF Research Database (Denmark)

    Yamada, Yukari; Vass, Mikkel; Hvas, Lotte

    2011-01-01

    To describe what characterizes preventive home visits with collaborative relationships among non-disabled home-dwelling older people in Japan. Background. Preventive home visits have the potential to result in improved health outcomes among older people. Collaboration, mutual understanding...... communication skills and professionalism, and practical actions after the visits characterized cases, where favourable changes in behaviour were obtained in non-disabled home-dwelling older people in Japan. Relevance to clinical practice. Education should be emphasized, because preventive home visitor...

  15. Family perspective on home visiting program

    Directory of Open Access Journals (Sweden)

    Sebahattin Ziyanak

    2015-08-01

    Full Text Available This study focused on a lately constructed survey instrument that was intended to test the family perspective on a home visiting program and school. The four areas investigated were parent-teacher communications, student-teacher interactions, the parent’s perception of the school and the parents’ understanding of the home visiting program. The participants were selected from parents/guardians of 7th, 8th, 9th and 10th grade students at a Charter school in a southwestern major city in Texas, the United States of America. Twenty-two questions were asked to evaluate parent’s viewpoint with the four designated areas of interaction and communication of among school-parent-teacher. The findings showed that 73.5% of the students’ families living were in low income. The outcomes for reliability were promising (a = .909. Yet, the factor analysis outcomes of a rotated four-factor solution were insufficient to assess validity. This might be related to a small sample size (n = 45.

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

    Directory of Open Access Journals (Sweden)

    Thomas Saïas

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

  17. Federal Home Visiting under the Affordable Care Act

    Science.gov (United States)

    Strader, Kathleen; Counts, Jacqueline; Filene, Jill

    2013-01-01

    The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is part of The Patient Protection and Affordable Care Act and provides $1.5 billion over 5 years to states, territories, and tribes with the goal of delivering evidence-based home visiting services as part of a high-quality, comprehensive early childhood system that promotes…

  18. Home Visiting Processes: Relations with Family Characteristics and Outcomes

    Science.gov (United States)

    Peterson, Carla A.; Roggman, Lori A.; Green, Beth; Chazan-Cohen, Rachel; Korfmacher, Jon; McKelvey, Lorraine; Zhang, Dong; Atwater, Jane B.

    2013-01-01

    Variations in dosage, content, and family engagement with Early Head Start (EHS) home visiting services were examined for families participating in the EHS Research and Evaluation Project. Families were grouped by characteristics of maternal age, maternal ethnicity, and level of family risk. All home visiting variables were related differentially…

  19. Program home visit Costa Rica's health system: guidelines for improvement

    Directory of Open Access Journals (Sweden)

    Katherine Solís Cordero

    2015-07-01

    Full Text Available Introduction. Home visit is the main strategy of primary care by bringing health services to the homes and workplaces of people, which allows knowing the needs of the population firsthand. Thus, home visit by the ATAP represents the first contact of the individual, family and community with the health system, with significant benefits both individually and collectively. This research responds to the need to identify the elements that the home visiting program needs to improve modify or replace in order to maximize the provision of this service.Method. It is a qualitative, observational analytic study. Data were collected through documentary research, key informant interviews and focus group. The analysis was performed from the grounded theory.Results. The main results showed the existence of elements at the level of the health system, home visiting program and the figure of the ATAP that should be reviewed, modified or replaced to the home visit, thus it has bigger and better results for the population and the health system.Conclusion. The Home Visiting Program is strength of the Costa Rican health system to address health inequities. However, it is imperative to make decisions and implementation of actions that promote the improvement and increased results of the home visit at a family and community level.

  20. Home visits as a strategy for health promotion by nursing

    Directory of Open Access Journals (Sweden)

    Jucelia Salgueiro Nascimento

    2014-09-01

    Full Text Available Objective: To analyze the domiciliary visit performed by nurses in the Family Health Strategy as an activity to promote health. Methods: Exploratory/descriptive study with qualitative approach. The subjects were nine nurses of the Primary Health Units from Health Districts in Maceió-AL. Data was collected through semi-structured interviews in the months from April to August 2012 and were analyzed using content analysis and in light of the theoretical framework of Health Promotion. Results: The nurses recognize that the domiciliary visit can be a way to promote the health of individuals, families and community, but, in daily life, action maintains focus on disease, with curative actions of individual character, which do not take into account the social context where the user and his family are inserted. Conclusion: It is considered that the use of home visits by nurses in the family health strategy as a health promotion activity is still incipient because, although the nurses recognize the need for change in the model of care, in practice, it is observed that the focus of this action is directed to the biological model. doi:http://dx.doi.org/10.5020/18061230.2013.p513

  1. Preventive home visits to elderly people in Denmark

    DEFF Research Database (Denmark)

    Hendriksen, C; Vass, M

    2005-01-01

    are obliged to offer home visits twice a year to all citizens 75 years and older. After six years with this law, there is still variation of how the law is managed and implemented. About 60% of the elderly people accept and receive the visits. Less than 50% of the municipalities have made specific guidelines......, manageable and ongoing educational intervention towards professionals working with preventive home visits is feasible and improves older people's functional mobility.......During the last 20 years several randomised controlled trials have been published about preventive home visits to old people, but the benefit of the visits is still controversial and under debate. Based on a state law from the Ministry of Social Affairs in 1998, the municipalities in Denmark...

  2. Current evidence on perinatal home visiting and intimate partner violence.

    Science.gov (United States)

    Sharps, Phyllis W; Campbell, Jacquelyn; Baty, Marguerite L; Walker, Keisha S; Bair-Merritt, Megan H

    2008-01-01

    To describe current evidence on home visiting interventions for pregnant or postpartum women with specific intimate partner violence assessment and content. Online bibliographic databases including PubMed, CINAHL Plus, and Web of Science and a hand search of bibliographies of relevant articles. Original research and intervention studies were included that contained (a) a well-described prenatal and/or postpartum home visitation; (b) an assessment of perinatal intimate partner violence; and (c) quantitative data describing health outcomes for the women and their infants. The search yielded 128 articles, and 8 relevant articles met all of the inclusion criteria. Nonresearch, nonintervention, and international articles were excluded. No perinatal home visiting interventions were designed to address intimate partner violence. Programs that screened for intimate partner violence found high rates, and the presence of intimate partner violence limited the ability of the intervention to improve maternal and child outcomes. Perinatal home visitation programs likely improve pregnancy and infant outcomes. Home visiting interventions addressing intimate partner violence in nonperinatal population groups have been effective in minimizing intimate partner violence and improving outcomes. This suggests that perinatal home visiting programs adding specific intimate partner violence interventions may reduce intimate partner violence and improve maternal and infant health. Continued rigorous research is needed.

  3. Infant Mental Health Home Visitation: Setting and Maintaining Professional Boundaries

    Science.gov (United States)

    Barron, Carla; Paradis, Nichole

    2010-01-01

    Relationship-based infant mental health home visiting services for infants, toddlers, and their families intensify the connection between the personal and professional. To promote the therapeutic relationship and maximize the effectiveness of the intervention, home visitors must exercise good judgment, in the field and in the moment, to set and…

  4. Child Maltreatment History and Response to CBT Treatment in Depressed Mothers Participating in Home Visiting.

    Science.gov (United States)

    Ammerman, Robert T; Peugh, James L; Teeters, Angelique R; Putnam, Frank W; Van Ginkel, Judith B

    2016-03-01

    Child maltreatment contributes to depression in adults. Evidence indicates that such experiences are associated with poorer outcomes in treatment. Mothers in home visiting programs display high rates of depression and child maltreatment histories. In-Home Cognitive Behavioral Therapy (IH-CBT) was developed to treat maternal depression in home visiting. The purpose of this study was to examine the moderating effects of child maltreatment history on depression, social functioning, and parenting in mothers participating in a clinical trial of IH-CBT. Ninety-three depressed mothers in home visiting between 2 and 10 months postpartum were randomly assigned to IH-CBT (n = 47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and then confirmation of major depressive disorder diagnosis. Measures of child maltreatment history, depression, social functioning, and parenting were administered at pre-treatment, post-treatment, and 3-month follow-up. Results indicated high rates of maltreatment in both conditions relative to the general population. Mixed model analyses found a number of main effects in which experiences of different types of trauma were associated with poorer functioning regardless of treatment condition. Evidence of a moderating effect of maltreatment on treatment outcomes was found for physical abuse and parenting and emotional abuse and social network size. Future research should focus on increasing the effectiveness of IH-CBT with depressed mothers who have experienced child maltreatment. © The Author(s) 2014.

  5. Effects of Home Exercise Programmes During Home Visits After Hip Replacement: A Systematic Review.

    Science.gov (United States)

    Ozdemir, Ozlem; Tosun, Bet Uuml L

    2017-01-01

    This study systematically reviews the research, focused on the effects of home exercise programmes implemented during home visits after hip replacement on patients. PubMed (MEDLINE), Wiley Online Library, EBSCOhost, Science Direct databases (between 2004 and June 2015) were searched with the keywords "hip replacement, home exercise programme and home visit". Eleven original articles were retrieved. Different parameters were used in the trials to assess the physical functions, mobility and quality of life of patients. In six trials, the intervention group achieved significantly better improvements statistically in all parameters after home exercise programmes. In three trials, the intervention group achieved better but not significant outcomes. Early recovery in daily living activities with home exercise programme was reported only in one trial. Reviewed studies suggest that home exercise programmes, implemented during home visits after hip replacement, improve patients' physical functions and life quality.

  6. Preventive home visits to older home-dwelling people in Denmark: are invitational procedures of importance?

    DEFF Research Database (Denmark)

    Ekmann, A; Vass, M; Avlund, K

    2010-01-01

    Since 1998 all municipalities in Denmark have been required by law to offer two annual preventive home visits to all home-dwelling citizens aged 75 or over. The influence of invitational procedures on acceptance rates has not been investigated. The aim of this study was to describe and investigate...... whether different invitational procedures were associated with first preventive home visit acceptance rates. The study was based on secondary analyses of data from the Danish Intervention Study on Preventive Home Visits. Data were collected from 1998 to 2002. Of the 4060 participants in the main study......, 3245 reported receiving an offer for an identifiable preventive home visit, of whom 2399 (73.9%) provided complete data for the main analyses in the present study. Invitational procedures were categorised as: (1) a letter with a proposed date and time for the visit, (2) a visitor telephone call, and (3...

  7. Reinventing the home visit for undergraduate nursing students.

    Science.gov (United States)

    Pohl, Carla J; Malin, Shelly; Kennell, Lynn

    2014-12-01

    The Family Outreach Project was designed to teach senior-level undergraduate nursing students how to assess, care for, and develop care plans for children with chronic health conditions and their families. Nursing students (n=24) could attend one focus group conducted at the end of the semester as part of the evaluation of the America's Promise School Project. Responses were audiotaped and transcribed verbatim. Qualitative methods were used to identify themes. Comfort with the visit, professionalism of the students, and usefulness of the home visit to families was assessed. Analysis of focus group responses identified four major themes: learning experience, observations about home environment, concerns about having nothing to offer families, and difficulties with arranging and carrying out the home visits. Family responses (n=10) supported students' perception that families were knowledgeable about their children's chronic health conditions. Families indicated that students were professional and treated families respectfully. Copyright 2014, SLACK Incorporated.

  8. A pilot study of palliative medicine fellows' hospice home visits.

    Science.gov (United States)

    Shoemaker, Laura K; Aktas, Aynur; Walsh, Declan; Hullihen, Barbara; Khan, Mohammed I Ahmed; Russell, Kraig M; Davis, Mellar P; Lagman, Ruth; LeGrand, Susan

    2012-12-01

    This was a prospective descriptive study of hospice physician home visits (HVs) conducted by Hospice and Palliative Medicine Fellows. Our objectives were 1) to improve our knowledge of hospice care at home by describing physician HVs 2) to identify the indications for physician HVs and the problems addressed during the HV. Data was collected on 58 consecutive patients using a standardized form completed before and after the home visit. More than half of the persons were women. Most were Caucasian. Median age was 75 years; 57% had cancer; 77% were do-not-resuscitate. 76% HV occurred in the home. The median visit duration was 60 minutes; median travel distance and time 25 miles and 42 minutes, respectively. A hospice nurse case manager was present in 95%. The most common issues addressed during HVs were: health education, symptom management, and psychosocial support. Medication review was prominent. Physicians identified previously unreported issues. Symptom control was usually pain, although 27 symptoms were identified. Medications were important; all home visits included drug review and two thirds drug change. Physicians had unique responsibilities and identified important issues in the HV. Physicians provided both education and symptom management. Physician HVs are an important intervention. HVs were important in continuity of care, however, time-consuming, and incurred considerable travel, and professional time and costs.

  9. Miller Early Childhood Sustained Home-visiting (MECSH trial: design, method and sample description

    Directory of Open Access Journals (Sweden)

    Anderson Teresa

    2008-12-01

    Full Text Available Abstract Background Home visiting programs comprising intensive and sustained visits by professionals (usually nurses over the first two years of life show promise in promoting child health and family functioning, and ameliorating disadvantage. Australian evidence of the effectiveness of sustained nurse home visiting in early childhood is limited. This paper describes the method and cohort characteristics of the first Australian study of sustained home visiting commencing antenatally and continuing to child-age two years for at-risk mothers in a disadvantaged community (the Miller Early Childhood Sustained Home-visiting trial. Methods and design Mothers reporting risks for poorer parenting outcomes residing in an area of socioeconomic disadvantage were recruited between February 2003 and March 2005. Mothers randomised to the intervention group received a standardised program of nurse home visiting. Interviews and observations covering child, maternal, family and environmental issues were undertaken with mothers antenatally and at 1, 12 and 24 months postpartum. Standardised tests of child development and maternal-child interaction were undertaken at 18 and 30 months postpartum. Information from hospital and community heath records was also obtained. Discussion A total of 338 women were identified and invited to participate, and 208 were recruited to the study. Rates of active follow-up were 86% at 12 months, 74% at 24 months and 63% at 30 months postpartum. Participation in particular data points ranged from 66% at 1 month to 51% at 24 months postpartum. Rates of active follow-up and data point participation were not significantly different for the intervention or comparison group at any data point. Mothers who presented for antenatal care prior to 20 weeks pregnant, those with household income from full-time employment and those who reported being abused themselves as a child were more likely to be retained in the study. The Miller Early

  10. Depression improvement and parenting in low-income mothers in home visiting.

    Science.gov (United States)

    Ammerman, Robert T; Altaye, Mekibib; Putnam, Frank W; Teeters, Angelique R; Zou, Yuanshu; Van Ginkel, Judith B

    2015-06-01

    Research on older children and high-resource families demonstrates that maternal improvement in depression often leads to parallel changes in parenting and child adjustment. It is unclear if this association extends to younger children and low-income mothers. This study examined if In-Home Cognitive Behavioral Therapy (IH-CBT), a treatment for depressed mothers participating in home visiting programs, contributes to improvements in parenting and child adjustment. Ninety-three depressed mothers in home visiting between 2 and 10 months postpartum were randomly assigned to IH-CBT (n = 47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and subsequent diagnosis of major depressive disorder (MDD). Measures of depression, parenting stress, nurturing parenting, and child adjustment were administered at pre-treatment, post-treatment, and 3 months follow-up. Results indicated that there were no differences between IH-CBT and controls on parenting and child adjustment. Low levels of depression were associated with decreased parenting stress and increased nurturing parenting. Improvement in depression was related to changes in parenting in low-income mothers participating in home visiting programs. IH-CBT was not independently associated with these improvements, although to the extent that treatment facilitated improvement; there were corresponding benefits to parenting. Child adjustment was not associated with maternal depression, a finding possibly attributed to the benefits of concurrent home visiting or measurement limitations. Future research should focus on longer-term follow-up, implications of relapse, and child adjustment in later years.

  11. Depression Improvement and Parenting in Low Income Mothers in Home Visiting

    Science.gov (United States)

    Ammerman, Robert T.; Altaye, Mekibib; Putnam, Frank W.; Teeters, Angelique R.; Zou, Yuanshu; Van Ginkel, Judith B.

    2014-01-01

    Purpose Research on older children and high resource families demonstrates that maternal improvement in depression often leads to parallel changes in parenting and child adjustment. It is unclear if this association extends to younger children and low income mothers. This study examined if In-Home Cognitive Behavioral Therapy (IH-CBT), a treatment for depressed mothers participating in home visiting programs, contributes to improvements in parenting and child adjustment. Methods Ninety-three depressed mothers in home visiting between 2–10 months postpartum were randomly assigned to IH-CBT (n=47) plus home visiting or standard home visiting (SHV; n = 46). Mothers were identified via screening and subsequent of MDD diagnosis. Measures of depression, parenting stress, nurturing parenting, and child adjustment were administered at pre-treatment, post-treatment, and three month follow-up. Results Results indicated that there were no differences between IH-CBT and controls on parenting and child adjustment. Low levels of depression were associated with decreased parenting stress and increased nurturing parenting. There was no association between maternal depression and child adjustment. Conclusions Improvement in depression was related to changes in parenting in low income mothers participating in home visiting programs. IH-CBT was not independently associated with these improvements, although to the extent that treatment facilitated improvement there were corresponding benefits to parenting. Child adjustment was not associated with maternal depression, a finding possibly attributed to the benefits of concurrent home visiting or measurement limitations. Future research should focus on longer term follow-up, implications of relapse, and child adjustment in later years. PMID:25369906

  12. Preventing Perinatal Depression in Low-Income Home Visiting Clients: A Randomized Controlled Trial

    Science.gov (United States)

    Tandon, S. Darius; Perry, Deborah F.; Mendelson, Tamar; Kemp, Karen; Leis, Julie A.

    2011-01-01

    Objective: To assess the efficacy of a 6-week cognitive-behavioral intervention in preventing the onset of perinatal depression and reducing depressive symptoms among low-income women in home visitation programs. Method: Sixty-one women who were pregnant or who had a child less than 6 months of age and who were assessed as at risk for perinatal…

  13. Maternal Engagement in Home Visiting: The MOM Program

    Science.gov (United States)

    Radcliffe, Jerilynn; Schwarz, Donald F.

    2013-01-01

    The MOM Program is an innovative home visiting program whose aim is to empower low-income urban mothers to obtain health and early intervention services for their children. The authors discuss a recent evaluation of the MOM program which sought to examine maternal involvement in the program. The results raise important questions and call for…

  14. The Home Visit: Creating Connections & Building Relationships with Parents

    Science.gov (United States)

    Patton, Melody

    2015-01-01

    One of the most important things teachers do is to create relationships and connections with the children and parents with whom they work. The strength of the individual relationships teachers have with parents and children affects the daily interactions with them and can act as a foundation later if difficult situations arise. Home visits (for…

  15. Maximizing Home Visit Time In Rural Early Intervention.

    Science.gov (United States)

    Jung, Lee Ann

    The 1997 reauthorization of the Individuals with Disabilities Education Act requires early intervention programs to serve children in natural environments. Because of geography and resources, it is often impossible for service providers to visit rural families at home as frequently as families were seen via a center-based model. At first glance,…

  16. Implementing Paraprofessional Strength-Based Early Intervention Home Visitations

    Science.gov (United States)

    Mykota, David B.

    2008-01-01

    The purpose of the present study is to evaluate the implementation process for Parenting Plus, an early intervention program in a rural, western Canadian health district. Parenting Plus, as modeled after Hawaii Healthy Start, provides strength-based paraprofessional home visitations to overburdened parents of newborns. The general inductive…

  17. Maternal Depression in Home Visitation: A Systematic Review

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Bosse, Nicole R.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2010-01-01

    Depression is prevalent in new mothers and has been shown to have profound negative impacts on parenting, maternal life course, and child development. High rates of maternal depression have been found in home visitation, a widely disseminated prevention approach for high risk mothers and their children. This paper reviews the emerging literature on the prevalence, impact, and treatment of depression in the context of home visitation. Findings are synthesized and methodological and design limitations are considered in interpretation of results. Promising approaches to addressing maternal depression and supporting home visitors in working with this clinical population are described. Recommendations for research and practice are offered that build upon the strong foundation of current efforts in this area. PMID:20401324

  18. Home Visits: How Do They Affect Teachers' Beliefs about Teaching and Diversity?

    Science.gov (United States)

    Lin, Miranda; Bates, Alan B.

    2010-01-01

    Based on Bronfenbrenner's ecological systems theory, this qualitative study examined the impact of home visits on a group of six Head Start educators. Each participant conducted two home visits. For the first home visit, participants were not provided any guidance. On the second visit, participants were provided a handout with questions intended…

  19. A randomized comparison of home visits and hospital-based group follow-up visits after early postpartum discharge.

    Science.gov (United States)

    Escobar, G J; Braveman, P A; Ackerson, L; Odouli, R; Coleman-Phox, K; Capra, A M; Wong, C; Lieu, T A

    2001-09-01

    Short postpartum stays are common. Current guidelines provide scant guidance on how routine follow-up of newly discharged mother-infant pairs should be performed. We aimed to compare 2 short-term (within 72 hours of discharge) follow-up strategies for low-risk mother-infant pairs with postpartum length of stay (LOS) of costs were studied using computerized databases and chart review. Breastfeeding continuation, maternal depressive symptoms, and maternal satisfaction were assessed by means of telephone interviews at 2 weeks postpartum. During a 17-month period in 1998 to 1999, we enrolled and randomized 1014 mother-infant pairs (506 to the control group and 508 to the intervention group). There were no significant differences between the study groups with respect to maternal age, race, education, household income, parity, previous breastfeeding experience, early initiation of prenatal care, or postpartum LOS. There were no differences with respect to neonatal LOS or Apgar scores. In the control group, 264 mother-infant pairs had an individual visit only, 157 had a group visit only, 64 had both a group and an individual visit, 4 had a home health and a hospital-based follow-up, 13 had no follow-up within 72 hours, and 4 were lost to follow-up. With respect to outcomes within 2 weeks after discharge, there were no significant differences in newborn or maternal hospitalizations or urgent care visits, breastfeeding discontinuation, maternal depressive symptoms, or a combined clinical outcome measure indicating whether a mother-infant pair had any of the above outcomes. However, mothers in the home visit group were more likely than those in the control group to rate multiple aspects of their care as excellent or very good. These included the preventive advice delivered (76% vs 59%) and the skills and abilities of the provider (84% vs 73%). Mothers in the home visit group also gave higher ratings on overall satisfaction with the newborn's posthospital care (71% vs 59

  20. An open trial of in-home CBT for depressed mothers in home visitation.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Stevens, Jack; Bosse, Nicole R; Short, Jodie A; Bodley, Amy L; Van Ginkel, Judith B

    2011-11-01

    Research has demonstrated that low income mothers participating in home visitation programs have high rates of depression. This study used an open trial design to evaluate In-Home Cognitive Behavioral Therapy (IH-CBT), an evidence-based treatment for depression that is delivered in the home setting and has been adapted to address the needs of low income mothers participating in home visitation. 64 depressed mothers recruited from a home visitation program and who had completed IH-CBT were compared to 241 mothers from the same setting who met identical screening criteria at enrollment but did not receive the treatment. In addition, pre- and post-treatment measures of depression and related clinical features were contrasted in the 64 mothers receiving IH-CBT. There was a significantly greater reduction in depressive symptoms in the IH-CBT group relative to their counterparts who did not receive the treatment. Results from pre-post comparisons showed that treated mothers had decreased diagnosis of major depression, lower reported stress, increased coping and social support, and increased positive views of motherhood at post-treatment. Findings suggest that IH-CBT is a promising approach to addressing maternal depression in the context of home visitation and warrants further study. Public health implications for home visiting programs are discussed.

  1. Preventive home visits to older home-dwelling people in Denmark: are invitational procedures of importance?

    Science.gov (United States)

    Ekmann, A; Vass, M; Avlund, K

    2010-11-01

    Since 1998 all municipalities in Denmark have been required by law to offer two annual preventive home visits to all home-dwelling citizens aged 75 or over. The influence of invitational procedures on acceptance rates has not been investigated. The aim of this study was to describe and investigate whether different invitational procedures were associated with first preventive home visit acceptance rates. The study was based on secondary analyses of data from the Danish Intervention Study on Preventive Home Visits. Data were collected from 1998 to 2002. Of the 4060 participants in the main study, 3245 reported receiving an offer for an identifiable preventive home visit, of whom 2399 (73.9%) provided complete data for the main analyses in the present study. Invitational procedures were categorised as: (1) a letter with a proposed date and time for the visit, (2) a visitor telephone call, and (3) a letter with encouragement to phone the visitor for appointment (letter without a proposed date). Covariates included sex, age, experience with preventive interventions, functional ability, self rated health, social relations and psychosocial characteristics. Statistical analyses included chi-square tests, and bi- and multivariable logistic regression analyses. Different invitational procedures were associated with first preventive home visit acceptance rates. Significantly more men (75.1%) than women (62.8%) declined the first preventive home visit regardless of the invitational procedure. Compared to 'letter with a proposed date', men had an odds ratio of 1.78 (95% CI: 1.16-2.74) for declining visits when 'telephone call' was used and an odds ratio 2.81 (95% CI: 1.79-4.40) when 'letter without a proposed date' was used as the invitational procedure. In women the odds ratios were 1.23 (95% CI: 0.91-1.68) and 1.87 (95% CI: 1.37-2.55), respectively.

  2. La visita médica al hogar Home visit

    Directory of Open Access Journals (Sweden)

    José Díaz Novás

    2007-03-01

    Full Text Available Se hace un breve resumen de la historia de la visita médica al hogar en Cuba, y se señala su evolución en las diferentes formas organizativas de la atención primaria en la etapa revolucionaria. Se enumeran las ventajas de las visitas médicas al hogar, su necesidad como componente fundamental e insustituible de la atención a los pacientes, y como complemento necesario del trabajo en el consultorio. Se exponen los motivos de la visita al hogar: enfermedades agudas, procesos crónicos, discapacidades, evaluar el entorno familiar e higiénico-epidemiológico del paciente, los ingresos domiciliarios, las altas hospitalarias precoces, y los pacientes con enfermedades terminales o con afecciones dispensarizadas, entre otros Se presenta un grupo de orientaciones para el desarrollo exitoso de la visita médica al hogarA summary of the history of home visit in Cuba is made, stressing its evolution in the different organizative ways of primary care in the revolutionary stage. The advantages of home visits, their need as a fundamental and irreplaceable component of the patients' care and a necessary complement of the work in the office are given. The reasons of the visits are explained: acute diseases, chronic processes, disabilities, evaluation of the family and hygienic-epidemiological setting of the patient, home admissions, early hospital discharges, and patients with end-stage diseases, or with categorized diseases, among others. Some instructions for the success of home visit are exposed.

  3. A cluster randomised controlled effectiveness trial evaluating perinatal home visiting among South African mothers/infants.

    Directory of Open Access Journals (Sweden)

    Mary Jane Rotheram-Borus

    Full Text Available Interventions are needed to reduce poor perinatal health. We trained community health workers (CHWs as home visitors to address maternal/infant risks.In a cluster randomised controlled trial in Cape Town townships, neighbourhoods were randomised within matched pairs to 1 the control, healthcare at clinics (n = 12 neighbourhoods; n = 594 women, or 2 a home visiting intervention by CBW trained in cognitive-behavioural strategies to address health risks (by the Philani Maternal, Child Health and Nutrition Programme, in addition to clinic care (n = 12 neighbourhoods; n = 644 women. Participants were assessed during pregnancy (2% refusal and 92% were reassessed at two weeks post-birth, 88% at six months and 84% at 18 months later. We analysed 32 measures of maternal/infant well-being over the 18 month follow-up period using longitudinal random effects regressions. A binomial test for correlated outcomes evaluated overall effectiveness over time. The 18 month post-birth assessment outcomes also were examined alone and as a function of the number of home visits received.Benefits were found on 7 of 32 measures of outcomes, resulting in significant overall benefits for the intervention compared to the control when using the binomial test (p = 0.008; nevertheless, no effects were observed when only the 18 month outcomes were analyzed. Benefits on individual outcomes were related to the number of home visits received. Among women living with HIV, intervention mothers were more likely to implement the PMTCT regimens, use condoms during all sexual episodes (OR = 1.25; p = 0.014, have infants with healthy weight-for-age measurements (OR = 1.42; p = 0.045, height-for-age measurements (OR = 1.13, p<0.001, breastfeed exclusively for six months (OR = 3.59; p<0.001, and breastfeed longer (OR = 3.08; p<0.001. Number of visits was positively associated with infant birth weight ≥2500 grams (OR = 1.07; p = 0

  4. Foreign Students in Tianjin Visit Elderly People’s Home

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>On the afternoon of December 7, 2007, the Tianjin Municipal People’s Association for Friendship with Foreign Countries (TMPAFFC) organized more than 20 Japanese and ROK teachers and students of Nankai University to visit the Tianjin Elderly People’s Home. The Tianjin Elderly People’s Home, built in 1953 and covering an area of over 40 mu, is a comprehensive welfare institution for the elderly people which provides such services as accommodation, medical care, nursing, nutrition counseling, rehabilitation, education, recreation, deathbed care and training. In it there are a branch of the Tianjin Elderly People’s University, the Tianjin Nurse Training School for Caring the Aged and a hospital for senile diseases with 500 beds. The Home mainly admits unsupported aged people, elderly people who pay for their own expenses and those who are critically ill needing deathbed care. People above 60 without infectious diseases or mental disorder can apply for admission.

  5. 76 FR 12977 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation

    Science.gov (United States)

    2011-03-09

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation AGENCY... Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation. SUMMARY: HRSA and... and Early Childhood Home Visiting Program Evaluation (``the Committee''), pursuant to subsection...

  6. Home telemonitoring and remote feedback between clinic visits for asthma.

    Science.gov (United States)

    Kew, Kayleigh M; Cates, Christopher J

    2016-08-03

    Asthma is a chronic disease that causes reversible narrowing of the airways due to bronchoconstriction, inflammation and mucus production. Asthma continues to be associated with significant avoidable morbidity and mortality. Self management facilitated by a healthcare professional is important to keep symptoms controlled and to prevent exacerbations.Telephone and Internet technologies can now be used by patients to measure lung function and asthma symptoms at home. Patients can then share this information electronically with their healthcare provider, who can provide feedback between clinic visits. Technology can be used in this manner to improve health outcomes and prevent the need for emergency treatment for people with asthma and other long-term health conditions. To assess the efficacy and safety of home telemonitoring with healthcare professional feedback between clinic visits, compared with usual care. We identified trials from the Cochrane Airways Review Group Specialised Register (CAGR) up to May 2016. We also searched www.clinicaltrials.gov, the World Health Organization (WHO) trials portal and reference lists of other reviews, and we contacted trial authors to ask for additional information. We included parallel randomised controlled trials (RCTs) of adults or children with asthma in which any form of technology was used to measure and share asthma monitoring data with a healthcare provider between clinic visits, compared with other monitoring or usual care. We excluded trials in which technologies were used for monitoring with no input from a doctor or nurse. We included studies reported as full-text articles, those published as abstracts only and unpublished data. Two review authors screened the search and independently extracted risk of bias and numerical data, resolving disagreements by consensus.We analysed dichotomous data as odds ratios (ORs) while using study participants as the unit of analysis, and continuous data as mean differences (MDs) while

  7. Promoting infant health through home visiting by a nurse-managed community worker team.

    Science.gov (United States)

    Barnes-Boyd, C; Fordham Norr, K; Nacion, K W

    2001-01-01

    This article describes the Resources, Education and Care in the Home program (REACH-Futures), an infant mortality reduction initiative in the inner city of Chicago built on the World Health Organization (WHO) primary health care model and over a decade of experience administering programs to reduce infant mortality through home visits. The program uses a nurse-managed team, which includes community residents selected, trained, and integrated as health advocates. Service participants were predominately African American families. All participants were low-income and resided in inner-city neighborhoods with high unemployment, high teen birth rates, violent crime, and deteriorated neighborhoods. Outcomes for the first 666 participants are compared to a previous home-visiting program that used only nurses. Participant retention rates were equivalent overall and significantly higher in the first months of the REACH-Futures program. There were two infant deaths during the course of the study, a lower death rate than the previous program or the city. Infant health problems and developmental levels were equivalent to the prior program and significantly more infants were fully immunized at 12 months. The authors conclude that the use of community workers as a part of the home-visiting team is as effective as the nurse-only team in meeting the needs of families at high risk of poor infant outcomes. This approach is of national interest because of its potential to achieve the desired outcomes in a cost-effective manner.

  8. Home Visiting: A Service Strategy to Reduce Poverty and Mitigate Its Consequences.

    Science.gov (United States)

    Minkovitz, Cynthia S; O'Neill, Kay M G; Duggan, Anne K

    2016-04-01

    Home visiting programs are increasingly recognized as an important part of the early childhood system of care in the United States. The objectives of this report are to review the rationale for home visiting; characterize the Federal Home Visiting Program; highlight the evidence of home visiting effectiveness, particularly for low income families; identify opportunities to promote coordination between medical homes and home visiting programs; and explain the critical role of research, evaluation, and quality improvement to strengthen home visiting effectiveness. Home visiting programs offer voluntary home-based services and other supports to meet the needs of vulnerable pregnant women and young families. Home visiting intends to address poverty in 2 ways. First, it promotes economic self-sufficiency directly by building parents' knowledge, skills, and motivation related to employment opportunities and by linking families with community services such as adult education and job training. Second, it mitigates the effects of poverty through direct service and community linkages to enhance parents' capacity for positive parenting and for their own health and family functioning. Home visiting has shown effectiveness in multiple domains, including family economic self-sufficiency, birth outcomes, maternal health, child health and development, and positive parenting practices. Authorized as part of the Affordable Care Act in 2010 and reauthorized in 2015, the Federal Home Visiting Program invests an unprecedented $1.9 billion in the form of grants to states to expand home visiting programs and support rigorous research. As part of the early childhood system of services, home visiting programs must coordinate with other community services and supports. Programs will be most effective when resources are used efficiently, duplication of services is avoided, and alignment and reinforcement of other providers' messages are achieved. The Federal Home Visiting Program has

  9. Home Away from Home: A Toolkit for Planning Home Visiting Partnerships with Family, Friend, and Neighbor Caregivers

    Science.gov (United States)

    Johnson-Staub, Christine; Schmit, Stephanie

    2012-01-01

    Home visiting is one tool used to prevent child abuse and improve child well-being by providing education and services in families' homes through parent education and connection to community resources. This toolkit provides state policymakers and advocates with strategies for extending and expanding access to state- or federally-funded home…

  10. [Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services].

    Science.gov (United States)

    Oh, Eui Geum; Lee, Hyun Joo; Kim, Yukyung; Sung, Ji Hyun; Park, Young Su; Yoo, Jae Yong; Woo, Soohee

    2015-10-01

    The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

  11. Effectiveness of a promotora home visitation program for underserved Hispanic children with asthma.

    Science.gov (United States)

    Rashid, Shumyla; Carcel, Consuelo; Morphew, Tricia; Amaro, Silvia; Galant, Stanley

    2015-06-01

    Retention in a mobile asthma clinic, the Breathmobile™, of ≥3 visits has previously been shown to be essential for attaining asthma control in underserved children. The objective of this study in primarily Hispanic-American children was to determine the difference in retention between those seen in the Breathmobile™ compared to those receiving an additional promotora-based home visit (HV). Children with asthma in the Breathmobile™ program were evaluated for asthma status and aeroallergen sensitivity. Indication for HV included poor asthma control, educational and environmental control needs. An initial visit consisted of environmental assessment as well as a 3-h interactive educational session covering asthma basics. A follow-up visit 1 month later assessed implementation. The primary outcome measure of retention was ≥6 months in the Breathmobile™ program. Of the 1007 asthmatic children seen between April 2002 and June of 2005, 136 received HV. These children showed significantly greater retention compared to those without HV with a median number of visits (5 visits versus 2 visits), ≥3 Breathmobile™ visits (86.0% versus 38.8%), median number of days in the program (299 versus 63 days) and percentage of patients in the program ≥6 months (67.8% versus 31.3%) p asthma severity were each independent predictors of retention. The addition of a promotora HV program proved effective in providing greater retention in the Breathmobile™ program essential for asthma control. Randomized clinical trials will be needed to show the impact on health care utilization and asthma control.

  12. Training Family Medicine Residents to Perform Home Visits: A CERA Survey.

    Science.gov (United States)

    Sairenji, Tomoko; Wilson, Stephen A; D'Amico, Frank; Peterson, Lars E

    2017-02-01

    Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training. To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors. This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers. There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits. There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.

  13. 78 FR 53150 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2013-08-28

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation; Notice of... Visiting Program Evaluation (MIECHVE). Authority: Section 10(a)(2) of the Federal Advisory Committee Act... Maternal, Infant, and Early Childhood Home Visiting Program Evaluation. Date and Time: September 12,...

  14. EFEKTIVITAS HOME VISIT TERHADAP PERUBAHAN PENGETAHUAN, SIKAP, DAN KETERAMPILAN KLIEN TBC DI WILAYAH PUSKESMAS KECAMATAN PASAR MINGGU JAKARTA SELATAN

    Directory of Open Access Journals (Sweden)

    Rani Chairani

    2012-11-01

    Full Text Available Home Visit represent materialization of nurse caring to problems of health faced by client in society, including  the problem of tuberkulosis. DKI Jakarta is one of the province having tuberkulosis prevalensi above national prevalensi that is 1,26%. Through visit home nurse of community get information about growth of health of client of tuberkulosis, running effort off is make-up of health, watching growth of run by medication of client, and also assist tired family and client of its independence level. This research aim to obtain; get picture about visit home efektivitas to make-up of knowledge, attitude, and is skilled of client of tuberkulosis in the effort operation  of failure of medication. Design this research is experiment kuasi with approach of pre-post  test with group control and intervention  group. lntervence in this research is to conduct to visit home counted 4 times visit conducted activity during visit home. Activity during visit home is continuation giving of education of health which have been given by Puskesmas, giving conseling, care direct, family entangling and society. This Research sampel is adult client of Positive BTA or client of BTA negative of positive thorax photo (old and new case which get medication of tuberkulosis during 6-8 months in the year 2009, comparison between group intervence and control 1:1 (33 group people intervence and 33 control group people, so that totalize sampel is 66 people. Result of test of t-paired prove there is difference which is very have a meaning of at knowledge, attitude, and is skilled of client about treatment and medication of tuberkulosis after done with 4 times visit home compared to previously. Result of test of t-pooled prove there is difference  which is very have a meaning  of  at knowledge, attitude, and is skilled of client about treatment and medication of tuberkulosis between group intervence  after conducted four times visit home with control group which do

  15. The Home Care Crew Scheduling Problem: Preference-based visit clustering and temporal dependencies

    DEFF Research Database (Denmark)

    Rasmussen, Matias Sevel; Justesen, Tor Fog; Dohn, Anders Høeg

    2012-01-01

    In the Home Care Crew Scheduling Problem a staff of home carers has to be assigned a number of visits to patients’ homes, such that the overall service level is maximised. The problem is a generalisation of the vehicle routing problem with time windows. Required travel time between visits and tim...

  16. Insights in public health: the Hawai'i Home Visiting Network: evidence-based home visiting services in Hawai'i.

    Science.gov (United States)

    Yoshimoto, D Kaulana; Robertson, N Tod; Hayes, Donald K

    2014-05-01

    Home visiting services are cost-effective and improve the health of children and families among those at increased risk. From 1985-2008, home visiting services in Hawai'i were provided primarily through state funding of the Hawai'i Healthy Start Program, but the program was severely reduced due to the economy and state budget changes over the past decade. The Maternal and Child Health Branch (MCHB) in the Family Health Services Division responded to these changes by seeking out competitive grant opportunities and collaborations in order to continue to promote home visiting services to those children and families in need. In 2010, the MCHB was awarded a federally funded Maternal, Infant and Early Childhood Home Visiting (MIECHV) grant for home visiting services to promote maternal, infant, and early childhood health, safety and development, strong parent-child relationships, and responsible parenting. In 2011, the MCHB was also awarded a competitive MIECHV development grant that funded the re-establishment of the hospital Early Identification program. Families in need of additional support identified through this program are referred for family strengthening services to a network of existing home visiting programs called the Hawai'i Home Visiting Network (HHVN). The HHVN is supported by MIECHV and a small amount of state funds to assist programs with capacity building, training, professional development, quality assurance, and accreditation/certification support. The MIECHV grant requires that programs are evidence-based and address specific outcome measures and benchmarks. The HHVN provides home visiting services to families prenatally through 5 years of age that reside in specific at-risk communities, and is aimed at fostering positive parenting and reducing child maltreatment using a strength-based approach by targeting six protective factors: (1) social connections, (2) nurturing and attachment, (3) knowledge of parenting and child development, (4) parental

  17. Home visits by Family Health Strategy nurses and community health agents

    Directory of Open Access Journals (Sweden)

    Luciana Valadão Alves Kebian

    2014-03-01

    Full Text Available The objective of this article was to describe the practice of nurses and community health agents within the context of the Family Health Strategy home visits. This is a descriptive study with a qualitative approach. Data collection was performed between January and March of 2010, through semi-structured interviews with eight nurses and seven community health agents from two family health units in the city of Rio de Janeiro. Data were submitted to content analysis. Low interaction was observed between nurses and community health agents in the home visits. Work overload and violence are the main hindrances identified for performing home visits. It was found that the home visit planning was unsystematic. Permanent education should be intensified with the purpose to discuss, following a problem-posing approach, the roles and attributions of each team member in the home visit, as well as the systematization of this activity. Descriptors: Family Health; Nursing; Community Health Workers; Home Visit.

  18. Predictors of Treatment Response in Depressed Mothers Receiving In-Home Cognitive-Behavioral Therapy and Concurrent Home Visiting

    Science.gov (United States)

    Ammerman, Robert T.; Peugh, James L.; Putnam, Frank W.; Van Ginkel, Judith B.

    2012-01-01

    Home visiting is a child abuse prevention strategy that seeks to optimize child development by providing mothers with support, training, and parenting information. Research has consistently found high rates of depression in mothers participating in home visiting programs and low levels of obtaining mental health treatment in the community.…

  19. Predictors of Treatment Response in Depressed Mothers Receiving In-Home Cognitive-Behavioral Therapy and Concurrent Home Visiting

    Science.gov (United States)

    Ammerman, Robert T.; Peugh, James L.; Putnam, Frank W.; Van Ginkel, Judith B.

    2012-01-01

    Home visiting is a child abuse prevention strategy that seeks to optimize child development by providing mothers with support, training, and parenting information. Research has consistently found high rates of depression in mothers participating in home visiting programs and low levels of obtaining mental health treatment in the community.…

  20. Occupational therapy predischarge home visits for patients with a stroke (HOVIS): results of a feasibility randomized controlled trial.

    Science.gov (United States)

    Drummond, A E R; Whitehead, P; Fellows, K; Sprigg, N; Sampson, C J; Edwards, C; Lincoln, N B

    2013-05-01

    To assess the feasibility of conducting a randomized controlled trial of occupational therapy predischarge home visits for people after stroke. Randomized controlled trial and cohort study. We randomized eligible patients for whom there was clinical uncertainty about the need to conduct a home visit to a randomized controlled trial; patients for whom a visit was judged 'essential' were enrolled into a cohort study. Stroke rehabilitation unit of teaching hospital. One hundred and twenty-six participants hospitalized following recent stroke. Predischarge home visit or structured, hospital-based interview. The primary objective was to collect information on the feasibility of a randomized controlled trial, including eligibility, control intervention and outcome assessments. The primary outcome measure was the Nottingham Extended Activities of Daily Living Scale at one month after discharge from hospital. Secondary outcomes included mood, quality of life and costs at one week and one month following discharge. Ninety-three people were allocated to the randomized controlled trial; 47 were randomized to intervention and 46 to control. Thirty-three were enrolled into the cohort study. More people were allocated to the randomized controlled trial as the study progressed. One hundred and thirteen people (90%) received the proposed intervention, although there was a need for stricter protocol adherence. Follow-up was good: at one month 114 (90%) were assessed. There were no significant differences between the groups in the randomized controlled trial for the primary outcome measure at one month. The average cost of a home visit was £208. A trial is feasible and warranted given the resource implications of predischarge occupational therapy home visits.

  1. Attrition in longitudinal randomized controlled trials: home visits make a difference

    Directory of Open Access Journals (Sweden)

    Peterson Janey C

    2012-11-01

    Full Text Available Abstract Background Participant attrition in longitudinal studies can introduce systematic bias, favoring participants who return for follow-up, and increase the likelihood that those with complications will be underestimated. Our aim was to examine the effectiveness of home follow-up (Home F/U to complete the final study evaluation on potentially “lost” participants by: 1 evaluating the impact of including and excluding potentially “lost” participants (e.g., those who required Home F/U to complete the final evaluation on the rates of study complications; 2 examining the relationship between timing and number of complications on the requirement for subsequent Home F/U; and 3 determining predictors of those who required Home F/U. Methods We used data from a randomized controlled trial (RCT conducted from 1991–1994 among coronary artery bypass graft surgery patients that investigated the effect of High mean arterial pressure (MAP (intervention vs. Low MAP (control during cardiopulmonary bypass on 5 complications: cardiac morbidity/mortality, neurologic morbidity/mortality, all-cause mortality, neurocognitive dysfunction and functional decline. We enhanced completion of the final 6-month evaluation using Home F/U. Results Among 248 participants, 61 (25% required Home F/U and the remaining 187 (75% received Routine F/U. By employing Home F/U, we detected 11 additional complications at 6 months: 1 major neurologic complication, 6 cases of neurocognitive dysfunction and 4 cases of functional decline. Follow-up of 61 additional Home F/U participants enabled us to reach statistical significance on our main trial outcome. Specifically, the High MAP group had a significantly lower rate of the Combined Trial Outcome compared to the Low MAP group, 16.1% vs. 27.4% (p=0.032. In multivariate analysis, participants who were ≥ 75 years (OR=3.23, 95% CI 1.52-6.88, p=0.002 or on baseline diuretic therapy (OR=2.44, 95% CI 1.14-5.21, p=0.02 were more

  2. Facilitating Mental Health Intervention in Home Visiting: Learning From Content, Context, Clients, and Community

    Science.gov (United States)

    Price, Sarah Kye; Gray, Lisa A.; El-Khoury, Dalia

    2014-01-01

    Home visiting programs recognize the importance of promoting women's mental health during and around the time of pregnancy. However, the process of planning and integrating mental health promotion and intervention into the home visiting setting can seem daunting. Using examples and lessons learned from research and practice, the authors provide a…

  3. 76 FR 12978 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2011-03-09

    ... Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation; Notice of..., Infant and Early Childhood Home Visiting Program Evaluation. Date and Time: March 23, 2011, 9 a.m.-3 p.m... Program Evaluation will meet for its first session on Wednesday, March 23, 2011, from 9 a.m. to 3 p.m....

  4. Pilot Evaluation of a Home Visit Parent Training Program in Disadvantaged Families

    Science.gov (United States)

    Leung, Cynthia; Tsang, Sandra; Heung, Kitty

    2013-01-01

    Objectives: The study reported the pilot evaluation of the Healthy Start Home Visit Program for disadvantaged Chinese parents with preschool children, delivered by trained parent assistants. Home visiting was used to make services more accessible to disadvantaged families. Method: The participants included 21 parent-child dyads. Outcome measures…

  5. Moving beyond Depression: A Collaborative Approach to Treating Depressed Mothers in Home Visiting Programs

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2014-01-01

    Research indicates that up to half of mothers in home visiting experience clinically significant levels of depression during their participation in services. Depression alters maternal life course, negatively impacts child development, and contributes to poorer home visiting outcomes. This article describes the Moving Beyond Depression (MBD)…

  6. The importance of trust in successful home visit programs for older people.

    NARCIS (Netherlands)

    Muntinga, M.E.; Leeuwen, K.M. van; Jansen, A.P.D.; Nijpels, G.; Schellevis, F.G.; Abma T.A.

    2016-01-01

    Outcomes of proactive home visit programs for frail, older people might be influenced by aspects of the caregiver–receiver interaction. We conducted a naturalistic case study to explore the interactional process between a nurse and an older woman during two home visits. Using an ethics of care, we p

  7. Moving beyond Depression: A Collaborative Approach to Treating Depressed Mothers in Home Visiting Programs

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Teeters, Angelique R.; Van Ginkel, Judith B.

    2014-01-01

    Research indicates that up to half of mothers in home visiting experience clinically significant levels of depression during their participation in services. Depression alters maternal life course, negatively impacts child development, and contributes to poorer home visiting outcomes. This article describes the Moving Beyond Depression (MBD)…

  8. Changes in Depressive Symptoms in First Time Mothers in Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Putnam, Frank W.; Altaye, Mekibib; Chen, Liang; Holleb, Lauren J.; Stevens, Jack; Short, Jodie A.; Van Ginkel, Judith B.

    2009-01-01

    Objective: The expansion of Home Visitation Programs for at-risk, first-time mothers and their young children has drawn attention to the potential impact of depression on program outcomes, yet little research has examined depression in the context of home visitation. The purpose of this study was to determine the prevalence of and changes in…

  9. Assessing adverse experiences from infancy through early childhood in home visiting programs.

    Science.gov (United States)

    McKelvey, Lorraine M; Whiteside-Mansell, Leanne; Conners-Burrow, Nicola A; Swindle, Taren; Fitzgerald, Shalese

    2016-01-01

    The general aim of early intervention and home visiting programs is to support families to minimize Adverse Childhood Experiences (ACEs). However, assessing children's exposure to these risks is complicated because parents serve as the conduit for both measurement and intervention. The primary aims of the study were to develop an assessment of children's exposure to ACEs and to examine concurrently measured parental child abuse and neglect potential and child social-emotional functioning. Home visiting programs in a southern state implemented the Family Map Inventories (FMI) as comprehensive family assessment and child screenings (N=1,282) within one month of enrollment. Children (M=33 months of age, SD=20) were exposed at rates of 27% to one, 18% to two, 11% to three, and 12% to four or more FMI-ACEs. FMI-ACEs were associated with increased parental beliefs and behaviors associated with child abuse and neglect. FMI-ACEs also significantly predicted the likelihood of the child having at-risk social-emotional development; children with 4 or more FMI-ACEs were over 6 times more likely than those with none to have at-risk scores. The findings add to our understanding of the negative impact of trauma on children and families. Assessing these risks as they occur in a family-friendly manner provides a platform for early intervention programs to work with families to increase family strengths and reduce the impacts of adverse experiences for their children.

  10. Effect of home visit training program on growth and development of preterm infants: a double blind randomized controlled trial.

    Science.gov (United States)

    Edraki, Mitra; Moravej, Hossian; Rambod, Masoume

    2015-01-01

    Home visit program can be effective in infants' growth and development. The present study aimed to investigate the effect of home visit program on preterm infants' growth and development within 6 months. It was a double-blind clinical trial study. The study was conducted in Hafez, Hazrat-e-Zeinab, and Namazee Hospitals affiliated to Shiraz University of Medical Sciences, Shiraz, Iran from 2010 to 2011. Preterm infants were divided into intervention (n=30) and control groups (n=30) through blocked randomization. The intervention group received home visit training program for 6 months, while the control group only received the hospital's routine care. Then, the infants' growth indexes, including weight, height, and head circumference, and development criteria were compared on the first day of admission in Neonatal Intensive Care Unit, and then first, second, third, and sixth months. The data were analyzed using Chi-square, independent t-test, and repeated measures ANCOVA. The mean weight of the intervention and control group infants was 7207.3±1129.74 and 6366.7±922.26 gr in the sixth month. Besides, the intervention group infants' mean weight was higher compared to the control group after six months (t=-3.05, P=0.03). Also, a significant difference was found between the two groups regarding development indexes, such as following moving objects with the head, keeping the head stable when changing the position from lying to sitting,  producing "Agha" sound, and taking objects by hand (Pdevelopment indexes at the sixth month. Considering the importance of infants' growth and development, healthcare staff is recommended to incorporate home visit training into their programs, so that steps can be taken towards improvement of preterm infants' health. IRCT2014082013690N3 

  11. The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program. A Report to Congress. OPRE Report 2015-11

    Science.gov (United States)

    Michalopoulos, Charles; Lee, Helen; Duggan, Anne; Lundquist, Erika; Tso, Ada; Crowne, Sarah Shea; Burrell, Lori; Somers, Jennifer; Filene, Jill H.; Knox, Virginia

    2015-01-01

    "The Mother and Infant Home Visiting Program Evaluation: Early Findings on the Maternal, Infant, and Early Childhood Home Visiting Program--A Report to Congress" presents the first findings from the Mother and Infant Home Visiting Program Evaluation (MIHOPE), the legislatively mandated national evaluation of the Maternal, Infant, and…

  12. Effects of home visits by home nurses to elderly people with health problems: design of a randomised clinical trial in the Netherlands [ISRCTN92017183

    Directory of Open Access Journals (Sweden)

    Kempen Gertrudis IJM

    2004-12-01

    Full Text Available Abstract Background Preventive home visits to elderly people by public health nurses aim to maintain or improve the functional status of elderly and reduce the use of institutional care services. A number of trials that investigated the effects of home visits show positive results, but others do not. The outcomes can depend on differences in characteristics of the intervention programme, but also on the selection of the target population. A risk group approach seems promising, but further evidence is needed. We decided to carry out a study to investigate the effects in a population of elderly with (perceived poor health rather than the general population. Also, we test whether nurses who are qualified at a lower professional level (home nurses instead of public health nurses are able to obtain convincing effects. The results of this study will contribute to the discussion on effective public health strategies for the aged. Methods/design The study is carried out as a parallel group randomised trial. To screen eligible participants, we sent a postal questionnaire to 4901 elderly people (70–84 years living at home in a town in the south of the Netherlands. After applying inclusion criteria (e.g., self-reported poor health status and exclusion criteria (e.g., those who already receive home nursing care, we selected 330 participants. They entered the randomisation procedure; 160 were allocated to the intervention group and 170 to the control group. The intervention consists of (at least 8 systematic home visits over an 18 months period. Experienced home nurses from the local home care organisation carry out the visits. The control group receives usual care. Effects on health status are measured by means of postal questionnaires after 12 months, 18 months (the end of the intervention period and after 24 months (the end of 6-months follow-up, and face-to-face interviews after 18 months. Data on mortality and service use are continuously registered

  13. Home visits - central to primary care, tradition or an obligation? A qualitative study

    Directory of Open Access Journals (Sweden)

    Müller Christiane A

    2011-04-01

    Full Text Available Abstract Background Home visits are claimed to be a central element of primary care. However, the frequency with which home visits are made is declining both internationally and in Germany despite the increase in the number of chronically ill elderly patients. Given this, the question arises as to how to ensure sufficient primary health care for this vulnerable patient group. The aim of this study was to explore German general practitioners' (GPs attitudes with regard to the feasibility, burden and outlook of continued home visits in German primary care. Methods Qualitative semi-structured interviews were carried out with 24 GPs from the city of Hannover, Germany, and its rural surroundings. Data was analysed using qualitative content analysis. Results The GPs indicated that they frequently conduct home visits, but not all of them were convinced of their benefit. Most were not really motivated to undertake home visits but some felt obliged to. The basic conditions covering home visits were described as unsatisfactory, in particular with respect to reimbursement and time constraints. House calls for vulnerable, elderly people remained undisputed, whereas visits of a social nature were mostly deleted. Urgent house calls were increasingly delegated to the emergency services. Visits to nursing homes were portrayed as being emotionally distressing. GPs considered good cooperation with nursing staff the key factor to ensure a successful nursing home visit. The GPs wanted to ease their work load while still ensuring quality home care but were unable to suggest how this might be achieved. Better financial compensation was proposed most often. The involvement of specially trained nurses was considered possible, but viewed with resentment. Conclusions Home visits are still an integral aspect of primary care in Germany and impose a considerable workload on many practices. Though the existing situation was generally perceived as unsatisfactory, German GPs

  14. Growing old at home – A randomized controlled trial to investigate the effectiveness and cost-effectiveness of preventive home visits to reduce nursing home admissions: study protocol [NCT00644826

    Directory of Open Access Journals (Sweden)

    Riedel-Heller Steffi G

    2008-05-01

    Full Text Available Abstract Background Regarding demographic changes in Germany it can be assumed that the number of elderly and the resulting need for long term care is increasing in the near future. It is not only an individual's interest but also of public concern to avoid a nursing home admission. Current evidence indicates that preventive home visits can be an effective way to reduce the admission rate in this way making it possible for elderly people to stay longer at home than without home visits. As the effectiveness and cost-effectiveness of preventive home visits strongly depends on existing services in the social and health system existing international results cannot be merely transferred to Germany. Therefore it is necessary to investigate the effectiveness and cost-effectiveness of such an intervention in Germany by a randomized controlled trial. Methods The trial is designed as a prospective multi-center randomized controlled trial in the cities of Halle and Leipzig. The trial includes an intervention and a control group. The control group receives usual care. The intervention group receives three additional home visits by non-physician health professionals (1 geriatric assessment, (2 consultation, (3 booster session. The nursing home admission rate after 18 months will be defined as the primary outcome. An absolute risk reduction from a 20% in the control-group to a 7% admission rate in the intervention group including an assumed drop out rate of 30% resulted in a required sample size of N = 320 (n = 160 vs. n = 160. Parallel to the clinical outcome measurement the intervention will be evaluated economically. The economic evaluation will be performed from a society perspective. Discussion To the authors' knowledge for the first time a trial will investigate the effectiveness and cost-effectiveness of preventive home visits for people aged 80 and over in Germany using the design of a randomized controlled trial. Thus, the trial will contribute to

  15. Pathways to Resilience: Enhancing Family Well-Being with a Home Visitation Model

    Directory of Open Access Journals (Sweden)

    Iván A. de la Rosa

    2015-03-01

    Full Text Available This paper highlights a study that examined outcome measures of a home visitation program, which provided services to first-born children and their parents living in Southwestern New Mexico. Home visitation workers conducted pre/posttest assessments for prenatal and postpartum periods for 109 families. The Revised North Carolina Family Assessment Scale measured family resilience. Paired sample t test and effect size analyses assessed for intervention effects. OLS regression measured effect of increased home visitation services on family well-being. Significant improvements with moderate to large effect sizes were observed for measures of social support, caregiver characteristics, family interaction, and a reduction in personal problems affecting parenting. These preliminary findings suggest that early intervention home visitation programs is an effective and acceptable method to enhance family well-being. Future directions could involve more comprehensive randomized controlled trials to examine the effectiveness of the group intervention. Practice implications are discussed.

  16. Family members' perceived meaning of visiting nursing home residents in Taiwan.

    Science.gov (United States)

    Tsai, Hsiu-Hsin; Tsai, Yun-Fang

    2012-02-01

    The purpose of this article is to report the findings of a study to explore perceived family meaning of visiting older nursing home residents in Taiwan. Family involvement in the care of institutionalized elders benefits residents, family and staff. Families have traditionally been involved through in-person visits. One factor influencing family visits is motivation, which is a vague concept, creating a need to better understand the meaning families ascribe to visiting nursing home residents. Understanding this meaning is necessary to develop intervention programmes that facilitate the quality of families' nursing-home visits. However, little is known about the meaning of family visits to nursing home residents in Asian countries. Data were collected April 2009-2010 in audiotaped, individual, in-depth interviews with 15 family members of residents at four nursing homes in Taiwan. These family members included five women and 10 men, predominantly residents' children and spouses. The meaning of family visits to nursing home residents was captured by five major themes: hoping for recovery, honouring filial/karmic responsibility, insuring care quality, maintaining family relationships and making up for guilt. The findings of this study can be considered by nurses and policy makers when designing interventions and allocating resources to improve the quality of family visits with nursing home residents. These interventions can be tailored to family members' perceived meanings for visiting, e.g. those hoping for residents' recovery may benefit from health-promotion programmes, and those honouring filial/karmic responsibility might be helped by education on different ways to show filial respect. © 2011 Blackwell Publishing Ltd.

  17. Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

    OpenAIRE

    Ammerman, Robert T.; Shenk, Chad E.; Teeters, Angelique R.; Noll, Jennie G.; Putnam, Frank W.; Van Ginkel, Judith B.

    2011-01-01

    Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the impacts of maternal depression and childhood trauma on parenting in the context of home visitation. This study contrasted depressed and non-depressed moth...

  18. Father participation in a community-doula home-visiting intervention with young, African American mothers.

    Science.gov (United States)

    Thullen, Matthew J; McMillin, Stephen Edward; Korfmacher, Jon; Humphries, Marisha L; Bellamy, Jennifer; Henson, Linda; Hans, Sydney

    2014-01-01

    This article examines the extent and nature of father participation in a perinatal, community-based doula home-visiting intervention that served young, African American mothers from low-income backgrounds and their infants. Home-visitor service records were used to assess the quantity, setting, and content of father-attended visits. Correlates of fathers' participation and thematic insights from mothers' and home-visitors' perspectives on how fathers perceived and interacted with the home-visiting program were analyzed to further characterize the nature of father participation. Although the community-doula home-visiting model does not include special outreach to increase father participation, almost half of the mothers had a doula visit at which their baby's father was present, many of which took place in medical settings. Mothers and doulas reported that fathers were generally positive about the doula, but expressed that fathers viewed the doula as a substitute provider of support that fathers seemed reticent to provide themselves. These results suggest that community doulas who visit pre- and postpartum in multiple settings have unique opportunities to have contact with fathers that traditional home visitors or early childhood specialists may not have.

  19. [Effects of different home visit strategies on prenatal care in Southern Brazil].

    Science.gov (United States)

    Cesar, Juraci A; Mendoza-Sassi, Raul A; Ulmi, Eduardo F; Dall'Agnol, Marinel M; Neumann, Nelson A

    2008-11-01

    This non-randomized community intervention study evaluated the impact of prenatal home visits by community health agents and volunteer leaders from the Children's Mission on prenatal care among poor pregnant women in Rio Grande, Rio Grande do Sul State, Brazil. Previously trained interviewers applied pre-coded questionnaires to the women at home, investigating demographic and reproductive characteristics, socioeconomic status, housing conditions, and prenatal care. Of the 339 pregnant women interviewed, 115 were assigned to the intervention group visited by community health agents, 116 to the group visited by volunteer leaders, and 108 to the control group. Pregnant women visited by community health agents began prenatal visits earlier than other groups, had more prenatal visits, lab tests, and clinical exams, and received more counseling on breastfeeding and iron supplementation. Participation by family members during medical consultations for pregnant women visited by volunteer leaders was higher than for community health agents. Pregnant women visited by community health agents received better prenatal care than the other groups. Home visits can improve the quality of prenatal care for poor women and increase participation by family members (mainly husbands) during the pregnancy.

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

    Science.gov (United States)

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

    2013-08-01

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

  1. Home Visiting for At-Risk Preschoolers: A Successful Model for Latino Families

    Science.gov (United States)

    Nievar, M. Angela; Jacobson, A.; Dier, S.

    2008-01-01

    The Home Instruction for Parents of Preschool Youngsters (HIPPY) program promotes school readiness by providing services directly to parents through home visitation. This study describes the outcomes of the HIPPY program for Latino immigrant families in a large Southwestern city. A quasi-experimental design compared 48 families on the program…

  2. General practice cooperatives : long waiting times for home visits due to long distances?

    NARCIS (Netherlands)

    Giesen, P.H.J.; Lin, N.G.C.B. van; Mokkink, H.G.A.; Bosch, W.J.H.M. van den; Grol, R.P.T.M.

    2007-01-01

    BACKGROUND: The introduction of large-scale out-of-hours GP cooperatives has led to questions about increased distances between the GP cooperatives and the homes of patients and the increasing waiting times for home visits in urgent cases. We studied the relationship between the patient's waiting

  3. Randomized trial of a cellular phone-enhanced home visitation parenting intervention.

    Science.gov (United States)

    Carta, Judith J; Lefever, Jennifer Burke; Bigelow, Kathryn; Borkowski, John; Warren, Steven F

    2013-11-01

    Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to examine whether mothers in a parenting intervention, Planned Activities Training (PAT), or cellular phone-enhanced version (CPAT) of the intervention would demonstrate greater use of parenting strategies after treatment and at 6 months post-treatment compared with a wait-list control (WLC). A sample of 371 low-income mothers and their 3.5- to 5.5-year-old children were randomly assigned to condition and assessed at pre-test, post-intervention, and 6 months post-intervention. Treatment efficacy was evaluated through observations of mother-child interactions as well as maternal interviews about depression, parenting stress, and child behaviors. Mothers receiving PAT and CPAT demonstrated more frequent use of parenting strategies and engaged in more responsive parenting than mothers in the WLC. Mothers receiving CPAT used more PAT parenting strategies than mothers in the other 2 groups and experienced greater reductions in depression and stress. Children of mothers receiving PAT and CPAT demonstrated higher rates of positive engagement, and children of CPAT mothers demonstrated higher levels of adaptive behaviors than children in the WLC. Importantly, changes in parenting, depression, and stress predicted positive child behaviors. PAT and CPAT conditions improved parenting strategies and child engagement and reduced children's challenging behaviors. The addition of cellular phones to a home visiting program enhanced maternal responsivity and reduced depression and stress.

  4. Randomized Trial of a Cellular Phone-Enhanced Home Visitation Parenting Intervention

    Science.gov (United States)

    Lefever, Jennifer Burke; Bigelow, Kathryn; Borkowski, John; Warren, Steven F.

    2013-01-01

    BACKGROUND AND OBJECTIVES: Although home visiting programs have been documented to improve parenting in high-risk families, their effectiveness is diminished when parents disengage from programs. Cellular phones offer an approach to promoting parent engagement and enhancing parenting outcomes. Our objective was to examine whether mothers in a parenting intervention, Planned Activities Training (PAT), or cellular phone-enhanced version (CPAT) of the intervention would demonstrate greater use of parenting strategies after treatment and at 6 months post-treatment compared with a wait-list control (WLC). METHODS: A sample of 371 low-income mothers and their 3.5- to 5.5-year-old children were randomly assigned to condition and assessed at pre-test, post-intervention, and 6 months post-intervention. Treatment efficacy was evaluated through observations of mother-child interactions as well as maternal interviews about depression, parenting stress, and child behaviors. RESULTS: Mothers receiving PAT and CPAT demonstrated more frequent use of parenting strategies and engaged in more responsive parenting than mothers in the WLC. Mothers receiving CPAT used more PAT parenting strategies than mothers in the other 2 groups and experienced greater reductions in depression and stress. Children of mothers receiving PAT and CPAT demonstrated higher rates of positive engagement, and children of CPAT mothers demonstrated higher levels of adaptive behaviors than children in the WLC. Importantly, changes in parenting, depression, and stress predicted positive child behaviors. CONCLUSIONS: PAT and CPAT conditions improved parenting strategies and child engagement and reduced children’s challenging behaviors. The addition of cellular phones to a home visiting program enhanced maternal responsivity and reduced depression and stress. PMID:24187120

  5. The effect of early postpartum home visits by health visitors: a natural experiment

    DEFF Research Database (Denmark)

    Kronborg, Hanne; Væth, Michael; Kristensen, Ingeborg

    2012-01-01

    included 3834 newborn and 375 health visitors, 75 of whom worked during the strike period. Intervention: All families were offered non- standardized home visits after discharge in the reference period. During the strike, the service was based on individual risk assessment. Results: Overall, no difference....... The mothers’ needs for postnatal visits differed depending on parity: primiparae underlined uncertainty, multiparae underlined previous breastfeeding experience. Mothers had missed out on guidance on all areas of the health visitors’ service. Conclusion: Non-standardized home visits by health visitors were...

  6. Delegation of GP-home visits to qualified practice assistants: assessment of economic effects in an ambulatory healthcare centre

    Directory of Open Access Journals (Sweden)

    Fleßa Steffen

    2010-06-01

    Full Text Available Abstract Background Against the background of a decreasing number of general practitioners (GPs in rural regions in Germany, the AGnES-concept (AGnES = GP-supporting, community-based, e-health-assisted, systemic intervention supports the delegation of regular GP-home visits to qualified practice assistants. The concept was implemented and evaluated in different model projects in Germany. To explore the economic effects of this concept, the development of the number of home visits in an ambulatory healthcare centre was analysed and compared with the number of home visits in the surrounding county. Methods Information about GP-home visits was derived from reimbursement data of the ambulatory healthcare centre and a statutory health insurance. Information about home visits conducted by AGnES-practice assistants was collected from the project documentation over a time period of 12 consecutive quarter years, four quarter years before the beginning of the project and 8 quarter years while the project was implemented, considering background temporal trends on the population level in the study region. Results Within the ambulatory healthcare centre, the home visits by the GPs significantly decreased, especially the number of medically urgent home visits. However, the overall rate of home visits (conducted by the GPs and the AGnES-practice assistants together did not change significantly after implementation of the AGnES-concept. In the surrounding county, the home visit rates of the GPs were continuous; the temporal patterns were approximately equal for both usual and urgent home visits. Conclusion The results of the analyses show that the support by AGnES-practice assistants led to a decrease of GP-home visits rather than an induction of additional home visits by the AGnES-practice assistants. The most extended effect is related to the medically urgent home visits rather than to the usual home visits.

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

    Directory of Open Access Journals (Sweden)

    Charlotte Löfqvist

    2012-01-01

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

  8. The impact of paraprofessional home visitors on infants' growth and health at 18 months.

    Science.gov (United States)

    le Roux, Ingrid M; Rotheram-Borus, Mary Jane; Stein, Judith; Tomlinson, Mark

    2014-01-01

    Paraprofessional home visitors trained to improve multiple outcomes (HIV, alcohol, infant health, and malnutrition) have been shown to benefit mothers and children over 18 months in a cluster randomised controlled trial (RCT). These longitudinal analyses examine the mechanisms which influence child outcomes at 18 months post-birth in Cape Town, South Africa. The results were evaluated using structural equation modelling, specifically examining the mediating effects of prior maternal behaviours and a home visiting intervention post-birth. Twelve matched pairs of neighbourhoods were randomised within pairs to: 1) the control condition, receiving comprehensive healthcare at community primary health care clinics (n=12 neighbourhoods; n=594 pregnant women), or 2) the Philani Intervention Program, which provided home visits by trained, paraprofessional community health workers, here called Mentor Mothers, in addition to clinic care (n=12 neighbourhoods; n=644 pregnant women). Recruitment of all pregnant neighbourhood women was high (98%) with 88% reassessed at six months and 84% at 18 months. Infants' growth and diarrhoea episodes were examined at 18 months in response to the intervention condition, breastfeeding, alcohol use, social support, and low birth weight, controlling for HIV status and previous history of risk. We found that randomisation to the intervention was associated with a significantly lower number of recent diarrhoea episodes and increased rates and duration of breastfeeding. Across both the intervention and control conditions, mothers who used alcohol during pregnancy and had low birth weight infants were significantly less likely to have infants with normal growth patterns, whereas social support was associated with better growth. HIV-infection was significantly associated with poor growth and less breastfeeding. Women with more risk factors had significantly smaller social support networks. The relationships among initial and sustained maternal risk

  9. Visiting nurses' posthospital medication management in home health care

    DEFF Research Database (Denmark)

    Kollerup, Mette Geil; Curtis, Tine; Schantz Laursen, Birgitte

    2017-01-01

    BACKGROUND: Medication management is the most challenging component of a successful transition from hospital to home, a challenge of growing complexity as the number of older persons living with chronic conditions grows, along with increasingly specialised and accelerated hospital treatment plans...

  10. Identification of the need for home visiting nurse: development of a new assessment tool

    Directory of Open Access Journals (Sweden)

    Atsuko Taguchi

    2014-03-01

    Full Text Available Objective: To develop a Home Visiting Nursing Service Need Assessment Form (HVNS-NAF to standardize the decision about the need for home visiting nursing service. Methods: The sample consisted of older adults who had received coordinated services by care managers. We defined the need for home visiting nursing service by elderly individuals as the decision of the need by a care manager so that the elderly can continue to live independently. Explanatory variables included demographic factors, medical procedure, severity of illness, and caregiver variables. Multiple logistic regression was carried out after univariate analyses to decide the variables to include and the weight of each variable in the HVNS-NAF. We then calculated the sensitivity and specificity of each cut-off value, and defined the score with the highest sensitivityand specificity as the cut-off value. Results: Nineteen items were included in the final HVNS-NAF. When the cut-off value was 2 points, the sensitivity was 77.0%, specificity 68.5%, and positive predictive value 56.8%. Conclusions: HVNS-NAF is the first validated standard based on characteristics of elderly clients who required home visiting nursing service. Using the HVNS-NAF may result in reducing the unmet need for home visiting nursing service and preventing hospitalization.

  11. Individual and organizational factors related to work engagement among home-visiting nurses in Japan.

    Science.gov (United States)

    Naruse, Takashi; Sakai, Mahiro; Watai, Izumi; Taguchi, Atsuko; Kuwahara, Yuki; Nagata, Satoko; Murashima, Sachiyo

    2013-12-01

    The increasing number of elderly people has caused increased demand for home-visiting nurses. Nursing managers should develop healthy workplaces in order to grow their workforce. This study investigated the work engagement of home-visiting nurses as an index of workplace health. The aim of the present study was to reveal factors contributing to work engagement among Japanese home-visiting nurses. An anonymous, self-administered questionnaire was sent to 208 home-visiting nurses from 28 nursing agencies in three districts; 177 (85.1%) returned the questionnaires. The Job Demands-Resources model, which explains the relationship between work environment and employee well-being, was used as a conceptual guide. The authors employed three survey instruments: (i) questions on individual variables; (ii) questions on organizational variables; and (iii) the Utrecht Work Engagement Scale (Japanese version). Multiple regression analyses were performed in order to examine the relationships between individual variables, organizational variables, and work engagement. Nurse managers and nurses who felt that there was a positive relationship between work and family had significantly higher work engagement levels than others. The support of a supervisor was significantly associated with work engagement. Nurses in middle-sized but not large agencies had significantly higher work engagement than nurses in small agencies. Supervisor support and an appropriate number of people reporting to each supervisor are important factors in fostering work engagement among home-visiting nurses. © 2013 The Authors. Japan Journal of Nursing Science © 2013 Japan Academy of Nursing Science.

  12. Inside the Black Box of Home Visiting: A Qualitative Analysis of Why Intended Outcomes Were Not Achieved.

    Science.gov (United States)

    Hebbeler, Kathleen M.; Gerlach-Downie, Suzanne G.

    2002-01-01

    This qualitative longitudinal investigation examined why a home visiting program was not more effective. Findings indicated that home visits had a consistent structure and that home visitors emphasized their social support role, placing little emphasis on changing parenting behavior. It was suggested that the program's flawed theory of change,…

  13. The Importance of Trust in Successful Home Visit Programs for Older People

    Directory of Open Access Journals (Sweden)

    Maaike E. Muntinga

    2016-11-01

    Full Text Available Outcomes of proactive home visit programs for frail, older people might be influenced by aspects of the caregiver–receiver interaction. We conducted a naturalistic case study to explore the interactional process between a nurse and an older woman during two home visits. Using an ethics of care, we posit that a trusting relationship is pivotal for older people to accept care that is proactively offered to them. Trust can be build when nurses meet the relational needs of older people. Nurses can achieve insight in these needs by exploring older people’s value systems and life stories. We argue that a strong focus on older people’s relational needs might contribute to success of proactive home visits for frail, older people.

  14. The Importance of Trust in Successful Home Visit Programs for Older People

    Directory of Open Access Journals (Sweden)

    Maaike E. Muntinga

    2016-11-01

    Full Text Available Outcomes of proactive home visit programs for frail, older people might be influenced by aspects of the caregiver–receiver interaction. We conducted a naturalistic case study to explore the interactional process between a nurse and an older woman during two home visits. Using an ethics of care, we posit that a trusting relationship is pivotal for older people to accept care that is proactively offered to them. Trust can be build when nurses meet the relational needs of older people. Nurses can achieve insight in these needs by exploring older people’s value systems and life stories. We argue that a strong focus on older people’s relational needs might contribute to success of proactive home visits for frail, older people.

  15. Preventive home visits to older people in Denmark: methodology of a randomized controlled study

    DEFF Research Database (Denmark)

    Vass, Mikkel; Avlund, Kirsten; Hendriksen, Carsten

    2002-01-01

    BACKGROUND AND AIMS: Preventive home visits were introduced by legislation in Denmark in 1998. This ongoing randomized controlled intervention study introduces a model where preventive home visits to elderly people are carried out in a standardized way, focusing on early signs of disability...... and on physical activity. The study includes general practitioners (GPs) in relevant parts of the assessment and endeavors coordinated interdisciplinary follow-up. Our main aim was to investigate whether this model gives enhanced active life expectancy, but the focus of the present paper is the design...

  16. General practitioners' home visit tendency and readmission-free survival after COPD hospitalisation

    DEFF Research Database (Denmark)

    Lykkegaard, Jesper; Larsen, Pia V; Paulsen, Maja S;

    2014-01-01

    obstructive pulmonary disease.Methods:All Danish patients first-time hospitalised with COPD during the years 2006-2008 were identified. The association between the GP's tendency to conduct home visits and the time from hospital discharge until death or all-cause readmission was analysed by means of Cox...... been readmitted and 1.6% had died without readmission. A U-shaped dose-response relationship was found between GP home visit tendency and readmission-free survival. The lowest adjusted risk of readmission or death was recorded among patients who were listed with a general practice in which >20...

  17. Universal and targeted early home visiting: perspectives of public health nurses, managers and mothers

    Directory of Open Access Journals (Sweden)

    Megan Aston

    2014-07-01

    Full Text Available Early home visits provided by public health nurses (PHNs around the world have been proven to positively impact physical, social, emotional and mental health outcomes of mothers and babies. Most of the research has focused on home visiting programs delivered by public health nurses and lay home visitors to support at risk or targeted mothers. Little research has been conducted to examine universal home visiting programs for mothers who are perceived to be lower-risk. The purpose of this research was to explore how universal and targeted early home visiting programs for mothers and babies were organized, delivered and experienced through the everyday practices of PHNs, mothers, and managers in one city in Atlantic Canada. Feminist post-structuralism was used to collect and analyze data through semi-structured face-to-face interviews with 16 PHNs, 16 mothers and 4 managers. Personal, social and institutional discourses of program delivery were examined using discourse analysis. Four main themes of the study include: i understanding targeted and universal programming; ii health outcomes; iii building relationships; and iv exploring a new surveillance. This article will discuss the first theme; understanding targeted and universal programming.

  18. Identifying potentially preventable emergency department visits by nursing home residents in the United States

    Science.gov (United States)

    Burke, Robert E.; Rooks, Sean P.; Levy, Cari; Schwartz, Robert; Ginde, Adit A.

    2015-01-01

    Objectives To identify and describe potentially preventable emergency department (ED) visits by nursing home (NH) residents in the United States. These visits are important because they are common, frequently lead to hospitalization, and can be associated with significant cost to the patient and the health care system. Design Retrospective analysis of the 2005-2010 National Hospital Ambulatory Care Survey (NHAMCS), comparing ED visits by nursing home residents that did not lead to hospital admission (potentially preventable) to those that led to admission (less likely preventable). Setting Nationally representative sample of United States EDs; Federal hospitals and hospitals with less than six beds were excluded. Participants Older (age ≥65 years) nursing home residents with an ED visit during this time period. Measurements Patient demographics, ED visit information including testing performed, interventions (both procedures and medications) provided, and diagnoses treated. Results Older NH residents accounted for 3,857 of 208,956 ED visits during the time period of interest (1.8%). When weighted to be nationally representative, these represent 13.97 million ED visits, equivalent to 1.8 ED visits annually per NH resident in the United States. More than half of visits (53.5%) did not lead to hospital admission; of those discharged from the ED, 62.8% had normal vital signs on presentation and 18.9% did not have any diagnostic testing prior to ED discharge. Injuries were 1.78 times more likely to be discharged than admitted (44.8% versus 25.3%, respectively, p<0.001), while infections were 2.06 times as likely to be admitted as discharged (22.9% versus 11.1%, respectively). CT scans were performed in 25.4% and 30.1% of older NH residents who were discharged from the ED and admitted to the hospital, respectively, and more than 70% of these were CTs of the head. NH residents received centrally acting, sedating medications prior to ED discharge in 9.4% of visits

  19. Implementing Universal Maternal Depression Screening in Home Visiting Programs: A Pragmatic Overview

    Science.gov (United States)

    Segre, Lisa S.; Taylor, Darby

    2014-01-01

    Maternal depression, although prevalent in low-income women, is not an inevitable consequence of poverty. Nevertheless, depression is a double burden for impoverished women: compromising infant development and diminishing mothers' ability to benefit from or effectively use home visiting services. Without universal screening, depression is often…

  20. Preventing Perinatal Depression through Home Visiting: The Mothers and Babies Course

    Science.gov (United States)

    Perry, Deborah F.; Tandon, S. Darius; Edwards, Karen; Mendelson, Tamar

    2014-01-01

    Home visiting (HV) programs serve women at high risk for developing postpartum depression because of factors such as poverty and low social support. Depression poses serious threats not only to mother-child attachment and healthy infant development but also to women's ability to engage with HV services and supports. The Mothers and Babies (MB)…

  1. The Effectiveness of Healthy Start Home Visit Program: Cluster Randomized Controlled Trial

    Science.gov (United States)

    Leung, Cynthia; Tsang, Sandra; Heung, Kitty

    2015-01-01

    Purpose: The study reported the effectiveness of a home visit program for disadvantaged Chinese parents with preschool children, using cluster randomized controlled trial design. Method: Participants included 191 parents and their children from 24 preschools, with 84 dyads (12 preschools) in the intervention group and 107 dyads (12 preschools) in…

  2. Effectiveness of home visiting in reducing partner violence for families experiencing abuse: A systematic review

    NARCIS (Netherlands)

    Prosman, G.J.; Wong, S.H.; Wouden, J.C. van der; Lagro-Janssen, A.L.M.

    2015-01-01

    BACKGROUND: Intimate partner violence (IPV) against women is a major, global societal problem with enormous health consequences both for mother and child. Home visiting interventions in families at risk of abuse seem promising in decreasing IPV. In this systematic review, we aim to assess the effect

  3. Effectiveness of Home Visiting as a Strategy for Promoting Children's Adjustment to School

    Science.gov (United States)

    Kirkland, Kristen

    2013-01-01

    A growing body of evidence suggests that involving families in home visiting services promotes positive experiences during the initial years of a child's life; however less is known about whether or not the benefits continue to accrue after a child enters school. This article describes the results of a study examining the effectiveness of an…

  4. Supporting Family Engagement in Home Visiting with the Family Map Inventories

    Science.gov (United States)

    Kyzer, Angela; Whiteside-Mansell, Leanne; McKelvey, Lorraine; Swindle, Taren

    2016-01-01

    The purpose of this study was to examine the feasibility and usefulness of a universal screening tool, the Family Map Inventory (FMI), to assess family strengths and needs in a home visiting program. The FMI has been used successfully by center-based early childcare programs to tailor services to family needs and build on existing strengths. Home…

  5. Social Work Home Visits to Children and Families in the UK: A Foucauldian Perspective.

    Science.gov (United States)

    Winter, Karen; Cree, Viviene E

    2016-07-01

    The home visit is at the heart of social work practice with children and families; it is what children and families' social workers do more than any other single activity (except for recording), and it is through the home visit that assessments are made on a daily basis about risk, protection and welfare of children. And yet it is, more than any other activity, an example of what Pithouse has called an 'invisible trade': it happens behind closed doors, in the most secret and intimate spaces of family life. Drawing on conceptual tools associated with the work of Foucault, this article sets out to provide a critical, chronological review of research, policy and practice on home visiting. We aim to explain how and in what ways changing discourses have shaped the emergence, legitimacy, research and practice of the social work home visit to children and families at significant time periods and in a UK context. We end by highlighting the importance for the social work profession of engagement and critical reflection on the identified themes as part of their daily practice.

  6. Does Home Visiting Benefit Only First-Time Mothers?: Evidence from Healthy Families Virginia

    Science.gov (United States)

    Huntington, Lee; Galano, Joseph

    2013-01-01

    It is a common assumption that mothers who have had previous births would participate less fully and have poorer outcomes from early home visitation programs than would first-time mothers. The authors conducted a qualitative and quantitative study to test that assumption by measuring three aspects of participation: time in the program, the number…

  7. Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Shenk, Chad E.; Teeters, Angelique R.; Noll, Jennie G.; Putnam, Frank W.; Van Ginkel, Judith B.

    2012-01-01

    Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the…

  8. Social Work Home Visits to Children and Families in the UK: A Foucauldian Perspective

    Science.gov (United States)

    Winter, Karen; Cree, Viviene E.

    2016-01-01

    The home visit is at the heart of social work practice with children and families; it is what children and families' social workers do more than any other single activity (except for recording), and it is through the home visit that assessments are made on a daily basis about risk, protection and welfare of children. And yet it is, more than any other activity, an example of what Pithouse has called an ‘invisible trade’: it happens behind closed doors, in the most secret and intimate spaces of family life. Drawing on conceptual tools associated with the work of Foucault, this article sets out to provide a critical, chronological review of research, policy and practice on home visiting. We aim to explain how and in what ways changing discourses have shaped the emergence, legitimacy, research and practice of the social work home visit to children and families at significant time periods and in a UK context. We end by highlighting the importance for the social work profession of engagement and critical reflection on the identified themes as part of their daily practice. PMID:27559221

  9. Impact of Depression and Childhood Trauma in Mothers Receiving Home Visitation

    Science.gov (United States)

    Ammerman, Robert T.; Shenk, Chad E.; Teeters, Angelique R.; Noll, Jennie G.; Putnam, Frank W.; Van Ginkel, Judith B.

    2012-01-01

    Research has documented the deleterious effects of maternal depression and childhood trauma on parenting and child development. There are high rates of both depression and childhood trauma in new mothers participating in home visitation programs, a prevention approach designed to optimize mother and child outcomes. Little is known about the…

  10. Building Practice Evidence for Parent Mentoring Home Visiting in Early Childhood

    Science.gov (United States)

    Zajicek-Farber, Michaela L.

    2010-01-01

    Objective: A multidisciplinary preventive parent mentoring intervention was applied through home visiting with high-risk families receiving well-baby health care. Two implementations were examined for effectiveness. Method: The first implementation employed a quasiexperimental nonequivalent group design, whereas the second used a randomized…

  11. Projected Outcomes of Nurse-Family Partnership Home Visitation During 1996-2013, United States

    Science.gov (United States)

    Miller, Ted R.

    2015-01-01

    Nurse-Family Partnership (NFP) targets intensive prenatal and postnatal home visitation by registered nurses to low-income first-time mothers. Through 2013, 177,517 pregnant women enrolled in NFP programs. This article projects how NFP will affect their lives and the lives of their babies. NFP has been evaluated in six randomized trials and several more limited analyses of operational programs. We systematically reviewed evaluation findings on 21 outcomes and calculated effects on 3 more. We added outcome data from the NFP national data system and personal communications that filled outcome data gaps on some trials. We assumed effectiveness in replication declined by 21.8%, proportionally with the decline in mean visits per family from trials to operational programs. By 2031, NFP program enrollments in 1996-2013 will prevent an estimated 500 infant deaths, 10,000 preterm births, 13,000 dangerous closely spaced second births, 4,700 abortions, 42,000 child maltreatment incidents, 36,000 intimate partner violence incidents, 90,000 violent crimes by youth, 594,000 property and public order crimes (e.g., vandalism, loitering) by youth, 36,000 youth arrests, and 41,000 person-years of youth substance abuse. They will reduce smoking during pregnancy, pregnancy complications, childhood injuries, and use of subsidized child care; improve language development, increase breast-feeding, and raise compliance with immunization schedules. They will eliminate the need for 4.8 million person-months of child Medicaid spending and reduce estimated spending on Medicaid, TANF, and food stamps by $3.0 billion (present values in 2010 dollars). By comparison, NFP cost roughly $1.6 billion. Thus, NFP appears to be a sound investment. It saves money while enriching the lives of participating low-income mothers and their offspring and benefiting society more broadly by reducing crime and safety net demand. PMID:26076883

  12. Projected Outcomes of Nurse-Family Partnership Home Visitation During 1996-2013, USA.

    Science.gov (United States)

    Miller, Ted R

    2015-08-01

    Nurse-Family Partnership (NFP) targets intensive prenatal and postnatal home visitation by registered nurses to low-income first-time mothers. Through 2013, 177,517 pregnant women enrolled in NFP programs. This article projects how NFP will affect their lives and the lives of their babies. NFP has been evaluated in six randomized trials and several more limited analyses of operational programs. We systematically reviewed evaluation findings on 21 outcomes and calculated effects on three more. We added outcome data from the NFP national data system and personal communications that filled outcome data gaps on some trials. We assumed effectiveness in replication declined by 21.8 %, proportionally with the decline in mean visits per family from trials to operational programs. By 2031, NFP program enrollments in 1996-2013 will prevent an estimated 500 infant deaths, 10,000 preterm births, 13,000 dangerous closely spaced second births, 4700 abortions, 42,000 child maltreatment incidents, 36,000 intimate partner violence incidents, 90,000 violent crimes by youth, 594,000 property and public order crimes (e.g., vandalism, loitering) by youth, 36,000 youth arrests, and 41,000 person-years of youth substance abuse. They will reduce smoking during pregnancy, pregnancy complications, childhood injuries, and use of subsidized child care; improve language development; increase breast-feeding; and raise compliance with immunization schedules. They will eliminate the need for 4.8 million person-months of child Medicaid spending and reduce estimated spending on Medicaid, TANF, and food stamps by $3.0 billion (present values in 2010 dollars). By comparison, NFP cost roughly $1.6 billion. Thus, NFP appears to be a sound investment. It saves money while enriching the lives of participating low-income mothers and their offspring and benefiting society more broadly by reducing crime and safety net demand.

  13. Boston children's hospital community asthma initiative: Five-year cost analyses of a home visiting program.

    Science.gov (United States)

    Bhaumik, Urmi; Sommer, Susan J; Giller-Leinwohl, Judith; Norris, Kerri; Tsopelas, Lindsay; Nethersole, Shari; Woods, Elizabeth R

    2017-03-01

    To evaluate the costs and benefits of the Boston Children's Hospital Community Asthma Initiative (CAI) through reduction of Emergency Department (ED) visits and hospitalizations for the full pilot-phase program participants. A cost-benefit analyses was conducted using hospital administrative data to determine an adjusted Return on Investment (ROI): on all 268 patients enrolled in the CAI program during the 33-month pilot program phase of CAI intervention between October 1, 2005 and June 30, 2008 using a comparison group of 818 patients from a similar cohort in neighboring ZIP codes without CAI intervention. Cost data through June 30, 2013 were used to examine cost changes and calculate an adjusted ROI over a 5-year post-intervention period. CAI patients had a cost reduction greater than the comparison group of $1,216 in Year 1 (P = 0.001), $1,320 in Year 2 (P Year 3, $1,123 (P = 0.004) in Year 4, and $997 (P = 0.022) in Year 5. Adjusting for the cost savings for the comparison group, the cost savings from the intervention resulted in an adjusted ROI of 1.91 over 5 years. Community-based, multidisciplinary, coordinated disease management programs can decrease the incidence of costly hospitalizations and ED visits from asthma. An ROI of greater than one, as found in this cost analysis, supports the business case for the provision of community-based asthma services as part of patient-centered medical homes and Accountable Care Organizations.

  14. Early detection of parenting and developmental problems in toddlers : A randomized trial of home visits versus well-baby clinic visits in the Netherlands

    NARCIS (Netherlands)

    Staal, Ingrid I E; van Stel, Henk F.; Hermanns, Jo M A; Schrijvers, Augustinus J P

    2015-01-01

    Objective: The early detection of parenting and developmental problems by preventive child health care (CHC) services in the Netherlands takes place almost exclusively at the well-baby clinic. This study assesses whether, compared to a visit to the well-baby clinic, a home visit improves early detec

  15. The Relationship Between the Use of a Worksite Medical Home and ED Visits or Hospitalizations

    Directory of Open Access Journals (Sweden)

    Marissa Stroo BS

    2015-10-01

    Full Text Available Worksite medical homes may be a good model for improving employee health. The aim of this study was to compare the likelihood of being seen in the emergency department (ED or being hospitalized by level of use (no use, occasional use, or primary care of a worksite medical home, overall and by type of user (employee, adult dependent, or pediatric dependent. This was a retrospective analysis of claims data, using covariate-adjusted logistic regression models for ED visits and inpatient hospitalizations. Secondary data for the years 2006 to 2008 from a company that offers an on-site health care center (HCC were used. Analyses were based on a data set that combines health plan claims and human resources demographic data. Overall, people who did not use the HCC were more likely to be seen in the ED (adjusted odds ratio [OR] = 1.20, 95% confidence interval or CI [1.06, 1.37], P = .005 or to be hospitalized (adjusted OR = 1.58; 95% CI [1.34, 1.86]; P < .0001 compared with those who used the HCC for primary care. Both ED visits and hospitalizations for employees and dependents in this study were lower among those who used the worksite medical home for primary care. Worksite medical homes can improve chronic disease management and thus reduce ED visits and hospitalizations. These findings contribute to growing evidence that worksite medical homes are potentially cost-effective.

  16. Effectiveness of home visiting programs on child outcomes: a systematic review

    Directory of Open Access Journals (Sweden)

    Peacock Shelley

    2013-01-01

    Full Text Available Abstract Background The effectiveness of paraprofessional home-visitations on improving the circumstances of disadvantaged families is unclear. The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families. Methods A comprehensive search of electronic databases (e.g., CINAHL PLUS, Cochrane, EMBASE, MEDLINE from 1990 through May 2012 was supplemented by reference lists to search for relevant studies. Through the use of reliable tools, studies were assessed in duplicate. English language studies of paraprofessional home-visiting programs assessing specific outcomes for children (0-6 years from disadvantaged families were eligible for inclusion in the review. Data extraction included the characteristics of the participants, intervention, outcomes and quality of the studies. Results Studies that scored 13 or greater out of a total of 15 on the validity tool (n = 21 are the focus of this review. All studies are randomized controlled trials and most were conducted in the United States. Significant improvements to the development and health of young children as a result of a home-visiting program are noted for particular groups. These include: (a prevention of child abuse in some cases, particularly when the intervention is initiated prenatally; (b developmental benefits in relation to cognition and problem behaviours, and less consistently with language skills; and (c reduced incidence of low birth weights and health problems in older children, and increased incidence of appropriate weight gain in early childhood. However, overall home-visiting programs are limited in improving the lives of socially high-risk children who live in disadvantaged families. Conclusions Home visitation by paraprofessionals is an intervention that holds promise for socially high-risk families with young children. Initiating the

  17. Impact of a Kentucky Maternal, Infant, and Early Childhood Home-Visitation Program on Parental Risk Factors

    Science.gov (United States)

    Ferguson, Jonnisa M.; Vanderpool, Robin C.

    2013-01-01

    As public health organizations continue to implement maternal and child health home-visitation programs, more evaluation of these efforts is needed, particularly as it relates to improving parental behaviors. The purpose of our study was to assess the impact of families' participation in a home-visitation program offered by a central Kentucky…

  18. Improving newborn care practices through home visits: lessons from Malawi, Nepal, Bangladesh, and Uganda

    Directory of Open Access Journals (Sweden)

    Deborah Sitrin

    2015-03-01

    Full Text Available Background: Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda. Objective: This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices. Design: Using data from cross-sectional surveys of women with live births at baseline and endline, the Pearson chi-squared test was used to assess changes over time. Generalised linear models were used to assess the relationship between the main independent variable – home visit from a community health worker (CHW during pregnancy (0, 1–2, 3+ – and use of selected practices while controlling for antenatal care, place of delivery, and maternal age and education. Results: There were statistically significant improvements in practices, except applying nothing to the cord in Malawi and early initiation of breastfeeding in Bangladesh. In Malawi, Nepal, and Bangladesh, women who were visited by a CHW three or more times during pregnancy were more likely to report use of selected practices. Women who delivered in a facility were also more likely to report use of selected practices in Malawi, Nepal, and Uganda; association with place of birth was not examined in Bangladesh because only women who delivered outside a facility were asked about these practices. Conclusion: Home visits can play a role in improving practices in different settings. Multiple interactions are needed, so programmes need to investigate the most appropriate and efficient ways to reach families and promote newborn care practices. Meanwhile, programmes must take advantage of

  19. Home visitation programs: An untapped opportunity for the delivery of early childhood obesity prevention

    Science.gov (United States)

    Salvy, Sarah-Jeanne; de la Haye, Kayla; Galama, Titus; Goran, Michael I.

    2016-01-01

    Background Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: 1) short duration and low intensity; 2) late timing of implementation, when children are already overweight or obese; 3) intervention delivery limiting their accessibility and sustainability; and 4) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. Objective This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. Conclusion The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (1) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health due to socio-economic and structural conditions; (2) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (3) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. PMID:27911984

  20. Therapeutic effects of dog visits in nursing homes for the elderly

    DEFF Research Database (Denmark)

    Thodberg, Karen; Uhrskov, Lisbeth; Christensen, Janne Winther

    2016-01-01

    .5 years; [79; 90]) from four nursing homes were randomly assigned to receive biweekly visits for 6 weeks from a person accompanied by either a dog, a robot seal (PARO), or a soft toy cat. Sleep patterns were measured using actigraphy technology before, during (the third and sixth week), and after...... by a dog rather than the robot seal or soft toy cat (dog: 610 1 127 min; seal: 498 1 146 min; cat: 540 1 163 min; F2,37 = 4.99; P = 0.01). No effects were found in the sixth week or after the visit period had ended. We found that visit type had no effect on weight (F2,88 = 0.13; P > 0.05), body mass index......Background: Previous studies have suggested that visiting dogs can have positive effects on elderly people in nursing homes. We wanted to study the effects of biweekly dog visits on sleep patterns and the psychiatric wellbeing of elderly people. Methods: A total of 100 residents (median age: 85...

  1. Continuity in a VA patient-centered medical home reduces emergency department visits.

    Directory of Open Access Journals (Sweden)

    Krisda H Chaiyachati

    Full Text Available One major goal of the Patient-Centered Medical Home (PCMH is to improve continuity of care between patients and providers and reduce the utilization of non-primary care services like the emergency department (ED.To characterize continuity under the Veterans Health Administration's PCMH model--the Patient Aligned Care Team (PACT, at one large Veterans Affair's (VA's primary care clinic, determine the characteristics associated with high levels of continuity, and assess the association between continuity and ED visits.Retrospective, observational cohort study of patients at the West Haven VA (WHVA Primary Care Clinic from March 2011 to February 2012.The 13,495 patients with established care at the Clinic, having at least one visit, one year before March 2011.Our exposure variable was continuity of care--a patient seeing their assigned primary care provider (PCP at each clinic visit. The outcome of interest was having an ED visit.The patients encompassed 42,969 total clinic visits, and 3185 (24% of them had 15,458 ED visits. In a multivariable logistic regression analysis, patients with continuity of care--at least one visit with their assigned PCP--had lower ED utilization compared to individuals without continuity (adjusted odds ratio [AOR] 0.54; 95% CI: 0.41, 0.71, controlling for frequency of primary care visits, comorbidities, insurance, distance from the ED, and having a trainee PCP assigned. Likewise, the adjusted rate of ED visits was 544/1000 person-year (PY for patients with continuity vs. 784/1000 PY for patients without continuity (p = 0.001. Compared to patients with low continuity (50% continuity were less likely to utilize the ED.Strong continuity of care is associated with decreased ED utilization in a PCMH model and improving continuity may help reduce the utilization of non-primary care services.

  2. Occupational Therapy Predischarge Home Visits in Acute Hospital Care: A Randomized Trial.

    Science.gov (United States)

    Clemson, Lindy; Lannin, Natasha A; Wales, Kylie; Salkeld, Glenn; Rubenstein, Laurence; Gitlin, Laura; Barris, Sarah; Mackenzie, Lynette; Cameron, Ian D

    2016-10-01

    To determine whether an enhanced occupational therapy discharge planning intervention that involved pre- and postdischarge home visits, goal setting, and follow-up (the HOME program) would be superior to a usual care intervention in which an occupational therapy in-hospital consultation for planning and supporting discharge to home is provided to individuals receiving acute care. Randomized controlled trial. Acute and medical wards. Individuals aged 70 and older (N = 400). Primary outcomes: activities daily living (ADLs; Nottingham Extended Activities of Daily Living) and participation in life roles and activities (Late Life Disability Index (LLDI)). Occupational therapist recommendations differed significantly between groups (P occupational therapy recommendations as the in-hospital only consultation, which had a greater emphasis on equipment provision, but HOME did not demonstrate greater benefit in global measures of ADLs or participation in life tasks than in-hospital consultation alone. It is not recommended that home visits be conducted routinely as part of discharge planning for acutely hospitalized medical patients. Further work should develop guidelines for quality in-hospital consultation. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  3. Feasibility and effects of preventive home visits for at-risk older people: Design of a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Catellier Diane

    2009-12-01

    Full Text Available Abstract Background The search for preventive methods to mitigate functional decline and unwanted relocation by older adults living in the community is important. Preventive home visit (PHV models use infrequent but regular visits to older adults by trained practitioners with the goal of maintaining function and quality of life. Evidence about PHV efficacy is mixed but generally supportive. Yet interventions have rarely combined a comprehensive (biopsychosocial occupational therapy intervention protocol with a home visit to older adults. There is a particular need in the USA to create and examine such a protocol. Methods/Design The study is a single-blind randomized controlled pilot trial designed to assess the feasibility, and to obtain preliminary efficacy estimates, of an intervention consisting of preventive home visits to community-dwelling older adults. An occupational therapy-based preventive home visit (PHV intervention was developed and is being implemented and evaluated using a repeated measures design. We recruited a sample of 110 from a population of older adults (75+ who were screened and found to be at-risk for functional decline. Participants are currently living in the community (not in assisted living or a skilled nursing facility in one of three central North Carolina counties. After consent, participants were randomly assigned into experimental and comparison groups. The experimental group receives the intervention 4 times over a 12 month follow-up period while the comparison group receives a minimal intervention of mailed printed materials. Pre- and post-intervention measures are being gathered by questionnaires administered face-to-face by a treatment-blinded research associate. Key outcome measures include functional ability, participation, life satisfaction, self-rated health, and depression. Additional information is collected from participants in the experimental group during the intervention to assess the feasibility of

  4. Preventive home visits to older people in Denmark--why, how, by whom, and when?

    DEFF Research Database (Denmark)

    Vass, M; Avlund, K; Hendriksen, C;

    2007-01-01

    or prevent functional decline. There is an urgent need of an interdisciplinary teamwork and management for such programmes, incorporating flexible cooperation between the primary and secondary health care sector. The value and importance of geriatric and gerontological education is evidence based....... older persons not normally seen in the health care system. In-home assessment is not just a health check, but also an opportunity to meet individual needs that may be of importance for older people to stay independent. Preventive home visits may be part of an overall culture and strategy to avoid...

  5. Daily life or diagnosis? Dual perspectives on perinatal depression within maternal and child health home visiting.

    Science.gov (United States)

    Price, Sarah Kye; Cohen-Filipic, Katherine

    2013-01-01

    This study describes a qualitative inquiry-informing program development in a maternal and child home visiting program. Low-income women's perceptions of the meaning and experiences of depression were ascertained through focus groups and interviews. Simultaneously, the study examines staff member perceptions and roles related to depression. Specific findings from clients and staff reveal culturally situated beliefs about depression and stressful life events; comparing and contrasting these beliefs offers a novel perspective on identification and intervention for maternal depression. This study offers a foundation for a translational research agenda that will be used for program and policy development to enhance mental health services situated within maternal and child health home visiting programs.

  6. Outcomes of Planned Home Visits of Intern Public Health Nurses: An Example from Turkey.

    Science.gov (United States)

    Ozkan, Ozlem; Ozdemir, Saadet

    This study aimed at evaluating the outcomes of planned home visits of intern public health nurses enrolled to a school of health over 8 educational years. The descriptive research consisted of 181 families (N = 745 individuals) who received primary services through the planned home visits undertaken by 431 intern public health nurses at Kocaeli province in Turkey. The data were collected from Family Nursing Process Records and Family Health Achievement Forms. Both of these data collection forms were classified according to North American Nursing Diagnosis Association (NANDA) Taxonomy II. Intern public health nurses provided primary health services to 181 families (N = 745 persons) with a total of 8771 planned home visits undertaken over 802 days and 14.874 student/practice days. A total of 1539 nursing diagnoses were identified and 1677 achievements about these diagnoses were reported. Nursing diagnosis per family and per individual turned out to be 8.50 and 2.1, respectively, and achievements were 9.3 per family and 2.3 per individual. Among the nursing diagnosis domains, health promotion (20.3%), safety/protection (16.8%), and activity/rest (16.0%) were the top 3 domains identified. The most common diagnoses turned out to be ineffective health maintenance (47.4%) in health promotion domain and risk for trauma (18.2%) in safety/protection domain. The achievements were reported most in health promotion (37.9%), activity/rest (17.6%), and safety/protection (9.6%), respectively. Planned and continuous home visits by intern public health nurses resulted in positive health achievements in families, especially for women and children. Copyright © 2016. Published by Elsevier Inc.

  7. Effectiveness of Home Visits in Pregnancy as a Public Health Measure to Improve Birth Outcomes.

    Directory of Open Access Journals (Sweden)

    Kayoko Ichikawa

    Full Text Available Birth outcomes, such as preterm birth, low birth weight (LBW, and small for gestational age (SGA, are crucial indicators of child development and health.To evaluate whether home visits from public health nurses for high-risk pregnant women prevent adverse birth outcomes.In this quasi-experimental cohort study in Kyoto city, Japan, high-risk pregnant women were defined as teenage girls (range 14-19 years old, women with a twin pregnancy, women who registered their pregnancy late, had a physical or mental illness, were of single marital status, non-Japanese women who were not fluent in Japanese, or elderly primiparas. We collected data from all high-risk pregnant women at pregnancy registration interviews held at a public health centers between 1 July 2011 and 30 June 2012, as well as birth outcomes when delivered from the Maternal and Child Health Handbook (N = 964, which is a record of prenatal check-ups, delivery, child development and vaccinations. Of these women, 622 women were selected based on the home-visit program propensity score-matched sample (pair of N = 311 and included in the analysis. Data were analyzed between January and June 2014.In the propensity score-matched sample, women who received the home-visit program had lower odds of preterm birth (odds ratio [OR], 0.62; 95% confidence interval [CI], 0.39 to 0.98 and showed a 0.55-week difference in gestational age (95% CI: 0.18 to 0.92 compared to the matched controlled sample. Although the program did not prevent LBW and SGA, children born to mothers who received the program showed an increase in birth weight by 107.8 g (95% CI: 27.0 to 188.5.Home visits by public health nurses for high-risk pregnant women in Japan might be effective in preventing preterm birth, but not SGA.

  8. Is the Families First Home Visiting Program Effective in Reducing Child Maltreatment and Improving Child Development?

    Science.gov (United States)

    Chartier, Mariette J; Brownell, Marni D; Isaac, Michael R; Chateau, Dan; Nickel, Nathan C; Katz, Alan; Sarkar, Joykrishna; Hu, Milton; Taylor, Carole

    2017-05-01

    While home visiting programs are among the most widespread interventions to support at-risk families, there is a paucity of research investigating these programs under real-world conditions. The effectiveness of Families First home visiting (FFHV) was examined for decreasing rates of being in care of child welfare, decreasing hospitalizations for maltreatment-related injuries, and improving child development at school entry. Data for 4,562 children from home visiting and 5,184 comparison children were linked to deidentified administrative health, social services, and education data. FFHV was associated with lower rates of being in care by child's first, second, and third birthday (adjusted risk ratio [aRR] = 0.75, 0.79, and 0.81, respectively) and lower rates of hospitalization for maltreatment-related injuries by third birthday (aRR = 0.59). No differences were found in child development at kindergarten. FFHV should be offered to at-risk families to decrease child maltreatment. Program enhancements are required to improve child development at school entry.

  9. Characteristics of communication with older people in home care: A qualitative analysis of audio recordings of home care visits.

    Science.gov (United States)

    Kristensen, Dorte V; Sundler, Annelie J; Eide, Hilde; Hafskjold, Linda; Ruud, Iren; Holmström, Inger K

    2017-03-16

    To describe the characteristics of communication practice in home care visits between older people (over 65 years old) and nurse assistants and to discuss the findings from a person-centered perspective. The older population is increasing worldwide, along with the need for healthcare services in the person's home. To achieve a high-quality care, person-centered communication is crucial. A descriptive design with a qualitative inductive approach was used. Fifteen audio recordings of naturally occurring conversations between 12 nurse assistants and 13 older people in Norway were analysed by qualitative content analysis. Four categories were revealed through analysis: (i) supporting older people's connection to everyday life; (ii) supporting older people's involvement in their own care; (iii) attention to older people's bodily and existential needs; and (iv) the impact of continuity and predictability on older people's well-being. The communication between the older people and the nurse assistants during home care visits was mainly task-oriented, but also related to the person. The older people were involved in the tasks to be carried out and humour was part of the communication. Greater attention was paid to bodily than existential needs. The communication was connected with the older people's everyday life in several ways. Time frames and interruptions concern the older people; hearing and speech impairments were a challenge to communication. To enhance person-centred communication, further studies are needed, especially intervention studies for healthcare professionals and students. Being responsive to older people's subjective experiences is important in meeting their needs in home care. Communication that addresses the need for trust and predictability is important for older people. Responding to existential needs require more attention. The home care setting has an impact on communication. © 2017 John Wiley & Sons Ltd.

  10. Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities.

    Directory of Open Access Journals (Sweden)

    Stéphanie Foulon

    Full Text Available Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France.CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440. The first assessment was at inclusion into the trial at the 27th week of pregnancy and the final assessment when the child reached the age of two. Attrition rates were calculated at 3 and 24 months postpartum. Stepwise logistic regression was used to identify predictors of early (between inclusion and 3 months postpartum and later (between 3 and 24 months postpartum attrition among social, psychological and parenting factors.Attrition rates were 17% and 63% at 3 and 24 months respectively. At 24 months, there was significantly more attrition in the control arm (70.6% compared to the intervention arm (55.2%. Five independent predictors of early attrition were identified: having already had an abortion; having greater attachment insecurity as measured with the Vulnerable Attachment Style Questionnaire (VASQ; having lower global severity of psychiatric symptoms as assessed with the Symptom Check-List (SCL-90 at inclusion, being neither currently employed nor studying; and declaring no tobacco consumption during pregnancy. Being randomized into the control arm, having undergone early parental loss before age 11 and having lower global severity of psychiatric symptoms (SCL-90 at 3 months postpartum were the only variables associated with later attrition.This study provides key information for identifying mothers who may require specific support to avoid study attrition in trials evaluating a home-visiting program.

  11. Predictors of Study Attrition in a Randomized Controlled Trial Evaluating a Perinatal Home-Visiting Program with Mothers with Psychosocial Vulnerabilities

    Science.gov (United States)

    Foulon, Stéphanie; Greacen, Tim; Pasquet, Blandine; Dugravier, Romain; Saïas, Thomas; Guedeney, Nicole; Guedeney, Antoine; Tubach, Florence

    2015-01-01

    Objective Randomised controlled trials evaluating perinatal home-visiting programs are frequently confronted with the problem of high attrition rates. The aim of the present study is to identify predictors of study attrition in a trial evaluating a perinatal home-visiting program in France. Materials and Methods CAPEDP is a French randomized trial comparing a perinatal home-visiting program using psychologists versus usual care (N = 440). The first assessment was at inclusion into the trial at the 27th week of pregnancy and the final assessment when the child reached the age of two. Attrition rates were calculated at 3 and 24 months postpartum. Stepwise logistic regression was used to identify predictors of early (between inclusion and 3 months postpartum) and later (between 3 and 24 months postpartum) attrition among social, psychological and parenting factors. Results Attrition rates were 17% and 63% at 3 and 24 months respectively. At 24 months, there was significantly more attrition in the control arm (70.6%) compared to the intervention arm (55.2%). Five independent predictors of early attrition were identified: having already had an abortion; having greater attachment insecurity as measured with the Vulnerable Attachment Style Questionnaire (VASQ); having lower global severity of psychiatric symptoms as assessed with the Symptom Check-List (SCL-90) at inclusion, being neither currently employed nor studying; and declaring no tobacco consumption during pregnancy. Being randomized into the control arm, having undergone early parental loss before age 11 and having lower global severity of psychiatric symptoms (SCL-90) at 3 months postpartum were the only variables associated with later attrition. Conclusion This study provides key information for identifying mothers who may require specific support to avoid study attrition in trials evaluating a home-visiting program. PMID:26554839

  12. Clinical supervision in the provision of intensive home visiting by health visitors.

    Science.gov (United States)

    Jarrett, Patricia; Barlow, Jane

    2014-02-01

    The objective of this paper is to explore the perceptions of health visitors working in frontline child protection concerning the role of clinical supervision. Fifteen health visitors ('home visitors') providing an intensive home visiting service to high-risk families in the south east of England were interviewed about their experience of receiving supervision. The model of clinical supervision used was based on the Family Partnership Programme and delivered by two trained psychotherapists. The data were analysed using thematic analysis. Home visitors believed that clinical supervision enabled them to maintain boundaries, regulate and reflect on their practice, and develop a better understanding of the issues clients were facing. The model of supervision used and the organisational context were believed to be important factors in the delivery of clinical supervision and to have contributed to its success.

  13. Structured social relationships: a review of volunteer home visiting programs for parents of young children.

    Science.gov (United States)

    Byrne, Fiona; Grace, Rebekah; Tredoux, Jaimie; Kemp, Lynn

    2016-06-01

    Objective The aims of the present paper were to: (1) review the research literature that contributes to an understanding of the role of volunteer home visiting programs in supporting the health and well being of families with young children; and (2) propose a conceptual model outlining service pathways for families in need of additional support. Methods An integrative literature review method was used, with a mix of electronic and manual search methods for the period January 1980-January 2014. Forty-five studies were identified that met the inclusion criteria for review and were coded according to themes developed a priori. Results There is little formal research that has examined the effectiveness of volunteer home visiting programs for supporting family health and well being. The available research suggests that volunteer home visiting programs provide socioemotional support through structured social relationships; however, there is limited empirical evidence to explicate the factors that contribute to these outcomes. Conclusion In recognition of the importance of peer support for new parents, the not-for-profit sector has been involved in providing volunteer home visiting services to families for decades. However, the body of research to support this work is characterised by methodological limitations, and rigorous evidence is limited. What is clear anecdotally and qualitatively from the existing research is that parents who are in need of additional support value engagement with a community volunteer. These structured social relationships appear to fulfil a service need within the community, helping build bridges to support social networks, and thus complementing professional services and relationships. Overall, structured social relationships in the form of volunteer home visiting programs appear to provide an important pathway to support family health and well being. Findings from the existing research are mixed and often characterised by methodological

  14. 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

  15. The value of pre-discharge occupational therapy home visits for patients who have had a stroke: p erceptions of patients, occupational therapists and experts

    OpenAIRE

    Fellows, Karen Rachael

    2014-01-01

    Pre-discharge occupational therapy home visits after stroke are routinely conducted during the discharge planning process. However, there is limited research evidence about the value of these visits for patients. The aims of this study were two fold. Firstly, to identify and report on the value of pre- discharge occupational therapy home visits for patients returning home after stroke. Secondly, to gain knowledge to inform the design of future research into home visits after stroke. M...

  16. Identification and assessment of intimate partner violence in nurse home visitation.

    Science.gov (United States)

    Jack, Susan M; Ford-Gilboe, Marilyn; Davidov, Danielle; MacMillan, Harriet L

    2017-08-01

    To develop strategies for the identification and assessment of intimate partner violence in a nurse home visitation programme. Nurse home visitation programmes have been identified as an intervention for preventing child abuse and neglect. Recently, there is an increased focus on the role these programmes have in addressing intimate partner violence. Given the unique context of the home environment, strategies for assessments are required that maintain the therapeutic alliance and minimise client attrition. A qualitative case study. A total of four Nurse-Family Partnership agencies were engaged in this study. Purposeful samples of nurses (n = 32), pregnant or parenting mothers who had self-disclosed experiences of abuse (n = 26) and supervisors (n = 5) participated in this study. A total of 10 focus groups were completed with nurses: 42 interviews with clients and 10 interviews with supervisors. The principles of conventional content analysis guided data analysis. Data were categorised using the practice-problem-needs analysis model for integrating qualitative findings in the development of nursing interventions. Multiple opportunities to ask about intimate partner violence are valued. The use of structured screening tools at enrolment does not promote disclosure or in-depth exploration of women's experiences of abuse. Women are more likely to discuss experiences of violence when nurses initiate nonstructured discussions focused on parenting, safety or healthy relationships. Nurses require knowledge and skills to initiate indicator-based assessments when exposure to abuse is suspected as well as strategies for responding to client-initiated disclosures. A tailored approach to intimate partner violence assessment in home visiting is required. Multiple opportunities for exploring women's experiences of violence are required. A clinical pathway outlining a three-pronged approach to identification and assessment was developed. © 2016 John Wiley & Sons Ltd.

  17. Targeted home visiting intervention: the impact on mother-infant relationships.

    Science.gov (United States)

    Walker, Anne Marie; Johnson, Rebecca; Banner, Catherine; Delaney, Jill; Farley, Rita; Ford, Margaret; Lake, Helen; Douglas, Hazel

    2008-03-01

    This paper reviews and reflects on six papers, which describe various early home visiting interventions that resulted in positive outcomes, particularly in relation to the mother-infant relationship. The papers were published in a special issue of the Infant Mental Health Journal in 2006. We provide a brief overview of each paper, highlighting the conclusions drawn across the six papers. Key learning points for health visitors in the UK are explored throughout. Suggestions are described for improvements to the way in which health visiting services in the UK are structured in order to further enhance mother-infant relationships. The overall finding is that mother-infant relationships and interactions can be improved through early home visiting interventions over a period of time, and that this prevents childhood problems later on. It is recommended that specific patient groups be targeted and offered tailored programmes of interventions that have a relevant theoretical base, by trained nursing staff who are supported by an infant mental health consultant.

  18. Impact of a Manualized Multifocal Perinatal Home-Visiting Program Using Psychologists on Postnatal Depression: The CAPEDP Randomized Controlled Trial

    Science.gov (United States)

    Dugravier, Romain; Tubach, Florence; Saias, Thomas; Guedeney, Nicole; Pasquet, Blandine; Purper-Ouakil, Diane; Tereno, Susana; Welniarz, Bertrand; Matos, Joana

    2013-01-01

    Context Postnatal maternal depression (PND) is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed. Objective This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties. Methods 440 primiparous women were recruited at their seventh month of pregnancy. All were future first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. The intervention consisted of intensive multifocal home visits through to the child’s second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS). Results At three months postpartum, mean (SD) EPDS scores were 9.4 (5.4) for the control group and 8.6 (5.4) for the intervention group (p = 0.18). The difference between the mean EPDS scores was 0.85 (95% CI: 0.35; 1.34). The intervention group had significantly lower EPDS scores than controls in certain subgroups: women with few depressive symptoms at inclusion (EPDS <8): difference = 1.66 (95%CI: 0.17; 3.15), p = 0.05, adjusted for baseline EPDS score), women who were planning to raise the child with the child’s father: difference = 1.45 (95%CI: 0.27; 2.62), p = 0.04 (adjusted); women with a higher educational level: difference = 1.59 (95%CI: 0.50; 2.68) p = 0.05 (adjusted). Conclusion CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in terms of primary prevention and in subgroups of women without certain risk factors. Effective overall reduction

  19. Impact of a manualized multifocal perinatal home-visiting program using psychologists on postnatal depression: the CAPEDP randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Romain Dugravier

    Full Text Available CONTEXT: Postnatal maternal depression (PND is a significant risk factor for infant mental health. Although often targeted alongside other factors in perinatal home-visiting programs with vulnerable families, little impact on PND has been observed. OBJECTIVE: This study evaluates the impact on PND symptomatology of a multifocal perinatal home-visiting intervention using psychologists in a sample of women presenting risk factors associated with infant mental health difficulties. METHODS: 440 primiparous women were recruited at their seventh month of pregnancy. All were future first-time mothers, under 26, with at least one of three additional psychosocial risk factors: low educational level, low income, or planning to raise the child without the father. The intervention consisted of intensive multifocal home visits through to the child's second birthday. The control group received care as usual. PND symptomatology was assessed at baseline and three months after birth using the Edinburgh Postnatal Depression Scale (EPDS. RESULTS: At three months postpartum, mean (SD EPDS scores were 9.4 (5.4 for the control group and 8.6 (5.4 for the intervention group (p = 0.18. The difference between the mean EPDS scores was 0.85 (95% CI: 0.35; 1.34. The intervention group had significantly lower EPDS scores than controls in certain subgroups: women with few depressive symptoms at inclusion (EPDS <8: difference = 1.66 (95%CI: 0.17; 3.15, p = 0.05, adjusted for baseline EPDS score, women who were planning to raise the child with the child's father: difference = 1.45 (95%CI: 0.27; 2.62, p = 0.04 (adjusted; women with a higher educational level: difference = 1.59 (95%CI: 0.50; 2.68 p = 0.05 (adjusted. CONCLUSION: CAPEDP failed to demonstrate an overall impact on PND. However, post-hoc analysis reveals the intervention was effective in terms of primary prevention and in subgroups of women without certain risk factors. Effective overall reduction of PND

  20. Early intervention of multiple home visits to prevent childhood obesity in a disadvantaged population: a home-based randomised controlled trial (Healthy Beginnings Trial

    Directory of Open Access Journals (Sweden)

    Alperstein Garth

    2007-05-01

    Full Text Available Abstract Background Studies have shown that a proportion of children as young as two years are already overweight. This indicates that obesity prevention programs that commence as early as possible and are family-focused are needed. This Healthy Beginnings Trial aims to determine the efficacy of a community-based randomized controlled trial (RCT of a home visiting intervention in preventing the early onset of childhood overweight and obesity. The intervention will be conducted over the first two years of life to increase healthy feeding behaviours and physical activity, decrease physical inactivity, enhance parent-child interaction, and hence reduce overweight and obesity among children at 2 and 5 years of age in the most socially and economically disadvantaged areas of Sydney, Australia. Methods/design This RCT will be conducted with a consecutive sample of 782 first time mothers with their newborn children. Pregnant women who are expecting their first child, and who are between weeks 24 and 34 of their pregnancy, will be invited to participate in the trial at the antenatal clinic. Informed consent will be obtained and participants will then be randomly allocated to the intervention or the control group. The allocation will be concealed by sequentially numbered, sealed opaque envelopes containing a computer generated random number. The intervention comprises eight home visits from a specially trained community nurse over two years and pro-active telephone support between the visits. Main outcomes include a duration of breastfeeding measured at 6 and 12 months, b introduction of solids measured at 4 and 6 months, c nutrition, physical activity and television viewing measured at 24 months, and d overweight/obesity status at age 2 and 5 years. Discussion The results of this trial will ascertain whether the home based early intervention is effective in preventing the early onset of childhood overweight and obesity. If proved to be effective, it

  1. Home visits by neighborhood Mentor Mothers provide timely recovery from childhood malnutrition in South Africa: results from a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Mbewu Nokwanele

    2010-11-01

    Full Text Available Abstract Background Child and infant malnourishment is a significant and growing problem in the developing world. Malnourished children are at high risk for negative health outcomes over their lifespans. Philani, a paraprofessional home visiting program, was developed to improve childhood nourishment. The objective of this study is to evaluate whether the Philani program can rehabilitate malnourished children in a timely manner. Methods Mentor Mothers were trained to conduct home visits. Mentor Mothers went from house to house in assigned neighborhoods, weighed children age 5 and younger, and recruited mother-child dyads where there was an underweight child. Participating dyads were assigned in a 2:1 random sequence to the Philani intervention condition (n = 536 or a control condition (n = 252. Mentor Mothers visited dyads in the intervention condition for one year, supporting mothers' problem-solving around nutrition. All children were weighed by Mentor Mothers at baseline and three, six, nine and twelve month follow-ups. Results By three months, children in the intervention condition were five times more likely to rehabilitate (reach a healthy weight for their ages than children in the control condition. Throughout the course of the study, 43% (n = 233 of 536 of children in the intervention condition were rehabilitated while 31% (n = 78 of 252 of children in the control condition were rehabilitated. Conclusions Paraprofessional Mentor Mothers are an effective strategy for delivering home visiting programs by providing the knowledge and support necessary to change the behavior of families at risk.

  2. Cost effectiveness of preventive home visits to the elderly: economic evaluation alongside randomized controlled study

    DEFF Research Database (Denmark)

    Kronborg, Christian; Vass, Mikkel; Lauridsen, Jørgen

    2006-01-01

    We evaluated the cost effectiveness of preventive home visits to elderly persons in Denmark alongside a 3-year randomized controlled study. The main outcome measure was incremental costs per active life-year gained. The number of active life-years was defined as those during which the person......, and interdisciplinary follow-up. The remaining 17 municipalities offered preventive home visits as usual. Outcomes were measured in 4,034 persons aged 75 or 80 years old and dwelling at home. The difference in mean total costs between the intervention and the control group discounted at 3% was -856 euro (95% CI -2......,455 to 744) in 75-year-olds and 694 euro (-2,684 to 4,071) in 80-year-olds. The discounted difference in mean active life-years was 0.034 (-0.058 to 0.125) and 0.197 (0.013 to 0.380), respectively. The study did not provide conclusive evidence on the cost effectiveness of the programs under consideration....

  3. [Preventive home visits for elderly patients: development and pilot testing of a multidimensional assessment instrument].

    Science.gov (United States)

    Peter-Wüest, I; Stuck, A E; Dapp, U; Nikolaus, T; Goetz, S M; Gillmann, G; Minder, C E; Beck, J C

    2000-02-01

    Preventive home visits with multidimensional geriatric assessment have been shown to delay or prevent the onset of disability and reduce nursing home admissions in older people. The purpose of the present study was to develop and test a multidimensional instrument for in-home preventive assessments in older persons. In developing the instrument, we conducted a systematic literature review of risk factors for functional status decline and of appropriate instruments for measuring these risk factors. Based on an Expert Panel using a modified Delphi process [1] the risk factor domains for functional status decline were chosen, [2] the instruments for evaluating each of the included risk factor domains were selected, and [3] the individual instruments were combined into one comprehensive assessment instrument. A German language version of the original English version of the instrument was developed based on translation, backtranslation, and cultural adaptation. The feasibility of use of the new instrument was evaluated in a field test in 150 people aged 75 years and older in Hamburg, Ulm, Germany, and Bern, Switzerland. The instrument was well accepted by the older persons. The prevalence of risk factors for functional status decline in these populations (e.g., physical inactivity, urinary incontinence, vision impairment) was high. There was also a high prevalence of underuse of preventive care measures (e.g., no pneumococcal vaccination in over 95 percent of persons). These preliminary results support the possible usefulness of this instrument for conducting preventive home visits or for epidemiological purposes (e.g., prevention surveillance). In a next phase, the test-retest reliability of the instrument, and the feasibility and reliability of self-administration as compared to interviewer administration will be described in a separate paper.

  4. 38 CFR 17.60 - Extensions of community nursing home care beyond six months.

    Science.gov (United States)

    2010-07-01

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

  5. [Home visits as a component of the Family Health Program: user's perceptions in Fortaleza, Ceará State, Brazil].

    Science.gov (United States)

    Albuquerque, Adriana Bezerra Brasil de; Bosi, Maria Lúcia Magalhães

    2009-05-01

    Home visits have become increasingly widespread in Brazil since the emergence of the Family Health Program. The present study deals with users' perceptions of these visits, focusing on comprehensiveness and humanization of care. The study was exploratory and qualitative. Twenty-one interviews were performed with users from the six administrative health districts of Fortaleza, capital of Ceará State, Brazil. Analysis of the interviews revealed the existence of three core themes: (1) health professional-user relationships, i.e. users' perceptions of completeness and humanization of care during visits; (2) characterization of visits, with emphasis on operational aspects; and (3) user-health facility interaction, focusing on integration with other service. This theme was divided into three items: health facility management, equity, and integration of care. In conclusion, the study suggests that home visiting practices can be improved by enhancing the aspects of intersubjectivity, dialogue, and negotiation between health professionals, users, and the community.

  6. Effects of Home Visitation on Maternal Competencies, Family Environment, and Child Development: a Randomized Controlled Trial.

    Science.gov (United States)

    Sierau, Susan; Dähne, Verena; Brand, Tilman; Kurtz, Vivien; von Klitzing, Kai; Jungmann, Tanja

    2016-01-01

    Based on the US Nurse-Family Partnership (NFP) program, the German home visiting program "Pro Kind" offered support for socially and financially disadvantaged first-time mothers from pregnancy until the children's second birthday. A multi-centered, longitudinal randomized controlled trial (RCT) was conducted to assess its effectiveness on mothers and children. A total of 755 women with multiple risk factors were recruited, 394 received regular home visits (treatment group), while 361 only had access to standard community services (control group). Program influences on family environment (e.g., quality of home, social support), maternal competencies (e.g., maternal self-efficacy, empathy, parenting style), and child development (e.g., cognitive and motor development) were assessed from mothers' program intake in pregnancy to children's second birthday based on self-reports in regular interviews and developmental tests. Generalized estimating equations (GEE) models showed small, but significant positive treatment effects on parental self-efficacy, and marginally significant effects on social support, and knowledge on child rearing. Maternal stress, self-efficacy, and feelings of attachment in the TG tend to show a more positive development over time. Subgroup effects were found for high-risk mothers in the TG, who reported more social support over time and, generally, had children with higher developmental scores compared to their CG counterparts. Post hoc analyses of implementation variables revealed the quality of the helping relationship as a significant indicator of treatment effects. Results are discussed in terms of implementation and public policy differences between NFP and Pro Kind.

  7. Association Between Home Visit Programs and Emergency Preparedness Among Elderly Vulnerable People in New South Wales, Australia

    Directory of Open Access Journals (Sweden)

    W. Kathy Tannous PhD

    2017-03-01

    Full Text Available Objective: The purpose of this study is to examine the association between home visit programs and emergency preparedness among elderly vulnerable people in New South Wales, Australia. Method: The study used data acquired from an intervention program run by emergency agencies and consisted of 370 older people. Seven emergency outcome measures were examined by adjusting for key demographic factors, using a generalized estimating equation model, to examine the association between home visit programs and emergency preparedness. Results: The study revealed that knowledge demonstrated by participants during visits and post home visits showed significant improvements in the seven emergency outcome measures. The odds of finding out what emergencies might affect one’s area were significantly lower among older participants who were born outside Australia and those who were women. Discussion: The findings suggest that the intervention via home visits and periodic reminders post these visits may be a useful intervention in improving emergency preparedness among older people, especially among men and those who were born outside of Australia. In addition, other reminders such as safety messaging via mobile or landline telephone calls may also be a supplementary and useful intervention to improve emergency preparedness among older people.

  8. Development and implementation of a quality assurance infrastructure in a multisite home visitation program in Ohio and Kentucky.

    Science.gov (United States)

    Ammerman, Robert T; Putnam, Frank W; Kopke, Jonathan E; Gannon, Thomas A; Short, Jodie A; Van Ginkel, Judith B; Clark, Margaret J; Carrozza, Mark A; Spector, Alan R

    2007-01-01

    As home visitation programs go to scale, numerous challenges are faced in implementation and quality assurance. This article describes the origins and implementation of Every Child Succeeds, a multisite home visitation program in southwestern Ohio and Northern Kentucky. In order to optimize quality assurance and generate new learning for the field, a Web-based system (eECS) was designed to systematically collect and use data. Continuous quality assurance procedures derived from business and industry have been established. Findings from data collection have documented outcomes, and have identified clinical needs that potentially undermine the impact of home visitation. An augmented module approach has been used to address these needs, and a program to treat maternal depression is described as an example of this approach. Challenges encountered are also discussed.

  9. The power of relationships: exploring how Public Health Nurses support mothers and families during postpartum home visits.

    Science.gov (United States)

    Aston, Megan; Price, Sheri; Etowa, Josephine; Vukic, Adele; Young, Linda; Hart, Christine; MacLeod, Emily; Randel, Patricia

    2015-02-01

    Postpartum home visiting by Public Health Nurses (PHNs) has been used by many health departments across Canada as a way of supporting new mothers and their families. Although positive health outcomes are linked with support from PHNs, little is known about how this occurs during the home visit. The purpose of this research was to explore how home visiting programs for mothers and babies were organized, delivered, and experienced through the everyday practices of PHNs, mothers, and managers in Nova Scotia, Canada. Feminist poststructuralism was used to guide the research and semi-structured face-to-face interviews were conducted with 16 PHNs, 16 mothers, and 4 managers. Participants described how relationships were an essential part of supporting mothers and families. These findings also challenge dominant health discourses and stereotypes that are often associated with mothering and the practice of PHNs with families. © The Author(s) 2014.

  10. Tackling community integration in mental health home visit integration in Finland.

    Science.gov (United States)

    Raitakari, Suvi; Haahtela, Riikka; Juhila, Kirsi

    2016-09-01

    Integration - and its synonym inclusion - is emphasised in the western welfare states and in the European Union in particular. Integration is also a central topic in the social sciences and in current mental health and homelessness research and practice. As mental healthcare has shifted from psychiatric hospitals to the community, it has inevitably become involved with housing and integration issues. This article explores how community integration is understood and tackled in mental health floating support services (FSSs) and, more precisely, in service user-practitioner home visit interaction. The aim, through shedding light on how the idea of integration is present and discussed in front-line mental health practices, is to offer a 'template' on how we might, in a systematic and reflective way, develop community integration research and practice. The analysis is based on ethnomethodological and micro-sociological interaction research. The research settings are two FSSs located in a large Finnish city. The data contain 24 audio-recorded and transcribed home visits conducted in 2011 and 2012 with 16 different service users. The study shows how the participants in service user-practitioner interaction give meaning to community integration and make decisions about how it should (or should not) be enhanced in each individual case. This activity is called community integration work in action. Community integration work in action is based on various dimensions of integration: getting out of the house, participating in group activities and getting along with those involved in one's life and working life. Additionally, the analysis demonstrates how community integration work is accomplished by discursive devices (resistance, positioning, excuses and justifications, delicacy and advice-giving). The article concludes that community integration is about interaction: it is not only service users' individual challenge but also a social challenge, our challenge.

  11. Peer supporter experiences of home visits for people with HIV infection

    Directory of Open Access Journals (Sweden)

    Lee HJ

    2015-09-01

    Full Text Available Han Ju Lee,1 Linda Moneyham,2 Hee Sun Kang,3 Kyung Sun Kim41Department of Nursing, Sangmyung University, Cheonan-si, Chungcheongnam-do, South Korea; 2School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA; 3Red Cross College of Nursing, Chung-Ang University, Seoul, South Korea; 4Gyeonggi Branch, Korean Alliance to Defeat AIDS, Anyang, Gyeonggi-do, South KoreaPurpose: This study's purpose was to explore the experiences of peer supporters regarding their work in a home visit program for people with HIV infection.Patients and methods: A qualitative descriptive study was conducted using focus groups. Participants were 12 HIV-positive peer supporters conducting home visits with people living with HIV/AIDS in South Korea. Thematic analysis was used to analyze the data.Results: Six major themes emerged: feeling a sense of belonging; concern about financial support; facing HIV-related stigma and fear of disclosure; reaching out and acting as a bridge of hope; feeling burnout; and need for quality education. The study findings indicate that although peer supporters experience several positive aspects in the role, such as feelings of belonging, they also experience issues that make it difficult to be successful in the role, including the position's instability, work-related stress, and concerns about the quality of their continuing education.Conclusion: The findings suggest that to maintain a stable and effective peer supporter program, such positions require financial support, training in how to prevent and manage stress associated with the role, and a well-developed program of education and training.Keywords: human immunodeficiency virus, qualitative research, workplace experience

  12. Clinical application of the Omaha system with the Nightingale Tracker: a community health nursing student home visit program.

    Science.gov (United States)

    Sloan, Helen L; Delahoussaye, Carolyn P

    2003-01-01

    The application of computer use in the clinical and educational arena needs to be emphasized for both the improved management of patient data and nursing knowledge. Faculty commitment to automation of home visit documentation records was essential to sustain the trial of implementing the Nightingale Trackers in the clinical area. The Nightingale Tracker is a software program that automates the Omaha system, a community-friendly nursing language that encourages a focus on health promotion. A team approach involving students, faculty, and technical support enabled the automation of the patient record of a home visiting program in a community health nursing course.

  13. Use of a geriatric home visit experience to teach medical students the functional status assessment.

    Science.gov (United States)

    Tung, Ericka E; Thomas, Matthew R

    2009-02-01

    Functional status measures strongly predict hospital outcomes and mortality, yet teaching of these measures is often missing from medical schools' curricula. To address this deficiency, we developed a Geriatric Home-based Assessment (GHA) module for third-year medical students. The module was composed of a workshop and two to three home visits. To determine whether the GHA module would improve students' knowledge and proficiency in the functional status assessment. Students completed a validated questionnaire and evaluated a standardized patient in an Observed Structured Clinical Examination (OSCE). Scores from students completing the GHA were compared to the scores of students without this experience. Thirty-one students participated in the GHA module, and 19 students were in the control group. The mean score on the written assessment was 87% among GHA students vs. 46% in the control group (p students' knowledge and proficiency in the functional status assessment. "Hands on" experiences like the GHA allow students to develop a solid foundation for assessing functional status and mobility.

  14. Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark

    DEFF Research Database (Denmark)

    Yamada, Yukari; Ekmann, Anette Addy; Nilsson, Charlotte Juul

    2012-01-01

    Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1) whether socioeconomic...... status was associated with acceptance of preventive home visits among older people and 2) whether municipality invitational procedures for the preventive home visits modified the association....

  15. Older persons' expressions of emotional cues and concerns during home care visits. Application of the Verona coding definitions of emotional sequences (VR-CoDES) in home care.

    Science.gov (United States)

    Sundler, Annelie J; Höglander, Jessica; Eklund, Jakob Håkansson; Eide, Hilde; Holmström, Inger K

    2017-02-01

    This study aims to a) explore to what extent older persons express emotional cues and concerns during home care visits; b) describe what cues and concerns these older persons expressed, and c) explore who initiated these cues and concerns. A descriptive and cross-sectional study was conducted. Data consisted of 188 audio recorded home care visits with older persons and registered nurses or nurse assistants, coded with the Verona coding definitions on emotional sequences (VR-CoDES). Emotional expressions of cues and concerns occurred in 95 (51%) of the 188 recorded home care visits. Most frequent were implicit expressions of cues (n=292) rather than explicit concerns (n=24). Utterances with hints to hidden concerns (63,9%, n=202) were most prevalent, followed by vague or unspecific expressions of emotional worries (15,8%, n=50). Most of these were elicited by the nursing staff (63%, n=200). Emotional needs expressed by the older persons receiving home care were mainly communicated implicitly. To be attentive to such vaguely expressed emotions may demand nursing staff to be sensitive and open. The VR-CoDES can be applied on audio recorded home care visits to analyse verbal and emotional communication, and may allow comparative research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Universal Home Visiting: A Recommendation from the U.S. Advisory Board on Child Abuse and Neglect.

    Science.gov (United States)

    Krugman, Richard D.

    1993-01-01

    In 1991, the U.S. Advisory Board on Child Abuse and Neglect recommended the federal government begin phasing in a national, universal home visiting program for children during the neonatal period to help prevent child abuse and neglect. This article discusses the political and social factors affecting this recommendation, as well as the response…

  17. Enriching Preschool Classrooms and Home Visits with Evidence-Based Programming: Sustained Benefits for Low-Income Children

    Science.gov (United States)

    Bierman, Karen L.; Heinrichs, Brenda S.; Welsh, Janet A.; Nix, Robert L.; Gest, Scott D.

    2017-01-01

    Background: Growing up in poverty undermines healthy development, producing disparities in the cognitive and social-emotional skills that support early learning and mental health. Preschool and home-visiting interventions for low-income children have the potential to build early cognitive and social-emotional skills, reducing the disparities in…

  18. Maternal, Infant and Early Childhood Home Visiting Program in the Affordable Care Act: Supplemental Instruction Request-February 2011

    Science.gov (United States)

    Schmit, Stephanie

    2011-01-01

    The latest Evidence-Based Home Visiting Supplemental Information Request (SIR) has recently been released by the Department of Health and Human Services (HHS) with collaboration from the Health Resources and Services Administration (HRSA) and the Administration for Children and Families (ACF) as outlined in the first Funding Opportunity…

  19. A feasibility study of UMTS mobile phones for supporting nurses doing home visits to patients with diabetic foot ulcers

    DEFF Research Database (Denmark)

    Larsen, Simon Bo; Clemensen, Jane; Ejskjær, Niels

    2006-01-01

    We tested the feasibility of Universal Mobile Telephone System (UMTS) mobile phones for video consultations in the home. Five patients with diabetic foot ulcers were included in the study. Each of them was offered three video consultations instead of visits to the hospital outpatient clinic...

  20. Increasing Participation and Improving Engagement in Home Visitation: A Qualitative Study of Early Head Start Parent Perspectives

    Science.gov (United States)

    Hubel, Grace S.; Schreier, Alayna; Wilcox, Brian L.; Flood, Mary Fran; Hansen, David J.

    2017-01-01

    Home visitation programs are designed to provide comprehensive services that promote parent's abilities to create stable, nurturing care environments for their children. In order for program goals to be met, parents must participate actively and be engaged with the programs' mission. However, promoting engagement and participation are complex…

  1. Healthy Start Programa Madrina: A Promotora Home Visiting Outreach and Education Program to Improve Perinatal Health among Latina Pregnant Women

    Science.gov (United States)

    Bill, Debra E.; Hock-Long, Linda; Mesure, Maryann; Bryer, Pamela; Zambrano, Neydary

    2009-01-01

    The purpose of this article is to describe the development, implementation, and evaluation of Healthy Start Programa Madrina (HSPM), a home visiting promotora outreach and education program for Latina pregnant women and to present the 10-year findings of the program (1996-2005). Perinatal health disparities continue to persist among low-income…

  2. A scale for home visiting nurses to identify risks of physical abuse and neglect among mothers with newborn infants

    NARCIS (Netherlands)

    Grietens, H; Geeraert, L; Hellinckx, W

    2004-01-01

    Objective: The aim was to construct and test the reliability (utility, internal consistency, interrater agreement) and the validity (internal validity, concurrent validity) of a scale for home visiting social nurses to identify risks of physical abuse and neglect in mothers with a newborn child. Met

  3. Patient Home Visits: Measuring Outcomes of a Community Model for Palliative Care Education

    Science.gov (United States)

    Allo, Julio A.; Cuello, Deanna; Zhang, Yi; Reddy, Suresh K.; Azhar, Ahsan

    2016-01-01

    Abstract Background: Health care professionals may have limited exposure to home-based care. There is no published literature that has described the experiences and satisfaction of participation in patient home visits (PHV). Objective: The objective of this article is to describe the characteristics of PHV, our approach, and evaluation by participants over a nine-year period. Methods: We conducted a review of surveys completed by participants in PHV from 2005–2013. All participants anonymously completed the evaluation questionnaires at the end of PHVs. Different PHV assessment forms were used for the 2005–2010 and 2011–2013 time periods. Results: A total of 34 PHVs were conducted with 106 patients and approximately 750 participants with a mean of 3 patients and 22 participants per PHV between 2005 and 2013. For 18 PHVs there are 317 surveys completed with 353 participants, making it a 90% response rate. Responding participants were physicians 125/543 (23%) and other professionals 418/543 (77%). In both time periods of 2005–2010 and 2011–2013 a survey with a 1 (completely agree) to 5 (completely disagree) scale was used. Agreeing that PHV was an effective teaching tool during 2005–2010 were 335/341 (98%); during 2011–2013, 191/202 (95%) agreed that PHV provided increased understanding and sharing of best practices in palliative care. Conclusions: PHV was perceived by participants as an effective way of providing interactive community education. A broad range of themes were addressed, and the participants reported high levels of learning in all domains of palliative care. There were no cases of patient or relative expression of distress as a result of PHV. PMID:26652056

  4. Cost-effectiveness of home visits in the outpatient treatment of patients with alcohol dependence.

    Science.gov (United States)

    Moraes, Edilaine; Campos, Geraldo M; Figlie, Neliana B; Laranjeira, Ronaldo; Ferraz, Marcos B

    2010-01-01

    The purpose of this study was to compare the cost-effectiveness of conventional outpatient treatment for alcoholic patients (CT) with this same conventional treatment plus home visits (HV), a new proposal for intervention within the Brazilian outpatient treatment system. A cost-effectiveness evaluation alongside a 12-week randomized clinical trial was performed. We identified the resources utilized by each intervention, as well as the cost according to National Health System (SUS), Brazilian Medical Association (AMB) tables of fees, and others based on 2005 data. The incremental cost-effectiveness ratio (ICER) was estimated as the main outcome measure - abstinent cases at the end of treatment. There were 51.8% abstinent cases for HV and 43.1% for CT, a clinically relevant finding. Other outcome measures, such as quality of life, also showed significant improvements that favored HV. The baseline scenario presented an ICER of USD 1,852. Sensitivity analysis showed an ICER of USD 689 (scenario favoring HV) and USD 2,334 (scenario favoring CT). The HV treatment was found to be cost-effective according to the WHO Commission on Macroeconomics and Health. 2009 S. Karger AG, Basel.

  5. Pregnant with possibilities: drawing on hermeneutic thought to reframe home-visiting programs for young mothers.

    Science.gov (United States)

    SmithBattle, Lee

    2009-09-01

    Although the positive outcomes achieved in home-visiting interventions targeting young, disadvantaged mothers are partly credited to therapeutic relationships, researchers rarely offer philosophical or theoretical explanations for these relationships. This omission is a conspicuous oversight as nurse-family relationships have figured prominently in public health nursing practice since its inception. In this study, I suggest that the contribution of therapeutic relationships to positive outcomes will remain theoretically undeveloped as long as clinical trials and nursing practice models follow the logic of techne. After describing how a scientific-clinical gaze misrepresents teen mothers and contributes to a rational-technical model of clinical practice, I draw on contemporary hermeneutics to describe how dialog and understanding are indispensable for clinical judgment and the judicious use of scientific knowledge. This hermeneutic corrective calls attention to the dialogical nature of truth and the relational skills that disclose meaning, preserve personhood, and support possibilities available in the life-world. Dialogical understanding also disrupts the scientific-clinical gaze by disclosing the social disparities that are implicated in early childbearing and teen mothers' long-term prospects. The implications of this thought for legitimating and supporting the flexibility and clinical know-how that 'strays' from protocol-driven care is addressed.

  6. Effects on health care use and associated cost of a home visiting program for older people with poor health status: a randomized clinical trial in the Netherlands.

    NARCIS (Netherlands)

    Bouman, A.; Rossum, E. van; Evers, S.; Ambergen, T.; Kempen, G.; Knipschild, P.

    2008-01-01

    BACKGROUND: Home visiting programs have been developed to improve the functional abilities of older people and subsequently to reduce the use of institutional care services. The results of trials have been inconsistent and their cost-effectiveness uncertain. Home visits for a high-risk population ra

  7. Useful tool for general practitioners, home health care nurses and social workers in assessing determinants of the health status and treatment of patients visited in their homes

    Directory of Open Access Journals (Sweden)

    Andrzej Brodziak

    2012-09-01

    Full Text Available The necessity is emphasized to distinguish between the traditional model of data acquisition reported by a patient in doctor’s office and the more valuable and desired model to become acquainted with the core of the problem by going to a patient’s domicile. In the desired model it is possible to come across various determinants of health during home visits. Family members can be approached and there is a possibility to evaluate the relationships between the patient and his loved ones. One can visually assess one’s living conditions and predictable environmental hazard. For several years, the desired model has been put into practice by general practitioners and home health care nurses. Recently this model is also promoted by “health care therapists” who are members of “teams of home health care”. The authors, being convinced of the merits of “home and environmental model” of practical medicine, have developed a method of recording and illustrating data collected during visits in patient’s home. The elaborated tool helps to communicate and exchange information among general practitioners, home health care nurses, social workers of primary health care centers and specialists. The method improves the formulation of the plan of further therapeutic steps and remedial interventions in psycho-social relations and living conditions of patients.

  8. Nurse home visits with or without alert buttons versus usual care in the frail elderly: a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Favela J

    2013-01-01

    Full Text Available Jesús Favela,1 Luis A Castro,2 Francisco Franco-Marina,3 Sergio Sánchez-García,4 Teresa Juárez-Cedillo,4 Claudia Espinel Bermudez,4 Julia Mora-Altamirano,4 Marcela D Rodriguez,5 Carmen García-Peña41Center for Scientific Research and Higher Education of Ensenada, Ensenada, Baja California, Mexico; 2Sonora Institute of Technology, Ciudad Obregon, Mexico; 3National Institute of Respiratory Diseases, Mexican Ministry of Health, Mexico City, Mexico; 4Epidemiologic and Health Service Research Unit, Aging Area, XXI Century National Medical Center, Mexican Institute of Social Security, Mexico City, Mexico; 5School of Engineering, MyDCI, Autonomous University of Baja California, Mexicali, MexicoObjective: To assess whether an intervention based on nurse home visits including alert buttons (NV+AB is effective in reducing frailty compared to nurse home visits alone (NV-only and usual care (control group for older adults.Design: Unblinded, randomized, controlled trial.Setting: Insured population covered by the Mexican Social Security Institute living in the city of Ensenada, Baja California, Mexico.Participants: Patients were aged over 60 years with a frailty index score higher than 0.14.Intervention: After screening and informed consent, participants were allocated randomly to the control, NV+AB, or NV-only groups.Measurements: The primary outcome was the frailty score 9 months later. Quality of life, depression, comorbidities, health status, and health service utilization were also considered.Results: The framing sample included 819 patients. Of those, 591 were not located because they did not have a landline/telephone (341 patients, they had died (107, they were ill (50, or they were not currently living in the city (28. A screening interview was applied to 228 participants, and 57 had a score ≤0.14, 171 had ≥0.14, and 16 refused to complete the baseline questionnaire. A home visit was scheduled for 155 patients. However, 22 did not complete

  9. The SKI*HI Model: Programming for Hearing Impaired Infants through Home Intervention, Home Visit Curriculum. Fourth Edition.

    Science.gov (United States)

    Clark, Thomas C.; Watkins, Susan

    The manual describes the SKI*HI Model, a comprehensive approach to identification and home intervention treatment of hearing impaired children and their families. The model features home programing in four basic areas: the home hearing aid program (nine lessons which facilitate the proper fit and acceptance of amplification by the child), home…

  10. Utilization and cost of services in the last 6 months of life of patients with cancer - with and without home hospice care.

    Science.gov (United States)

    Bentur, Netta; Resnizky, Shirli; Balicer, Ran; Eilat-Tsanani, Tsofia

    2014-11-01

    This study examined the utilization and cost of all health services consumed during the last six months of life by cancer patients, and compared those with and without home-hospice care. Detailed information was extracted from the health care electronic administrative data files on 193 deceased cancer patients that their family approved the study (out of 429, 45%). About 88% had been hospitalized for 19 days on average and 53% visited the ER. One quarter received home-hospice care. Their average cost was $13,648 compared to $18,503 for patients without home-hospice care. Hospitalization contributed 32% to the total cost of patients with home-hospice care and 64% for those with it. The findings support the justification for significant expansion of home-hospice care.

  11. Development of a nurse home visitation intervention for intimate partner violence

    Directory of Open Access Journals (Sweden)

    Jack Susan M

    2012-02-01

    Full Text Available Abstract Background Despite an increase in knowledge about the epidemiology of intimate partner violence (IPV, much less is known about interventions to reduce IPV and its associated impairment. One program that holds promise in preventing IPV and improving outcomes for women exposed to violence is the Nurse-Family Partnership (NFP, an evidence-based nurse home visitation program for socially disadvantaged first-time mothers. The present study developed an intervention model and modification process to address IPV within the context of the NFP. This included determining the extent to which the NFP curriculum addressed the needs of women at risk for IPV or its recurrence, along with client, nurse and broader stakeholder perspectives on how best to help NFP clients cope with abusive relationships. Methods Following a preliminary needs assessment, an exploratory multiple case study was conducted to identify the core components of the proposed IPV intervention. This included qualitative interviews with purposeful samples of NFP clients and community stakeholders, and focus groups with nurse home visitors recruited from four NFP sites. Conventional content analysis and constant comparison guided data coding and synthesis. A process for developing complex interventions was then implemented. Results Based on data from 69 respondents, an IPV intervention was developed that focused on identifying and responding to IPV; assessing a client's level of safety risk associated with IPV; understanding the process of leaving and resolving an abusive relationship and system navigation. A need was identified for the intervention to include both universal elements of healthy relationships and those tailored to a woman's specific level of readiness to promote change within her life. A clinical pathway guides nurses through the intervention, with a set of facilitators and corresponding instructions for each component. Conclusions NFP clients, nurses and stakeholders

  12. A home-visiting intervention targeting determinants of infant mental health: the study protocol for the CAPEDP randomized controlled trial in France

    Directory of Open Access Journals (Sweden)

    Tubach Florence

    2012-08-01

    Full Text Available Abstract Background Several studies suggest that the number of risk factors rather than their nature is key to mental health disorders in childhood. Method and design The objective of this multicentre randomized controlled parallel trial (PROBE methodology is to assess the impact in a multi-risk French urban sample of a home-visiting program targeting child mental health and its major determinants. This paper describes the protocol of this study. In the study, pregnant women were eligible if they were: living in the intervention area; able to speak French, less than 26 years old; having their first child; less than 27 weeks of amenorrhea; and if at least one of the following criteria were true: less than twelve years of education, intending to bring up their child without the presence of the child’s father, and 3 low income. Participants were randomized into either the intervention or the control group. All had access to usual care in mother-child centres and community mental health services free of charge in every neighbourhood. Psychologists conducted all home visits, which were planned on a weekly basis from the 7th month of pregnancy and progressively decreasing in frequency until the child’s second birthday. Principle outcome measures included child mental health at 24 months and two major mediating variables for infant mental health: postnatal maternal depression and the quality of the caring environment. A total of 440 families were recruited, of which a subsample of 120 families received specific attachment and caregiver behaviour assessment. Assessment was conducted by an independent assessment team during home visits and, for the attachment study, in a specifically created Attachment Assessment laboratory. Discussion The CAPEDP study is the first large-scale randomised, controlled infant mental health promotion programme to take place in France. A major specificity of the program was that all home visits were conducted by

  13. Antenatal and neonatal visits increase complete immunization status among children aged 12-23 months in rural area of Indonesia

    Directory of Open Access Journals (Sweden)

    Suparmi Suparmi

    2015-01-01

    -23 months in rural area of Indonesia.Methods: The assessment used a part data of the 2013 Basic Health Research (Riskesdas. The sub- samples consisted of children aged 12-23 months livedin rural area. Out of the 8747 children aged 12-23 months who lived in rural area, 5452 children had complete data for the analysis. Complete basic immunization status based on record on immunization card and mother’s recall. Cox regression analysis with constant time was used for the analysis.Results: Out of 5452 children, 52.8% (2880/5452 had completed the basic immunization. Dominant factors related to basic complete immunization status were antenatal and neonatal visit, wealth index, mother’s education, and mother’s occupation. Compared with those who did not antenatal visit, those who had antenatal visit had 38% to be more complete basic immunization [adjusted relative risk (RRa = 1.38; 95% confidence interval (CI = 1.27 - 1.50; P = 0.000]. In term of neonatal visit, those who had neonatal visit had 37% to be more complete basic immunization compare to those who did not have neonatal visit (RRa = 1.37; 95% CI = 1.29 - 1.46; P = 0.000.Conclusion: In Indonesia rural areas the children who had antenatal and neonatal visits tend to have more complete basic immunization status. (Health Science Indones 2014;2:73-7Key words: complete basic immunization, antenatal and neonatal visits, rural

  14. Home visits by family physicians during the end-of-life: Does patient income or residence play a role?

    Directory of Open Access Journals (Sweden)

    Johnston Grace

    2005-01-01

    Full Text Available Abstract Background With a growing trend for those with advanced cancer to die at home, there is a corresponding increase in need for primary medical care in that setting. Yet those with lower incomes and in rural regions are often challenged to have their health care needs met. This study examined the association between patient income and residence and the receipt of Family Physician (FP home visits during the end-of-life among patients with cancer. Methods Data Sources/Study Setting. Secondary analysis of linked population-based data. Information pertaining to all patients who died due to lung, colorectal, breast or prostate cancer between 1992 and 1997 (N = 7,212 in the Canadian province of Nova Scotia (NS was extracted from three administrative health databases and from Statistics Canada census records. Study Design. An ecological measure of income ('neighbourhood' median household income was developed using census information. Multivariate logistic regression was then used to assess the association of income with the receipt of at least one home visit from a FP among all subjects and by region of residency during the end-of-life. Covariates in the initial multivariate model included patient demographics and alternative health services information such as total days spent as a hospital inpatient. Data Extraction Methods. Encrypted patient health card numbers were used to link all administrative health databases whereas the postal code was the link to Statistics Canada census information. Results Over 45% of all subjects received at least one home visit (n = 3265. Compared to those from low income areas, the log odds of receiving at least one home visit was significantly greater among subjects who reside in middle to high income neighbourhoods (for the highest income quintile, adjusted odds ratio [OR] = 1.37, 95% confidence interval [CI] = 1.15, 1.64; for upper-middle income, adjusted OR = 1.19, 95%CI = 1.02, 1.39; for middle income

  15. Implementation of evidence-based home visiting programs aimed at reducing child maltreatment: A meta-analytic review.

    Science.gov (United States)

    Casillas, Katherine L; Fauchier, Angèle; Derkash, Bridget T; Garrido, Edward F

    2016-03-01

    In recent years there has been an increase in the popularity of home visitation programs as a means of addressing risk factors for child maltreatment. The evidence supporting the effectiveness of these programs from several meta-analyses, however, is mixed. One potential explanation for this inconsistency explored in the current study involves the manner in which these programs were implemented. In the current study we reviewed 156 studies associated with 9 different home visitation program models targeted to caregivers of children between the ages of 0 and 5. Meta-analytic techniques were used to determine the impact of 18 implementation factors (e.g., staff selection, training, supervision, fidelity monitoring, etc.) and four study characteristics (publication type, target population, study design, comparison group) in predicting program outcomes. Results from analyses revealed that several implementation factors, including training, supervision, and fidelity monitoring, had a significant effect on program outcomes, particularly child maltreatment outcomes. Study characteristics, including the program's target population and the comparison group employed, also had a significant effect on program outcomes. Implications of the study's results for those interested in implementing home visitation programs are discussed. A careful consideration and monitoring of program implementation is advised as a means of achieving optimal study results.

  16. Cardiac surgery nurse practitioner home visits prevent coronary artery bypass graft readmissions

    National Research Council Canada - National Science Library

    Hall, Michael H; Esposito, Rick A; Pekmezaris, Renee; Lesser, Martin; Moravick, Donna; Jahn, Lynda; Blenderman, Robert; Akerman, Meredith; Nouryan, Christian N; Hartman, Alan R

    2014-01-01

    We designed and tested an innovative transitional care program, involving cardiac surgery nurse practitioners, to improve care continuity after patient discharge home from coronary artery bypass graft (CABG...

  17. Scope of a nursing diagnostic list for fulfilling basic human needs in home-visit nursing.

    Science.gov (United States)

    Esaki, Fusako; Muranaka, Yoko; Tamaki, Miyoko; Akiba, Kimiko; Aoki, Ryouko

    2006-01-01

    Inscriptions on 291 nursing diagnosis items regarding 100 home convalescents were subjected to analysis. The 291-item nursing diagnosis was found to be consistent with a previously reported nursing diagnosis developed by the authors from Henderson's 14 items covering basic nursing practice. Additionally, the analysis indicated a need for nursing diagnosis items for family members, as caregivers for the patients recuperating at home.

  18. Home visits by neighborhood Mentor Mothers provide timely recovery from childhood malnutrition in South Africa: results from a randomized controlled trial

    OpenAIRE

    2010-01-01

    Abstract Background Child and infant malnourishment is a significant and growing problem in the developing world. Malnourished children are at high risk for negative health outcomes over their lifespans. Philani, a paraprofessional home visiting program, was developed to improve childhood nourishment. The objective of this study is to evaluate whether the Philani program can rehabilitate malnourished children in a timely manner. Methods Mentor Mothers were trained to conduct home visits. Ment...

  19. Are acceptance rates of a national preventive home visit programme for older people socially imbalanced?: a cross sectional study in Denmark

    Directory of Open Access Journals (Sweden)

    Yamada Yukari

    2012-06-01

    Full Text Available Abstract Background Preventive home visits are offered to community dwelling older people in Denmark aimed at maintaining their functional ability for as long as possible, but only two thirds of older people accept the offer from the municipalities. The purpose of this study is to investigate 1 whether socioeconomic status was associated with acceptance of preventive home visits among older people and 2 whether municipality invitational procedures for the preventive home visits modified the association. Methods The study population included 1,023 community dwelling 80-year-old individuals from the Danish intervention study on preventive home visits. Information on preventive home visit acceptance rates was obtained from questionnaires. Socioeconomic status was measured by financial assets obtained from national registry data, and invitational procedures were identified through the municipalities. Logistic regression analyses were used, adjusted by gender. Results Older persons with high financial assets accepted preventive home visits more frequently than persons with low assets (adjusted OR = 1.5 (CI95%: 1.1-2.0. However, the association was attenuated when adjusted by the invitational procedures. The odds ratio for accepting preventive home visits was larger among persons with low financial assets invited by a letter with a proposed date than among persons with high financial assets invited by other procedures, though these estimates had wide confidence intervals. Conclusion High socioeconomic status was associated with a higher acceptance rate of preventive home visits, but the association was attenuated by invitational procedures. The results indicate that the social inequality in acceptance of publicly offered preventive services might decrease if municipalities adopt more proactive invitational procedures.

  20. Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (Building Blocks): a pragmatic randomised controlled trial

    OpenAIRE

    Robling, Michael Richard; Bekkers, Marie; Bell, Kerry; Butler, Christopher Collett; Cannings-John, Rebecca Louise; Channon, Susan Jane; Martin, Belen Corbacho; Gregory, John Welbourn; Hood, Kerenza; Kemp, Alison Mary; Kenkre, Joyce; Montgomery, Alan A; Moody, Gwenllian; Owen-Jones, Catrin Eleri; Pickett, Kate

    2015-01-01

    Summary Background Many countries now offer support to teenage mothers to help them to achieve long-term socioeconomic stability and to give a successful start to their children. The Family Nurse Partnership (FNP) is a licensed intensive home-visiting intervention developed in the USA and introduced into practice in England that involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained family nurses. We aimed to assess t...

  1. Promoting uptake of child HIV testing: an evaluation of the role of a home visiting program for orphans and vulnerable children in South Africa.

    Science.gov (United States)

    Thurman, Tonya R; Luckett, Brian; Taylor, Tory; Carnay, Melissa

    2016-03-01

    HIV counseling and testing (HCT) is critical for children in generalized epidemic settings, but significant shortfalls in coverage persist, notably among orphans and others at disproportionate risk of infection. This study investigates the impact of a home visiting program in South Africa on orphaned and vulnerable children's uptake of HCT. Using propensity score matching, survey data for children receiving home visits from trained community-based care workers were compared to data from children living in similar households that had not yet received home visits (n = 1324). Home visits by community-based care workers increased the odds of a child being tested by 97% (OR = 1.97, 95% CI = 1.34-2.92). The home visitation program had an especially pronounced effect on orphans, more than doubling their odds of being tested (OR = 2.12, 95% CI = 1.00-4.47) compared to orphans living in similar households that did not receive home visits. Orphan status alone had no effect on HCT independent of program exposure, suggesting that the program was uniquely able to increase testing in this subgroup. Results highlight the potential for increasing HCT access among children at high risk through targeted community-based initiatives.

  2. Preventive home visits for mortality, morbidity, and institutionalization in older adults: a systematic review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Evan Mayo-Wilson

    Full Text Available BACKGROUND: Home visits for older adults aim to prevent cognitive and functional impairment, thus reducing institutionalization and mortality. Visitors may provide information, investigate untreated problems, encourage medication compliance, and provide referrals to services. METHODS AND FINDINGS: DATA SOURCES: Ten databases including CENTRAL and Medline searched through December 2012. STUDY SELECTION: Randomized controlled trials enrolling community-dwelling persons without dementia aged over 65 years. Interventions included visits at home by a health or social care professional that were not related to hospital discharge. DATA EXTRACTION AND SYNTHESIS: Two authors independently extracted data. Outcomes were pooled using random effects. MAIN OUTCOMES AND MEASURES: Mortality, institutionalization, hospitalization, falls, injuries, physical functioning, cognitive functioning, quality of life, and psychiatric illness. RESULTS: Sixty-four studies with 28642 participants were included. Home visits were not associated with absolute reductions in mortality at longest follow-up, but some programs may have small relative effects (relative risk = 0.93 [0.87 to 0.99]; absolute risk = 0.00 [-0.01 to 0.00]. There was moderate quality evidence of no overall effect on the number of people institutionalized (RR = 1.02 [0.88 to 1.18] or hospitalized (RR = 0.96 [0.91 to 1.01]. There was high quality evidence for number of people who fell, which is consistent with no effect or a small effect (odds ratio = 0.86 [0.73 to 1.01], but there was no evidence that these interventions increased independent living. There was low and very low quality evidence of effects for quality of life (standardised mean difference = -0.06 [-0.11 to -0.01] and physical functioning (SMD = -0.10 [-0.17 to -0.03] respectively, but these may not be clinically important. CONCLUSIONS: Home visiting is not consistently associated with differences in mortality or

  3. Effect of nurse home visits vs. usual care on reducing intimate partner violence in young high-risk pregnant women: a randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Jamila Mejdoubi

    Full Text Available BACKGROUND: Expectant mothers and mothers of young children are especially vulnerable to intimate partner violence (IPV. The nurse-family partnership (NFP is a home visitation program in the United States effective for the prevention of adverse child health outcomes. Evidence regarding the effect of nurse home visiting on IPV is inconsistent. This study aims to study the effect of VoorZorg, the Dutch NFP, on IPV. METHODS: A random sample of 460 eligible disadvantaged women <26 years, with no previous live births, was randomized. Women in the control group (C; n=223 received usual care; women in the intervention group (I; n=237 received usual care plus nurse home visits periodically during pregnancy and until the child's second birthday. RESULTS: At 32 weeks of pregnancy, women in the intervention group self-reported significantly less IPV victimization than women in the control group in: level 2 psychological aggression (C: 56% vs. I: 39%, physical assault level 1 (C: 58% vs. I: 40% and level 2 (C: 31% vs. I: 20%, and level 1 sexual coercion (C: 16% vs. I: 8%. Furthermore, women in the intervention group reported significantly less IPV perpetration in: level 2 psychological aggression (C: 60% vs. I: 46%, level 1 physical assault (C: 65% vs. I: 52%, and level 1 injury (C: 27% vs. I: 17%. At 24 months after birth, IPV victimization was significantly lower in the intervention group for level 1 physical assault (C: 44% vs. I: 26%, and IPV perpetration was significantly lower for level 1 sexual assault (C: 18% vs. I: 3%. Multilevel analyses showed a significant improvement in IPV victimization and perpetration among women in the intervention group at 24 months after birth. CONCLUSION: VoorZorg, compared with the usual care, is effective in reducing IPV during pregnancy and in the two years after birth among young high-risk women. TRIAL REGISTRATION: Dutch Trial Register NTR854 http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=854.

  4. Relationship types among adolescent parents participating in a home-visiting program: A latent-transition analysis.

    Science.gov (United States)

    Raskin, Maryna; Fosse, Nathan E; Fauth, Rebecca C; Bumgarner, Erin; Easterbrooks, M Ann

    2016-04-01

    Young parents (less than 25 years of age) have been shown to have especially low rates of father involvement and union stability. However, research has also shown that parenting experiences of young fathers may not be uniform. There is a need for more research that assesses both the multidimensionality of relationship typologies and their temporality. Using a large longitudinal sample of low-income, young mothers enrolled in a randomized control study of a home-visitation program (n = 704; 61% program, 39% control), we evaluated how mother-father relationship dynamics changed over time. Ten mother-reported indicators of relationships (e.g., coresidence, marital status, types of father support) were used to conduct a latent-class analysis of relationship types. A 4-class solution was identified at each time point: Single Parent, Supportive Nonresident Partner, Supportive Resident Partner, and Questioning/Ambivalent Coupling. Latent-transition analyses were used to evaluate stability of relationships across 2 years. At each transition, a large proportion of women moved from one relationship class to another, indicating heterogeneity in relationship dynamics of adolescent parents. Results revealed the potential of a home-visiting program targeted at young parents to favorably promote more stable and supportive mother-father relationships and coparenting arrangements.

  5. Motivation to take part in integrated care - an assessment of follow-up home visits to elderly persons

    Directory of Open Access Journals (Sweden)

    Ulf Hjelmar

    2011-08-01

    Full Text Available Objectives: The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons. Theory and methods: The analysis is based on inter-organisational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses. Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials. Conclusions: The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programs in order to fully exploit the potential health benefits.

  6. Motivation to take part in integrated care - an assessment of follow-up home visits to elderly persons

    Directory of Open Access Journals (Sweden)

    Ulf Hjelmar

    2011-08-01

    Full Text Available Objectives: The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons.Theory and methods: The analysis is based on inter-organisational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses.Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials.Conclusions: The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programs in order to fully exploit the potential health benefits.

  7. Motivation to take part in integrated care-an assessment of follow-up home visits to elderly persons.

    Science.gov (United States)

    Hjelmar, Ulf; Hendriksen, Carsten; Hansen, Kirsten

    2011-07-01

    The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital) is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly persons. The analysis is based on inter-organizational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners, and district nurses. Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared understanding of values and learning potentials. The study concludes that we need to focus on specific care fields and actors to reduce complexity in the area and more fully understand what motivates care providers to participate in cross-sectoral activities, such as a follow-up home visit programme. One lesson for current policy is that motivational factors need to be addressed in future collaborative programmes in order to fully exploit the potential health benefits.

  8. Association between underweight and hospitalization, emergency room visits, and mortality among patients in community medical homes

    Directory of Open Access Journals (Sweden)

    Takahashi PY

    2013-01-01

    Full Text Available Paul Y Takahashi.1 Jennifer L St Sauver,2 Timothy C Olson,1 Jill M Huber,1 Stephen S Cha,2 Jon O Ebbert11Division of Primary Care Internal Medicine, 2Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USABackground: In older adults, underweight (body mass index [BMI] < 18.5 has been associated with increased mortality. This increased mortality risk may be associated with increased health care utilization. We evaluated the relationship between underweight and hospitalization, emergency room visits, and mortality.Methods: An analysis of a retrospective cohort study was conducted at a multisite academic primary care medical practice in Minnesota. The patients were ≥60 years of age, impaneled within primary care on January 1, 2011, and had a BMI measurement recorded between January 1, 2011, and December 31, 2011. Individuals were excluded if they refused review of their medical record. The primary measurement was BMI, which was categorized as underweight (BMI < 18.5 or normal and obese (BMI ≥ 18.5. The outcomes were hospitalization, emergency room visits, and mortality in the 2011 calendar year. Associations between underweight and each outcome were calculated using logistic regression. Interactions between underweight and gender were assessed in the logistic regression models. The final results were adjusted for age, gender, comorbid health conditions, and single living status.Results: The final cohort included 21,019 patients, of whom 220 (1% were underweight. Underweight patients had a higher likelihood of hospitalization compared with patients with higher BMI (adjusted odds ratio [OR] 1.64; 95% confidence interval [CI] 1.21–2.22. Underweight patients were also more likely to visit the emergency room (adjusted OR 1.70; 95% CI 1.28–2.25 or to die (adjusted OR 3.64; 95% CI 2.33–5.69. Men with a BMI < 18.5 compared with those having a BMI ≥ 18.5 had the highest odds of hospitalization (OR 3.45; 95% CI 1.59–7

  9. Design and pilot results of a single blind randomized controlled trial of systematic demand-led home visits by nurses to frail elderly persons in primary care [ISRCTN05358495

    Directory of Open Access Journals (Sweden)

    Tybout Willemijn

    2005-09-01

    Full Text Available Abstract Background The objective of this article is to describe the design of an evaluation of the cost-effectiveness of systematic home visits by nurses to frail elderly primary care patients. Pilot objectives were: 1. To determine the feasibility of postal multidimensional frailty screening instruments; 2. to identify the need for home visits to elderly. Methods Main study: The main study concerns a randomized controlled in primary care practices (PCP with 18 months follow-up and blinded PCPs. Frail persons aged 75 years or older and living at home but neither terminally ill nor demented from 33 PCPs were eligible. Trained community nurses (1 visit patients at home and assess the care needs with the Resident Assessment Instrument-Home Care, a multidimensional computerized geriatric assessment instrument, enabling direct identification of problem areas; (2 determine the care priorities together with the patient; (3 design and execute interventions according to protocols; (4 and visit patients at least five times during a year in order to execute and monitor the care-plan. Controls receive usual care. Outcome measures are Quality of life, and Quality Adjusted Life Years; time to nursing home admission; mortality; hospital admissions; health care utilization. Pilot 1: Three brief postal multidimensional screening measures to identify frail health among elderly persons were tested on percentage complete item response (selected after a literature search: 1 Vulnerable Elders Screen, 2 Strawbridge's frailty screen, and 3 COOP-WONCA charts. Pilot 2: Three nurses visited elderly frail patients as identified by PCPs in a health center of 5400 patients and used an assessment protocol to identify psychosocial and medical problems. The needs and experiences of all participants were gathered by semi-structured interviews. Discussion The design holds several unique elements such as early identification of frail persons combined with case-management by

  10. Predictors of compliance with a home-based exercise program added to usual medical care in preventing postmenopausal osteoporosis: an 18-month prospective study.

    Science.gov (United States)

    Mayoux-Benhamou, M A; Roux, C; Perraud, A; Fermanian, J; Rahali-Kachlouf, H; Revel, M

    2005-03-01

    This prospective 18-month study was designed to assess long-term compliance with a program of exercise aimed to prevent osteoporosis after an educational intervention and to uncover determinants of compliance. A total of 135 postmenopausal women were recruited by flyers or instructed by their physicians to participate in an educational session added to usual medical care. After a baseline visit and dual-energy X-ray absorptiometry, volunteers participated in a 1-day educational session consisting of a lecture and discussion on guidelines for appropriate physical activity and training in a home-based exercise program taught by a physical therapist. Scheduled follow-up visits were 1, 6, and 18 months after the educational session. Compliance with the exercise program was defined as an exercise practice rate 50% or greater than the prescribed training. The 18-month compliance rate was 17.8% (24/135). The main reason for withdrawal from the program was lack of motivation. Two variables predicted compliance: contraindication for hormone replacement therapy (odds ratio [OR] = 0.13; 95% confidence interval [95% CI], 0.04 to 0.46) and general physical function scores from an SF-36 questionnaire (OR=1.26; 95% CI, 1.03 to 1.5). To a lesser extent, osteoporosis risk, defined as a femoral T-score exercise, only a minority of postmenopausal women adhered to a home-based exercise program after 18 months.

  11. Design and implementation of an integrated, continuous evaluation, and quality improvement system for a state-based home-visiting program.

    Science.gov (United States)

    McCabe, Bridget K; Potash, Dru; Omohundro, Ellen; Taylor, Cathy R

    2012-10-01

    To describe the design and implementation of an evaluation system to facilitate continuous quality improvement (CQI) and scientific evaluation in a statewide home visiting program, and to provide a summary of the system's progress in meeting intended outputs and short-term outcomes. Help Us Grow Successfully (HUGS) is a statewide home visiting program that provides services to at-risk pregnant/post-partum women, children (0-5 years), and their families. The program goals are to improve parenting skills and connect families to needed services and thus improve the health of the service population. The evaluation system is designed to: (1) integrate evaluation into daily workflow; (2) utilize standardized screening and evaluation tools; (3) facilitate a culture of CQI in program management; and, (4) facilitate scientifically rigorous evaluations. The review of the system's design and implementation occurred through a formative evaluation process (reach, dose, and fidelity). Data was collected through electronic and paper surveys, administrative data, and notes from management meetings, and medical chart review. In the design phase, four process and forty outcome measures were selected and are tracked using standardized screening and monitoring tools. During implementation, the reach and dose of training were adequate to successfully launch the evaluation/CQI system. All staff (n = 165) use the system for management of families; the supervisors (n = 18) use the system to track routine program activities. Data quality and availability is sufficient to support periodic program reviews at the region and state level. In the first 7 months, the HUGS evaluation system tracked 3,794 families (7,937 individuals). System use and acceptance is high. A successful implementation of a structured evaluation system with a strong CQI component is feasible in an existing, large statewide program. The evaluation/CQI system is an effective mechanism to drive modest change in management

  12. [Outpatient Parenteral Antimicrobial Therapy (OPAT) with Elastomeric Pumps in Collaboration with Home-visit Nursing Services in Japan: Experience of the First 10 Patients].

    Science.gov (United States)

    Hase, Ryota; Uno, Shunsuke; Miyoshi, Kazuyasu; Fujita, Koji; Suzuki, Hiroyuki; Suzuki, Daisuke; Mikawa, Takahiro; Muranaka, Kiyoharu; Hosokawa, Naoto

    2015-09-01

    In 2014, we reported the first trial based on outpatient parenteral antimicrobial therapy (OPAT) with continuous infusions in Japan. Following this, we found many patients who were eligible for OPAT but could not undertake it owing to difficulties in accessing the clinic daily. To overcome this problem, we created a model in collaboration with visiting nursing stations and started providing OPAT with the services. We report herein on a summary of the investigation of the first 10 patients treated under this model. We collected data pertaining to diseases, organisms, antimicrobials, treatment duration, bed days saved, outcome, readmission rate, and cost reductions associated with these patients. The most commonly targeted disease was osteomyelitis, followed by infective endocarditis. The condition of nine of the patients was complicated by bacteremia. The most commonly targeted organism was Staphylococcus aureus. Cefazolin was the most frequently prescribed antimicrobial, followed by Penicillin G. The median duration for OPAT was 12 days (range: 5-23 days). The total number of bed days saved was 129. All patients completed the planned OPAT. Eight patients were cured and two showed improvement. Only one patient was readmitted within a month after the completion of therapy. The estimated medical cost reduction was 496,540 yen, which is approximately 4,200 US dollars. Collaboration with visiting nursing stations provided OPAT to the patients who had difficulties in accessing the clinic daily. Our study shows that OPAT administered by continuous infusion in collaboration with home-visit nursing services would be a safe and feasible practice for efficient bed utilization and medical cost saving.

  13. Study protocol: follow-up home visits with nutrition: a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Beck Anne Marie

    2011-12-01

    Full Text Available Abstract Background Geriatric patients are at high risk of re-admission after discharge. Pre-existing nutritional risk amongst these patients is of primary concern, with former nutritional intervention studies being largely ineffective. None of these studies has included individual dietary counselling by a registered dietician or has considered competing medical conditions in the participants. A former randomised study has shown that comprehensive discharge follow-up in geriatric patients homes by general practitioners and district nurses was effective in reducing the re-admission risk in the intervention group compared to the control group. That study did not include a nutritional intervention. The purpose of this study is to assess the combined benefits of an intervention consisting of discharge follow-up in geriatric patients' home by a general practitioner and a registered dietician. Methods/design This single-blind randomised controlled study, will recruit 160 hospitalised geriatric medical patients (65+ y at nutritional risk. Participants will be randomly allocated to receive in their homes, either 12 weeks individualised nutritional counselling by a registered dietician complemented with follow-up by general practitioners or a 12 weeks follow-up by general practitioners alone. Discussion This trial is the first of its kind to provide individual nutritional intervention combined with follow-up by general practitioner as an intervention to reduce risk of re-admission after discharge among geriatric medical patients. The results will hopefully help to guide the development of more effective rehabilitation programs following hospital admissions, which may ultimately lead to reduced health care costs, and improvement in mobility, independence and quality of life for geriatric patients at nutritional risk. Trial Registration ClinicalTrials.gov 2010 NCT01249716

  14. Motivation to take part in integrated care – an assessment of follow-up home visits to elderly persons

    DEFF Research Database (Denmark)

    Hjelmar, U; Hendriksen, Carsten; Hansen, K

    2011-01-01

    persons. Theory and methods: The analysis is based on inter-organizational network theory in an attempt to explain the role of motivation in network formation between organizational systems. The empirical findings are based on focus groups and in-depth interviews with hospital staff, general practitioners...... to implement because of a number of organizational obstacles, including co-ordination between the organizations involved in the process. In this paper we look at the factors that affect motivation to participate in a cross-sectoral programme in Copenhagen, Denmark, implementing follow-up home visits to elderly......, and district nurses. Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared...

  15. Emancipatory practices of nurses in primary health care: the home visit as an instrument of health needs assessment

    Directory of Open Access Journals (Sweden)

    Celia Maria Sivalli Campos

    2014-08-01

    Full Text Available Objective Identify nurses’ emancipatory practices in primary care, to contribute to the improvement of health care. Method A case study type social research of qualitative nature, in which nurses of a primary health care service unit in São Paulo were interviewed. Results The home visit was identified as a nursing practice possible to be expanded in order to identify social determinants of health, triggering emancipatory practices in the service. This expansion occurred because the design of health care labour intended by the service team changed its focus from the traditional object of health services, the disease. Conclusion First, it is advocated that social policies lead projects with the purpose of improving health needs. On the other hand, the daily labour needs to provide opportunities for reflection and discussion of healthcare projects, leading workers to propose labour-processes targeted to both the social determinants of health and people’s illness.

  16. Effects of nurse home-visiting on maternal life course and child development: age 6 follow-up results of a randomized trial.

    Science.gov (United States)

    Olds, David L; Kitzman, Harriet; Cole, Robert; Robinson, JoAnn; Sidora, Kimberly; Luckey, Dennis W; Henderson, Charles R; Hanks, Carole; Bondy, Jessica; Holmberg, John

    2004-12-01

    To test, with an urban, primarily black sample, the effects of prenatal and infancy home visits by nurses on mothers' fertility and economic self-sufficiency and the academic and behavioral adjustment of their children as the children finished kindergarten, near their sixth birthday. We conducted a randomized, controlled trial of a program of prenatal and infancy home-visiting in a public system of obstetric and pediatric care in Memphis, Tennessee. A total of 743 primarily black women at or =2 sociodemographic risk characteristics (unmarried, violence, current partner's educational level, or behavioral problems attributable to the use of alcohol or drugs. This program of prenatal and infancy home-visiting by nurses continued to improve the lives of women and children at child age 6 years, 4 years after the program ended.

  17. Exploring patients' reasons for participation in a medical education home visit program: a qualitative study in Malaysia.

    Science.gov (United States)

    Tan, Chai-Eng; Jaffar, Aida; Tohit, Noorlaili; Hamzah, Zuhra; Hashim, Syahnaz Mohd

    2017-06-01

    Direct contact with patients for medical education is essential in healthcare professional training. Patients who were recruited for a medical education home visit program in Malaysia did so on a voluntary basis without remuneration. This paper aims to explore their reasons for participation in this program. An exploratory qualitative study was conducted on patients who had been visited during the 2012/2013 academic session. Purposive sampling was done to select adult participants from varying ethnicities and ages from the list of patients. In-depth interviews were conducted at the participants' homes and were audio recorded. The transcripts of these interviews were analyzed using thematic analysis. A total of nine in-depth interviews were conducted. Four main themes were identified from thematic analysis: 1) Perceived meaning of the visit; 2) Perceived benefits and risks; 3) Past healthcare experiences; 4) Availability for visits. The home visits meant different things to different participants, including a teaching-learning encounter, a social visit, a charitable deed or a healthcare check-up. The benefits and risks of accepting unknown students to their homes and sharing their health issues with them had been weighed prior to participation. Prior experience with healthcare services such as gratitude to healthcare providers or having a relative in the healthcare profession increased their receptivity for involvement. Lastly, enabling factors such as availability of time would determine their acceptance for home visits. Patients agree to participate in medical education activities on a voluntary basis for various reasons. Providing good healthcare service and sufficient preparation are crucial to increase patient receptivity for such activities.

  18. Effects of a simple home-based exercise program on fall prevention in older adults: A 12-month primary care setting, randomized controlled trial.

    Science.gov (United States)

    Boongird, Chitima; Keesukphan, Prasit; Phiphadthakusolkul, Soontraporn; Rattanasiri, Sasivimol; Thakkinstian, Ammarin

    2017-04-24

    To investigate the effects of a simple home-based exercise program on falls, physical functioning, fear of falling and quality of life in a primary care setting. Participants (n = 439), aged ≥65 years with mild-to-moderate balance dysfunction were randomly assigned to an exercise (n = 219) or control (n = 220) group. The program consisted of five combined exercises, which progressed in difficulty, and a walking plan. Controls received fall prevention education. Physical functioning and other outcomes were measured at 3- and 6-month follow-up visits. Falls were monitored with fall diaries and phone interviews at 3, 6, 9, and 12 months respectively. The 12 months of the home-based exercise program showed the incidence of falls was 0.30 falls per person year in the exercise group, compared with 0.40 in the control group. The estimated incidence rate ratio was 0.75 (95% CI 0.55-1.04), which was not statistically significant. The fear of falling (measured by the Thai fall efficacy scale) was significantly lower in the exercise than control group (24.7 vs 27.0, P = 0.003). Also, the trend of program adherence increased in the exercise group. (29.6% to 56.8%). This simple home-based exercise program showed a reduction in fear of falling and a positive trend towards exercise adherence. Further studies should focus on factors associated with exercise adherence, the benefits of increased home visits and should follow participants longer in order to evaluate the effects of the program. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  19. Bridging the gap between hospital and primary care: the pharmacist home visit.

    Science.gov (United States)

    Ensing, Hendrik T; Koster, Ellen S; Stuijt, Clementine C M; van Dooren, Ad A; Bouvy, Marcel L

    2015-06-01

    Bridging the gap between hospital and primary care is important as transition from one healthcare setting to another increases the risk on drug-related problems and consequent readmissions. To reduce those risks, pharmacist interventions during and after hospitalization have been frequently studied, albeit with variable effects. Therefore, in this manuscript we propose a three phase approach to structurally address post-discharge drug-related problems. First, hospitals need to transfer up-todate medication information to community pharmacists. Second, the key phase of this approach consists of adequate follow-up at the patients' home. Pharmacists need to apply their clinical and communication skills to identify and analyze drug-related problems. Finally, to prevent and solve identified drug related problems a close collaboration within the primary care setting between pharmacists and general practitioners is of utmost importance. It is expected that such an approach results in improved quality of care and improved patient safety.

  20. Cardiac surgery nurse practitioner home visits prevent coronary artery bypass graft readmissions.

    Science.gov (United States)

    Hall, Michael H; Esposito, Rick A; Pekmezaris, Renee; Lesser, Martin; Moravick, Donna; Jahn, Lynda; Blenderman, Robert; Akerman, Meredith; Nouryan, Christian N; Hartman, Alan R

    2014-05-01

    We designed and tested an innovative transitional care program, involving cardiac surgery nurse practitioners, to improve care continuity after patient discharge home from coronary artery bypass graft (CABG) operations and decrease the composite end point of 30-day readmission and death. A total of 401 consecutive CABG patients were eligible between May 1, 2010, and August 31, 2011, for analysis. Patient data were entered prospectively into The Society of Thoracic Surgeons database and the New York State Cardiac Surgery Reporting System and retrospectively analyzed with Institutional Review Board approval. The "Follow Your Heart" program enrolled 169 patients, and 232 controls received usual care. Univariate and multivariate analyses were used to identify readmission predictors, and propensity score matching was performed with 13 covariates. Binary logistic regression analysis identified "Follow Your Heart" as the only independently significant variable in preventing the composite outcome (p=0.015). Odds ratios for readmission were 3.11 for dialysis patients, 2.17 for Medicaid recipients, 1.87 for women, 1.86 for non-Caucasians, 1.78 for chronic obstructive pulmonary disease, 1.26 for diabetes, and 1.09 for congestive heart failure. Propensity score matching yielded matches for 156 intervention patients (92%). The intervention showed a significantly lower 30-day readmission/death rate of 3.85% (6 of 156) compared with 11.54% (18 of 156) for the usual care matched group (p=0.023). A home transition program providing continuity of care, communication hub, and medication management by treating hospital nurse practitioners significantly reduced the 30-day composite end point of readmission/death after CABG. More targeted resource allocation based on odds ratios of readmission may further improve results and be applicable to other patient groups. Copyright © 2014 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Measurement of special access to home visit nursing services among Japanese disabled elderly people: using GIS and claim data.

    Science.gov (United States)

    Naruse, Takashi; Matsumoto, Hiroshige; Fujisaki-Sakai, Mahiro; Nagata, Satoko

    2017-05-30

    Home care service demands are increasing in Japan; this necessitates improved service allocation. This study examined the relationship between home visit nursing (HVN) service use and the proportion of elderly people living within 10 min' travel of HVN agencies. The population of elderly people living within reach of HVN agencies for each of 17 municipalities in one low-density prefecture was calculated using public data and geographic information systems. Multilevel logistic analysis for 2641 elderly people was conducted using medical and long-term care insurance claims data from October 2010 to examine the association between the proportion of elderly people reachable by HVNs and service usage in 13 municipalities. Municipality variables included HVN agency allocation appropriateness. Individual variables included HVN usage and demographic variables. The reachable proportion of the elderly population ranged from 0.0 to 90.2% in the examined municipalities. The reachable proportion of the elderly population was significantly positively correlated with HVN use (odds ratio: 1.938; confidence interval: 1.265-2.967). Residents living in municipalities with a lower reachable proportion of the elderly population are less likely to use HVN services. Public health interventions should increase the reachable proportion of the elderly population in order to improve HVN service use.

  2. The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Maria Giné-Garriga

    Full Text Available Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity.To assess the effectiveness of a Primary Health Care (PHC based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period.Randomized controlled trial.Three hundred and sixty-two (n = 362 inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD; 68.3 (8.8 years; 118 women were randomly allocated to the physical activity program (IG. One hundred and seventy-nine patients (n = 179; 67.2 (9.1 years; 106 women were allocated to the control group (CG. The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources.The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2 was assessed at baseline (month 0, at the end of the intervention (month 3, and at 12 months follow-up after the end of the intervention (month 15.The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5. The CG remained about the same: 18.2 (11.1 (P = .002.Our findings indicate that a 3-month physical activity program linked to community resources is a short-duration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits.ClinicalTrials.gov NCT00714831.

  3. Occupational therapists' views on using a virtual reality interior design application within the pre-discharge home visit process.

    Science.gov (United States)

    Atwal, Anita; Money, Arthur; Harvey, Michele

    2014-12-18

    A key role of Occupational Therapists (OTs) is to carry out pre-discharge home visits (PHV) and propose appropriate adaptations to the home environment in order to enable patients to function independently after hospital discharge. However, research shows that more than 50% of specialist equipment installed as part of home adaptations is not used by patients. A key reason for this is that decisions about home adaptations are often made without adequate collaboration and consultation with the patient. Consequently, there is an urgent need to seek out new and innovative uses of technology to facilitate patient/practitioner collaboration, engagement, and shared decision making in the PHV process. Virtual reality interior design applications (VRIDAs) primarily allow users to simulate the home environment and visualize changes prior to implementing them. Customized VRIDAs, which also model specialist occupational therapy equipment, could become a valuable tool to facilitate improved patient/practitioner collaboration, if developed effectively and integrated into the PHV process. The intent of the study was to explore the perceptions of OTs with regard to using VRIDAs as an assistive tool within the PHV process. Task-oriented interactive usability sessions, utilizing the think-aloud protocol and subsequent semi-structured interviews were carried out with seven OTs who possessed significant experience across a range of clinical settings. Template analysis was carried out on the think-aloud and interview data. Analysis was both inductive and driven by theory, centering around the parameters that impact upon the acceptance, adoption, and use of this technology in practice as indicated by the Technology Acceptance Model (TAM). OTs' perceptions were identified relating to three core themes: (1) perceived usefulness (PU), (2) perceived ease of use (PEoU), and (3) actual use (AU). Regarding PU, OTs believed VRIDAs had promising potential to increase understanding, enrich

  4. Occupational Therapists’ Views on Using a Virtual Reality Interior Design Application Within the Pre-Discharge Home Visit Process

    Science.gov (United States)

    Atwal, Anita

    2014-01-01

    Background A key role of Occupational Therapists (OTs) is to carry out pre-discharge home visits (PHV) and propose appropriate adaptations to the home environment in order to enable patients to function independently after hospital discharge. However, research shows that more than 50% of specialist equipment installed as part of home adaptations is not used by patients. A key reason for this is that decisions about home adaptations are often made without adequate collaboration and consultation with the patient. Consequently, there is an urgent need to seek out new and innovative uses of technology to facilitate patient/practitioner collaboration, engagement, and shared decision making in the PHV process. Virtual reality interior design applications (VRIDAs) primarily allow users to simulate the home environment and visualize changes prior to implementing them. Customized VRIDAs, which also model specialist occupational therapy equipment, could become a valuable tool to facilitate improved patient/practitioner collaboration, if developed effectively and integrated into the PHV process. Objective The intent of the study was to explore the perceptions of OTs with regard to using VRIDAs as an assistive tool within the PHV process. Methods Task-oriented interactive usability sessions, utilizing the think-aloud protocol and subsequent semi-structured interviews were carried out with seven OTs who possessed significant experience across a range of clinical settings. Template analysis was carried out on the think-aloud and interview data. Analysis was both inductive and driven by theory, centering around the parameters that impact upon the acceptance, adoption, and use of this technology in practice as indicated by the Technology Acceptance Model (TAM). Results OTs’ perceptions were identified relating to three core themes: (1) perceived usefulness (PU), (2) perceived ease of use (PEoU), and (3) actual use (AU). Regarding PU, OTs believed VRIDAs had promising potential

  5. Access to Difficult-to-reach Population Subgroups: A Family Midwife Based Home Visiting Service for Implementing Nutrition-related Preventive Activities - A Mixed Methods Explorative Study

    Directory of Open Access Journals (Sweden)

    Helena Walz

    2015-08-01

    Full Text Available Health and social inequality are tightly linked and still pose an important public health problem. However, vulnerable and disadvantaged populations are difficult to reach for health-related interventions. Given the long-lasting effects of an adverse, particular nutrition-related, intrauterine and neonatal environment on health development (perinatal programming, an early and easy access is essential for sustainable interventions. The goal of this explorative study was therefore to elucidate whether an existing access of family midwives (FMs to families in need of support could be an option to implement effective public health and nutrition interventions. To that end three research objectives were formulated: (1 to determine whether a discernible impact of home visits by FMs can be described; (2 to identify subgroups among these families in need of more specific interventions; (3 to determine how relevant nutrition-related topics are for both FMs and the supported families. For addressing these objectives a mixed methods design was used: Routine documentation data from 295 families visited by a family midwife (FM were analyzed (secondary analysis, and structured expert interviews with FMs were conducted and analyzed. Study reporting followed the STROBE (STrengthening the Reporting of OBservational studies in Epidemiology statement. Based on the FMs reports, a significant improvement (p < 0.001 regarding psycho-social variables could be determined after the home visits. Single mothers, however, seemed to benefit less from the FMs service compared to their counterparts (p = 0.015. Nutritional counseling was demanded by 89% of the families during the home visits. In addition, nutrition-related topics were reported in the interviews to be of high interest to both families and the FMs. Based on the obtained results it is concluded that FMs home visits offer a promising access to vulnerable and disadvantaged families for implementing nutrition

  6. Effectiveness of a nurse-led intensive home-visitation programme for first-time teenage mothers (Building Blocks): a pragmatic randomised controlled trial.

    Science.gov (United States)

    Robling, Michael; Bekkers, Marie-Jet; Bell, Kerry; Butler, Christopher C; Cannings-John, Rebecca; Channon, Sue; Martin, Belen Corbacho; Gregory, John W; Hood, Kerry; Kemp, Alison; Kenkre, Joyce; Montgomery, Alan A; Moody, Gwenllian; Owen-Jones, Eleri; Pickett, Kate; Richardson, Gerry; Roberts, Zoë E S; Ronaldson, Sarah; Sanders, Julia; Stamuli, Eugena; Torgerson, David

    2016-01-09

    Many countries now offer support to teenage mothers to help them to achieve long-term socioeconomic stability and to give a successful start to their children. The Family Nurse Partnership (FNP) is a licensed intensive home-visiting intervention developed in the USA and introduced into practice in England that involves up to 64 structured home visits from early pregnancy until the child's second birthday by specially recruited and trained family nurses. We aimed to assess the effectiveness of giving the programme to teenage first-time mothers on infant and maternal outcomes up to 24 months after birth. We did a pragmatic, non-blinded, randomised controlled, parallel-group trial in community midwifery settings at 18 partnerships between local authorities and primary and secondary care organisations in England. Eligible participants were nulliparous and aged 19 years or younger, and were recruited at less than 25 weeks' gestation. Field-based researchers randomly allocated mothers (1:1) via remote randomisation (telephone and web) to FNP plus usual care (publicly funded health and social care) or to usual care alone. Allocation was stratified by site and minimised by gestation (language of data collection (English vs non-English). Mothers and assessors (local researchers at baseline and 24 months' follow-up) were not masked to group allocation, but telephone interviewers were blinded. Primary endpoints were biomarker-calibrated self-reported tobacco use by the mother at late pregnancy, birthweight of the baby, the proportion of women with a second pregnancy within 24 months post-partum, and emergency attendances and hospital admissions for the child within 24 months post-partum. Analyses were by intention to treat. This trial is registered with ISRCTN, number ISRCTN23019866. Between June 16, 2009, and July 28, 2010, we screened 3251 women. After enrolment, 823 women were randomly assigned to receive FNP and 822 to usual care. All follow-up data were retrieved by

  7. BEST PRACTICE IN INDIVIDUAL SUPERVISION OF PSYCHOLOGISTS WORKING IN THE FRENCH CAPEDP PREVENTIVE PERINATAL HOME-VISITING PROGRAM: RESULTS OF A DELPHI CONSENSUS PROCESS.

    Science.gov (United States)

    Greacen, Tim; Welniarz, Bertrand; Purper-Ouakil, Diane; Wendland, Jaqueline; Dugravier, Romain; Saïas, Thomas; Tereno, Susana; Tubach, Florence; Haddad, Alain; Guedeney, Antoine

    2017-03-01

    Individual supervision of home-visiting professionals has proved to be a key element for perinatal home-visiting programs. Although studies have been published concerning quality criteria for supervision in North American contexts, little is known about this subject in other national settings. In the context of the CAPEDP program (Compétences parentales et Attachement dans la Petite Enfance: Diminution des risques liés aux troubles de santé mentale et Promotion de la résilience; Parental Skills and Attachment in Early Childhood: Reducing Mental Health Risks and Promoting Resilience), the first randomized controlled perinatal mental health promotion research program to take place in France, this article describes the results of a study using the Delphi consensus method to identify the program supervisors' points of view concerning best practice for the individual supervision of home visitors involved in such programs. The final 18 recommendations could be grouped into four general themes: the organization and setting of supervision sessions; supervisor competencies; relationship between supervisor and supervisee; and supervisor intervention strategies within the supervision process. The quality criteria identified in this perinatal home-visiting program in the French cultural context underline the importance of clinical supervision and not just reflective supervision when working with families with multiple, highly complex needs.

  8. Analysis of team types based on collaborative relationships among doctors, home-visiting nurses and care managers for effective support of patients in end-of-life home care.

    Science.gov (United States)

    Fujita, Junko; Fukui, Sakiko; Ikezaki, Sumie; Otoguro, Chizuru; Tsujimura, Mayuko

    2017-02-21

    To define the team types consisting of doctors, home-visiting nurses and care managers for end-of-life care by measuring the collaboration relationship, and to identify the factors related to the team types. A questionnaire survey of 43 teams including doctors, home-visiting nurses and care managers was carried out. The team types were classified based on mutual evaluations of the collaborative relationships among the professionals. To clarify the factors between team types with the patient characteristics, team characteristics and collaboration competency, univariate analysis was carried out with the Fisher's exact test or one-way analysis and multiple comparison analysis. Three team types were classified: the team where the collaborative relationships among all healthcare professionals were good; the team where the collaborative relationships between the doctors and care managers were poor; and the team where the collaborative relationships among all of the professionals were poor. There was a statistically significant association between the team types and the following variables: patient's dementia level, communication tool, professionals' experience of working with other team members, home-visiting nurses' experience of caring for dying patients, care managers' background qualifications, doctor's face-to-face cooperation with other members and home-visiting nurses' collaborative practice. It is suggested that a collaborative relationship would be fostered by more experience of working together, using communication tools and enhancing each professional's collaboration competency. Geriatr Gerontol Int 2017; ••: ••-••. © 2017 Japan Geriatrics Society.

  9. Teacher Home Visits

    Science.gov (United States)

    Kronholz, June

    2016-01-01

    Volumes of research suggest that one key to a child's academic success is having "engaged" parents, but parents know that, to teachers, engagement means a fairly circumscribed round of activities--back-to-school nights, parent-teacher conferences, potlucks, and interactive homework. Making the connection between schools and families is…

  10. Effect of the delegation of GP-home visits on the development of the number of patients in an ambulatory healthcare centre in Germany

    Directory of Open Access Journals (Sweden)

    van den Berg Neeltje

    2012-10-01

    Full Text Available Abstract Background The AGnES-concept (AGnES: GP-supporting, community-based, e-health-assisted, systemic intervention was developed to support general practitioners (GPs in undersupplied regions. The project aims to delegate GP-home visits to qualified AGnES-practice assistants, to increase the number of patients for whom medical care can be provided. This paper focuses on the effect of delegating GP-home visits on the total number of patients treated. First, the theoretical number of additional patients treated by delegating home visits to AGnES-practice assistants was calculated. Second, actual changes in the number of patients in participating GP-practices were analyzed. Methods The calculation of the theoretical increase in the number of patients was based on project data, data which were provided by the Association of Statutory Health Insurance Physicians, or which came from the literature. Setting of the project was an ambulatory healthcare centre in the rural county Oberspreewald-Lausitz in the Federal State of Brandenburg, which employed six GPs, four of which participated in the AGnES project. The analysis of changes in the number of patients in the participating GP-practices was based on the practices’ reimbursement data. Results The calculated mean capacity of AGnES-practice assistants was 1376.5 home visits/year. GPs perform on average 1200 home visits/year. Since home visits with an urgent medical reason cannot be delegated, we included only half the capacity of the AGnES-practice assistants in the analysis (corresponding to a 20 hour-work week. Considering all parameters in the calculation model, 360.1 GP-working hours/year can be saved. These GP-hours could be used to treat 170 additional patients/quarter year. In the four participating GP-practices the number of patients increased on average by 133 patients/quarter year during the project period, which corresponds to 78% of the theoretically possible number of patients

  11. Follow-up home visits with registered dietitians have a positive effect on the functional and nutritional status of geriatric medical patients after discharge

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Kjær, Stine; Hansen, Birthe Stenbæk

    2013-01-01

    , rehabilitation capacity), nutritional status (weight, BMI, energy and protein intake), need of social services (home care, home nursing, meals-on-wheels) and mortality.Results:One hundred and fifty-two patients were included; 132 (87%) completed the first and 124 (82%) the second data collection after 12 weeks......Objective:To assess the additional benefits of individualized nutritional counselling by a registered dietitian in geriatric patients' home after discharge from hospital, in relation to risk of re-admissions, functional status, nutritional status, use of social services and mortality.......Design:Twelve-week single-blind randomized controlled study.Setting and subjects:Geriatric medical patients (65+ years) at nutritional risk.Interventions:Participants were randomly allocated to receive a visit in their homes, either three individualized nutritional counselling by a registered dietitian complemented...

  12. Behavioral Responses of Nursing Home Residents to Visits From a Person with a Dog,a Robot Seal or a Toy Cat

    DEFF Research Database (Denmark)

    Thodberg, Karen; Sørensen, Lisbeth U; Videbech, Poul B

    2016-01-01

    participant received a total of 12 visits, during which their behaviors, including interactions between the visitor and the accom- panying animal (real or artificial), were recorded. Also, data on cognitive im- pairment, presence of depressive symptoms, age, time lived in the nursing home, dementia diagnoses......, and gender were collected. We found that the immediate responses to, and interaction with, the visiting animal depended on the type of animal that was brought along. The dog and the interactive robot seal triggered the most interaction, in the form of physical contact (F(2,103) = 7.50, p ... contact (F(4,151) = 6.26, p animal and less toward humans...

  13. Effects of general practitioner team home visiting program for community-dwelling elderlies%全科团队家访服务在高龄老人社区居家养老中的作用

    Institute of Scientific and Technical Information of China (English)

    易景娜; 陈利群; 贾守梅; 陆敏敏; 荀雪琴

    2012-01-01

    Objective To explore the effects of general practitioner team home visiting program for community-dwelling elderlies. Methods Totally 140 elderlies aged over 80 years old were divided into two groups. The elderlies in the experimental group received the general practitioner team home visiting program for 12 months. The elderlies in the control group received routine community health service. The scores of depression,loneliness and quality of life were compared by repeated-measures ANOVA, Results There were significant differences in the scores of depression,loneliness and quality of life at 3 months,6 months and 12 months after the intervention between the two groups. Conclusion The general practitioner team home visiting program can significantly improve the health status of community-dwelling elderlies and provide community-based medical support for the home care services among community-dwelling elderlies.%目的 探讨全科团队家访服务在高龄老人社区居家养老中的作用.方法 将140例80岁以上居家老人分为干预组和对照组,干预组接受12个月的全科团队家访服务,对照组接受常规社区卫生服务.采用重复测量方差分析两组在干预前及干预后抑郁、孤独及生活质量变化.结果 两组高龄老人抑郁、孤独及生活质量各维度得分在干预后3、6、12个月测量时的差异均有统计学意义.结论 全科团队家访服务能显著改善高龄居家老人的健康状况,为居家养老提供社区医疗支持.

  14. Infusing Technology Into Perinatal Home Visitation in the United States for Women Experiencing Intimate Partner Violence: Exploring the Interpretive Flexibility of an mHealth Intervention.

    Science.gov (United States)

    Bacchus, Loraine J; Bullock, Linda; Sharps, Phyllis; Burnett, Camille; Schminkey, Donna L; Buller, Ana Maria; Campbell, Jacquelyn

    2016-11-17

    Intimate partner violence (IPV) is common during pregnancy and the postpartum. Perinatal home visitation provides favorable conditions in which to identify and support women affected by IPV. However, the use of mHealth for delivering IPV interventions in perinatal home visiting has not been explored. Our objective was to conduct a nested qualitative interpretive study to explore perinatal home visitors' and women's perceptions and experiences of the Domestic Violence Enhanced Home Visitation Program (DOVE) using mHealth technology (ie, a computer tablet) or a home visitor-administered, paper-based method. We used purposive sampling, using maximum variation, to select women enrolled in a US-based randomized controlled trial of the DOVE intervention for semistructured interviews. Selection criteria were discussed with the trial research team and 32 women were invited to participate. We invited 45 home visitors at the 8 study sites to participate in an interview, along with the 2 DOVE program designers. Nonparticipant observations of home visits with trial participants who chose not to participate in semistructured interviews were undertaken. We conducted 51 interviews with 26 women, 23 home visiting staff at rural and urban sites, and the 2 DOVE program designers. We conducted 4 nonparticipant observations. Among 18 IPV-positive women, 7 used the computer tablet and 11 used the home visitor method. Among 8 IPV-negative women, 7 used the home visitor method. The computer tablet was viewed as a safe and confidential way for abused women to disclose their experiences without fear of being judged. The meanings that the DOVE technology held for home visitors and women led to its construction as either an impersonal artifact that was an impediment to discussion of IPV or a conduit through which interpersonal connection could be deepened, thereby facilitating discussion about IPV. Women's and home visitors' comfort with either method of screening was positively influenced

  15. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program

    OpenAIRE

    Deepa Mankikar; Carla Campbell; Rachael Greenberg

    2016-01-01

    This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes educati...

  16. 论班主任家访的定位与有效家访的策略%On the Positioning and Effective Strategies of Teachers' Home Visits

    Institute of Scientific and Technical Information of China (English)

    洪伟

    2011-01-01

    Effective teachers' home visits can connect emotionally and spiritually with students and their parents,and in this process, teachers and parents can reach a consensus in teaching children so as to guide students to grow up healthily according to their characteristics. In this paper, the writer discusses the positioning and effective strategies of teachers' home visits combining with the actual class management of middle school.%班主任的有效家访可以与学生和家长架起感情联系与心灵沟通的桥梁,与家长在教育孩子方面达成共识,引导学生根据自己的特点健康成长。本文结合中学班级管理工作的实际,阐述家访的定位及有效家访的策略。

  17. Effect of 3-Months Home-Based Exercise Program on Changes of Cognitive Functioning in Older Adults Living in Old People’s Home

    Directory of Open Access Journals (Sweden)

    Nemček Dagmar

    2016-05-01

    Full Text Available The aim of the study was to determine the effect of regular participation in home-based exercise programme on cognitive functioning changes in institutionalised older adults. Two groups of participants were recruited for the study: experimental (n = 17 in mean age 76 ± 5.6 years, who participated in home-based exercise program and control (n = 14 in mean age 80 ± 4.2 years. The standardised Stroop Color-Word Test-Victoria version (VST was used to measure the level of cognitive functions. Group differences were analyzed with Mann-Whitney U-test for independent samples and for differences between pre-measurements and post-measurements on experimental and control group we used non-parametric Wilcoxon Signed - Rank Test. The level of significance was α < 0.05. Application of 3-months home-based exercise program significantly improved the cognitive functions only in one (Word condition; p<0.01 from three VST conditions in institutionalised older adults. That’s why we recommend longer participation in home-based exercise program, at least 6- months, with combination of various types of cognitive interventions, like concepts of cognitive training, cognitive rehabilitation, and cognitive stimulation to improve cognitive functioning in older adults living in old peoples’ homes.

  18. The effect of homecare team visits in terminal cancer patients: Role of health teams reaching patients homes

    Directory of Open Access Journals (Sweden)

    Pratik Banerjee

    2009-01-01

    Conclusion: The eagerness of patients wanting the teams to reach their residence may be judged by the given figures. The total number of patients visited by the homecare teams of Cansupport in the year 2008-2009 was 1025. Out of them, there were about 104 patients who were discharged. The term discharge means that the patients were not interested in our visit or were not available in our subsequent visit. It has to be mentioned here that the service is a definite demand by society provided that the cost may be catered too.

  19. What students experienced: a narrative analysis of essays written by first-year medical students participating in a geriatrics home visit.

    Science.gov (United States)

    O'Donnell, Linsey; Carson, Lesley; Forciea, Mary Ann; Kinosian, Bruce; Shea, Judy; Yudin, Jean; Miller, Rachel K

    2013-09-01

    To develop a house call experience for first-year medical students introducing them to challenges that homebound, chronically ill elderly adults face. During the semester, two students were paired with a preceptor to see two to three patients. The house call practices of the Division of Geriatric Medicine at the University of Pennsylvania and the Philadelphia Veterans Affairs Hospital. One hundred sixty-five first-year medical students. Pairs of students worked together to write an essay after the visit. Essays addressed specific areas, as detailed in a provided checklist, including noting patients' functional limitations, identifying community supports available to patients, and writing about general surprises that the students discovered during their visit. These data were then measured using narrative analysis. In all domains, students identified core goals and objectives. In the first domain (meeting challenges of functional limitations), students recognized the importance of family support. In the second domain (mentioning of functional limitation), high levels of compliance were seen. In the third domain (community support), students mentioned specific formal supports. In the fourth domain (surprises during the visit), students identified many important geriatrics concepts. In writing their essays, students demonstrated a high level of recognition of functional impairment and noted the importance of family, social networks, and home environment in enabling homebound, chronically ill elderly adults to stay in their homes. Many students also demonstrated an awareness of the possibilities of independence and happiness despite significant illness and disability. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

  20. Cost of physician-led home visit care (Zaitaku care) compared with hospital care at the end of life in Japan.

    Science.gov (United States)

    Kinjo, Kentaro; Sairenji, Tomoko; Koga, Hidenobu; Osugi, Yasuhiro; Yoshida, Shin; Ichinose, Hidefumi; Nagai, Yasunori; Imura, Hiroshi; South-Paul, Jeannette E; Meyer, Mark; Honda, Yoshihisa

    2017-01-17

    Physician-led home visit care with medical teams (Zaitaku care) has been developed on a national scale to support those who wish to stay at home at the end of life, and promote a system of community-based integrated care in Japan. Medical care at the end of life can be expensive, and is an urgent socioeconomic issue for aging societies. However medical costs of physician-led home visits care have not been well studied. We compared the medical costs of Zaitaku care and hospital care at the end of life in a rapidly aging community in a rural area in Japan. A cross-sectional study was performed to compare the total medical costs during patients' final days of life (30 days or less) between Zaitaku care and hospital care from September 2012 to August 2013 in Fukuoka Prefecture, Japan. Thirty four patients died at home under Zaitaku care, and 72 patients died in the hospital during this period. The average daily cost of care during the last 30 days did not differ significantly between the two groups. Although Zaitaku care costs were higher than hospital care costs in the short-term (≦10 days, Zaitaku care $371.2 vs. Hospital care $202.0, p = 0.492), medical costs for Zaitaku care in the long-term care (≧30 days) were less than that of hospital care ($155.8 vs. $187.4, p = 0.055). Medical costs of Zaitaku care were less compared with hospital care if incorporated early for long term care, but it was high if incorporated late for short term care. For long term care, medical costs for Zaitaku care was 16.7% less than for hospitalization at the end of life. This physician-led home visit care model should be an available option for patients who wish to die at home, and may be beneficial financially over time.

  1. An open cluster-randomized, 18-month trial to compare the effectiveness of educational outreach visits with usual guideline dissemination to improve family physician prescribing.

    Science.gov (United States)

    Pinto, Daniel; Heleno, Bruno; Rodrigues, David S; Papoila, Ana Luísa; Santos, Isabel; Caetano, Pedro A

    2014-01-15

    The Portuguese National Health Directorate has issued clinical practice guidelines on prescription of anti-inflammatory drugs, acid suppressive therapy, and antiplatelets. However, their effectiveness in changing actual practice is unknown. The study will compare the effectiveness of educational outreach visits regarding the improvement of compliance with clinical guidelines in primary care against usual dissemination strategies. A cost-benefit analysis will also be conducted. We will carry out a parallel, open, superiority, randomized trial directed to primary care physicians. Physicians will be recruited and allocated at a cluster-level (primary care unit) by minimization. Data will be analyzed at the physician level. Primary care units will be eligible if they use electronic prescribing and have at least four physicians willing to participate. Physicians in intervention units will be offered individual educational outreach visits (one for each guideline) at their workplace during a six-month period. Physicians in the control group will be offered a single unrelated group training session. Primary outcomes will be the proportion of cyclooxygenase-2 inhibitors prescribed in the anti-inflammatory class, and the proportion of omeprazole in the proton pump inhibitors class at 18 months post-intervention. Prescription data will be collected from the regional pharmacy claims database. We estimated a sample size of 110 physicians in each group, corresponding to 19 clusters with a mean size of 6 physicians. Outcome collection and data analysis will be blinded to allocation, but due to the nature of the intervention, physicians and detailers cannot be blinded. This trial will attempt to address unresolved issues in the literature, namely, long term persistence of effect, the importance of sequential visits in an outreach program, and cost issues. If successful, this trial may be the cornerstone for deploying large scale educational outreach programs within the Portuguese

  2. The Relationship between Twelve-Month Home Stimulation and School Achievement.

    Science.gov (United States)

    van Doorninck, William J.; And Others

    1981-01-01

    Scores on the Home Observation for Measurement of Environment (HOME), designed to reflect parental support of early cognitive and social development, were correlated with elementary school achievement five to nine years later. Results supported the predictive value of the instrument for school achievement among low-income families. (Author/DB)

  3. Rumination and Loneliness Independently Predict Six-Month Later Depression Symptoms among Chinese Elderly in Nursing Homes.

    Directory of Open Access Journals (Sweden)

    Pei Gan

    Full Text Available Previous studies conducted in Western countries independently demonstrated that loneliness and rumination are remarkable risk factors of depression among the elderly in both community and nursing homes. However, knowledge on the relationship between these three constructs among the elderly in Eastern countries is scarce. The current study aims to determine the relationship between loneliness, rumination, and depression among Chinese elderly in nursing homes.A total of 71 elderly participants with an average age of 82.49 years completed this six-month longitudinal study. Physical reports indicated that none of the participants were clinically depressed before the study. At Time 1, their loneliness and rumination were measured using UCLA-8 Loneliness Scale and Ruminative Responses Scale. Six months later, the participants completed the Center for Epidemiologic Studies Depression Scale to assess depressive symptoms (Time 2.Multiple regression analysis revealed that both loneliness and rumination at Time 1 were the predictors of depression symptoms at Time 2 among the Chinese elderly in nursing homes. However, in the mediation analysis using PROCESS, the indirect effect between loneliness at Time 1 and depression symptoms at Time 2 was insignificant.Results suggest that previous loneliness and rumination thinking are predictors of future depression symptoms among the Chinese elderly in nursing homes. However, the insignificant mediation further suggests that the differences between loneliness and rumination should be explored in future studies. Findings have important implications for mental health professionals in nursing homes in China.

  4. A home assistance model for dementia: outcome in patients with mild-to-moderate Alzheimer's disease after three months

    Directory of Open Access Journals (Sweden)

    Gabriele Carbone

    2013-03-01

    Full Text Available The treatment of dementias, which are currently incurable pathologies, requires an approach to care that involves both the patients and their families. The effect of alternative interventions, besides the pharmacological approach, therefore warrants evaluation. In this paper, we describe one such intervention, which was provided by our home care team for Alzheimer's Disease. Patients were granted a three-month period of home care assistance, which included physical and cognitive rehabilitation as well as interventions on the home environment and the family, such as psychological support for the main caregivers. The assistance was provided in thrice-weekly sessions, each lasting six hours. Twenty-two patients (age 78.4±6.5 yrs, all of whom had received a diagnosis of probable AD, were enrolled. There was a statistically significant improvement in the NPI score (p = 0.004, Barthel index (p = 0.01, Tinetti's scale (p = 0.013 and CBI score (p = 0.016 at the end of the 3-month treatment period. The patients' caregivers also reported a significant improvement in the physical and social burden at the CBI at the end of the period of home care assistance (p = 0.026 and p = 0.006. In a further evaluation performed 3 months after the end of the treatment period, the beneficial effect previously observed in both patients and caregivers was no longer present.

  5. Nursing Home Checklist

    Science.gov (United States)

    ... nursing home: ____________________________________________________ Address: ________________________________________________________________ Phone number: __________________________________________________________ Date of visit: _____________________________________________________________ Basic information Yes No Notes Is the nursing home Medicare certified? Is the nursing home Medicaid ...

  6. Increased emergency room visits or hospital admissions in females after 12-month MMR vaccination, but no difference after vaccinations given at a younger age.

    Science.gov (United States)

    Wilson, Kumanan; Ducharme, Robin; Ward, Brian; Hawken, Steven

    2014-02-26

    Previous studies have suggested that a child's sex may be a predictor of vaccine reactions. We used a self-controlled case series design, an extension of retrospective cohort methodology which controls for fixed confounders using a conditional Poisson modeling approach. We compared a risk period immediately following vaccination to a control period farther removed from vaccination in each child and estimated the relative incidence of emergency room visits and/or hospital admissions following the 2-, 4-, 6-, and 12-month vaccinations to investigate the effect of sex on relative incidence. All infants born in Ontario, Canada between April 1, 2002 and March 31, 2009 were eligible for study inclusion. In analyses combining immunizations at 2, 4 and 6 months and examining these vaccinations separately, there was no significant relationship between the relative incidence of an event and sex of the child. At 12 months, we observed a significant effect of sex, with female sex being associated with a significantly higher relative incidence of events (P=0.0027). The relative incidence ratio (95% CI) comparing females to males following the 12-month vaccination was 1.08 (1.03 to 1.14), which translates to 192 excess events per 100,000 females vaccinated compared to the number of events that would have occurred in 100,000 males vaccinated. As the MMR vaccine is given at 12 months of age in Ontario, our findings suggest that girls may have an increased reactogenicity to the MMR vaccine which may be indicative of general sex differences in the responses to the measles virus. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

    Science.gov (United States)

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

    2014-10-25

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

  8. Tai Chi-based exercise program provided via telerehabilitation compared to home visits in a post-stroke population who have returned home without intensive rehabilitation: study protocol for a randomized, non-inferiority clinical trial.

    Science.gov (United States)

    Tousignant, Michel; Corriveau, Hélène; Kairy, Dahlia; Berg, Katherine; Dubois, Marie-France; Gosselin, Sylvie; Swartz, Richard H; Boulanger, Jean-Martin; Danells, Cynthia

    2014-01-30

    The incidence of strokes in industrialized nations is on the rise, particularly in the older population. In Canada, a minority of individuals who have had a stroke actually receive intensive rehabilitation because most stroke patients do not have access to services or because their motor recovery was judged adequate to return home. Thus, there is a considerable need to organize home-based rehabilitation services for everyone who has had a stroke. To meet this demand, telerehabilitation, particularly from a service center to the patient's home, is a promising alternative approach that can help improve access to rehabilitation services once patients are discharged home. This non-inferiority study will include patients who have returned home post-stroke without requiring intensive rehabilitation. To be included in the study, participants will: 1) not be referred to an Intensive Functional Rehabilitation Unit, 2) have a Rankin score of 2 or 3, and 3) have a balance problem (Berg Balance Scale score between 46 and 54). Participants will be randomly assigned to either the teletreatment group or the home visits group. Except for the delivery mode, the intervention will be the same for both groups, that is, a personalized Tai Chi-based exercise program conducted by a trained physiotherapist (45-minute session twice a week for eight consecutive weeks). The main objective of this research is to test the non-inferiority of a Tai Chi-based exercise program provided via telerehabilitation compared to the same program provided in person at home in terms of effectiveness for retraining balance in individuals who have had a stroke but do not require intensive functional rehabilitation. The main outcome of this study is balance and mobility measured with the Community Balance and Mobility Scale. Secondary outcomes include physical and psychological capacities related to balance and mobility, participants' quality of life, satisfaction with services received, and cost

  9. Transforming Teacher-Family Relationships: Shifting Roles and Perceptions of Home Visits through the Funds of Knowledge Approach

    Science.gov (United States)

    Whyte, Kristin Lyn; Karabon, Anne

    2016-01-01

    Education has embraced the idea of an "asset approach" to working with families and children, creating a focus on developing collaborative relationships with families by building on what they bring to the table. In this paper we explore what happened when early childhood teachers entered homes to learn from families and identify their…

  10. Motivation to take part in integrated care – an assessment of follow-up home visits to elderly persons

    DEFF Research Database (Denmark)

    Hjelmar, U; Hendriksen, Carsten; Hansen, K

    2011-01-01

    Objectives: The aim of follow-up visits by the general practitioner and district nurse (within a week after discharge from hospital) is to reduce hospital readmissions and improve the overall wellbeing of the patient. There is strong evidence that these programmes are effective, but are difficult......, and district nurses. Results: Care providers are motivated to collaborate by a number of factors. The focus of collaboration needs to be clearly defined and agreed upon, there needs to be a high degree of equality between the professionals involved, and there has to be a will to co-operate based on a shared...

  11. Are patients reliable when self-reporting medication use? Validation of structured drug interviews and home visits by drug analysis and prescription data in acutely hospitalized patients

    DEFF Research Database (Denmark)

    Glintborg, Bente; Hillestrøm, Peter René; Olsen, Lenette Holm

    2007-01-01

    The medication history among hospitalized patients often relies on patients' self-reports due to insufficient communication between health care professionals. The aim of the present study was to estimate the reliability of patients' self-reported medication use. Five hundred patients admitted...... to an acute medical department at a Danish university hospital were interviewed on the day of admission about their recent medication use. Blood samples drawn immediately after admission were screened for contents of 5 drugs (digoxin, bendroflumethiazide, amlodipine, simvastatin, glimepiride), and the results...... were compared to the patients' self-reported medication history. Information on prescribed drugs dispensed from any Danish pharmacy was collected from nationwide real-time pharmacy records. The authors performed home visits in a subgroup of 115 patients 4 weeks after their discharge. Stored drugs were...

  12. Nursing intervention of home visiting improving post partum depression of puerpera staying in home%家庭访视护理干预改善居家产妇产后抑郁情绪的效果研究

    Institute of Scientific and Technical Information of China (English)

    侯玉翠; 李遵清

    2011-01-01

    Objective To study the nursing intervention of home visiting improving post partum depression of puerpera staying in home. Methods There were 70 cases of inpatient puerpera who were divided into observation group (28 cases) and control group (32 casea). After leaving hospital, the control group was given family nursing with self-management method, and the observation group was given nursing intervention by home visiting group composed of obstetric nurses. Before and after visiting nursing, the SSRS and LES, HAMD were used to evaluate the effect. Results The SSRS score of observation group was higher, the negative life events and stimulation were lower,the positive life events and stimulation were higher than those of control group (P<0.01). The HAMD score was no significance difference before visiting between the two group, and after visiting, the HAMD score of observation group was lower than that of control group (P<0. 01 ) . Conclusions Home visiting can improve puerpera's post partum depression, and prevent from postpartum psychosis, increase the puerpera's life quality.%目的 探讨家庭访视护理干预改善居家产妇产后抑郁情绪的效果.方法 70例住院产妇按抛硬币分组法分为研究组(28例)和对照组(32例).出院后,对照组按自我管理方法实施家庭护理,不接受任何形式的医疗干预,研究组则接受为期8周的由产科护士组成的家庭访视小组给予的生活心理等方面的护理干预,访视护理前后,两组采用社会支持评定量表(SSRS)生活事件量表(LES)和汉密顿抑郁量表(HAMD)进行效果评定.结果 研究组产妇SSRS评分高于对照组(P<0.01);研究组负性生活事件数和负性生活事件刺激量明显低于对照组(P<0.01);研究组正性生活事件数和正性生活事件刺激量明显高于对照组(P<0.01);访视前HAMD评分两组无明显差异(P>0.05),访视后比较,研究组HAMD评分明显低于对照组(P<0.01).结论 家庭访视护

  13. Quality in Australian after-hours doctor home visits: exploring the clinical, professional and security supports available to involved practitioners.

    Science.gov (United States)

    Ifediora, Chris Onyebuchi

    2017-04-01

    The after-hours house call (AHHC) services in Australia has gained huge popularity in recent years, but it is not clear how well supported the involved doctors feel regarding the clinical, professional and security aspects of their work. It is important that this knowledge gap is filled given that appropriate support helps engender quality in health service delivery. This is a questionnaire-based electronic survey involving a sample frame of all 300 doctors participating in AHHC through the National Home Doctor Service. National Home Doctor Service is Australia's largest AHHC service provider. A total of 168 valid responses (56.0%) were received. Overall, the mean support levels were mild to moderate, ranging from 2.4 to 2.8 out of 4.0 for all three parameters. Specifically, 65.3% of the respondents felt well-supported on clinical issues, 64.7% on professional issues and 43.2% on security issues. Australian-trained doctors were less likely to feel well supported on all aspects [Clinical: odds ratio (OR) 0.38, confidence interval (CI) 0.16 to 0.90; Professional: OR 0.30, CI 0.13 to 0.72; and Security: OR 0.22; CI 0.09 to 0.53] compared with overseas-trained ones. Unsurprisingly, doctors who adopted protective measures felt significantly better supported regarding security (OR 2.75; CI 1.31 to 5.78). There is room for improvement regarding support on AHHC in Australia, and concerned Surgeries should ensure that where available these supports are appropriately utilized. © 2016 John Wiley & Sons, Ltd.

  14. High retention and appropriate use of insecticide-treated nets distributed to HIV-affected households in Rakai, Uganda: results from interviews and home visits

    Directory of Open Access Journals (Sweden)

    Ludigo James

    2009-04-01

    Full Text Available Abstract Background Distribution of insecticide-treated nets (ITNs has recently been incorporated into comprehensive care strategies for HIV-positive people in malaria-endemic areas. WHO now recommends free or low-cost distribution of ITNs to all persons in malaria-endemic areas, regardless of age, pregnancy and HIV status. Knowledge about and appropriate use of ITNs among HIV-positive ITN recipients and their household members has not been well characterized. Methods 142 randomly selected adults were interviewed in July–August 2006 to assess knowledge, retention, and appropriate use of ITNs they had received through a PEPFAR-funded comprehensive HIV care programme in rural Uganda. Results Among all participants, 102 (72%, CI: 65%–79% reported they had no ITNs except those provided by the programme. Of 131 participants who stated they were given ≥ 1 ITN, 128 (98%, CI: 96%–100% stated they still possessed at least one programme-provided ITN. Reported programme-ITN (pITN use by participants was high: 119 participants (91%, CI: 86%–96% reported having slept under pITN the night prior to the survey and 115 (88%, CI: 82%–94% reported sleeping under pITN seven days per week. Being away from home and heat were the most common reasons given for not sleeping under an ITN. A sub-study of thirteen random home visits demonstrated concordance between participants' survey reports and actual use of ITNs in homes. Conclusion There was excellent self-reported retention and appropriate use of ITNs distributed as a part of a community-based outpatient HIV care programme. Participants perceived ITNs as useful and were unlikely to have received ITNs from other sources.

  15. 社区护士主导的全科团队家访服务对高龄居家老人心理状况的影响%Influence of community nurse-led multidisciplinary team home visiting services on psychological state of old age of home elderly

    Institute of Scientific and Technical Information of China (English)

    易景娜; 陈利群; 贾守梅; 陆敏敏; 荀雪琴

    2012-01-01

    Objective:To probe into the influence of community nurse - led multidisciplinary team home visiting service on psychological state such as depression and loneliness of community advanced age of old people at home. Methods: A total of 144 old people at home whose cognition was clear and whose age was over 80 years old were randomly divided into intervention group(n = 74) and control group(n = 70) by throwing coins. The intervention group patients received the nurse - led multidisciplinary team home visiting. The control group cases received routine community health service. The changes of depression and loneliness indexes were observed respectively before intervention, at three months after intervention and six months after intervention. Results: There was statistical significant difference in depression and loneliness score of advanced age of old people at home between both groups(P0. 05). Conclusion: The nurse-led multi-disciplinary home visiting service can improve the adverse psychological conditions such as depression and loneliness of advanced age of old people at home,and the team mode is operational and practical.%[目的]探讨以社区护士为主导的全科团队家访服务对社区高龄居家老人抑郁、孤独等心理状况的影响.[方法]采用投掷硬币法将144名认知清楚的80岁以上居家老人按照居住地随机分为干预组(74例)和对照组(70例),干预组接受社区护士为主导的全科团队家访服务,对照组接受常规社区卫生服务.采用重复测量方差分析两组干预前、干预3个月、6个月时抑郁、孤独指标的变化.[结果]两组高龄居家老人抑郁、孤独得分比较差异有统计学意义(P<0.001);两组抑郁、孤独各时间点的单独处理效应显示干预组在干预3个月、6个月时各领域得分均较干预前降低(P<0.001),而对照组无明显变化(P>0.05).[结论]社区护士为主导的全科团队家访服务可明显改善高龄居家老人的抑郁

  16. The Study of Patients' Adherence with COPD Therapy by Home Visit%家庭访视对慢性阻塞性肺病患者治疗依从性的影响

    Institute of Scientific and Technical Information of China (English)

    胡波; 苗秀欣; 朱秀丽; 修麓璐; 赵京明

    2013-01-01

    目的 探讨家庭访视对慢性阻塞性肺病患者治疗依从性的影响.方法 将70名COPD患者分为观察组和对照组各35例,对照组行常规治疗指导和定期复诊;观察组在常规治疗指导、定期复诊的基础上行家庭访视,历时24周.两组干预前后以及干预后3个月应用六分钟步行距离(six minute walking distance,6-MWD)测验、中文版西雅图阻塞性肺疾病问卷(SOLDQ)以及治疗依从性指标进行测量;应用SPSS统计学软件进行数据分析.结果 干预后两组比较,6-MWD、呼吸困难量表(MRC)测定及治疗依从性指标差异具有统计学意义(P<0.01),干预后3个月测定,两组差异仍具有统计学意义(P<0.05).结论 定期家庭访视,能显著提高慢性阻塞性肺病患者的治疗依从性、提高运动耐力和生活质量,成效至少可维持3个月.%Objective To study the patients adherence with therapy of chronic obstructive pulmonary disease by home visit. Methods Seventy patients with COPD were divided into observation group and control group, with 35 cases in each group. The control group received conventional treatment guidelines, which included regular reexamination, observation group received home visit based on the conventional treatment of guidance and regular reexamination, which lasted 24 weeks. Before and after 3 months of intervention,two groups were surveyed by six minute walking distance (six minute walking distance,6-MWD) test,the Chinese version of the Seattle obstructive pulmonary disease questionnaire (SOLDQ) and therapy adherence index measurement. The outcomes were analyzed applying SPSS statistical software. Results After intervention, two groups showed significant differences ( P < 0.01) in MWD, MRC determination and therapy adherence index, however the difference between the two groups was significant after 3 months ( P < 0. 05 ). Conclusion The therapy adherence and exercise tolerance and quality of life can be significantly

  17. Effects of Motor Development Stimulation on Anthropometric Indices of Infants Aged 1-12 Months in Foster Care Homes

    Directory of Open Access Journals (Sweden)

    Arezou NikNezhad Jalali

    2015-12-01

    Full Text Available Background: The first three years of life have a pivotal role in growth and development of infants. Extra-uterine environment largely affects brain development of infants during the first year of life.However,no specific programs are available for brain development stimulation in foster homes. Aim: This study aimed to evaluate the effects of motor development stimulation package on anthropometric indices of infants staying in foster homes. Method: This experimental study was conducted on 50 infants aged 1-12 months at Ali Asghar foster home of Mashhad, Iran in 2013. Infants were randomly divided into two groups of intervention (n=25 and control (n=25. Motor development stimulation packages were used for intervention group three times a week for eight consecutive weeks (24 sessions, two hours each. Anthropometric indices of infants were evaluated using standard instruments before and after intervention. Data analysis was performed in SPSS V.11.5 using independent T-test and Mann-Whitney U test. Results: In this study, mean age of infants in intervention and control groups was 6.04±3.48 and 4.3±3.70 months, respectively. In total, 68% of infants were male, and 32% were female. After intervention, Mann-Whitney test results showed no statistically significant difference in height (P=0.47 and head circumference (P=0.11 of infants between the groups. However, independent T-test showed a statistically significant difference in body weight of infants (P=0.007 between the groups after intervention with the stimulation care package. Implications for Practice: According to the results of this study, use of evidence-based motor development stimulation package for eight weeks resulted in increased weight of infants, while it had no effect on height and head circumference. Therefore, it is recommended that complementary studies be conducted in this regard.

  18. [Home care in Sapporo].

    Science.gov (United States)

    Yazaki, Kazuo

    2003-12-01

    We established a clinic specialized in home care in Sapporo in July 2001. In these 2 years we have provided medical home care service to 160 patients, and 97 are still receiving regular service. At first we accepted any patients living within 16 km from the clinic. However, bad traffic conditions in winter made it difficult to visit patients living in districts far away from the clinic. Therefore, we planned a network of home care physicians in Sapporo. Now 12 home care physicians hold monthly meetings. In Sapporo, meetings of home care related workers are organized in each ward, as suggested by the Sapporo Medical Association. There is a relatively good supply of home care related services and resources, including availability of an important number of visiting nurses. Patients being taken care of at home who present an acute exacerbation of symptoms are relatively easily accepted by acute hospitals. But those who have difficulties in continuing home care due to a sudden change in family conditions are not easily accepted by nursing hospitals. Recently, the number of group homes and lodging houses for elderly persons has markedly increased in Sapporo. It might have some problems in medical support in the near future.

  19. Design and pilot results of a single blind randomized controlled trial of systematic demand-led home visits by nurses to frail elderly persons in primary care [ISRCTN05358495

    NARCIS (Netherlands)

    Hout, van H.P.J.; Nijpels, M.G.A.A.M.; Marwijk, van H.W.J.; Jansen, A.P.D.; Veer, van 't P.J.; Tybout, W.; Stalman, W.A.B.

    2005-01-01

    BACKGROUND: The objective of this article is to describe the design of an evaluation of the cost-effectiveness of systematic home visits by nurses to frail elderly primary care patients. Pilot objectives were: 1. To determine the feasibility of postal multidimensional frailty screening instruments;

  20. 奥马哈问题分类系统在系统性红斑狼疮病人居家访视中的应用效果评价%Evaluation of application effect of Omaha problem classification system in home visit of systemic lupus erythemato-sus patients

    Institute of Scientific and Technical Information of China (English)

    敬雪明; 敬雨佳; 敬剑英; 李芸; 梅小平

    2015-01-01

    [目的]评估奥马哈问题分类系统在系统性红斑狼疮(SLE)病人居家访视中的效果,为 SLE 病人提供一种更适宜的居家管理模式。[方法]引进奥马哈系统(Omaha System)构建居家访视评估表,对86例 SLE病人居家访视中出现的营养、药物治疗、健康照顾督导的认知、行为、状况进行指导和评估。[结果]居家生活中的 SLE病人出现的营养、药物治疗、健康照顾督导的认知、行为、状况评分在随着居家访视指导次数增加而提升,访视指导前后病人各项目的认知、行为、状况评分改变有统计学意义(P<0.05)。86例SLE病人在居家访视的1个月内,出现问题最多的是药物治疗方案改变和营养不合理,发生率分别是26.7%、25.6%,其次是睡眠和休息型态、精神健康不佳,发生率分别是20.9%、18.6%,呼吸困难问题最少(5.8%)。[结论]居家访视从环境、社会心理、生理和健康行为4个方面影响着 SLE病人,可有效改变病人不良健康相关行为习惯。%Objective:To evaluate the effect of Omaha problem classification system for home visit of systemic lupus erythematosus patients,in order to provide a more comfortable home management mode for SLE pa-tients.Methods:The home visit evaluation scale was established by the introduction of the Omaha system,a to-tal of 86 SLE patients were guided and evaluated on the cognition and behavior state on nutrition,medication and health care supervision in the home visit.Results:The scores of the cognition,behaviors and state of nutri-tion,medication and health care supervision in the home visit for SLE patients were enhanced with the increase of the frequency of home visit guidance,and there was statistically significant difference in the score change of the cognition,behaviors and state of all items between before and after the visit guidance(P<0.05).The most problems of 86 SLE patients in home visit for a month were changes in

  1. Home-based nursing interventions improve knowledge of disease and management in patients with heart failure

    Directory of Open Access Journals (Sweden)

    Karina de Oliveira Azzolin

    2015-02-01

    Full Text Available OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire.METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered.RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001; and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001. The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01, but weak and non significant at visit 4.CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument.

  2. GOLIAH (Gaming Open Library for Intervention in Autism at Home): a 6-month single blind matched controlled exploratory study.

    Science.gov (United States)

    Jouen, Anne-Lise; Narzisi, Antonio; Xavier, Jean; Tilmont, Elodie; Bodeau, Nicolas; Bono, Valentina; Ketem-Premel, Nabila; Anzalone, Salvatore; Maharatna, Koushik; Chetouani, Mohamed; Muratori, Filippo; Cohen, David

    2017-01-01

    To meet the required hours of intensive intervention for treating children with autism spectrum disorder (ASD), we developed an automated serious gaming platform (11 games) to deliver intervention at home (GOLIAH) by mapping the imitation and joint attention (JA) subset of age-adapted stimuli from the Early Start Denver Model (ESDM) intervention. Here, we report the results of a 6-month matched controlled exploratory study. From two specialized clinics, we included 14 children (age range 5-8 years) with ASD and 10 controls matched for gender, age, sites, and treatment as usual (TAU). Participants from the experimental group received in addition to TAU four 30-min sessions with GOLIAH per week at home and one at hospital for 6 months. Statistics were performed using Linear Mixed Models. Children and parents participated in 40% of the planned sessions. They were able to use the 11 games, and participants trained with GOLIAH improved time to perform the task in most JA games and imitation scores in most imitation games. GOLIAH intervention did not affect Parental Stress Index scores. At end-point, we found in both groups a significant improvement for Autism Diagnostic Observation Schedule scores, Vineland socialization score, Parental Stress Index total score, and Child Behavior Checklist internalizing, externalizing and total problems. However, we found no significant change for by time × group interaction. Despite the lack of superiority of TAU + GOLIAH versus TAU, the results are interesting both in terms of changes by using the gaming platform and lack of parental stress increase. A large randomized controlled trial with younger participants (who are the core target of ESDM model) is now discussed. This should be facilitated by computing GOLIAH for a web platform. Trial registration Clinicaltrials.gov NCT02560415.

  3. Healthy Homes University: A Home-Based Environmental Intervention and Education Program for Families with Pediatric Asthma in Michigan

    OpenAIRE

    2011-01-01

    Environmental conditions within the home can exacerbate asthmatic children's symptoms. To improve health outcomes among this group, we implemented an in-home environmental public health program—Healthy Homes University—for low-income families in Lansing, Michigan, from 2005 to 2008. Families received four visits during a six-month intervention. Program staff assessed homes for asthma triggers and subsequently provided products and services to reduce exposures to cockroaches, dust mites, mold,...

  4. Visit safety

    CERN Multimedia

    2012-01-01

    Experiment areas, offices, workshops: it is possible to have co-workers or friends visit these places.     You already know about the official visits service, the VIP office, and professional visits. But do you know about the safety instruction GSI-OHS1, “Visits on the CERN site”? This is a mandatory General Safety Instruction that was created to assist you in ensuring safety for all your visits, whatever their nature—especially those that are non-official. Questions? The HSE Unit will be happy to answer them. Write to safety-general@cern.ch.   The HSE Unit

  5. Home environment and cord blood levels of lead, arsenic, and zinc on neurodevelopment of 24 months children living in Chitwan Valley, Nepal.

    Science.gov (United States)

    Parajuli, Rajendra Prasad; Fujiwara, Takeo; Umezaki, Masahiro; Watanabe, Chiho

    2015-01-01

    In a birth cohort living in Chitwan Valley, lowland Nepal, we have previously reported inverse associations between in utero levels of lead (Pb), arsenic (As) and neurodevelopment at birth measured by the Brazelton Neonatal Behavioral Assessment Scale, third edition (NBAS III). In the present paper, a follow-up of the same cohort was made on 24-month-old infants regarding the neurodevelopmental effects of these metals, taking the postnatal environment into account. In total, the same100 mother-infant pairs as the previous study, whose Pb, As, and Zn concentrations in cord blood were known, were recruited. Postnatal raising environment was evaluated using the Home Observation for Measurement of Environment (HOME) scale. Neurodevelopment of children at 24 months of age (n=74) was assessed using the Bayley Scale of Infant Development, Second Edition (BSID II). Multivariable regression adjusting for covariates was performed to determine the associations of in utero levels of toxic and essential elements and the home environment with neurodevelopment scores. Unlike the NBAS III conducted for newborns, none of the BSID II cluster scores in 24-month-old infants were associated with cord blood levels of Pb, As, and Zn. The total HOME score was positively associated with the mental development scale (MDI) score (coefficient=0.67, at 95% CI=0.03 to 1.31). In this cohort, a detrimental effect of in utero Pb and As on neurodevelopmental indicators observed at birth disappeared at 24 months, while an association between neurodevelopment and home environment continued.

  6. Home-based nursing interventions improve knowledge of disease and management in patients with heart failure 1

    Science.gov (United States)

    Azzolin, Karina de Oliveira; Lemos, Dayanna Machado; Lucena, Amália de Fátima; Rabelo-Silva, Eneida Rejane

    2015-01-01

    OBJECTIVE: to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire. METHODS: in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered. RESULTS: overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4. CONCLUSION: the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument. PMID:25806630

  7. A 3-month at-home tube feeding in 118 bulimia nervosa patients: a one-year prospective survey in adult patients.

    Science.gov (United States)

    Daniel, Rigaud; Didier, Perrin; Hélène, Pennacchio

    2014-04-01

    To study the 1-yr follow-up of 118 bulimia nervosa (BN) patients after a 3-month at-home tube feeding (TF) in a prospective study. At-home TF lasted 3 months, including one month of exclusive TF (no food). All patients fulfilled 4 questionnaires (score of binge/purging episodes (BP), eating disorder inventory, anxiety, depression), before, at the 3-month TF point, and 6 and 12 months latter. The score of BP episodes dramatically decreased from 28.8 ± 15 (before TF) to 7.3 ± 5.4 at 3 months, as well as at 1 yr (15.1 ± 6.2). We also obtained a 50% decrease in Beck score (depression) and Hamilton score (anxiety). Curiously, there was no difference between the BP scores of the patients following psychotherapy and those who did not, despite lower scores for anxiety and depression. In conclusion, in bulimia nervosa patients having normal BMI and purging behavior, home-TF allow to obtain total withdrawal from bingeing/purging in at least 75% of the cases at short term (3 months) and in 25% of the patients at one year, whatever the patients have or have not psychotherapy. Copyright © 2013 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.

  8. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program.

    Science.gov (United States)

    Mankikar, Deepa; Campbell, Carla; Greenberg, Rachael

    2016-09-09

    This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children's asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013-2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term.

  9. Home

    Directory of Open Access Journals (Sweden)

    Rokeya Sakhawat Hossain

    2012-11-01

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

  10. Visit ISOLDE!

    CERN Multimedia

    CERN Bulletin

    2013-01-01

    CERN Internal Communication is organising a visit to ISOLDE – an opportunity for you to see the CERN set-up that can produce over 1000 different isotopes!   If you wish to participate, you can sign up for a visit by sending us an e-mail. Note that the visits will take place between 18 and 22 February, and will be open only to CERN access-card holders.   The visit will include an introduction by experts and a tour of the ISOLDE set-up. NB: For security reason, pregnant women and kids under the age of 16 can not take the tour.  

  11. Hospital Readmission Following Emergency Room Visit for Cholelithiasis

    Science.gov (United States)

    Williams, Taylor P.; Dimou, Francesca M.; Adhikari, Deepak; Kimbrough, Thomas D.; Riall, Taylor S.

    2015-01-01

    Background For patients presenting with symptomatic cholelithiasis, cholecystectomy is the definitive treatment modality. Our goal was to evaluate the surgical follow-up and outcomes in patients seen in the Emergency Department (ED) for an episode of symptomatic cholelithiasis and discharged home for elective follow-up. Methods We performed a retrospective review of consecutive patients seen in the ED for cholelithiasis and discharged without hospital admission between August 2009 and May 2014. All patients were followed for two years from the date of initial ED visit. We evaluated outpatient surgeon visits, elective and emergent cholecystectomy rates, and additional ED visits. Cumulative incidence and Kaplan-Meier curves were used to examine the time from the initial ED visit to outpatient surgeon evaluation and the time from initial ED visit to ED readmission. Results Seventy-one patients were discharged from the ED with a diagnosis of symptomatic gallstones. 12.6% of patients had an elective cholecystectomy in the two years after the initial visit. In this group, the mean time from the initial ED visit to outpatient surgeon follow-up was 7.7 days and all elective cholecystectomies occurred within one month of the initial visit. Of the 62 patients who did not have an elective cholecystectomy, only 14.5% of patients in this group had outpatient surgeon follow-up at mean time of 137 days from the initial ED visit for symptomatic gallstones. In addition, 37.1% of patients in this group had additional ED visits for gallstone-related symptoms, with 17.7 % of patients having two or more additional ED visits, and 12.9% required emergent/urgent cholecystectomy. 43.5% of additional ED visits occurred within one month and 60.9% within three months of their initial ED visit. In patients with additional ED visits for symptomatic cholelithiasis, 60.9% had more than one abdominal Ultrasound (US) or Computed Tomography (CT) scan during the course of multiple visits. Conclusion

  12. Visiting and office home care workers' occupational health: An analysis of workplace flexibility and worker insecurity measures associated with emotional and physical health

    OpenAIRE

    Zeytinoglu, Isik U.; Denton, Margaret; Davies, Sharon; Seaton, M. Bianca; Millen, Jennifer

    2009-01-01

    The home health care sector in Canada experienced major restructuring in the mid-1990s creating a variety of flexibilities for organizations and insecurities for workers. This paper examines the emotional and physical health consequences of employer flexibilities and worker insecurities on home health care workers. For emotional health the focus is on stress and for physical health the focus is on selfreported musculoskeletal disorders. Data come from our survey of home health care workers in...

  13. Effectiveness of Multidisciplinary Group-Based Intervention versus Individual Physiotherapy for Improving Chronic Low Back Pain in Nursing Staff: A Clinical Trial with 3- and 6-Month Follow-Up Visits from Tehran, Iran.

    Science.gov (United States)

    Ghadyani, Leila; Tavafian, Sedigheh Sadat; Kazemnejad, Anoshirvan; Wagner, Joan

    2017-06-01

    Clinical trial. To evaluate the effectiveness of a multidisciplinary group-based intervention on improving pain and disability among Iranian nurses with chronic low back pain in Tehran, Iran. Although low back pain (LBP) is one of the most important health problems, the challenge remains on how to find an effective intervention to reduce pain and related disabilities. Overall, 136 eligible nurses with chronic mechanical LBP were classified into two groups. The intervention group (n=66 participants) participated in a physiotherapy educational program (for 120 minutes) plus a health educational program based on predictive constructs of the social cognitive theory (for 120 minutes). These interventions were delivered by a physiotherapist and a health education specialist. The control group (n=70 participants) participated in a physiotherapy educational program (for 120 minutes). Disability rate, pain severity, and back pain prevention behavior were measured initially and at 3- and 6-month follow-up visits using the visual analogue scale, Roland-Morris Disability, and Nursing Low Back Pain Preventive Behaviors Questionnaire. Data were analyzed by SPSS ver. 16. There were statistically significant differences between the two groups in the main outcome measures immediately after the educational program and at 3- and 6-month follow-up visits. Preventive behaviors of participants in the intervention group were improved at 3- and 6- month follow-up visits (ppreventive behaviors in the intervention group were improved after 3 and 6 months (p<0.001). Finally, in the intervention group, pain severity and disability were decreased significantly. This study showed that a multidisciplinary educational program intervention can be an effective approach for reducing LBP and related disabilities among nurses.

  14. A Visitation/Training Program for Institutionalized Elderly.

    Science.gov (United States)

    Fling, Sheila; Tayloe, Bryan

    Research on the use of paraprofessionals and trained volunteers for visitation programs with elders is limited. To determine the effects of a visitation program on nursing home residents and their college student and elder visitors, and to explore the effectiveness of special training for such visitation, nursing home residents (N=25) visited with…

  15. 对社区精神分裂症患者实施家庭访视的康复效果研究%The healing effect of home visit on community schizophrenia patients

    Institute of Scientific and Technical Information of China (English)

    翟爱玲; 李遵清

    2010-01-01

    Objective To investigate the healing effect of home visit on community schizophrenia patients. Methods A total of 240 schizophrenia patients who had been cured were divided into control and investigation groups, each for 120 cases. After leaving hospital,the two groups patients were all treated with drug and mental health education, and investigation group was given additional nursing intervention every three months. After 1 year, FES, SDSS, Gqoli and BPRS were used to assess the family circunstance, social function, life quality and patients'condition of the two groups. Results The family circumstance, social function, life quality and patients'condition of investigation group were better than those of control group after one year, there was significant difference between the two groups (P <0. 01 ) . Conclusion Family circumstance and the deficient of social function affect schizophrenia patients' life qualities, home visit could improve the schizophrenia patients'family circumstance, enhance patients' social function, improve patients'condition, and help to patients'healing.%目的 探讨家庭访视对改善社区精神分裂症患者家庭环境和生活质量的效果.方法 将临床"痊愈"出院的精神分裂症患者240例随机分为研究组(120例)和对照组(120例),出院后两组患者均给予抗精神药物维持治疗和一般的心理健康教育.研究组在上述基础上,实施为期1年的以家庭访视为模式的护理干预.于出院后每3个月深入家庭进行家访;于1年后,采用家庭环境量表(FES)、社会功能缺陷评定量表(SDSS)、生活质量综合评定问卷(gQOLI)以及简明精神病量表(BPRS)分别对两组患者的家庭环境状况、社会功能、生活质量以及病情进行评估.结果 1年后,研究组患者的家庭环境、社会功能、生活质量以及病情总体上优于对照组,有显著性差异(P<0.01).结论 家庭环境、精神病性症状和社会功能缺陷影响着精神分裂

  16. Visit Itinerary

    CERN Multimedia

    2002-01-01

    The visit itinerary includes five area of halls 191 and 180:. End-Cap Toroid Integration Area . Barrel Toroid Integration Area . Cryogenic Test Facility for Toroid Magnets and Helium Pumps . Liquid Argon Cryostats Assembly Area . Central Solenoid Magnet Test Station

  17. [Healthcare and daily needs of expectant Brazilian women residing in Japan. Analysis of fieldwork conducted during prenatal examinations and home visits].

    Science.gov (United States)

    Uemura, Naoko; Martinez, Makiko; Hatashita, Hiroyo

    2012-10-01

    To investigate the everyday lives and public healthcare needs of Brazilian nursing mothers and pregnant women residing in Japan, during the pregnancy and postpartum period, and the difficulties experienced in using or accessing the Japanese public healthcare system. The participants included 10 Brazilian expectant mothers who were residing in Prefecture A, but did not understand Japanese well, and those who were delivering for the first time in Japan. From August 2007 to July 2009, the researcher and interpreter conducted fieldwork by accompanying participants to medical examinations and making home visits. Analysis of the findings of this field study was carried out by labeling the relevant field note descriptions of each participant's thoughts and feelings concerning pregnancy and childbirth, the state of their everyday lives, and any additional public health-related difficulties encountered during this time. Additionally, individuals with common occurrences were again grouped and categorized for performing the analysis. Among the 10 participants, 8 were in their twenties and 2 were in their thirties; 8 participants had lived in Japan for less than 3 years and 2 of them for less than 10 years. Eight participants had had no prior experience with childbirth, whereas 2 had experienced childbirth. All 10 had resigned from work before entering into the late pregnancy stage, rendering their economic conditions solely dependent upon their husbands' income. In fact, many participants were in a difficult financial state. 6 women lived with their husbands, 2 others lived with husbands and had children, and 2 others were living with their husbands and parents in the same house. Six participants had families nearby that could provide support. However, none of the 10 participants maintained interactions with friends after having resigned from work. Participants were organized into the following 4 major categories based on the state of their everyday lives and the difficulties

  18. 社区护士家庭访视干预对改善老年2型糖尿病患者睡眠质量的影响研究%Study on the Effect of Community Nurses Home Visiting Intervention on Im_proving the Quality of Sleep of Elderly Patients with Type 2 Diabetes

    Institute of Scientific and Technical Information of China (English)

    章晓峰

    2014-01-01

    Objective To explore the effect of community nurses home visiting intervention on improving the quality of sleep in el_derly patients with type 2 diabetes. Methods 106 cases of elderly patients with type 2 diabetes were selected and randomly divid_ed into experimental group of 53 cases and control group of 53 cases. The control group was given conventional health education, the experimental group was given individual family visit health education management of diabetes patients and their family mem_bers on the basis of conventional health education. Results 6 months after the community nurses home visiting intervention, the sleep quality score of the experimental group was higher than that of the control group, the coping styles avoidance, yield factor decreased significantly, the difference was statistically significant (P<0.05). Conclusion Community nurses home visiting gives ef_fective guidance aiming at causes, makes the patients coordinating with positive coping style, and improves the quality of sleep of elderly patients with type 2 diabetes effectively.%目的:探讨社区护士家庭访视干预对改善老年2型糖尿病患者睡眠质量的影响。方法该院选取2011年6月—2012年9月收治的老年2型糖尿病患者106例,随机分为实验组53例和对照组53例,对照组给予常规健康教育,实验组在此基础上通过对糖尿病患者及其家庭主要成员给予个体化家庭访视健康教育形式的管理。结果社区护士家庭访视干预6个月时,实验组睡眠质量评分高于对照组,应对方式上回避、屈服因子明显降低,差异有统计学意义(P<0.05)。结论社区护士家庭访视干预针对原因有效指导,使其配合采用积极的应对方式,有效地改善了老年2型糖尿病患者的睡眠质量。

  19. Diferentes estratégias de visita domiciliar e seus efeitos sobre a assistência pré-natal no extremo Sul do Brasil Effects of different home visit strategies on prenatal care in Southern Brazil

    Directory of Open Access Journals (Sweden)

    Juraci A. Cesar

    2008-11-01

    Full Text Available Este estudo do tipo intervenção comunitária controlada unicega não randomizada teve por objetivo avaliar o impacto das visitas realizadas pelos agentes comunitários de saúde e líderes voluntários da Pastoral da Criança sobre o pré-natal de gestantes pobres em Rio Grande, Rio Grande do Sul, Brasil. Aplicaram-se questionários padronizados antes e depois do parto buscando conhecer suas características demográficas, reprodutivas, assistência recebida durante o pré-natal e nível sócio-econômico e condição de moradia. Estas gestantes foram divididas em três grupos, sendo dois grupos-intervenção e um controle. Dentre as 339 gestantes estudadas, 115 pertenciam ao grupo cuja intervenção foi realizada pelos agentes comunitários de saúde, 116 pelos líderes voluntários da pastoral e 108 pertenciam ao grupo controle. Gestantes visitadas pelos agentes comunitários iniciaram o pré-natal mais precocemente, realizaram maior número de consultas, exames clínicos e testes laboratoriais, foram mais comumente orientadas sobre amamentação e suplementadas com sulfato ferroso. A participação de familiares nas consultas de pré-natal foi maior entre gestantes visitadas pelos líderes voluntários. Visitas domiciliares podem melhorar a qualidade do pré-natal entre gestantes pobres e aumentar a participação de familiares, sobretudo do marido, na gestação.This non-randomized community intervention study evaluated the impact of prenatal home visits by community health agents and volunteer leaders from the Children's Mission on prenatal care among poor pregnant women in Rio Grande, Rio Grande do Sul State, Brazil. Previously trained interviewers applied pre-coded questionnaires to the women at home, investigating demographic and reproductive characteristics, socioeconomic status, housing conditions, and prenatal care. Of the 339 pregnant women interviewed, 115 were assigned to the intervention group visited by community health agents

  20. Effect of Home-Based Complementary Food Fortification on Prevalence of Anemia Among Infants and Young Children Aged 6 to 23 Months in Poor Rural Regions of China.

    Science.gov (United States)

    Huo, Junsheng; Sun, Jing; Fang, Zheng; Chang, Suying; Zhao, Liyun; Fu, Ping; Wang, Jie; Huang, Jian; Wang, Lijuan; Begin, France; Hipgrave, David B; Ma, Guansheng

    2015-12-01

    Following the 2008 Wenchuan earthquake, the Chinese government instituted an infant and young and child nutrition program that included promotion of in-home fortification of complementary food with ying yang bao (YYB), a soy-based powder containing iron, 2.5 mg as iron-EDTA and 5 mg as ferrous fumarate, and other micronutrients. Ying yang bao was provided to participating families in 8 poor rural counties in Sichuan, Shaanxi, and Gansu provinces by the Ministry of Health. We assessed hemoglobin levels among infants and young children (IYC) aged 6 to 23 months at baseline in May 2010 (n = 1290) and during follow-up in November 2010 (n = 1142), May 2011 (n = 1118), and November 2011 (n = 1040), using the Hemocue method. Interviewers collected basic demographic information and child feeding practices from the children's caretakers. Altitude-adjusted hemoglobin level averaged 10.8 g/dL, and total anemia prevalence was 49.5% at baseline. Average hemoglobin was 11.3 g/dL at 6 months, 11.6 g/dL at 12 months, and 11.7 g/dL at 18 months after introduction of YYB. Moderate anemia (hemoglobin: 70-99 g/dL) decreased from 20.3% at baseline to 7.5%, 5.8%, and 7.3% after 6, 12, and 18 months of home fortification, respectively (P regions of China.

  1. Austrian visit

    CERN Multimedia

    2003-01-01

    Hans Hoffmann, Director for Technology Transfer and Scientific Computing, and Maria Rauch-Kallat, Minister of Health and Women's Issues, Austria, signing the visitors' book.Maria Rauch-Kallat, Minister of Health and Women's Issues, Austria, was welcomed by Hans Hoffmann, Director for Technology Transfer and Scientific Computing, on her visit to CERN on 19 May 2003. The theme of the visit was Technology Transfer and spin-offs from CERN for medical applications. Maria Rauch-Kallat toured also the installations of ATLAS.

  2. Polish visit

    CERN Multimedia

    2003-01-01

    On 6 October, Professor Michal Kleiber, Polish Minister of Science and Chairman of the State Committee for Scientific Research, visited CERN and met both the current and designated Director General, Luciano Maiani and Robert Aymar. Professor Kleiber visited the CMS and ATLAS detector assembly halls, the underground cavern for ATLAS, and the LHC superconducting magnet string test hall. Michal Kleiber (left), Polish minister of science and Jan Krolikowski, scientist at Warsaw University and working for CMS, who shows the prototypes of the Muon Trigger board of CMS.

  3. NOTE FROM VISITS SERVICE

    CERN Multimedia

    ETT Division; Division ETT; Service des visites

    2000-01-01

    The Visit Service noticed that for many years countries such as Great Britain, Germany, Spain, Portugal, the Netherlands and the Scandinavian countries visit CERN less than other member countries and that is due to the high price of the trip for the students. To improve the situation the Visit Service plans to create a network of 'Family-Accommodation' ('Famille-Accueil') in Geneva and in France nearbywith the aim to facilitate the trip to foreign students especially from the more distant member countries and to encourage them to visit our unique laboratory. We expect this exchange to be an interesting experience for both the students and the welcoming family ('famille d'accueil'). If you are interested in participating in this family network, please fill in the questionnaire below. The questionnaire is to be returned to the Visit Service, Mrs Christine Fromm, e-mail Christine.Fromm@cern.ch.Name: First name: CERN address: E-mail: Portable phone number: Home address...

  4. Evaluation of a Home-Based Environmental and Educational Intervention to Improve Health in Vulnerable Households: Southeastern Pennsylvania Lead and Healthy Homes Program

    Directory of Open Access Journals (Sweden)

    Deepa Mankikar

    2016-09-01

    Full Text Available This evaluation examined whether participation in a home-based environmental educational intervention would reduce exposure to health and safety hazards and asthma-related medical visits. The home intervention program focused on vulnerable, low-income households, where children had asthma, were at risk for lead poisoning, or faced multiple unsafe housing conditions. Home visitors conducted two home visits, two months apart, consisting of an environmental home assessment, Healthy Homes education, and distribution of Healthy Homes supplies. Measured outcomes included changes in participant knowledge and awareness of environmental home-based hazards, rate of children’s asthma-related medical use, and the presence of asthma triggers and safety hazards. Analysis of 2013–2014 baseline and post-intervention program data for a cohort of 150 families revealed a significantly lower three-month rate (p < 0.05 of children’s asthma-related doctor visits and hospital admissions at program completion. In addition, there were significantly reduced reports of the presence of home-based hazards, including basement or roof leaks (p = 0.011, plumbing leaks (p = 0.019, and use of an oven to heat the home (p < 0.001. Participants’ pre- and post- test scores showed significant improvement (p < 0.05 in knowledge and awareness of home hazards. Comprehensive home interventions may effectively reduce environmental home hazards and improve the health of asthmatic children in the short term.

  5. The Mother-Child Home Program.

    Science.gov (United States)

    Levenstein, Phyllis

    This paper provides a description and evaluation of the Mother-Child Program (developed by the Verbal Interaction Project) for prevention of educational disadvantage. The program consists of 46 semi-weekly home visits by "Toy Demonstrators" in each of two seven month program years, following the local school calendar. Toy Demonstrators are former…

  6. European visit

    CERN Multimedia

    2006-01-01

    The European Commissioner for Science and Research, Janez Potočnik, (on the right) visited the CMS assembly hall accompanied by Jim Virdee, Deputy Spokesman of CMS (on the left), and Robert Aymar, Director-General of CERN. The European Commissioner for Science and Research, Janez Potočnik, visited CERN on Tuesday 31 January. He was welcomed by the Director-General, Robert Aymar, who described the missions and current activities of CERN to him, in particular the realisation of the LHC with its three components: accelerator, detectors, storage and processing of data. The European Commissioner then visited the CMS assembly hall, then the hall for testing the LHC magnets and the ATLAS cavern. During this first visit since his appointment at the end of 2004, Janez Potočnik appeared very interested by the operation of CERN, an example of successful scientific co-operation on a European scale. The many projects (30 on average) that CERN and the European Commission carry out jointly for the benefit of res...

  7. Supervised training and home-based rehabilitation in patients with stabilized ankylosing spondylitis on TNF inhibitor treatment: a controlled clinical trial with a 12-month follow-up.

    Science.gov (United States)

    Masiero, Stefano; Poli, Patrizia; Bonaldo, Lara; Pigatto, Maurizia; Ramonda, Roberta; Lubrano, Ennio; Punzi, Leonardo; Maffulli, Nicola

    2014-06-01

    To assess the 12-month's follow-up effects on pain, mobility, and physical function outcomes of a supervised training and home-based rehabilitation for ankylosing spondylitis patients stabilized with TNF-inhibitor therapy. Controlled clinical trial (sequentially determined allocation) with 12-months' follow-up. Patients' homes. A total of 69 subjects were allocated to either a rehabilitation programme (rehabilitation group, n = 22), an educational-behavioural programme (educational group, n = 24), and to neither programme (control group, n = 23). Rehabilitation programme included supervised training and home exercises (stretching, strengthening, aerobic, chest, and spine/hip joint flexibility exercises); educational-behavioural programme included information on ankylosing spondylitis, pain and stress mechanisms, and control. Spinal pain intensity, Bath Ankylosing Spondylitis Metrology Index, Bath Ankylosing Spondylitis Functional Index, Bath Ankylosing Spondylitis Disease Activity Index, chest expansion, and cervical and lumbar spine active range of motion measured by a pocket goniometer. At baseline, the three groups exhibited comparable demographic characteristics and basal evaluations. Intra-group changes in the rehabilitation group from baseline to 12 months yielded statistically significant gains (p Ankylosing Spondylitis Disease Activity Index (p = 0.012 and p = 0.050), and in some goniometric measurements as cervical rotation (p = 0.007 and p = 0.014), toraco-lumbar rotation (p = 0.009 and p = 0.050), and total cervical movements (p = 0.009 and p = 0.001). In comparison with the educational-behavioural programme or no intervention, supervised training and home exercises improved long-term outcome in patients with ankylosing spondylitis. © The Author(s) 2013.

  8. Cosmic visits

    CERN Multimedia

    Stefania Pandolfi

    2015-01-01

    On Saturday, 19 September, ESA astronaut Luca Parmitano and Amalia Ercoli Finzi, Principal Investigator of the SD2 experiment on board the ESA Rosetta spacecraft, visited the AMS Control Centre and other CERN installations.   From left to right: Sergio Bertolucci (CERN Director of Research and Computing), Amalia Ercoli Finzi (Emeritus Professor in the Aerospace department of the Polytechnic University of Milan and Principal Investigator of the SD2 experiment on board the ESA Rosetta spacecraft), Maurice Bourquin (AMS-02 Senior Scientist and Honorary Professor in the Nuclear and Corpuscular Physics department of the University of Geneva) and Luca Parmitano (Major in the Italian Air Force and European Space Agency astronaut) in the AMS Payload and Operation Control Centre. They were welcomed in the early morning by Sergio Bertolucci and then headed to the Prévessin site to visit the CERN Control Centre and the Payload and Operation Control Centre (POCC) of the Alpha Magnetic Sp...

  9. Armenian visit

    CERN Multimedia

    2003-01-01

    During his visit to CERN on 4 July 2003, Karen Chshmaritian, Armenian Minister for Trade and Economic Development, toured the ATLAS experimental cavern and assembly hall. From left to right: Aram Kotzinian, from the international organization JINR from Dubna, Marzio Nessi from ATLAS, Karen Chshmaritian, Armenian Minister for Trade and Economic Development, Zohrab Mnatsakanian, Ambassador at the Permanent Mission of the Republic of Armenia to the United Nations in Geneva, Alexandre Sissakian, Vice-Director of JINR and Peter Jenni, ATLAS spokesman.

  10. Randomized intervention trial on preventive home visits to older people: baseline and follow-up characteristics of participants and non-participants

    DEFF Research Database (Denmark)

    Vass, Mikkel; Avlund, Kirsten; Hendriksen, Carsten

    2007-01-01

    of municipality employees) was done at municipality level. In total 5,788 home-dwelling 75- and 80-year-olds living in these municipalities were invited to participate in the study. Written consent was obtained from 4,060 persons (participation rate 71%). RESULTS: During five-year follow-up non-participants had...

  11. Home-based Early Intervention on Auditory and Speech Development in Mandarin-speaking Deaf Infants and Toddlers with Chronological Aged 7-24 Months

    Institute of Scientific and Technical Information of China (English)

    Ying Yang; Yue-Hui Liu; Ming-Fu Fu; Chun-Lin Li; Li-Yan Wang; Qi Wang; Xi-Bin Sun

    2015-01-01

    Background:Early auditory and speech development in home-based early intervention of infants and toddlers with hearing loss younger than 2 years are still spare in China.This study aimed to observe the development of auditory and speech in deaf infants and toddlers who were fitted with hearing aids and/or received cochlear implantation between the chronological ages of 7-24 months,and analyze the effect of chronological age and recovery time on auditory and speech development in the course of home-based early intervention.Methods:This longitudinal study included 55 hearing impaired children with severe and profound binaural deafness,who were divided into Group A (7-12 months),Group B (13-18 months) and Group C (19-24 months) based on the chronological age.Categories auditory performance (CAP) and speech intelligibility rating scale (SIR) were used to evaluate auditory and speech development at baseline and 3,6,9,12,18,and 24 months of habilitation.Descriptive statistics were used to describe demographic features and were analyzed by repeated measures analysis of variance.Results:With 24 months of hearing intervention,78% of the patients were able to understand common phrases and conversation without lip-reading,96% of the patients were intelligible to a listener.In three groups,children showed the rapid growth of trend features in each period of habilitation.CAP and SIR scores have developed rapidly within 24 months after fitted auxiliary device in Group A,which performed much better auditory and speech abilities than Group B (P < 0.05) and Group C (P < 0.05).Group B achieved better results than Group C,whereas no significant differences were observed between Group B and Group C (P > 0.05).Conclusions:The data suggested the early hearing intervention and home-based habilitation benefit auditory and speech development.Chronological age and recovery time may be major factors for aural verbal outcomes in hearing impaired children.The development of auditory

  12. Spanish Visit

    CERN Multimedia

    2004-01-01

    On 23 January, CERN welcomed a visit by Pedro Morenés Eulate, Spanish Secretary of State for Scientific and Technological Policy. He was taken on a tour of the LHC Superconducting test facility, the CMS magnet assembly hall and the civil engineering works at Point 5. After a brief presentation on the AMS (Alpha Magnetic Spectrometer) experiment, delivered by Sam Ting, and lunch hosted by Director General Robert Aymar, he continued his tour of the ATLAS assembly hall and the ISOLDE experimental hall. Pedro Morenés finished his visit by meeting with the Spanish scientific community working at CERN. From left to right: Juan-Antonio Rubio, CERN, Responsible for the Education & Communication, Technology transfer and Scientific Information groups; Gonzalo León, General Secretary of the Spanish Ministry; Joaquín Pérez-Villanueva y Tovar, Ambassador, Permanent Representative of Spain to the United Nations Office; Robert Aymar, CERN Director General; Maria-José Garcia-Borge, ISOLDE and NTOF, CSIC Madrid Tea...

  13. Effect of home visit on anxiety and depression status of patients with peritoneal dialysis%家庭访视对腹膜透析患者焦虑抑郁状态的影响

    Institute of Scientific and Technical Information of China (English)

    赵小红; 赵红; 张瑞娟

    2014-01-01

    Objective:To explore the effect of home visit on anxiety and depression status of patients with peritoneal dialysis. Methods:60 patients with peritoneal dialysis were randomly divided into the intervention group and the control group(30 cases in each group). The routine follow-up was made in the control group and the home visiting intervention was additionally carried out in the intervention group. The anxiety and depression status of the patients was assessed by using SDS and SAS in the two groups. Results:The anxiety and depres-sion scores of the patients were lower after the intervention than those before the intervention in the two groups and the scores were also lower in the intervention group than the control group(P<0. 01);the incidence of anxiety and depression in any grade was lower in the intervention group than the control group(P<0. 05). Conclusion:The home visit,as an effective follow-up method,can relieve the anxie-ty and depression status of patients with peritoneal dialysis.%目的:探讨家庭访视对腹膜透析( PD)患者焦虑抑郁状态的影响。方法:将60例PD患者随机分为干预组和对照组各30例,对照组采用常规随访,干预组在此基础上实施家庭访视干预。应用自评抑郁量表( SDS)和自评焦虑量表( SAS)评估两组焦虑和抑郁状态。结果:干预后两组患者焦虑、抑郁得分低于干预前,也低于对照组同期水平( P<0.01)。干预组焦虑和抑郁分级后发现,各级的焦虑抑郁发生率均低于对照组( P<0.05)。结论:家庭访视是一种有效的随访方式,能改善PD患者的焦虑抑郁状态,应引起临床护理人员的高度重视。

  14. Visita domiciliária: um olhar da enfermagem psiquiátrica La visita a domicilio: una mirada de la enfermería psiquiátrica Home visit: the perspective of the psychiatric nursing

    Directory of Open Access Journals (Sweden)

    Renata Curi Labate

    2004-10-01

    Full Text Available A visita domiciliária é tema de interesse em diversas áreas da enfermagem. Em psiquiatria, com a implantação de serviços psiquiátricos na comunidade, a necessidade de realizar visita domiciliaria tornou-se evidente. Por um período de um ano estivemos envolvidos com esta atividade, solicitando-a ou realizando-a para pacientes atendidos no Núcleo de Saúde Mental. O objetivo deste trabalho é relatar esta experiência, destacando os seguintes aspectos: O Espaço Público e o Privado da família e a articulação entre visitadores e os recursos da comunidade. A visita domiciliaria aproxima a equipe do contexto do doente e favorece a articulação entre o doente, sua família, o serviço de saúde e os recursos da comunidade.La visita domiciliaria es tema de interés en diversas áreas de enfermería. En psiquiatría, con la implantación de servicios psiquiátricos en la comunidad, la necesidad para las visitas ha llegado a ser evidente. Durante un año hemos estado involucrados en esta actividad, realizándola o solicitándola para pacientes atendidos en el Núcleo de Salud Mental. El objetivo de este trabajo es describir nuestra experiencia, detallando los siguientes aspectos: La Vida Pública y Privada de la Familia y la colaboración entre los profesionales y los recursos en la comunidad. Las visitas domiciliarias reúnen al equipo desde el contexto del enfermo y favorece la articulación entre el enfermo, su familia, el servicio de salud y los recursos de la comunidad.The home visit is a matter of concern in diverse areas of nursing. With the implementation of psychiatric services in the community, the need for visits has become evident. For one year, we were involved with this activity, requesting it or providing it for patients assisted in the Núcleo de Saúde Mental (Mental Health Center. The aim of this paper is to describe our experience, detailing the following aspects: the public and private life of the family and the

  15. Leg extensor muscle strength, postural stability, and fear of falling after a 2-month home exercise program in women with severe knee joint osteoarthritis.

    Science.gov (United States)

    Rätsepsoo, Monika; Gapeyeva, Helena; Sokk, Jelena; Ereline, Jaan; Haviko, Tiit; Pääsuke, Mati

    2013-01-01

    BACKGROUND AND OBJECTIVE. The aim of this study was to compare the leg extensor muscle strength, the postural stability, and the fear of falling in the women with severe knee joint osteoarthritis (OA) before and after a 2-month home exercise program (HEP). MATERIAL AND METHODS. In total, 17 women aged 46-72 years with late-stage knee joint OA scheduled for total knee arthroplasty participated in this study before and after the 2-month HEP with strengthening, stretching, balance, and step exercises. The isometric peak torque (PT) of the leg extensors and postural stability characteristics when standing on a firm or a foam surface for 30 seconds were recorded. The fear of falling and the pain intensity (VAS) were estimated. RESULTS. A significant increase in the PT and the PT-to-body weight (PT-to-BW) ratio of the involved leg as well as the bilateral PT and the PT-to-BW ratio was found after the 2-month HEP compared with the data before the HEP (Pknee joint OA.

  16. Concepções da equipe de saúde da família sobre as visitas domiciliares Concepciones del equipo de salud de la familia sobre das visitas domiciliarias Conceptions of the family health team about home visits

    Directory of Open Access Journals (Sweden)

    Karen Namie Sakata

    2007-12-01

    Full Text Available Entendendo as visitas domiciliares enquanto tecnologia de interação no cuidado à saúde da família, o objetivo foi compreender as concepções da equipe de Saúde da Família sobre as visitas. Utilizou-se abordagem qualitativa e a entrevista semi-estruturada foi o instrumento de coleta de dados. Foram entrevistados dezenove profissionais de duas equipes de Saúde de Família de um município do interior paulista. Os resultados mostraram que as visitas são atividades potenciais para o cuidado à família, mais humano e acolhedor, permitindo o vínculo, laços de confiança e conhecer o usuário no seu ambiente familiar. Apreende-se que as visitas ora são compreendidas como acompanhamento da saúde, ora como fiscalização. Dificuldades existiram como pouco tempo disponível e impotência da equipe frente aos problemas.Entendiendo las visitas domiciliarias como tecnología de interacción en el cuidado a la salud de la familia, la finalidad fue comprender las concepciones del equipo de Salud de la Familia sobre las visitas. Se utilizó una aproximación cualitativa y la entrevista semiestructurada fue el instrumento de recolecta de datos. Se entrevistaron a diecinueve profesionales de dos equipos de Salud de la Familia de un municipio del interior paulista. Los resultados mostraron que las visitas son actividades potenciales para el cuidado a la familia, más humano y acogedor, permitiendo el vínculo, lazos de confianza y conocer al usuario en su ambiente familiar. Se aprehende que las visitas ora son comprendidas como acompañamiento de la salud, ora como fiscalización. Dificultades existieron, tales como poco tiempo disponible e impotencia del equipo ante los problemas.Connsidering home visits as a technology for interaction in family health care, this study aimed to understand how the Family Health team conceives these visits. A qualitative approach was used and data were collected through semistructured interviews. We interviewed

  17. Illness recognition, home care, and care-seeking for sick infants less than two months of age in Shebedino District, Sidama Zone, Ethiopia.

    Science.gov (United States)

    Tefera, Worku; Tesfaye, Hailu; Kayessa, Elias; Waltensperger, Karen Z; Tadesse, Yenealem; Marsh, David R

    2014-10-01

    The incidence of newborn and young infant health danger signs is unknown in Ethiopia. Neverthe- less, experience shows that care-seeking is far lower than conservative morbidity estimates would project. To examine illness recognition, home care, decision-making, and care-seeking for sick infants less than two months of age in Shebedino District, Southern Nations, Nationalities and Peoples Region in 2011. Focus group interviews of mothers (n = 60) of recently ill children. Mothers reported recognizing many, but not all, evidence-based newborn danger signs. Home care ranged from probably harmless to harmful and delayed definitive care-seeking. Decision-making was widespread, but patterns of care-seeking rarely led to prompt, evidence-based care. Mothers reported 10 barriers to care- seeking at health posts: lack of knowledge about availability of curative services, fear of evil eye, social stigma, perceived financial barrier, perceived young infant fragility, an elder's contrary advice, distance, husband's re- fusal, fear of injection, and belief in recovery without medicine. Young infants are more vulnerable to illness than their older counterparts, yet they are less likely to receive the care they need without a targeted, contextualized communication strategy to generate demand for case management services that are accessible, available, and of good quality.

  18. Cardiorespiratory fitness and walking endurance improvements after 12 months of an individualised home and community-based exercise programme for people after stroke.

    Science.gov (United States)

    Dunn, Ashlee; Marsden, Dianne L; Barker, Daniel; Van Vliet, Paulette; Spratt, Neil J; Callister, Robin

    2017-09-05

    To evaluate the immediate and longer-term effects of an individually tailored, home- and community-based exercise programme with ongoing remote support in people with stroke on cardiorespiratory fitness (CRF), ambulation and health-related quality of life (HRQoL). Twenty people 5.3 ± 3.5 months post stroke completed the 12-week HowFITSS? exercise programme aimed at increasing CRF and daily physical activity. Support was provided by phone and email, which decreased in frequency over time. Participants were assessed at baseline, then at 3, 6 and 12 months after initiation of the intervention. CRF (VO2peak) was evaluated using a portable metabolic system during the 6-minute walk test (6MWT), the Shuttle Walk Test (SWT) and the cycle graded exercise test (cGXT). Walking speed, balance, body composition, fatigue, depression and HRQoL were also measured. CRF improved significantly from pre-intervention to 12-month follow-up on the 6MWT (Effect Size, ES = 0.87; p = 0.002) and cGXT (ES = 0.60; p < 0.001), with more modest improvements on the SWT (ES = 0.52; p = 0.251). From baseline to 12 months, significant within-participant improvements were found for self-selected walking speed, balance and HRQoL. Performances on the remaining tests were maintained over the post-intervention period. There may be health benefits of providing people with stroke an exercise intervention with long-term support that encourages increased regular physical activity.

  19. Measuring recreational visitation at U.S. National Parks with crowd-sourced photographs.

    Science.gov (United States)

    Sessions, Carrie; Wood, Spencer A; Rabotyagov, Sergey; Fisher, David M

    2016-12-01

    Land managers rely on visitation data to inform policy and management decisions. However, visitation data is often costly and burdensome to obtain, and provides a limited depth of information. In this paper, we assess the validity of using crowd-sourced, online photographs to infer information about the habits and preferences of recreational visitors by comparing empirical data from the National Park Service to photograph data from the online platform Flickr for 38 National Parks in the western United States. Using multiple regression analysis, we find that the number of photos posted monthly in a park can reliably indicate the number of visitors to a park in a given month. Through additional statistical testing we also find that the home locations of photo-takers, provided voluntarily on an online profile, accurately show the home origins of park visitors. Together, these findings validate a new method for measuring recreational visitation, opening an opportunity for land managers worldwide to track and understand visitation by augmenting current data collection methods with crowd-sourced, online data that is easy and inexpensive to obtain. In addition, it enables future research on how visitation rates change with changes in access, management or infrastructure, weather events, or ecosystem health, and facilitates valuation research, such as travel cost studies.

  20. Is a home based video teleconcltation setup cost effective for lowering HBA1C for patients with type-2 diabetes over a six-month period?

    DEFF Research Database (Denmark)

    Sall Jensen, Morten; Rasmussen, Ole Winther

    perspective. Cost data were based on study measured time consumption pr. HVT, consultations at out-patient clinic, HVT-equipment, -subscription, -support costs, and hospital operating cost. Medicine costs weren’t included in the model. Model output included the cost of a 1 mmol/l point reduction of HbA1c......OBJECTIVES: A RCT assessed the effectiveness and costs of a home based video teleconsultation (HVT) setup to lower HbA1c in patients with type-2 diabetes against usual out-patient treatment on the hospital. The HVT equipment was delivered to the patients by the hospital. This analysis shows...... the potential incremental cost-effectiveness ratio (ICER) of using a HVT setup on six-months health care effects and costs. METHODS: The study effectiveness outcome was HbA1c level in mmol/l. The economic analysis was performed with a spreadsheet decision tree model with a Danish hospital payer’s direct cost...

  1. Three European ministers visit CERN

    CERN Multimedia

    2007-01-01

    There have been three ministerial visits to CERN this month. Gediminas Kirkilas, Prime Minister of Lithuania, and Robert Aymar, CERN’s Director-General.On 2 July, the Prime Minister of Lithuania, Gediminas Kirkilas, was welcomed by CERN’s Director-General, Robert Aymar, before being taken on a visit of the ATLAS cavern at Point 2 and the LHC tunnel. Michal Sewerynski, Poland’s Minister for Science and Higher Education, and Robert Aymar, CERN’s Director-General.Ten days later, Poland’s Minister for Science and Higher Education, Michal Sewerynski, visited the CMS cavern and assembly hall and the LHC tunnel. He was also given a tour of the LHC Computer Centre and the CERN Control Centre. His visit was rounded off with a presentation of Polish companies involved in CERN’s activities, followed by a meeting with Polish personnel working at CERN. J�...

  2. Variables associated with change in quality of life among persons with dementia in nursing homes: a 10 months follow-up study.

    Directory of Open Access Journals (Sweden)

    Marit Mjørud

    Full Text Available To investigate variables associated with change in quality of life (QOL, measured by QUALID scale and three subscales; tension, sadness and wellbeing, among dementia patients in nursing homes.A 10 months follow-up study including 198 (female 156, 79% nursing home patients, mean age 87 (s.d 7.7 years. Scales applied; quality of life in late stage dementia (QUALID scale and three subscales (wellbeing, sadness and tension, neuropsychiatric inventory questionnaire 10 items (NPI-10-Q, clinical dementia rating (CDR scale, physical self-maintenance (PSMS scale and a scale of general medical health. Use of psychotropic medication, gender and age was collected from the patient's records.Mean baseline QUALID score: 20.6 (s.d.7.0, follow-up score: 22.9 (s.d.7.4, mean change 2.8 (s.d.7.4. QOL improved in 30.8%, were unchanged in 14.7%, deteriorated in 54.6% of patients. A regression analysis revealed that change in QUALID score was significantly associated with: QUALID baseline score (beta -.381, p-value.000, change in NPI score (beta.421, p-value.000, explained variance 38.1%. Change in score on wellbeing subscale associated with: change in PSMS score (beta.185, p-value.019, wellbeing baseline score (beta -.370, p-value.000, change in NPI score (beta.186, p-value.017, explained variance 25.3%. Change in score on tension subscale associated with: change in CDR sum-of-boxes (beta.214, p-value.003, change in NPI score (beta.270, p-value.000, tension baseline score (beta -.423, p-value.000, explained variance 34.6%. Change in score on sadness subscale associated with: change in NPI score (beta.404, p-value.000, sadness baseline score (beta -.438, p-value.000, explained variance 38.8%.The results imply that a lower baseline score (better QOL results in a larger change in QOL (towards worse QOL. Change in QOL is mostly associated with change in neuropsychiatric symptoms. In almost 50% of patients QOL did not deteriorate.

  3. Dairy Company Owner Sentenced to Six Months of Home Detention and Ordered to Pay $15,000 Fine for Discharging 11,000 Gallons of Cow Feces into the French Broad River

    Science.gov (United States)

    ATLANTA - William Billy Franklin Johnston, the owner of one of North Carolina's largest dairy farms located in Fletcher, N.C., was sentenced Thursday to four years of probation, six months of which he has to spend in home detention, for his role i

  4. Factors associated with home death for individuals who receive home support services: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Bedard Michel

    2002-03-01

    Full Text Available Abstract Objectives To determine the factors associated with a home death among older adults who received palliative care nursing home services in the home. Methods The participants in this retrospective cohort study were 151 family caregivers of patients who had died approximately 9 months prior to the study telephone interview. The interview focused on the last year of life and covered two main areas, patient characteristics and informal caregiver characteristics. Results Odds ratios [OR] and 95% confidence intervals [95% CI] were used to determine which of the 15 potential informal caregiver and seven patient predictor variables were associated with dying at home. Multivariate analysis revealed that the odds of dying at home were greater when the patient lived with a caregiver [OR = 7.85; 95% CI = (2.35, 26.27], the patient stated a preference to die at home [OR= 6.51; 95% CI = (2.66,15.95], and the family physician made home visits [OR = 4.79; 95% CI = (1.97,11.64]. However the odds were lower for patients who had caregivers with fair to poor health status [OR = 0.22; 95% CI = (0.07, 0.65] and for patients who used hospital palliative care beds [OR = 0.31; 95% CI = (0.12, 0.80]. Discussion The findings suggest that individuals who indicated a preference to die at home and resided with a healthy informal caregiver had better odds of dying at home. Home visits by a family physician were also associated with dying at home.

  5. Predictors of Return Visits Among Insured Emergency Department Mental Health and Substance Abuse Patients, 2005–2013

    Science.gov (United States)

    Lee, Sangil; Herrin, Jeph; Bobo, William V.; Johnson, Ryan; Sangaralingham, Lindsey R.; Campbell, Ronna L.

    2017-01-01

    Introduction Our goal was to describe the pattern and identify risk factors of early-return ED visits or inpatient admissions following an index mental health and substance abuse (MHSA)-related ED visit in the United States. Methods We performed a retrospective cohort study using Optum Labs Data Warehouse, a nationally representative database containing administrative claims data on privately insured and Medicare Advantage enrollees. Authors identified patients presenting to an ED with a primary diagnosis of MHSA between 2005 and 2013 who were discharged home. Study inclusion required continuous insurance enrollment for the 12 months preceding and the 31 days following the index ED visit. During the study period we included only the first ED visit for each patient. Results A total of 49,672 (14.2%) had a return visit to the ED or had a hospitalization within 30 days following discharge. Mean time to the next ED visit or inpatient admission was 11.7 days. An increased age (age 65+ vs. age return visits within 30 days following discharge. Conclusion In an analysis of nearly 350,000 ED visits for MHSA, 14.2 % of patients returned to the ED or hospital within 30 days. This study identified a number of factors associated with return visits for acute care. PMID:28874941

  6. Visits to Cultural Learning Places in the Early Childhood

    Science.gov (United States)

    Mudiappa, Michael; Kluczniok, Katharina

    2015-01-01

    Studies show the important role of the home learning environment in early childhood for later school success. This article focuses on a particular aspect of the home learning environment: visits to cultural learning places (e.g. museums) as a component of the quality of the home learning environment. Therefore the educational concept of…

  7. Spaceflight participant visits CERN!

    CERN Document Server

    Kathryn Coldham

    2016-01-01

    On 15 July, CERN welcomed spaceflight participant Anousheh Ansari.   Anousheh Ansari’s grin stretches from ear to ear, during an intriguing conversation with Nobel laureate Samuel C.C. Ting at AMS POCC. (Image: Maximilien Brice/CERN) Iranian-American Anousheh Ansari was the first-ever female spaceflight participant, spending eight days on the International Space Station (ISS) in 2006. She now has a new addition to her list of extraordinary sights ­– the home of the world’s largest particle accelerator: CERN.   On 15 July, Anousheh Ansari came to CERN and, unsurprisingly, visited the control room of the experiment attached to the ISS: the AMS. At the AMS Payload Operations Control Centre (AMS POCC) on CERN’s Prévessin site, she met the Nobel laureate Samuel Ting, spokesperson of the AMS experiment. Ansari and her accompanying guests were thrilled to expand their knowledge about CERN, its research and its...

  8. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Garne, Kristina; Brødsgaard, Anne; Zachariassen, Gitte;

    2016-01-01

    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...... 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...

  9. ICU visitation policies.

    Science.gov (United States)

    Cleveland, A M

    1994-09-01

    Critically ill patients need their families more than ever, but rigid policies often restrict family visitation in ICU. Family visitation is not a "privilege" granted by hospitals, it is a necessary adjunct to the therapeutic regimen. Though changing outdated visitation policies can be difficult, it must be done. The clinical nurse specialist can play an important role in planning and implementing needed change.

  10. Home Health Aides

    Science.gov (United States)

    ... specifications Help to keep clients engaged in their social networks and communities Home health aides, unlike personal care aides , typically work ... self-care and everyday tasks. They also provide social supports and assistance that enable clients to participate in their ... more information about home health aides, including voluntary credentials for aides, visit ...

  11. Healthy Homes University: a home-based environmental intervention and education program for families with pediatric asthma in Michigan.

    Science.gov (United States)

    Largo, Thomas W; Borgialli, Michele; Wisinski, Courtney L; Wahl, Robert L; Priem, Wesley F

    2011-01-01

    Environmental conditions within the home can exacerbate asthmatic children's symptoms. To improve health outcomes among this group, we implemented an in-home environmental public health program-Healthy Homes University--for low-income families in Lansing, Michigan, from 2005 to 2008. Families received four visits during a six-month intervention. Program staff assessed homes for asthma triggers and subsequently provided products and services to reduce exposures to cockroaches, dust mites, mold, tobacco smoke, and other triggers. We also provided asthma education that included identification of asthma triggers and instructions on specific behaviors to reduce exposures. Based on self-reported data collected from 243 caregivers at baseline and six months, the impact of asthma on these children was substantially reduced, and the proportion who sought acute unscheduled health care for their asthma decreased by more than 47%.

  12. Healthy Homes University: A Home-Based Environmental Intervention and Education Program for Families with Pediatric Asthma in Michigan

    Science.gov (United States)

    Largo, Thomas W.; Borgialli, Michele; Wisinski, Courtney L.; Wahl, Robert L.; Priem, Wesley F.

    2011-01-01

    Environmental conditions within the home can exacerbate asthmatic children's symptoms. To improve health outcomes among this group, we implemented an in-home environmental public health program—Healthy Homes University—for low-income families in Lansing, Michigan, from 2005 to 2008. Families received four visits during a six-month intervention. Program staff assessed homes for asthma triggers and subsequently provided products and services to reduce exposures to cockroaches, dust mites, mold, tobacco smoke, and other triggers. We also provided asthma education that included identification of asthma triggers and instructions on specific behaviors to reduce exposures. Based on self-reported data collected from 243 caregivers at baseline and six months, the impact of asthma on these children was substantially reduced, and the proportion who sought acute unscheduled health care for their asthma decreased by more than 47%. PMID:21563708

  13. Serotonin transporter gene (SLC6A4) polymorphism and susceptibility to a home-visiting maternal-infant attachment intervention delivered by community health workers in South Africa: Reanalysis of a randomized controlled trial

    Science.gov (United States)

    Moser, Dirk; Skeen, Sarah; Cooper, Peter; Murray, Lynne; Moran, Greg

    2017-01-01

    Background Clear recognition of the damaging effects of poverty on early childhood development has fueled an interest in interventions aimed at mitigating these harmful consequences. Psychosocial interventions aimed at alleviating the negative impacts of poverty on children are frequently shown to be of benefit, but effect sizes are typically small to moderate. However, averaging outcomes over an entire sample, as is typically done, could underestimate efficacy because weaker effects on less susceptible individuals would dilute estimation of effects on those more disposed to respond. This study investigates whether a genetic polymorphism of the serotonin transporter gene moderates susceptibility to a psychosocial intervention. Methods and findings We reanalyzed data from a randomized controlled trial of a home-visiting program delivered by community health workers in a black, isiXhosa-speaking population in Khayelitsha, South Africa. The intervention, designed to enhance maternal-infant attachment, began in the third trimester and continued until 6 mo postpartum. Implemented between April 1999 and February 2003, the intervention comprised 16 home visits delivered to 220 mother–infant dyads by specially trained community health workers. A control group of 229 mother–infant dyads did not receive the intervention. Security of maternal-infant attachment was the main outcome measured at infant age 18 mo. Compared to controls, infants in the intervention group were significantly more likely to be securely attached to their primary caregiver (odds ratio [OR] = 1.7, p = 0.029, 95% CI [1.06, 2.76], d = 0.29). After the trial, 162 intervention and 172 control group children were reenrolled in a follow-up study at 13 y of age (December 2012–June 2014). At this time, DNA collected from 279 children (134 intervention and 145 control) was genotyped for a common serotonin transporter polymorphism. There were both genetic data and attachment security data for 220 children

  14. Estimulación en el hogar y desarrollo motor en niños mexicanos de 36 meses Stimulation at home and motor development among 36 month-old Mexican children

    Directory of Open Access Journals (Sweden)

    Erika Osorio

    2010-02-01

    Full Text Available OBJETIVO: Identificar la relación entre la estimulación en el hogar y el desarrollo motor en niños de 36 meses de edad. MATERIAL Y MÉTODOS: Se evaluó el desarrollo motor grueso y fino de 169 infantes (50.9% varones mediante la Escala de Desarrollo Motor de Peabody y se determinó la calidad de estimulación en el hogar en una evaluación previa con la Escala HOME a los 30 meses de edad. RESULTADOS: La estimulación total en el hogar se asoció significativamente con un mejor desempeño en las áreas motora gruesa y fina. Aspectos particulares de esta estimulación se relacionaron con una mejor motricidad gruesa y fina. CONCLUSIÓN: Equilibrio y locomoción en la motricidad gruesa y agarre e integración visomotora en la motricidad fina son los componentes motores asociados a aspectos particulares de la estimulación como la interacción madre-hijo, el reforzamiento de acciones positivas en forma verbal y la presencia de límites claros.OBJECTIVE: To identify the relationship between stimulation at home and motor development among 36 month-old children. MATERIALS AND METHODS: The development of gross and fine motor skills of 169 infants (50.9% boys and 49.1% girls was assessed at the age of 36 months with the Peabody Developmental Motor Scale. The quality of home stimulation was determined during a prior evaluation (at 30 months by means of the HOME Scale. RESULTS: Total stimulation at home was significantly associated with better performance in the gross and fine motor areas. Particular aspects of this home stimulation were related to better gross and fine motor functions. CONCLUSION: Static balance and locomotion (gross motor skills and grasping and visual-motor integration (fine motor skills are associated with particular aspects of home stimulation, such as parent-child interaction, verbal reinforcement of the child's positive actions and providing the child with clear boundaries.

  15. Home-based Early Intervention on Auditory and Speech Development in Mandarin-speaking Deaf Infants and Toddlers with Chronological Aged 7–24 Months

    Directory of Open Access Journals (Sweden)

    Ying Yang

    2015-01-01

    Conclusions: The data suggested the early hearing intervention and home-based habilitation benefit auditory and speech development. Chronological age and recovery time may be major factors for aural verbal outcomes in hearing impaired children. The development of auditory and speech in hearing impaired children may be relatively crucial in thefirst year's habilitation after fitted with the auxiliary device.

  16. Can home care for homebound patients with chronic heart failure reduce hospitalizations and costs?

    Science.gov (United States)

    Punchik, Boris; Komarov, Roman; Gavrikov, Dmitry; Semenov, Anna; Freud, Tamar; Kagan, Ella; Goldberg, Yury

    2017-01-01

    Background Congestive heart failure (CHF), a common problem in adults, is associated with multiple hospitalizations, high mortality rates and high costs. Purpose To evaluate whether home care for homebound patients with CHF reduces healthcare service utilization and overall costs. Methods A retrospective study of healthcare utilization among homebound patients who received home care for CHF from 2012–1015. The outcome measures were number of hospital admissions per month, total number of hospitalization days and days for CHF only, emergency room visits, and overall costs. A comparison was conducted between the 6-month period prior to entry into home care and the time in home care. Results Over the study period 196 patients were treated by home care for CHF with a mean age of 79.4±9.5 years. 113 (57.7%) were women. Compared to the six months prior to home care, there were statistically significant decreases in hospitalizations (46.3%), in the number of total in-hospital days (28.7%), in the number of in-hospital days for CHF (66.7%), in emergency room visits (47%), and in overall costs (23.9%). Conclusion Home care for homebound adults with CHF can reduce healthcare utilization and healthcare costs. PMID:28753675

  17. A Significant Visit

    Institute of Scientific and Technical Information of China (English)

    SHI YONGMING

    2010-01-01

    @@ North Korean leader KimJong Ⅱ paid a visit to China from May 3-7. The trip was on the agenda as early as last January, when Wang Jiarui, head of the International Department of the Communist Party of China Central Committee visited North Korea and delivered Chinese President Hu Jintao's invitation to Kim.

  18. Berliner Philarmoniker ATLAS visit

    CERN Multimedia

    ATLAS Collaboration

    2017-01-01

    The Berliner Philarmoniker in on tour through Europe. They stopped on June 27th in Geneva, for a concert at the Victoria Hall. An ATLAS visit was organised the morning after, lead by the ATLAS spokesperson Karl Jakobs (welcome and overview talk) and two ATLAS guides (AVC visit and 3D movie).

  19. Telemedicine in Neonatal Home Care

    DEFF Research Database (Denmark)

    Holm, Kristina Garne; Brødsgaard, Anne; Zachariassen, Gitte

    2016-01-01

    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...... 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...... with the neonatal unit, and (4) an online knowledge base on preterm infant care, breastfeeding, and nutrition. CONCLUSIONS: Our findings highlight the importance of neonatal home care. NH provides parents with a feeling of being a family, supports their self-efficacy, and gives them a feeling of security when...

  20. Home telemental health implementation and outcomes using electronic messaging.

    Science.gov (United States)

    Godleski, Linda; Cervone, Dana; Vogel, Donna; Rooney, Meghan

    2012-01-01

    In 2007, the VA Connecticut Healthcare System began a home electronic messaging programme for mental health patients. During the first two years, 76 patients with diagnoses of schizophrenia, post traumatic stress disorder, depression and substance-use disorders received a home messaging device, which was connected via an ordinary telephone line. There were daily questions, which were based on disease management protocols, and included alerts, data and educational components. Patient data were sent to a nurse practitioner each day for triage and follow-up. Patients used the device for at least six months. In the six months prior to enrolment, 42 patients were hospitalized for 46 admissions. In the following six months, six patients were hospitalized for nine admissions (P < 0.0001). In the six months prior to enrolment, 47 patients had a total of 80 ER visits. In the following six months, 16 patients had a total of 32 ER visits (P < 0.0001). Questionnaire responses indicated a high level of satisfaction with the home messaging programme.

  1. Visit-to-visit blood pressure variability and future functional decline in old age

    DEFF Research Database (Denmark)

    Ogliari, Giulia; Smit, Roelof A J; Westendorp, Rudi G J

    2016-01-01

    OBJECTIVE: Higher blood pressure variability (BPV), independent of mean blood pressure (BP), has been associated with adverse health outcomes. We investigated the association between visit-to-visit BPV and functional decline in older adults at high cardiovascular risk. METHODS: In PROspective Study...... of Pravastatin in the Elderly at Risk, 4745 participants with mean age of 75.2 years and high cardiovascular risk were followed for a mean of 3.2 years. BP was measured in every 3 months during the first 18 months. BPV was defined as the intraindividual SD of measurements across these visits. Functional status.......008) in IADL score. These associations were not modified by sex, hypertension or antihypertensives. These findings were independent of mean BP, cardiovascular risk factors and morbidities and cognition. CONCLUSION: Higher visit-to-visit SBPV but not DBPV was associated with steeper functional decline in older...

  2. Visiting Nurse Service of New York celebrates multiculturalism.

    Science.gov (United States)

    Kolatch, A; Brandvold, M C

    1997-10-01

    Home health providers must develop culturally sensitive and specific programs for many populations. This article outlines the steps agencies and practitioners can take to design these programs. Examples of two specialty programs developed by the Visiting Nurse Service of New York, one focusing on the Jewish and Russian Jewish community and the other on the Asian Home Care Program, provide insight into the importance of a comprehensive approach to all cultural home care programs.

  3. The influence of sucking habits on occlusion development in the first 36 months

    OpenAIRE

    Santos Neto,Edson Theodoro dos; Oliveira,Adauto Emmerich; Barbosa,Rodrigo Walter; Zandonade, Eliana; Oliveira,Zilda Fagundes Lima

    2012-01-01

    OBJECTIVE: The objective of this study was to identify the influence of sucking habits on the occlusal characteristics of the deciduous dentition. METHODS: The initial sample consisted of 86 infants, aged 0 to 3 months. Seven home visits were performed, when and information on breastfeeding practice, nutritive and non-nutritive sucking habits, mouth breathing and dentition development was collected. From the first sample, impressions of the dental arches were obtained from 58 children at the ...

  4. CPAFFC Delegation Visits Ukraine

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    <正>A3-member delegation led by Su Guang, vice president of the CPAFFC and the China-Ukraine Friendship Association (CUFA), paid a goodwill working visit to Kiev, capital of Ukraine, and Yalta from June 20 to 27.

  5. CPAFFC Delegation Visits Ukraine

    Institute of Scientific and Technical Information of China (English)

    NiuYingli

    2004-01-01

    A3-member delegation led by Su Guang, vice president of the CPAFFC and the ChinaUkraine Friendship Association (CUFA), paid a goodwill working visit to Kiev, capital of Ukraine,and Yalta from June 20 to 27.

  6. Visits from two ministers

    CERN Multimedia

    2005-01-01

    Two ministers have recently paid visits to CERN. On 30 June, Mosibudi Mangena, South Africa's Minister for Science and Technology, was welcomed by CERN's Chief Scientific Officer, Jos Engelen. He also visited the ALICE experiment down at Point 2, accompanied by the ALICE spokesman, Jürgen Schukraft. Physicists from the University of Cape Town are members of the ALICE collaboration. Jürgen Schukraft, ALICE spokesman, accompanies Mosibudi Mangena, South Africa's Minister for Science and Technology. The Vice-Minister-President of the Flemish Government, Fientje Moerman, visited the CMS cavern and assembly hall, followed by Building SM18, where the LHC superconducting magnets are being tested. After lunch with the CERN Management, her visit ended with a tour of the ISOLDE facilities. Fientje Moerman, Flemish Vice-Minister-President, with members of her delegation and the CMS collaboration in front of the CMS detector.

  7. Visit by two Ministers

    CERN Document Server

    2008-01-01

    Last December CERN received visits from two Ministers. Bulgaria’s Deputy Prime Minister and Minister of Science and Education, Daniel Vylchev, visited the CMS experiment in the company of the CMS Spokesman, T. Virdee, and several Bulgarian physicists. From left to right: J. Stamenov, M. Mateev, S. Stavrev, T. Virdee, V. Genchev, the Minister Daniel Vylchev, A. Hristova Vutsova, L. Litov and G. Soultanov. CERN Director-General, Robert Aymar, and Montenegro’s Minister of Education and Science, Slobodan Backović. On 18 December, Robert Aymar welcomed Bulgaria’s Deputy Prime Minister and Minister of Science and Education, Daniel Vylchev. A particular highlight of his visit was a tour of the CMS site, during which he met the many Bulgarian physicists working on the experiment. He also attended a presentation of the LHC Computing Grid and visited the Computer Centre. Bulgaria has been a CERN ...

  8. Visit-to-visit variability of blood pressure and renal function decline in patients with diabetic chronic kidney disease.

    Science.gov (United States)

    Yokota, Kei; Fukuda, Masamichi; Matsui, Yoshio; Kario, Kazuomi; Kimura, Kenjiro

    2014-05-01

    The authors previously reported that the visit-to-visit variability of blood pressure is correlated with renal function decline in nondiabetic chronic kidney disease. Little is known about the association between visit-to-visit variability and renal function decline in patients with diabetic chronic kidney disease. The authors retrospectively studied 69 patients with diabetic chronic kidney disease stage 3a, 3b, or 4. The standard deviation and coefficient of variation of blood pressure in 12 consecutive visits were defined as visit-to-visit variability of blood pressure. The median observation period was 32 months. In univariate correlation, the standard deviation and coefficient of variation of blood pressure were not significantly associated with the slope of estimated glomerular filtration rate. There was no significant association between the visit-to-visit variability of blood pressure and renal function decline in patients with diabetic chronic kidney disease, in contrast with our previous study of nondiabetic patients with chronic kidney disease.

  9. Home visit improves knowledge, self-care and adhesion in heart failure: randomized Clinical Trial HELEN-I Visita domiciliar mejora conocimiento, auto cuidado, adhesión en la insuficiencia cardíaca: Ensayo Clínico Aleatorizado HELEN - I Visita domiciliar melhora conhecimento, autocuidado e adesão na insuficiência cardíaca: ensaio clínico randomizado HELEN-I

    Directory of Open Access Journals (Sweden)

    Cláudia Motta Mussi

    2013-02-01

    Full Text Available OBJECTIVE: To verify the effect of an educative nursing intervention composed of home visits and phone calls on patients' knowledge about the disease, self-care and adhesion to the treatment. METHODS: Randomized clinical trial with patients with recent hospitalization caused by decompensated heart failure. There were two groups: the intervention group, which has received four home visits and four phone calls to reinforce the guidelines during six months of follow up; and the control group, which has received conventional follow up with no visits or phone calls. RESULTS: Two hundred patients were randomized (101 in the intervention group and 99 in the control group. After six months, a significant improvement was observed in self-care and knowledge about the disease in the intervention group (P=0.001 and POBJETIVO: Verificar el efecto de una intervención educativa de enfermería combinada de visita domiciliaria y contacto telefónico en pacientes con internación reciente por insuficiencia cardiaca descompensada, en el conocimiento de la enfermedad, las habilidades para el autocuidado y la adhesión al tratamiento comparado con el acompañamiento convencional de pacientes en el período de seis meses. MÉTODOS: Ensayo Clínico Aleatorizado en pacientes que fueron ingresados recientemente por insuficiencia cardiaca descompensada. El grupo intervención recibió cuatro visitas domiciliarias y cuatro contactos telefónicos para reforzar las orientaciones en seis meses de acompañamiento; el grupo control recibió acompañamiento convencional sin visitas y sin contactos telefónicos. RESULTADOS: Fueron aleatorizados doscientos pacientes (101: intervención y 99: control. Tras seis meses, se observó una mejoría significativa en el conocimiento y el autocuidado para el grupo intervención (P=0,001 y POBJETIVO: verificar o efeito de uma intervenção educativa de enfermagem combinada, caracterizada por visita domiciliar e contato telefônico, em

  10. A Successful Visit

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    A state visit to China during the first year in office is unprecedented for a U. S.president, but Barack Obama has made it. Moreover, the fact that President Obama spent four days and three nights of his seven-day visit to four Asian nations in Beijing and Shanghai has demonstrated the importance his administration attaches to China and to Sino-U.S. relations in its global strategy.

  11. Study on the feasibility of mother -infant discharge at 48 hours after vaginal delivery combined with home visit%正常产后48h母婴出院联合家庭访视的可行性研究

    Institute of Scientific and Technical Information of China (English)

    侯庆中; 王晨虹

    2012-01-01

    目的:评价经选择的母婴正常产后48 h出院联合家庭访视的可行性.方法:选择在深圳妇幼保健院正常产并接受产后家庭访视的10172例产妇和9297例新生儿为研究A组,同期拆线后出院的正常产产妇5286例和新生儿4604例为对照A组,比较两组产妇会阴伤口愈合不良发生率和婴儿再入院率.产后42天对1000例产妇进行有关母乳喂养和产褥期母婴情况的问卷调查,按照是否曾接受产后访视将调查对象分为研究B组和对照B组,比较两组母乳喂养成功率和产褥期抑郁症的发生率.结果:通过产后家庭访视,平均缩短住院时间(1.76±0.44)天,研究A组产妇会阴伤口愈合不良发生率明显低于对照A组(P<0.05);研究A组婴儿再入院率和对照A组相比,差异无统计学意义(P>0.05);研究B组母乳喂养成功率明显高于对照组(P<0.05);研究B组产褥期抑郁症的发生率明显低于对照B组(P<0.05).结论:对于经过选择的低风险产妇和婴儿,正常产后48 h出院联合家庭访视安全、经济、有效.%Objective: To evaluate the feasibility of selected mother - infant discharge at 48 hours after vaginal delivery combined with home visit Methods; A total of 10 172 mothers and 9 297 neonates who were discharged at 48 hours after vaginal delivery and received home visit were selected as study A group, while 5 286 mothers and 4 604 neonates who were discharged at 48 hours after vaginal delivery were selected as control A group, the incidences of poor perineal wound healing among the mothers and the readmission rates of infants in the two groups were compared. At 42 days after delivery, the knowledge about breastfeeding and maternal - infantile conditions during postpar-tum were investigated by a questionnaire among 1 000 mothers, then the research objects were divided into study B group and control B group according to they receiving home visit or not, the success rates of breastfeeding and the

  12. A visita domiciliária na Estratégia de Saúde da Família: conhecendo as percepções das famílias Home visiting in the Family Health Strategy: investigating families' perceptions

    Directory of Open Access Journals (Sweden)

    Mariene Mirian Cruz

    2010-09-01

    Full Text Available Entendendo as visitas domiciliárias enquanto tecnologia de interação no cuidado à saúde da família, este artigo teve por objetivo compreender os significados atribuídos por essas famílias à visita domiciliária realizada pela Estratégia Saúde da Família (ESF, com a intenção de reconhecer as dificuldades e potencialidades dessa prática. Nessa perspectiva, utilizou-se abordagem qualitativa, em que os dados foram coletados através de entrevista aberta e analisados segundo a Teoria das Representações Sociais. A pesquisa foi realizada no território de abrangência de uma Unidade Básica de Saúde da Família (UBSF localizada na zona leste do município de São Paulo, sendo selecionadas cinco famílias aleatoriamente (sorteio. Os resultados mostraram que a visita domiciliária, apesar de apresentar limitações devido à concentração em torno de práticas curativistas direcionadas aos indivíduos, que tornam secundárias a produção de autonomia e a corresponsabilização das famílias no cuidado à saúde, foi concebida como importante meio de aproximação entre as famílias e a ESF, favorecendo o acesso às ações e aos serviços de saúde, sendo apontada como instrumento de humanização da atenção à saúde ao propiciar a construção de novas relações entre usuários e profissionais e a formação de vínculo entre esses.Understanding home visiting as interaction technology in family healthcare, this article aimed to apprehend the meanings attributed by these families to the home visiting performed by Estratégia Saúde da Família (ESF - Family Health Strategy, with the purpose of recognizing the difficulties and potentialities of this practice. In this perspective, a qualitative approach was used. Data were collected through open interviews and analyzed in accordance with Social Representations Theory. The research was carried out in the catchment area of a Primary Family Health Care Unit, which is located in the

  13. Japanese Dietmen's Delegation Visits China

    Institute of Scientific and Technical Information of China (English)

    YuanMindao

    2004-01-01

    Invited by the China-Japan Friendship Association, (CJFA), a 12-member Japanese dietmen's delegation headed by Takeshi Noda,Diet member and former minister of home affairs,paid a visit to China from August 24 to 26, 2004.Tang Jiaxuan, state councillor, Lu Yongxiang, vice chairman of the Standing Committee of the National People's Congress and president of the Chinese Academy of Sciences, and Song Jian,

  14. PERUBAHAN MUTU KECAP PRODUKSI SKALA RUMAH TANGGA SELAMA TIGA BULAN PENYIMPANAN [Quality Change of Soysauce Produced by Home Scale Industry During Three Months of Storage

    Directory of Open Access Journals (Sweden)

    Henky Isnawan Hendritomo

    2003-12-01

    Full Text Available The investigation was conducted to study of the change of soysauce quality during three months of storage. The soysauce quality observed included, sucrose, protein, NaCl content and total microflora such as molds and bacteria. The result showed that the a mount of sucrose and protein of the soysauce were content was 67,8% and 3,07%, respectively after 3 months of storage the sucrose and protein content decreased to 58,8%, and 2,3%. During storage, the number of bacteria and mold increased from 2.1 x103 to 3.7 x 103 and 4.0 x102 to 6.1 x103 CFU/ml, respectively. It was concluded that separation process at 100 mesh was ineffective to reduce bacteria and mold. When compared to SNI, the soysauce quality is still good and safe to consume.

  15. Maintained hand function and forearm bone health 14 months after an in-home virtual-reality videogame hand telerehabilitation intervention in an adolescent with hemiplegic cerebral palsy.

    Science.gov (United States)

    Golomb, Meredith R; Warden, Stuart J; Fess, Elaine; Rabin, Bryan; Yonkman, Janell; Shirley, Bridget; Burdea, Grigore C

    2011-03-01

    Virtual reality videogames can be used to motivate rehabilitation, and telerehabilitation can be used to improve access to rehabilitation. These uses of technology to improve health outcomes are a burgeoning area of rehabilitation research. So far, there is a lack of reports of long-term outcomes of these types of interventions. The authors report a 15-year-old boy with hemiplegic cerebral palsy and epilepsy because of presumed perinatal stroke who improved his plegic hand function and increased his plegic forearm bone health during a 14-month virtual reality videogame hand telerehabilitation intervention. A total of 14 months after the intervention ended, repeat evaluation demonstrated maintenance of both increased hand function and forearm bone health. The implications of this work for the future of rehabilitation in children with neurological disabilities are discussed in this article.

  16. Snails home

    Science.gov (United States)

    Dunstan, D. J.; Hodgson, D. J.

    2014-06-01

    Many gardeners and horticulturalists seek non-chemical methods to control populations of snails. It has frequently been reported that snails that are marked and removed from a garden are later found in the garden again. This phenomenon is often cited as evidence for a homing instinct. We report a systematic study of the snail population in a small suburban garden, in which large numbers of snails were marked and removed over a period of about 6 months. While many returned, inferring a homing instinct from this evidence requires statistical modelling. Monte Carlo techniques demonstrate that movements of snails are better explained by drift under the influence of a homing instinct than by random diffusion. Maximum likelihood techniques infer the existence of two groups of snails in the garden: members of a larger population that show little affinity to the garden itself, and core members of a local garden population that regularly return to their home if removed. The data are strongly suggestive of a homing instinct, but also reveal that snail-throwing can work as a pest management strategy.

  17. The Oportunidades program's fortified food supplement, but not improvements in the home diet, increased the intake of key micronutrients in rural Mexican children aged 12-59 months.

    Science.gov (United States)

    Ramírez-Silva, Ivonne; Rivera, Juan A; Leroy, Jef L; Neufeld, Lynnette M

    2013-05-01

    Mexico's Oportunidades program provides conditional cash transfers, nutrition education, health services, and fortified food supplements for the young children of poor families. We have documented the effects of the program on growth and reduction of anemia. To better understand the impact pathways and disentangle the relative effects on dietary intake of the food supplements compared with other program components, we analyzed data from a randomized effectiveness evaluation of the Oportunidades program in rural children aged 12-59 mo. All Oportunidades beneficiaries received the cash transfers and the health and education components, but some children did not consume the supplements. The children's diet was evaluated using a single 24-h recall. The impact was estimated using multiple linear regression models with community-level random effects. Comparisons were made among children who received all the benefits of Oportunidades, including the fortified food supplement (SG), beneficiaries of the program who did not consume the food supplement (NSG), and the control group (CG). Relative to the NSG and CG, respectively, the SG consumed greater amounts of [mean (95% CI)]: energy, 94 (28, 160) and 111 (43, 180) kcal/d; iron, 7.6 (6.3, 8.9) and 7.7 (6.5, 9.0) mg/d; zinc, 7.5 (6.4, 8.6) and 7.6 (6.5, 8.7) mg/d; and vitamin A, 0.109 (0.071, 0.147) and 0.120 (0.080, 0.159) mg retinol equivalents/d. No differences were found between the NSG and CG (P > 0.05). To conclude, the Oportunidades program had a positive impact on the diet of children. The effects of the program on dietary intake resulted from the food supplement and not from improvements in the home diet. Our findings are useful for identifying which program components contributed to the effects on the nutritional status of children.

  18. ATLAS Virtual Visits

    CERN Document Server

    Goldfarb, Steven; The ATLAS collaboration

    2015-01-01

    ATLAS Virtual Visits is a project initiated in 2011 for the Education & Outreach program of the ATLAS Experiment at CERN. Its goal is to promote public appreciation of the LHC physics program and particle physics, in general, through direct dialogue between ATLAS physicists and remote audiences. A Virtual Visit is an IP-based videoconference, coupled with a public webcast and video recording, between ATLAS physicists and remote locations around the world, that typically include high school or university classrooms, Masterclasses, science fairs, or other special events, usually hosted by collaboration members. Over the past two years, more than 10,000 people, from all of the world’s continents, have actively participated in ATLAS Virtual Visits, with many more enjoying the experience from the publicly available webcasts and recordings. We present an overview of our experience and discuss potential development for the future.

  19. Dutch ministerial visit

    CERN Multimedia

    2007-01-01

    Dutch Minister of Education, Culture and Science R. Plasterk (third from left) in the ATLAS cavern with NIKHEF Director F. Linde, CERN Chief Scientific Officer J. Engelen, Ambassador J. van Eenennaam, ATLAS Collaboration Spokesperson P. Jenni, Mission Representative G. Vrielink and ATLAS Magnet Project Leader H. ten Kate.Minister of Education, Culture and Science from the Kingdom of the Netherlands, Ronald Plasterk, visited CERN on 25th October. With Jos Engelen, CERN Scientific Director, as his guide he visited Point 1 of the LHC tunnel and ATLAS, where Nikhef (the national institute for subatomic physics, a Dutch government and university collaboration) constructed all 96 of the largest muon drift chambers in the barrel as well as parts of the magnet system, the inner detector, the DAQ and triggering. Overall the Netherlands contribute 4.5% to the annual CERN budget and the minister’s visit celebrated the contributions of the 79 ...

  20. Visit by two Ministers

    CERN Multimedia

    2007-01-01

    Two European ministers have recently paid visits to CERN. On 11 June, the Austrian Minister for Science and Research, Johannes Hahn, visited the CMS cavern and assembly hall, before being given a tour of the CERN Control Centre. Following a lunch with the Ambassador, he was shown the LHC Computing Grid. His visit was rounded off with meetings with Robert Aymar and with Austrian students working at CERN. The Austrian Minister for Science and Research, Johannes Hahn, and Felicitas Pauss, Deputy Chair of the CMS Collaboration Committee, in front of one of the sections of the CMS detector. Jos Engelen, CERN’s Chief Scientific Officer, Jens Jorgen Gaardhoje, a physicist from the Niels Bohr Institute and a member of the ALICE collaboration, and the Danish Employment Minister, Claus Hjort Frederiksen, in front of the ALICE detector. On 12 June, Claus Hjort Frederiksen, the Danish Employment Minister,...

  1. NEWHINTS cluster randomised trial to evaluate the impact on neonatal mortality in rural Ghana of routine home visits to provide a package of essential newborn care interventions in the third trimester of pregnancy and the first week of life: trial protocol

    Directory of Open Access Journals (Sweden)

    Pitt Catherine

    2010-05-01

    Full Text Available Abstract Background Tackling neonatal mortality is essential for the achievement of the child survival millennium development goal. There are just under 4 million neonatal deaths, accounting for 38% of the 10.8 million deaths among children younger than 5 years of age taking place each year; 99% of these occur in low- and middle-income countries where a large proportion of births take place at home, and where postnatal care for mothers and neonates is either not available or is of poor quality. WHO and UNICEF have issued a joint statement calling for governments to implement "Home visits for the newborn child: a strategy to improve survival", following several studies in South Asia which achieved substantial reductions in neonatal mortality through community-based approaches. However, their feasibility and effectiveness have not yet been evaluated in Africa. The Newhints study aims to do this in Ghana and to develop a feasible and sustainable community-based approach to improve newborn care practices, and by so doing improve neonatal survival. Methods Newhints is an integrated intervention package based on extensive formative research, and developed in close collaboration with seven District Health Management Teams (DHMTs in Brong Ahafo Region. The core component is training the existing community based surveillance volunteers (CBSVs to identify pregnant women and to conduct two home visits during pregnancy and three in the first week of life to address essential care practices, and to assess and refer very low birth weight and sick babies. CBSVs are supported by a set of materials, regular supervisory visits, incentives, sensitisation activities with TBAs, health facility staff and communities, and providing training for essential newborn care in health facilities. Newhints is being evaluated through a cluster randomised controlled trial, and intention to treat analyses. The clusters are 98 supervisory zones; 49 have been randomised for

  2. Auger Physicists visit CMS

    CERN Multimedia

    Hoch, Michael

    2012-01-01

    Visit at CERN P5 CMS in the experimental cavern Alan Watson, Auger Spokesperson Emeritus, University of Leeds; Jim Cronin, Nobel Laureate, Auger Spokesperson Emeritus, University of Chicago; Jim Virdee, CMS Former Spokesperson, Imperial College; Jim Matthews, Auger Co-Spokesperson, Louisiana State University

  3. Albert Einstein visits Argentina

    CERN Document Server

    Gangui, A; Gangui, Alejandro; Ortiz, Eduardo L.

    2005-01-01

    This is a detailed, day by day, account of Albert Einstein's activities, both social and scientific, during his 30-day stay in Argentina in 1925, including his lectures on relativity at the various local universities and his visit to the National Academy of Sciences, as follows from his personal Diary of the trip to South-America and other contemporary documents.

  4. CPAFFC Delegation Visits Gabon

    Institute of Scientific and Technical Information of China (English)

    Tang; Ruimin

    2013-01-01

    <正>In March, when warm spring had come and flowers were in bloom, a CPAFFC delegation visited Gabon. It was accorded warm welcome from the Gabon-China Friendship Association (GCFA), with Ms. Pierrette Djouassa, former Procurator General of Gabon and President of the GCFA, leading all her members to greet the delegation at

  5. Pakistan Guest Visit HRC

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Companied by CMEC Beijing representative, Dr. Eng. S.M.Bhutta,a technical advisor of Alternative Energy Development Board (AEDB) in Pakistan, paid a visit to HRC during June 3-5, 2005. Both sides exchanged ideas on micro & small hydropower development, and intended to further strengthen the cooperation in micro & small hydropower fields as to push forward the rural electrification program in Pakistan.

  6. Thomas Kibble visits CERN

    CERN Multimedia

    Rosaria Marraffino

    2014-01-01

    Emeritus Professor Sir Thomas W.B. Kibble, from Imperial College London visited LHC for the first time last week and delivered a colloquium on the genesis of electroweak unification and the Brout-Englert-Higgs mechanism.   From left to right: Jim Virdee, Tiziano Camporesi, Tom Kibble and Austin Ball on the visit to CMS. On his way back from Trieste, where he received the Abdus Salam International Centre for Theoretical Physics' Dirac Medal, Tom Kibble stopped by CERN for his first visit to the LHC. Kibble had a standing invitation from Jim Virdee, former CMS spokesperson, who is also a researcher from Imperial College London. Peter Jenni (left) and Tom Kibble tour the ATLAS detector. (Image: Erwan Bertrand) Kibble made the trip to CERN a family outing and brought along 14 relatives,  including his children and grandchildren. He visited the ATLAS detector with Peter Jenni, its former spokesperson, on Friday 10 October. In the afternoon, Kibble delivered a colloquium in the...

  7. Italian Minister visits CERN

    CERN Multimedia

    2002-01-01

    Passing through Geneva, the Italian Deputy Minister for Productive Activities, Dr. Adolfo Urso, came to visit the SM18 hall where LHC magnets are tested. From left to right: Adolfo Urso, Deputy Minister for Productive Activities, CERN's Roberto Saban, Director General Luciano Maiani, Mario Gerbino, Director General of the Ministry and Lucio Rossi, LHC Main Magnet and Superconductors Group Leader.

  8. Home Sweet Home

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    A family-run nursing home that gives elderly people the feel of a real of a real home Jiang Shaoju’s three-year-old family-run nursing home for the elderly in Dalian breaks all stereotypes people might attach to traditional homes for the aged.There are no nurses in uniforms,no numbered bedding and there is a lot of laughter. Jiang,56,has given almost every one of the 12 elderly women in her nursing home a nickname.She calls 92-year-old Xuan Shoulan"vice principal"because Xuan likes giving orders to others in the house and

  9. Home care A to Z.

    Science.gov (United States)

    Killeen, M E

    1994-12-01

    My home care agency gives out little gold pins to employees to mark an anniversary. Now that I have one I feel confident in telling the real story about home care. I don't mean the dull paragraphs buried in the Policies and Procedures Manual or the dry information presented in our agency's mission. I am talking about the truth that every social worker, nurse, home care aide, or physical or occupational or speech therapist faces daily in visits to clients' homes. I dream of the day that this primer will be integrated into each new staff person's orientation. Here is the working bible of home care from A to Z.

  10. My Home in Beijing

    Institute of Scientific and Technical Information of China (English)

    1996-01-01

    In 1989 and 1995, Patricia Leuchtman visited China twice to work as a language editor for Women of China, and during her tenure established a profound friendship with Chinese colleagues. Before leaving off for home in America in May this year, Pat wrote a story for Women of China revealing her experiences while living in the Friendship Hotel in Beijing.

  11. Six-month postintervention depression and disability outcomes of in-home telehealth problem-solving therapy for depressed, low-income homebound older adults.

    Science.gov (United States)

    Choi, Namkee G; Marti, C Nathan; Bruce, Martha L; Hegel, Mark T; Wilson, Nancy L; Kunik, Mark E

    2014-08-01

    Despite their high rates of depression, homebound older adults have limited access to evidence-based psychotherapy. The purpose of this paper was to report both depression and disability outcomes of telehealth problem-solving therapy (tele-PST via Skype video call) for low-income homebound older adults over 6 months postintervention. A 3-arm randomized controlled trial compared the efficacy of tele-PST to in-person PST and telephone care calls with 158 homebound individuals who were aged 50+ and scored 15+ on the 24-item Hamilton Rating Scale for Depression (HAMD). Treatment effects on depression severity (HAMD score) and disability (score on the WHO Disability Assessment Schedule [WHODAS]) were analyzed using mixed-effects regression with random intercept models. Possible reciprocal relationships between depression and disability were examined with a parallel-process latent growth curve model. Both tele-PST and in-person PST were efficacious treatments for low-income homebound older adults; however the effects of tele-PST on both depression and disability outcomes were sustained significantly longer than those of in-person PST. Effect sizes (dGMA-raw ) for HAMD score changes at 36 weeks were 0.68 for tele-PST and 0.20 for in-person PST. Effect sizes for WHODAS score changes at 36 weeks were 0.47 for tele-PST and 0.25 for in-person PST. The results also supported reciprocal and indirect effects between depression and disability outcomes. The efficacy and potential low cost of tele-delivered psychotherapy show its potential for easy replication and sustainability to reach a large number of underserved older adults and improve their access to mental health services. © 2014 Wiley Periodicals, Inc.

  12. The New York State Healthy Neighborhoods Program: Findings From an Evaluation of a Large-Scale, Multisite, State-Funded Healthy Homes Program.

    Science.gov (United States)

    Reddy, Amanda L; Gomez, Marta; Dixon, Sherry L

    A growing evidence base suggests that a comprehensive healthy homes approach may be an effective strategy for improving housing hazards that affect health, but questions remain about the feasibility of large-scale implementation. To evaluate the impact of a large-scale, multisite, state-funded healthy homes program. Homes in high-risk neighborhoods of 13 counties funded under the New York State Healthy Neighborhoods Program (NYS HNP) from 2008 to 2012. A total of 28 491 homes received an initial visit and 6436 dwellings received a revisit (follow-up assessment 3 to 6 months after the intervention). A majority of residents are low-income renters living in buildings built prior to 1950. The NYS HNP is a low-intensity healthy homes program. Participating homes undergo a visual assessment to identify potential environmental health and safety hazards, and interventions (education, referrals, and products) are provided to address any hazards identified during the visit. The proportion of homes affected by several types of housing hazards, improvement in hazards among revisited homes, and the change in the overall number of hazards per home were assessed. Among the homes that were revisited, there were significant improvements in the conditions assessed for tobacco control, fire safety, lead poisoning prevention, indoor air quality, and other hazards (including pests and mold). There was a significant reduction in the number of hazards per home (2.8 to 1.5; P homes were not hazard-free at the revisit. This evaluation suggests that a comprehensive, low-intensity healthy housing approach can produce short-term impacts with public health significance. This evaluation provides information about hazards that are common, easily assessed, and easily corrected or improved, which may be of use to a variety of programs that already provide in-home services and are seeking to expand the scope of their visits or to inform the development of new programs.

  13. A royal visit

    CERN Multimedia

    Katarina Anthony

    2014-01-01

    On Wednesday, 21 May, CERN received His Majesty Philippe, King of the Belgians, for a full-day visit of the Laboratory.   From left to right: Tiziano Camporesi, CMS Spokesperson; François Englert, Nobel Prize in Physics 2013; Rolf Heuer, CERN Director-General; His Majesty Philippe, King of the Belgians; Philippe Courard, Belgium's State Secretary for Scientific Policy and Walter Van Doninck, CERN Council Vice-President. Director-General Rolf Heuer welcomed King Philippe to CERN at Point 5 (Cessy). This was to be no small visit, with His Majesty accompanied by a host of diplomats, prominent Belgian physicists - including François Englert - and even members of Belgium's press corps. After quick introductions, the morning began with a tour of the CMS underground experimental area and the LHC tunnel at Point 5, guided by the CMS Collaboration Spokesperson, Tiziano Camporesi, and the Director for Accelerators and Technology, Frédérick Bord...

  14. Belgian Firms Visit CERN

    CERN Document Server

    2001-01-01

    Fifteen Belgian firms visited CERN last 2 and 3 April to present their know-how. Industrial sectors ranging from precision machining to electrical engineering and electronics were represented. And for the first time, companies from the Flemish and Brussels regions of the country joined their Walloon compatriots, who have come to CERN before. The visit was organised by Mr J.-M. Warêgne, economic and commercial attaché at the Belgian permanent mission for the French-speaking region, Mr J. Van de Vondel, his opposite number for the Flemish region, and Mrs E. Solowianiuk, economic and commercial counsellor at the Belgian permanent mission for the Brussels-Capital region.

  15. Romanian President Visits CERN

    CERN Multimedia

    2001-01-01

    Director General Luciano Maiani watches as Romanian President Ion Iliescu signs the CERN guest book. On Friday the 12th of October, Romanian President Ion Iliescu arrived at CERN and was warmly greeted by Director General Luciano Maiani at the steps of building 500. After initial greetings and a general presentation of the laboratory, President Iliescu and his entourage embarked on a whistle stop tour of the CERN facilities. They visited the CMS magnet assembly hall and civil engineering work where presentations were made by CMS spokesperson Michel Della Negra and the ATLAS Tile Calorimeter where the president was introduced to Romanian physicists working here at CERN. Michel Della Negra explains some of the general principles behind CMS to President Iliescu during his visit last week. The Romanian teams working on CERN projects make very visible contributions, for example to the construction of the ATLAS experiment and to the preparation of its eventual scientific exploitation. 'Those of us on the ATLAS ...

  16. Indian President visits CERN

    CERN Multimedia

    Katarina Anthony

    2011-01-01

    On 1 October, her Excellency Mrs Pratibha Devisingh Patil, President of India, picked CERN as the first stop on her official state visit to Switzerland. Accompanied by a host of Indian journalists, a security team, and a group of presidential delegates, the president left quite an impression when she visited CERN’s Point 2!   Upon arrival, Pratibha Patil was greeted by CERN Director General Rolf Heuer, as well as senior Indian scientists working at CERN, and various department directors. After a quick overview of the Organization, Rolf Heuer and the President addressed India’s future collaboration with CERN. India is currently an Observer State of the Organization, and is considering becoming an Associate Member State. A short stop in LHC operations gave Steve Myers and the Accelerator team the opportunity to take the President on a tour through the LHC tunnel. From there, ALICE’s Tapan Nayak and Spokesperson Paolo Giubellino took Pratibha Patil to the experiment&am...

  17. Kandinsky College Visits CERN

    CERN Multimedia

    CERN Video productions; Angelos Alexopoulos

    2012-01-01

    This video documents the visit of nine senior high school students of the Kandinsky College in Nijmegen (Netherelands) to CERN. The students visited many of CERN's experimental facilities, took part in a Cloud Chamber workshop, attended talks and roundtable discussions of SpacePart12 and worked on the evaluation of the Microcosm exhibition as part of a school inquiry-based research project. The students and their teacher, Paul de Haas (a participant of the High School Teachers 2012 Programme at CERN) were connected with Prof. Christine Kourkoumelis and George Vasileiadis at the University of Athens and learned hands-on how to analyse real physics events, including Higgs-like ones, from the ATLAS experiment at the LHC using the HYPATIA Applet.

  18. German visits to CERN

    CERN Multimedia

    2007-01-01

    State secretary to Germany's Federal Ministry of Education and Research, Frieder Meyer-Krahmer, with CERN's Director-General Robert Aymar.On 21 February, Professor Frieder Meyer-Krahmer, State Secretary to Germany's Federal Ministry of Education and Research, came to CERN. He visited the ALICE and ATLAS experiments and the computing centre before meeting the CERN's Director-General, some German physicists and members of the top management. The Minister of Science, Research and the Arts of the Baden-Württemberg regional government, Peter Frankenberg, and CERN's Director-General, Robert Aymar, signing an agreement on education. In the background: Sigurd Lettow, CERN's Director of Finance and Human Resources, and Karl-Heinz Meisel, Rector of the Fachhochschule Karlsruhe. The Minister of Science, Research and the Arts of the Baden-Württemberg regional government, Prof. Peter Frankenberg, visited CERN on 23 February. He was accompanied by the Rector of the Fachhochschule Karlsruhe, Prof. Karl-Heinz Meisel, and b...

  19. Toy Demonstrator's "VISIT" Handbook.

    Science.gov (United States)

    Levenstein, Phyllis

    The role of the toy demonstrator in a home-based, mother-involved intervention effort (Verbal Interaction Project) is presented in this handbook for staff members. It is believed that the prerequisites for functioning in the toy demonstrator's role are a sense of responsibility, patience with the children and their mothers, and willingness to be…

  20. [Visiting the Amana Colonies.

    Science.gov (United States)

    Ohrn, Deborah Gore, Ed.

    1992-01-01

    This issue of "The Goldfinch: Iowa History for Young People" focuses upon the Amana Colonies, which were home to many German immigrants in the 19th century, and which retain much of their ethnic heritage today. The articles and activities included in this issue are "Amana Today"; "No Black Buggies in Amana";…

  1. Putin's Visit Bears Fruit

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The Russian President's trip to China marks progress in overall cooperation between the two countries If one word could be used to describe Russian President Vladimir Putin's recent visit to China, it would be "fruitful." During his brief two-day stay, which began March 21, Putin had a compact agenda-he met with his Chinese counterpart, President Hu Jintao, Chinese Premier Wen Jiabao and China's top legis-

  2. On Visiting Our Dead

    Directory of Open Access Journals (Sweden)

    Joanna Clapps Herman

    2013-08-01

    Full Text Available A redefining of the meaning of death and grief: this essay explores a rejection of conventional ideas about mourning and describes the experiences of two daughters after they have lost their beloved father. In the one case, it is an evocation of his spirit that feels like a conversation and, in the other, visits by the father to the daughter through palpable signs.

  3. The Home Care Crew Scheduling Problem

    DEFF Research Database (Denmark)

    Rasmussen, Matias Sevel; Justesen, Tor

    In the Home Care Crew Scheduling Problem (HCCSP) a staff of caretakers has to be assigned a number of visits, such that the total number of assigned visits is maximised. The visits have different locations and positions in time, and travelling time and time windows must be respected. The challenge...... clustering of the visits based on the problem structure. The algorithm is tested on real-life problem instances and we obtain solutions that are better than current practice in all cases....

  4. Spanish Visit to CERN

    CERN Multimedia

    2002-01-01

    Last week CERN was visited by the Spanish Minister of Science and Technology, Josep Piqué i Camps. While here, he was able to visit the ATLAS assembly hall where many items of equipment are being built in collaboration with Spanish academic institutions or firms. These include the vacuum vessels for the ATLAS barrel toroid magnets supplied by the Spanish firm Felguera Construcciones Mechanics. Similarly, the Universidad Autónoma de Madrid is participating in the manufacture of the electromagnetic calorimeter endcaps, while the Barcelona Institute for High Energy Physics and the Valencia IFIC (Instituto de Física Corpuscular) are highly involved in the production of barrel modules for the tile calorimeter. The delegation, accompanied by Spanish scientists at CERN, also visited the LHC superconducting magnet test hall (photo). From left to right: Felix Rodriguez Mateos of CERN LHC Division, Josep Piqué i Camps, Spanish Minister of Science and Technology, César Dopazo, Director-General of CIEMAT (Spanish ...

  5. EUCYS prizewinner visits CERN

    CERN Multimedia

    Jennifer Toes

    2016-01-01

    Young Turkish student Baris Volkan Gürses visited CERN from 4 to 8 July after winning the prize in the 2015 European Contest for Young Scientists (EUCYS).    Baris Volkan Gürses, EUCYS prizewinner, visiting the Microcosm. After winning both regional and national competitions in Turkey, 18-year-old student Baris Volkan Gürses competed against 169 young scientists and was awarded a visit to CERN by EIROforum for his physics project in EUCYS 2015. His project, entitled “Generation of artificial gravity by using electrostatic force for prevention of muscle atrophy and osteoporosis occurring in gravity-free environments”, focused on the design of a mechanism to help with the impact of spaceflight on the human body. “My objective was to eliminate the negative effects of a gravity-free environment on astronauts who stay in space for longer periods of time, like in the International Space Station,” explained Volkan. &...

  6. EU Commissioner visits CERN

    CERN Multimedia

    2005-01-01

    European Commissioner Viviane Reding in front of one of the computers showing how the Grid works and, from left to right, Robert Aymar, CERN's Director-General, Wolfgang von Rüden, Head of the Information Technology Department, and Bob Jones, the newly appointed director of the EGEE project since 1st November. Viviane Reding, European Commissioner for Information Society and Media, visited CERN on 28 October. Accompanied throughout by CERN's Director-General, Robert Aymar, and the Head of the Information Technology Department, Wolfgang von Rüden, the Commissioner visited the ATLAS cavern before going on to the Information Technology Department, where she was given a complete overview of CERN's activities in the strategic field of Grid computing. Viviane Reding's visit coincided with the end of the EGEE (Enabling Grids for E-sciencE) conference, which took place in Pisa in Italy. Co-ordinated by CERN and funded by the European Commission, the EGEE project aims to set up a worldwide grid infrastructure for sc...

  7. A boost to visits

    CERN Multimedia

    2005-01-01

    Several guides were rewarded by CERN's Director-General and Secretary-General for their contributions in 2004. Left to right: Géraldine Chuste, the Director-General Robert Aymar, Klaus Batzner, Philippe Moret, Joanna Weng, Alberto Ribon, Head of the Visits Service, Emma Sanders, and the Secretary-General, Maximilian Metzger. Three other guides not in the photograph, Antonio Francano, Christoph Ilgner and Tzanko Spassoff, were also rewarded for their contributions. As every year, the CERN Visits Service has paid tribute to its guides, all of whom are volunteers and devote some of their time to showing people around their Laboratory. The guides were invited to a get-together in Microcosm during which the Director-General, Robert Aymar, expressed his special gratitude for their efforts and presented awards to the most dedicated among them. He encouraged members of the Laboratory to become guides and underlined that 2004 had been an exceptional year for visits, which had risen by 15% to almost 22,000. Including ...

  8. Serbian President visits CERN

    CERN Document Server

    Katarina Anthony

    2012-01-01

    On Tuesday 10 January, Serbian President Boris Tadić visited the Laboratory to sign the Agreement of granting the status of Associate Membership as the pre-stage to full Membership of CERN.    Before the signing ceremony, the President, welcomed by Director-General Rolf Heuer at CERN’s Point 5, took the opportunity to visit CERN. After a general introduction, the President took advantage of the shutdown to visit the LHC’s underground caverns. Leading the President through their respective experiments were spokespersons Fabiola Gianotti (ATLAS) and Joe Incandela (CMS).  After a morning of tours, President Tadić and Rolf Heuer signed the Agreement. Serbia’s status as an Associate Member as pre-stage to full Membership is expected to come into force following ratification by the Serbian Parliament. After a maximum period of five years, the CERN Council will decide on the admission of Serbia to full Membership. This new agreement continues Serbia&a...

  9. Medicare program; Home Health Prospective Payment System rate update for calendar year 2013, hospice quality reporting requirements, and survey and enforcement requirements for home health agencies. Final rule.

    Science.gov (United States)

    2012-11-08

    This final rule updates the Home Health Prospective Payment System (HH PPS) rates, including the national standardized 60-day episode rates, the national per-visit rates, the low-utilization payment amount (LUPA), the non-routine medical supplies (NRS) conversion factor, and outlier payments under the Medicare prospective payment system for home health agencies effective January 1, 2013. This rule also establishes requirements for the Home Health and Hospice quality reporting programs. This final rule will also establish requirements for unannounced, standard and extended surveys of home health agencies (HHAs) and sets forth alternative sanctions that could be imposed instead of, or in addition to, termination of the HHA's participation in the Medicare program, which could remain in effect up to a maximum of 6 months, until an HHA achieves compliance with the HHA Conditions of Participation (CoPs) or until the HHA's provider agreement is terminated.

  10. A visita domiciliária realizada pelo agente comunitário de saúde sob a ótica de adultos e idosos The home visit performed by the community health agent from the perspective of adults and elderly

    Directory of Open Access Journals (Sweden)

    Ariane Netto de Lima

    2010-12-01

    Full Text Available A visita domiciliária constitui o principal instrumento de trabalho dos agentes comunitários na Estratégia Saúde da Família. O objetivo deste estudo foi descrever a percepção de adultos e idosos em relação à visita domiciliária realizada pelo agente comunitário de saúde. Como referencial metodológico foi utilizada a abordagem qualitativa embasada em algumas figuras metodológicas do Discurso do Sujeito Coletivo. Os dados foram coletados em maio de 2007, em uma Unidade de Saúde da Família de Botucatu-SP, por meio de formulário sociodemografico e entrevista semiestruturada aplicada a 14 usuários. A análise dos dados permitiu identificar dois temas: "Sentimentos e percepções em relação à visita e ao agente comunitário" e "O reconhecimento das ações do agente comunitário". Apesar de os entrevistados sentirem-se satisfeitos e gratos diante da visita, o fato de perceberem a frequência mensal como insuficiente e de alegarem desconhecer o conteúdo das anotações realizadas pelo agente no momento da visita sinalizam a necessidade de o enfermeiro investir de maneira mais intensa em atividades educativas junto a esses profissionais, priorizando questões que envolvem os processos de comunicação. Acredita-se que com essa medida será possível otimizar, qualitativamente, a realização da atividade.Home visits are the main working tool for community agents in the Family Health Strategy. The objective of this study was to describe the perception of adults and elderly about the home visit performed by the community health agent. The employed methodology was the qualitative approach based on some methodological procedures of the Discourse of the Collective Subject. Data were collected in May 2007 at a Family Health Unit of the city of Botucatu, state of São Paulo, by means of a socio-demographic form and a semi-structured interview conducted with 14 users. Data analysis identified two themes: "Feelings and perceptions in

  11. Patterns of Family Visitation During Immigration Detention

    Directory of Open Access Journals (Sweden)

    Caitlin Patler

    2017-07-01

    Full Text Available The population detained by Immigration and Customs Enforcement more than doubled between 2001 and 2013, swelling to over 477,000 individuals. Despite this growth, few studies analyze the experiences of detained immigrants. We draw from one of the first studies of detention in the United States, analyzing survey data from 565 noncitizens detained for six months or longer in California. Criminal incarceration literature finds that family visitation helps maintain social ties but is not evenly distributed. We analyze the predictors of contact and visitation with children during immigration detention. Results indicate that demographic background, the type of detention facility, and children’s legal status substantially affect contact and visitation experiences. Findings suggest that immigration detention replicates experiences of criminal incarceration and is perpetuating inequality in immigrant communities.

  12. Rethinking emergency department visits.

    Science.gov (United States)

    Resar, Roger K; Griffin, Frances A

    2010-01-01

    Efforts to date have been unable to reverse the trend of increased emergency department utilization. The Institute for Healthcare Improvement has developed a framework for reducing avoidable emergency department visits on the basis of the formation of local coalitions. These coalitions include interested partners approaching improvement by integrating community resources and nonmedical solutions. Targeted patient populations are identified via homogeneous characteristics. Open-ended interview questions are used to identify possible community and nonmedical solutions to complement medical strategies. This article describes the framework and process of testing. If validated, this approach will have significant policy implications.

  13. CPAFFC Delegation Visits India

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    <正>A CPAFFC delegation headed by Wang Wenyuan,former vice chairman of the National Committee of the Chinese Peo-ple’s Political Consultative Conference and adviser to the CPAFFC,paid a goodwill visit to India from December 19 to 28,2007 at the invitation of the Indian Council for Cultural Relations(ICCR).Also on the delegation were CPAFFC President Chen Haosu and Vice President Feng Zuoku.It was the highest-level delegation the CPAFFC has sent to India over the last decade.

  14. Emergency presurgical visit

    Directory of Open Access Journals (Sweden)

    Alfredo Castro Díaz

    2009-07-01

    Full Text Available The objective has been to create a Protocol of Structured Presurgical Visit applicable to the patients who are undergoing an emergency surgery, to provide the user and his family all the necessary cares on the basis of those nursing diagnosis that prevail in all the cases of surgical emergency interventions. The used method has been an analysis of the emergency surgical interventions more prevalent from February 2007 until October 2008 in our area (a regional hospital, and statistic of those nursing diagnosis that more frequently appeared in these interventions, the previous moment to the intervention and in addition common to all of them. The results were the following ones: the more frequent emergency operations were: Caesarean, ginecological curettage, laparotomy, help in risk childbirth, orthopaedic surgery and appendectomy. The more frequent nursing diagnosis in all the emergency operations at the previous moment of the intervention were: risk of falls, pain, anxiety, deficit of knowledge, risk of infection, movement stress syndrome, risk of hemorrhage, cutaneous integrity deterioration. The conclusion is that users present at the previous moment to an emergency operation several problems, which force to the emergency surgical ward nurse to the introduction of the nursing methodology, in order to identify the problems, to mark results and to indicate the interventions to achieve those results, besides in a humanitarian way and with quality. This can be obtained by performing a Structured Emergency Presurgical Visit.

  15. Steven Weinberg visits CERN

    CERN Multimedia

    2009-01-01

    Steven Weinberg visiting the ATLAS cavern accompanied by Peter JenniIt was no surprise that the CERN audience arrived early in the Globe of Science and Innovation for the colloquium on 7 July. Nobel laureate Steven Weinberg is one of the major contributors to the Standard Model of particle physics. He received the Nobel Prize for Physics in 1979 for his work on the unified theory of the electromagnetic and weak interactions, one of the essential pillars of the Standard Model. After lunch at CERN and a visit to ATLAS, Weinberg gave a colloquium on "The Quantum Theory of Fields: Effective or Fundamental" to a packed audience. In his talk, he looked at how the use of quantum field theory in particle physics has fluctuated in popularity since Paul Dirac first introduced the approach to describe the interaction of particles with electromagnetic fields in the late 1920s. In particular, he posed the question: Is quantum field theory fundamental or does it a...

  16. Kofi Annan visits CERN

    CERN Document Server

    Katarina Anthony

    2011-01-01

    On Tuesday 13 September, former Secretary-General of the United Nations and Nobel Peace Laureate Kofi Annan paid a visit to CERN.   Arriving in the early afternoon, Kofi Annan and his family were greeted by Director-General Rolf Heuer on the steps of Building 500. After a quick introduction to the Laboratory, they were whisked off to SM18 for a tour of the LHC’s superconducting magnet test hall, guided by Technology Department Head Frédérick Bordry. After a light lunch in Restaurant 2, Kofi Annan added his signature to CERN’s Guest Book. He is the second UN Secretary-General to add their name to CERN’s roster; his successor Ban Ki-Moon’s visited CERN in 2008.  Kofi Annan was then guided by spokesperson Fabiola Gianotti on a tour of ATLAS’s Visitor Centre. This was an opportunity for some of the younger members of the ATLAS collaboration to meet the former Secretary-General and to answer his questions about the exper...

  17. k-visit Attribute Grammars

    DEFF Research Database (Denmark)

    Nielson, Hanne Riis; Skyum, S.

    1981-01-01

    It is shown that any well-defined attribute grammar is k-visit for some k. Furthermore, it is shown that given a well-defined grammar G and an integer k, it is decidable whether G is k-visit. Finally it is shown that the k-visit grammars specify a proper hierarchy with respect to translations...

  18. Community Oncology Medical Homes: Physician-Driven Change to Improve Patient Care and Reduce Costs.

    Science.gov (United States)

    Waters, Teresa M; Webster, Jennifer A; Stevens, Laura A; Li, Tao; Kaplan, Cameron M; Graetz, Ilana; McAneny, Barbara L

    2015-11-01

    Although the patient-centered medical home is a well-established model of care for primary care providers, adoption by specialty providers has been relatively limited. Recently, there has been particular interest in developing specialty medical homes in medical oncology because of practice variation, care fragmentation, and high overall costs of care. In 2012, the Center for Medicare and Medicaid Innovation awarded Innovative Oncology Business Solutions a 3-year grant for their Community Oncology Medical Home (COME HOME) program to implement specialty medical homes in seven oncology practices across the country. We report our early experience and lessons learned.Through September 30, 2014, COME HOME has touched 16,353 unique patients through triage encounters, patient education visits, or application of clinical pathways. We describe the COME HOME model and implementation timeline, profile use of key services, and report patient satisfaction. Using feedback from practice sites, we highlight patient-centered innovations and overall lessons learned.COME HOME incorporates best practices care driven by triage and clinical pathways, team-based care, active disease management, enhanced access and care, as well as financial support for the medical home infrastructure. Information technology plays a central role, supporting both delivery of care and performance monitoring. Volume of service use has grown steadily over time, leveling out in second quarter 2014. The program currently averages 1,265 triage encounters, 440 extended hours visits, and 655 patient education encounters per month.COME HOME offers a patient-centered model of care to improve quality and continuity of care. Copyright © 2015 by American Society of Clinical Oncology.

  19. A randomized controlled trial of telemonitoring in older adults with multiple health issues to prevent hospitalizations and emergency department visits.

    Science.gov (United States)

    Takahashi, Paul Y; Pecina, Jennifer L; Upatising, Benjavan; Chaudhry, Rajeev; Shah, Nilay D; Van Houten, Holly; Cha, Steve; Croghan, Ivana; Naessens, James M; Hanson, Gregory J

    2012-05-28

    Efficiently caring for frail older adults will become an increasingly important part of health care reform;telemonitoring within homes may be an answer to improve outcomes. This study sought to assess differences in hospitalizations and emergency department (ED) visits among older adults using telemonitoring vs usual care. A randomized controlled trial was performed among adults older than 60 years at high risk for rehospitalization. Participants were randomized to telemonitoring (with daily input) or to patient-driven usual care. Telemonitoring was accomplished by daily biometrics,symptom reporting, and videoconference. The primary outcome was a composite end point of hospitalizations and ED visits in the 12 months following enrollment. Secondary end points included hospitalizations,ED visits, and total hospital days. Intent-to-treat analysis was performed. Two hundred five participants were enrolled,with a mean age of 80.3 years. The primary outcome of hospitalizations and ED visits did not differ between the telemonitoring group (63.7%) and the usual care group(57.3%) (P=.35). No differences were observed in secondary end points, including hospitalizations, ED visits,and total hospital days. No significant group differences in hospitalizations and ED visits were found between the pre-enrollment period vs the post-enrollment period. Mortality was higher in the telemonitoring group (14.7%)than in the usual care group (3.9%) (P=.008). Among older patients, telemonitoring did not result in fewer hospitalizations or ED visits. Secondary outcomes demonstrated no significant differences between the telemonitoring group and the usual care group.The cause of greater mortality in the telemonitoring group is unknown.

  20. CPAFFC Delegation Visits Maori Community in New Zealand

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    <正>At the invitation of the New Zealand Maori China Friendship Association (NZMCFA), a CPAFFC delegation paid a visit to New Zealand from February 28 to March 9. They had a close contact with the Maoris in New Zealand. They stayed at their homes, and

  1. Health visiting in rural Gambia.

    Science.gov (United States)

    Hoare, K

    1991-01-01

    A British nurse was the 1st health visitor in the village of Keneba in the Gambia. She was at a nutritional research center which provided basic medical services. In addition to visiting mothers in their homes to talk about health education, such as oral rehydration and advice on hand washing, she would also encourage them to bring their children to the infant welfare clinic for immunizations. She told the mothers that the health staff would check the growth and nutritional status of their children and why these activities were important. Staff at the clinic aimed to see all the children 2 years 9 times the 1st year and 4 times the 2nd year. All anthropometric data were forwarded to Cambridge, England to be included in a continuing study on the growth of the population. The clinic referred children with serious illnesses to the pediatrician or, if necessary, took them to a hospital on the coast. Children that came to the clinic with a fever 37.4 degrees Celsius during the wet season had a blood film taken to check for malaria parasites. Indeed cerebral malaria contributed greatly to child deaths in the Gambia. If malaria was present, children received their 1st dose of chloroquine immediately so the staff could determine tolerance. 3 doses followed this dose. The health visitor also organized the health education component of the clinic. The clinic dresser interpreted the British nurse's presentations to eventually conduct them alone. The nurse divided the mothers and fathers into 2 groups. In the future, she would evaluate the 2 groups to determine if weekly education on hand washing and skin hygiene would reduce diarrheal and cutaneous disease incidence in children 3 years old. The other group learned about family planning. Both groups learned about immunization, detection of illness, safety, sanitation, nutritional advice, dental care, and food preparation.

  2. Long-term home care scheduling

    DEFF Research Database (Denmark)

    Gamst, Mette; Jensen, Thomas Sejr

    In several countries, home care is provided for certain citizens living at home. The long-term home care scheduling problem is to generate work plans spanning several days such that a high quality of service is maintained and the overall cost is kept as low as possible. A solution to the problem...... provides detailed information on visits and visit times for each employee on each of the covered days. We propose a branch-and-price algorithm for the long-term home care scheduling problem. The pricing problem generates one-day plans for an employee, and the master problem merges the plans with respect...

  3. Avaliação das condições de habitação e saneamento: a importância da visita domiciliar no contexto do Programa de Saúde da Família Assessment of sanitation and housing conditions: the importance of home visits in the Family Health Program context

    Directory of Open Access Journals (Sweden)

    Catarina Machado Azeredo

    2007-06-01

    Full Text Available O conhecimento das condições do meio pertinente à saúde, como saneamento e moradia, são essenciais no estabelecimento de medidas de promoção da qualidade de vida do indivíduo, famílias e comunidades. Objetivou-se avaliar, através de visitas domiciliares, as condições habitacionais e de saneamento básico das famílias adstritas no PSF de Teixeiras-MG. Tratou-se de estudo observacional transversal, com realização de entrevistas a 10% (n=364 das famílias adstritas no PSF, utilizando questionário semi-estruturado. A cobertura por rede de abastecimento de água era de 83% dos domicílios da zona urbana e 11,7% da zona rural, e a rede pública era o destino final da água utilizada em 82,2% dos domicílios da zona urbana e de apenas 10,9% da zona rural. Destaca-se distribuição desigual de infra-estrutura e saneamento entre as zonas urbana e rural. A visita domiciliar permitiu um olhar in loco da realidade do usuário do PSF e se constitui em importante instrumento na Estratégia Saúde da Família, identificando determinantes do processo saúde-doença percebidos no ambiente em que vivem as famílias e possibilitando promoção da saúde por meio da educação em saúde.Knowledge of health-related environmental conditions - such as basic sanitation and housing - are of singular importance for establishing measures designed to upgrade the quality of life at the individual, family and community levels. Through home visits, this paper evaluates families enrolled in the Family Health Program (FHP in Teixeiras, Minas Gerais State, Brazil, including their housing and basic sanitation conditions. A transverse observational study, its semi-structured questionnaire was applied to 10% (n=364 of the families enrolled in this Program. The net water supply coverage reached 83% of homes in urban areas and 11.7% in rural areas. The public water supply was the final disposal point for the water used in 82.2% of urban dwellings and 10.9% of rural

  4. Pintando novos caminhos: a visita domiciliar em saúde mental como dispositivo de cuidado em enfermagem Pintando nuevos caminos: la visita domiciliaria en salud mental como dispositivo de intervención de enfermería Painting new paths: the home visit in mental health as a device of nursing care

    Directory of Open Access Journals (Sweden)

    Rosane Mara Pontes de Oliveira

    2006-12-01

    ó la importancia de la participación de la familia y del sujeto en un proceso continuo de cuidado, permitiendo a la enfermera construir un cuidado creativo, solidario y sensible, que posibilita a los sujetos nuevos contratos con la vida.Study about the analysis of the daily of the psychiatric patient at home after the hospital internment, by the home visit, giving emphasis to the understanding of the Psychiatric Nursing practical at the patient home. Was discussed the difficulties, the relationships and the possibilities of care. The study is qualitative with ethnomethodology approach. The production of data was by the participant observation and open interviews. The daily of Michel de Certeau was adopted as theoretician referential. The subjects that were deriving of the quarrels had formed an axle for the reflective process, having as base the agreement about family, work, leisure and myth/spirituality. The data reflects how the care offered by the nurse in the hospital internment has few perspectives of construction. The home visit showed the importance of the participation of the family and the citizen in a continuous process of care, allowing to the nurse to construct a creative, solidary and sensible care, that makes possible to the citizens new contracts with the life.

  5. Postanesthesia care unit visitation decreases family member anxiety.

    Science.gov (United States)

    Carter, Amy J; Deselms, JoAnn; Ruyle, Shelley; Morrissey-Lucas, Marcella; Kollar, Suzie; Cannon, Shelly; Schick, Lois

    2012-02-01

    Despite advocacy by professional nursing organizations, no randomized controlled trials (RCTs) have evaluated the response of family members to a visit with an adult patient during a postanesthesia care unit (PACU) stay. Therefore, the purpose of this RCT was to evaluate the impact of a brief PACU visitation on the anxiety of family members. The study was conducted in a phase I PACU of a large community-based hospital. Subjects were designated adult family members or significant others of an adult PACU patient who had undergone general anesthesia. A pretest-posttest RCT design was used. The dependent variable was the change in anxiety scores of the visitor after seeing his or her family member in the PACU. Student t test (unpaired, two tailed) was used to determine if changes in anxiety scores (posttest score-pretest score) were different for the PACU visit and no visit groups. A total of 45 participants were studied over a 3-month period, with N=24 randomly assigned to a PACU visit and N=21 assigned to usual care (no PACU visit). Participants in the PACU visit group had a statistically significant (P=.0001) decrease in anxiety after the visitation period (-4.11±6.4); participants in the usual care group (no PACU visit) had an increase in anxiety (+4.47±6.6). The results from this study support the value and importance of PACU visitation for family members.

  6. Chair Professors and Visiting Professors of "Chang Jiang Scholars Program"

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    In responding to the ongoing development needs of the university, we are seeking to recruit Chair Professors and Visiting Professors of "Chang Jiang Scholars Program" at home and abroad. School of Medicine, Tsinghua University

  7. Hospital readmission after emergency room visit for cholelithiasis.

    Science.gov (United States)

    Williams, Taylor P; Dimou, Francesca M; Adhikari, Deepak; Kimbrough, Thomas D; Riall, Taylor S

    2015-08-01

    For patients presenting with symptomatic cholelithiasis, cholecystectomy is the definitive treatment modality. Our goal was to evaluate the surgical follow-up and outcomes in patients seen in the emergency department (ED) for an episode of symptomatic cholelithiasis and discharged home for elective follow-up. We performed a retrospective review of consecutive patients seen in the ED for cholelithiasis and discharged without hospital admission between August 2009 and May 2014. All patients were followed for 2 y from the date of the initial ED visit. We evaluated outpatient surgeon visits, elective and emergent cholecystectomy rates, and additional ED visits. Cumulative incidence and Kaplan-Meier curves were used to examine the time from the initial ED visit to outpatient surgeon evaluation and the time from the initial ED visit to ED readmission. Seventy-one patients were discharged from the ED with a diagnosis of symptomatic gallstones. Patients who had an elective cholecystectomy in the 2 y after the initial visit were 12.6%. In this group, the mean time from the initial ED visit to outpatient surgeon follow-up was 7.7 d, and all elective cholecystectomies occurred within 1 mo of the initial visit. Of the 62 patients who did not have an elective cholecystectomy, only 14.5% of patients in this group had outpatient surgeon follow-up at mean time of 137 d from the initial ED visit for symptomatic gallstones. In addition, 37.1% of patients in this group had additional ED visits for gallstone-related symptoms, with 17.7% of patients having two or more additional ED visits, and 12.9% required emergent and/or urgent cholecystectomy. Additional ED visits (43.5%) occurred within 1 mo and 60.9% within 3 mo of their initial ED visit. In patients with additional ED visits for symptomatic cholelithiasis, 60.9% had more than one abdominal ultrasound or computed tomography scan during the course of multiple visits. Failure to achieve a timely surgical follow-up leads to multiple

  8. What children do on the Internet: domains visited and their relationship to socio-demographic characteristics and academic performance.

    Science.gov (United States)

    Jackson, Linda A; Samona, Ricky; Moomaw, Jeff; Ramsay, Lauren; Murray, Christopher; Smith, Amy; Murray, Lindsay

    2007-04-01

    HomeNetToo is a longitudinal field study designed to examine the antecedents and consequences of home Internet use in low-income families. Participants included 140 children, mostly 13-year-old African American (83%) boys (58%), living in single-parent households (75%) where the median annual income was $15,000 (USD). This report focuses on children's Internet activities, socio-demographic characteristics related to their Internet activities, and the relationship between academic performance and Internet activities. Overall, findings indicate that low-income children initially use the Internet primarily for entertainment. As home Internet use loses its novelty children become more focused in their Internet activities, reducing the number of websites they visit and visiting more websites targeted to their specific interests. Pornography websites are popular initially, especially among boys, but their popularity decreases dramatically after 3 months. Age, race, and sex have little influence on which websites are most popular. Academic performance predicts subsequent Internet activities, and Internet activities predict subsequent academic performance. Directions for future research to identify mechanisms that mediate the relationship between Internet activities and academic performance and implications for the digital divide are discussed.

  9. Common cold - how to treat at home

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000466.htm Common cold - how to treat at home To use ... this page, please enable JavaScript. Colds are very common. A visit to your health care provider's office ...

  10. Integrated working between residential care homes and primary care: a survey of care homes in England

    Science.gov (United States)

    2012-01-01

    Background Older people living in care homes in England have complex health needs due to a range of medical conditions, mental health needs and frailty. Despite an increasing policy expectation that professionals should operate in an integrated way across organisational boundaries, there is a lack of understanding between care homes and the National Health Service (NHS) about how the two sectors should work together, meaning that residents can experience a poor "fit" between their needs, and services they can access. This paper describes a survey to establish the current extent of integrated working that exists between care homes and primary and community health and social services. Methods A self-completion, online questionnaire was designed by the research team. Items on the different dimensions of integration (funding, administrative, organisational, service delivery, clinical care) were included. The survey was sent to a random sample of residential care homes with more than 25 beds (n = 621) in England in 2009. Responses were analysed using quantitative and qualitative methods. Results The survey achieved an overall response rate of 15.8%. Most care homes (78.7%) worked with more than one general practice. Respondents indicated that a mean of 14.1 professionals/ services (other than GPs) had visited the care homes in the last six months (SD 5.11, median 14); a mean of .39 (SD.163) professionals/services per bed. The most frequent services visiting were district nursing, chiropody and community psychiatric nurses. Many (60%) managers considered that they worked with the NHS in an integrated way, including sharing documents, engaging in integrated care planning and joint learning and training. However, some care home managers cited working practices dictated by NHS methods of service delivery and priorities for care, rather than those of the care home or residents, a lack of willingness by NHS professionals to share information, and low levels of respect for

  11. Integrated working between residential care homes and primary care: a survey of care homes in England

    Directory of Open Access Journals (Sweden)

    Gage Heather

    2012-11-01

    Full Text Available Abstract Background Older people living in care homes in England have complex health needs due to a range of medical conditions, mental health needs and frailty. Despite an increasing policy expectation that professionals should operate in an integrated way across organisational boundaries, there is a lack of understanding between care homes and the National Health Service (NHS about how the two sectors should work together, meaning that residents can experience a poor "fit" between their needs, and services they can access. This paper describes a survey to establish the current extent of integrated working that exists between care homes and primary and community health and social services. Methods A self-completion, online questionnaire was designed by the research team. Items on the different dimensions of integration (funding, administrative, organisational, service delivery, clinical care were included. The survey was sent to a random sample of residential care homes with more than 25 beds (n = 621 in England in 2009. Responses were analysed using quantitative and qualitative methods. Results The survey achieved an overall response rate of 15.8%. Most care homes (78.7% worked with more than one general practice. Respondents indicated that a mean of 14.1 professionals/ services (other than GPs had visited the care homes in the last six months (SD 5.11, median 14; a mean of .39 (SD.163 professionals/services per bed. The most frequent services visiting were district nursing, chiropody and community psychiatric nurses. Many (60% managers considered that they worked with the NHS in an integrated way, including sharing documents, engaging in integrated care planning and joint learning and training. However, some care home managers cited working practices dictated by NHS methods of service delivery and priorities for care, rather than those of the care home or residents, a lack of willingness by NHS professionals to share information, and low

  12. Commissaire Moulin visits CERN

    CERN Multimedia

    CERN Bulletin

    2014-01-01

    The French actor and film-maker Yves Rénier was shown around the Laboratory on Friday 6 June by friends at CERN.   Yves Rénier at LEIR. (Photo: Ludwig Pregernig) A keen diver and star of the long-running French television police drama Commissaire Moulin, Yves Rénier took advantage of a stopover in Geneva on his way to the Red Sea to meet up with his friends from the CERN Diving Club, who were only too pleased to take him on a tour of the Laboratory. In the morning, Yves Rénier visited the CERN Control Centre (CCC), Linac2 and LEIR. After lunch at the brasserie in Restaurant No. 2, the actor continued his tour with the CERN Computer Centre, the SM18 superconducting magnet test facility, and lastly the ATLAS experiment. “Thank you so much for showing me around and introducing me to a world I knew so little about,” confided Yves Rénier. “It’s fascinating to see so many scientists of different cultures,...

  13. A royal visit

    CERN Multimedia

    2009-01-01

    On 19 February Albert II, King of the Belgians, visited CERN. He took a very active interest during his tour of the tunnel and the CMS cavern, in particular the pixel detector, which was made in Belgium. var flash_video_player=get_video_player_path(); insert_player_for_external('Video/Public/Movies/2009/CERN-MOVIE-2009-002/CERN-MOVIE-2009-002-0753-kbps-640x360-25-fps-audio-64-kbps-44-kHz-stereo', 'mms://mediastream.cern.ch/MediaArchive/Video/Public/Movies/2009/CERN-MOVIE-2009-002/CERN-MOVIE-2009-002-Multirate-200-to-753-kbps-640x360-25-fps.wmv', 'false', 533, 300, 'https://mediastream.cern.ch/MediaArchive/Video/Public/Movies/2009/CERN-MOVIE-2009-002/CERN-MOVIE-2009-002-posterframe-640x360-at-10-percent.jpg', '1164771', true, 'Video/Public/Movies/2009/CERN-MOVIE-2009-002/CERN-MOVIE-2009-002-0600-kbps-maxH-360-25-fps-audio-128-kbps-48-kHz-stereo.mp4'); Watch the video! Albert II, King of the Belgians receiving a souvenir from Sergio Bertolucci, Director for Research and...

  14. Claude Nicollier visits CERN

    CERN Multimedia

    Jordan Juras

    2011-01-01

    Switzerland’s first astronaut, Claude Nicollier, paid a short visit to CERN on Thursday 22 June, to lead a colloquium about the Hubble Space Telescope. With the Shuttle programme soon coming to an end. Nicollier recalled the enriching experience he had at NASA and gave us a preview of the futuristic project that he is currently involved in.   The colloquium, Hubble, the astronomer, the telescope, the results, surveyed the three themes suggested by its title: the fundamental discoveries made by Edwin Hubble in the early 20th century, servicing the telescope in orbit and the main results recently obtained relating to the structure and history of our universe. Nicollier spoke from the rare perspective of an astronaut who has had real contact with Hubble in orbit and included some of his own photography from the missions. Nicollier has an intimate relationship with the telescope that very few astrophysicists share. “I had the opportunity to service Hubble twice, both from the comf...

  15. Monthly errors

    Data.gov (United States)

    U.S. Environmental Protection Agency — The 2006 monthly average statistical metrics for 2m Q (g kg-1) domain-wide for the base and MODIS WRF simulations against MADIS observations. This dataset is...

  16. Texas First Dental Home: A Snapshot after Five Years.

    Science.gov (United States)

    Solomon, Eric S; Voinea-Griffin, Andreea E

    2015-06-01

    Early caries is still the most prevalent disease of childhood. Its incidence continues to be high, despite recent progress in the amount of untreated caries. The disease is more prevalent in low socio-economic and minority groups. To address this issue, in 2008 Texas implemented the First Dental Home Program for Medicaid children from 6 to 35 months old. The program consists in providing up to 10 preventive and oral health education visits to children very early in life. A specific dental visit code and a bundled payment of $94 were offered to insure adequate dental provider participation. Little is known about the program results to date. This paper evaluates program development at 5 years. Two data sets on first dental home patients and providers were obtained from the Texas Department of Health Services. The data cover a 5-year period (3rd quarter of 2008 to end of 2nd quarter 2013). Program participants were geocoded and their distribution was compared to dental underserved areas. Program uptake over time and the relationship between provider and patient locations were also evaluated. The program covered 440,191 children between September 1st, 2011 and February 28th, 2013. All but two counties in Texas had at least one patient enrolled in the program. As expected, program uptake was higher in highly populated and economically disadvantaged counties. Forty-five percent of Texas licensed dentists participated in the program. The number of dental providers certified to provide first dental home services was highly correlated with the number of patients enrolled in the program (r = 0.893). The number of children participating in the program was between 20.4% and 23%. 29.7% of the first dental home patients had only one visit while only 17.1% had five or more visits. The number of patients and the number of visits per patient peaked at the end of 2011 and flatten thereafter. Many children benefited from the program since its rollout. However, despite considerable

  17. Scientific Inquiry into Home Electronic Technology Usage

    Science.gov (United States)

    Lazaros, Edward J.; Spotts, Thomas H.; Verdon, Jessica E.

    2010-01-01

    This activity promotes ways to save electricity in the home. Students identify electronic devices in the home and examine wattage, hours of use per month, estimated wattage per month, kilowatt hours per month, average retail price per kilowatt hour in each state, and the estimated cost per month. Students gain an appreciation for how saving power…

  18. Using oxygen at home

    Science.gov (United States)

    Oxygen - home use; COPD - home oxygen; Chronic obstructive airways disease - home oxygen; Chronic obstructive lung disease - home oxygen; Chronic bronchitis - home oxygen; Emphysema - home oxygen; Chronic respiratory ...

  19. The Home Care Crew Scheduling Problem:

    DEFF Research Database (Denmark)

    Rasmussen, Matias Sevel; Justesen, Tor; Dohn, Anders

    In the Home Care Crew Scheduling Problem a staff of caretakers has to be assigned a number of visits to patients' homes, such that the overall service level is maximised. The problem is a generalisation of the vehicle routing problem with time windows. Required travel time between visits and time...... windows of the visits must be respected. The challenge when assigning visits to caretakers lies in the existence of soft preference constraints and in temporal dependencies between the start times of visits. We model the problem as a set partitioning problem with side constraints and develop an exact...... branch-and-price solution algorithm, as this method has previously given solid results for classical vehicle routing problems. Temporal dependencies are modelled as generalised precedence constraints and enforced through the branching. We introduce a novel visit clustering approach based on the soft...

  20. Hospitalization and emergency department visits among seniors receiving homecare: a pilot study

    Directory of Open Access Journals (Sweden)

    Abernathy Tom

    2005-07-01

    Full Text Available Abstract Background Despite the recent growth in home health services, data on clinical outcomes and acute health care utilization among older adults receiving homecare services are sparse. Obtaining such data is particularly relevant in Ontario where an increasing number of frail seniors receiving homecare are awaiting placement in long-term care facilities. In order to determine the feasibility of a large-scale study, we conducted a pilot study to assess utilization of acute health care services among seniors receiving homecare to determine associated clinical outcomes. Methods This prospective cohort study followed forty-seven seniors admitted to homecare by two homecare agencies in Hamilton, Ontario over a 12-month period. Demographic information and medical history were collected at baseline, and patients were followed until either termination of homecare services, death, or end of study. The primary outcome was hospitalization. Secondary outcomes included emergency department visits that did not result in hospitalization and death. Rates of hospitalization and emergency department visits without admission were calculated, and univariate analyses were performed to test for potential risk factors. Survival curves for accumulative rates of hospitalization and emergency department visits were created. Results 312 seniors were eligible for the study, of which 123 (39% agreed to participate initially. After communicating with the research nurse, of the 123 who agreed to participate initially, 47 (38% were enrolled in the study. Eleven seniors were hospitalized during 3,660 days of follow-up for a rate of 3.0 incident hospitalizations per 1,000 homecare-days. Eleven seniors had emergency department visits that did not result in hospitalization, for a rate of 3.3 incident emergency department visits per 1,000 homecare-days. There were no factors significantly associated with hospitalization or emergency department visits when adjustment was made

  1. Hanford Laboratories monthly activities report, August 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-09-16

    This is the monthly report for the Hanford Laboratories Operation, August 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  2. Hanford Laboratories monthly activities report, July 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-08-15

    This is the monthly report for the Hanford Laboratories Operation, July 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  3. Hanford Laboratories monthly activities report, June 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-07-15

    This is the monthly report for the Hanford Laboratories Operation, June 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  4. Hanford Laboratories monthly activities report, September 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-10-15

    This is the monthly report for the Hanford Laboratories Operation, September 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  5. Hanford Laboratories monthly activities report, October 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-11-15

    This is the monthly report for the Hanford Laboratories Operation, October 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  6. Hanford Laboratories monthly activities report, November 1963

    Energy Technology Data Exchange (ETDEWEB)

    1963-12-16

    This is the monthly report for the Hanford Laboratories Operation, November 1963. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  7. Effectiveness of Comprehensive Geriatric Assessment-Based Intervention to Reduce Frequent Emergency Department Visits: A Report of Four Cases

    Directory of Open Access Journals (Sweden)

    Mei-Chen Liao

    2012-06-01

    Full Text Available A small number of clustered visits by emergency department frequent users (EDFUs may over-consume emergency care resources. We report the effectiveness of comprehensive geriatric assessment (CGA-based multidisciplinary team (MDT care for four EDFUs, in reducing ED visits. Case 1 had visited the ED twice/month due to chest discomfort. Her ED visits were significantly reduced to 0.2 visits/month following CGA-based MDT care. Case 2 had failed back surgery syndrome and bipolar disorder. His ED visit was reduced from 2.8 visits to 0.8 visits/month following CGA-based MDT intervention. Case 3 had chronic obstructive pulmonary disease, heart failure, and urinary incontinence, with a urinary catheter in place. He made 31 ED visits (5.1 visits/month before his lung cancer and depression were discovered by CGA. He died 2 months later. Case 4 made 27 ED visits (2.7 visits/month due to dizziness. His problems of early dementia and neglect were identified by CGA, and he visited the ED only once following MDT intervention. In conclusion, CGA-based MDT intervention successfully reduced ED visits among these EDFUs, but further investigation is needed to evaluate the effectiveness of geriatric services in the ED.

  8. Outcomes of Follow-Up Visits to Chronic Nonmalignant Pain Patients

    DEFF Research Database (Denmark)

    Sørensen, Jan

    2010-01-01

    and randomized to intervention or control group. Intervention group patients (n = 52) received home visits every fourth month for 2 years. The findings showed that HRQoL improved generally more in the intervention group. Statistically significant improvements were observed for physical function and bodily pain....... Whereas the intervention group maintained the pain level on a visual analog scale, the control group reported more pain. During the observation period, the control group increased dosage of opioids whereas the intervention group maintained stable dosage. No significant effect on quality of life was found...... pain after discharge from multidisciplinary pain treatment. The intervention improved physical functioning, reduced bodily pain and pain intensity and prevented opioid dosage increase. Most episodes of depression were identified and referred to relevant treatment....

  9. 150 Bulgarian students visit CERN

    CERN Multimedia

    Alizée Dauvergne

    2010-01-01

    Between 27 March and 8 April 2010, 150 Bulgarian students from the Astronomical Observatory in Varna visited CERN as part of the “From Galileo to CERN” programme. Bulgarian students participating in the "From Galileo to CERN" educational programme. “It’s interesting to combine astronomy and particle physics”, explains Svejina Dimitrova, organiser of the programme and Director of Varna Astronomical Observatory. The three groups, each one comprising 50 students, first visited Pisa, Padua and other places in Italy  related to Galileo’s life. “Thanks to the visit, students understood telescopes and why Galileo is such an important scientist”, says Svejina. After Italy, they came to CERN for three days and visited several sites: Linac, the Computer Centre CCC, etc. Another group of Bulgarian students in their visit to CERN. “They became aware that particle physics is not only the...

  10. Homing oneself

    DEFF Research Database (Denmark)

    Winther, Ida Wentzel

    2009-01-01

    expands on the notion that home indicates more than a house, but also responds to the overuse of the concept home. The aim of this article is to examine how home is done, stretched between everyday life, practices, dreams, loss and cultural ideas of home. My intention is not to remove home......, but to revitalize it to prevent it from turning into a pell-mell or a zombie (Beck 1999). This is important because we are moving away from the hegemonic idea of one home to the tactics of feeling at home, even in more mobile ways. The study is cross-disciplinary, drawing on cultural phenomenology, the history...

  11. Early home visitation in families at risk for child maltreatment

    NARCIS (Netherlands)

    Bouwmeester-Landweer, Merian Bride Rafael

    2006-01-01

    Raising a child is no easy task. Nevertheless Dutch parents do not get offered help with childrearing untill they ask for it or demonstrable problems have developed – at the expense of the child. Particularly parents with ‘excess bagage’ – for instance a troubled childhood, personal problems or a sm

  12. The impact of systematic dietary counseling during the first year of life on prevalence rates of anemia and iron deficiency at 12-16 months.

    Science.gov (United States)

    Bortolini, Gisele Ane; Vitolo, Márcia Regina

    2012-01-01

    To evaluate the impact that a program based on maternal dietary counseling covering breastfeeding and healthy complementary feeding had on the prevalence of iron deficiency, anemia and iron deficiency anemia in children aged 12 to 16 months. Newborn infants were randomized at birth to an intervention or a control group. Mothers in the intervention group received home visits during the children's first year of life on a monthly basis up to 6 months, and at 8, 10 and 12 months. The mothers in the control group received visits for data collection when children reached 6 and 12 months. All children were visited at ages between 12 and 16 months and 24-hour dietary recalls and hemoglobin and ferritin tests were conducted. There was no evidence that the intervention had an effect on anemia incidence, which was 66.5% in the intervention group and 61.8% in the control group. There was also no evidence of any difference between the groups in the prevalence of iron deficiency anemia or of iron deficiency. However, a higher percentage of children in the intervention group were exclusively breastfed at 4 and 6 months, and breastfed at 6 and 12 months. Intervention group children also consumed more meat and were fed diets with better iron bioavailability and consumed less cow's milk and calcium than children from the control group. This intervention had no effect on the prevalence of anemia, iron deficiency or iron deficiency anemia. Clinical trial registry identification number: NCT00629629.

  13. Hospital selection of home infusion therapy companies as preferred providers.

    Science.gov (United States)

    Rich, D S; Ayers, N

    1992-07-01

    The process by which a hospital selected home infusion therapy providers is described. Administrators at a 379-bed teaching hospital decided to attempt to reduce the high mean length of stay by expanding the use of home infusion therapy. Direct diversification into this field by the hospital was not feasible, so it was decided to establish contractual agreements with providers. A task force was appointed to evaluate and choose vendors in the area and to increase the number of patient referrals. The task force examined reports on past experience with providers, price lists, the range and level of services offered, and the amount of free care given and visited the companies' facilities. The group designated three providers as preferred and two as unacceptable. The number of patients referred increased from 21 during the 12 months before the task force was convened to 46 in the first 9 months afterward, for a saving of 2198 patients days. After one year the task force met again to consider company requests for evaluation or reevaluation, establish a plan for publicizing the benefits of home infusion therapy, and replace the site visits with a requirement for accreditation by the Joint Commission. After two years, the task force developed provider-evaluation criteria to streamline the process and reflect the experience gained. The responsibility for reviewing providers was transferred to the P&T committee. When a direct venture into home infusion therapy is not fiscally desirable, contracting for services can still offer the advantages of reduced length of stay and decreased drug expenses.

  14. Ensuring Quality Nursing Home Care

    Science.gov (United States)

    ... your healthcare provider about your medications, symptoms, and health problems. May 2013 Ensuring Quality Nursing Home Care Expert information from Healthcare Professionals Who Specialize in the Care of Older Adults After you’ve placed your family member in a facility KEEP VISITING! Seeing family ...

  15. [Assessment of our home care and home palliative care].

    Science.gov (United States)

    Midorikawa, Yasuhiko; Suzushino, Seiko; Tamotsu, Kiyokazu

    2014-12-01

    We conducted home care and home palliative care from the department of home care. We provided home care services to 190 patients(105 men, 85 women)in October 2013. Their average age was 78.7(range: 32-102)years old, and home care had been underway from 1 day to 8 years, 10 months. Among all participants, 168(88.4%)suffered from malignant diseases, 168 patients had died, and over half of deceased patients(88 out of 168)had died at home. We used opioids for control of cancer pain, carried out home parenteral nutrition(HPN), home enteral nutrition(HEN), percutaneous endoscopic gastrostomy( PEG), and removed pleural effusion and ascites during home care. In order to facilitate the practice of palliative care by the palliative care team, which consists of various medical staff in the hospital, we are giving high priority to education and enlightenment in the hospital. To provide enlightenment, education, and cooperation between regional home care and home palliative care, we are also conducting educational lectures in the regional party of the Iwaki city medical associate, and providing combined educational-medical training for home care and home palliative care by various medical staff.

  16. Protected Area Tourism in a Changing Climate: Will Visitation at US National Parks Warm Up or Overheat?

    Directory of Open Access Journals (Sweden)

    Nicholas A Fisichelli

    Full Text Available Climate change will affect not only natural and cultural resources within protected areas but also tourism and visitation patterns. The U.S. National Park Service systematically collects data regarding its 270+ million annual recreation visits, and therefore provides an opportunity to examine how human visitation may respond to climate change from the tropics to the polar regions. To assess the relationship between climate and park visitation, we evaluated historical monthly mean air temperature and visitation data (1979-2013 at 340 parks and projected potential future visitation (2041-2060 based on two warming-climate scenarios and two visitation-growth scenarios. For the entire park system a third-order polynomial temperature model explained 69% of the variation in historical visitation trends. Visitation generally increased with increasing average monthly temperature, but decreased strongly with temperatures > 25°C. Linear to polynomial monthly temperature models also explained historical visitation at individual parks (R2 0.12-0.99, mean = 0.79, median = 0.87. Future visitation at almost all parks (95% may change based on historical temperature, historical visitation, and future temperature projections. Warming-mediated increases in potential visitation are projected for most months in most parks (67-77% of months; range across future scenarios, resulting in future increases in total annual visits across the park system (8-23% and expansion of the visitation season at individual parks (13-31 days. Although very warm months at some parks may see decreases in future visitation, this potential change represents a relatively small proportion of visitation across the national park system. A changing climate is likely to have cascading and complex effects on protected area visitation, management, and local economies. Results suggest that protected areas and neighboring communities that develop adaptation strategies for these changes may be able

  17. Protected Area Tourism in a Changing Climate: Will Visitation at US National Parks Warm Up or Overheat?

    Science.gov (United States)

    Fisichelli, Nicholas A; Schuurman, Gregor W; Monahan, William B; Ziesler, Pamela S

    2015-01-01

    Climate change will affect not only natural and cultural resources within protected areas but also tourism and visitation patterns. The U.S. National Park Service systematically collects data regarding its 270+ million annual recreation visits, and therefore provides an opportunity to examine how human visitation may respond to climate change from the tropics to the polar regions. To assess the relationship between climate and park visitation, we evaluated historical monthly mean air temperature and visitation data (1979-2013) at 340 parks and projected potential future visitation (2041-2060) based on two warming-climate scenarios and two visitation-growth scenarios. For the entire park system a third-order polynomial temperature model explained 69% of the variation in historical visitation trends. Visitation generally increased with increasing average monthly temperature, but decreased strongly with temperatures > 25°C. Linear to polynomial monthly temperature models also explained historical visitation at individual parks (R2 0.12-0.99, mean = 0.79, median = 0.87). Future visitation at almost all parks (95%) may change based on historical temperature, historical visitation, and future temperature projections. Warming-mediated increases in potential visitation are projected for most months in most parks (67-77% of months; range across future scenarios), resulting in future increases in total annual visits across the park system (8-23%) and expansion of the visitation season at individual parks (13-31 days). Although very warm months at some parks may see decreases in future visitation, this potential change represents a relatively small proportion of visitation across the national park system. A changing climate is likely to have cascading and complex effects on protected area visitation, management, and local economies. Results suggest that protected areas and neighboring communities that develop adaptation strategies for these changes may be able to both

  18. Economic analysis of a pragmatic randomised trial of home visits by a nurse to elderly people with hypertension in Mexico Análisis económico de un ensayo clínico aleatorizado de visitas de enfermera en casa a ancianos con hipertensión en México

    Directory of Open Access Journals (Sweden)

    Carmen García-Peña

    2002-01-01

    Full Text Available Objective. To analyse the costs and the effectiveness of an intervention of home visits made by nurses to elderly people versus usual care given by the family medicine units. Material and Methods. A sample of 4 777 subjects aged 60 years and over covered by the Mexican Institute of Social Security (Instituto Mexicano del Seguro Social, IMSS were screened. Those with a systolic and/or diastolic blood pressure level higher or equal than 160/90 mm Hg were randomly allocated to the intervention or control groups. The intervention consisted of visits at home by nurses who gave health and lifestyle advice to the participants. The economic evaluation was considered from a health services and patient perspective. Direct and indirect costs were calculated as incremental. Effectiveness was measured in terms of cost per millimetre of mercury reduced. Results. Three hundred and forty five participants were allocated to the intervention group and compared with 338 controls. At the end of the intervention period the difference in the mean change in systolic blood pressure was 3.31 mm Hg (95% CI 6.32, 0.29; p=0.03 comparing with the control group. In diastolic blood pressure the difference was 3.67 (95% CI 5.22, 2.12; pObjetivo. Analizar los costos y la efectividad de una intervención basada en visitas de enfermería en casa a ancianos hipertensos comparada con el tratamiento usual otorgado por el médico familiar. Material y métodos. Una muestra de 4 777 sujetos de 60 años y más derechohabientes del Instituto Mexicano del Seguro Social (IMSS fueron sometidos a escrutinio. Aquellos con cifras sistólica o diastólica iguales o superiores a 160/90 mm Hg fueron asignados aleatoriamente al grupo de intervención o al control. La intervención consistió en visitas de enfermera en casa que daban promoción de la salud. La evaluación económica fue considerada desde una perspectiva del paciente y de los servicios de salud. Costos directos e indirectos fueron

  19. 外来务工青年群体节假日返乡探望父母情况的调研分析——以武汉市外来务工的青年群体为例%The Analysis of Research on the Migrant Youth Group Which Would Return Home to Visit Parents during the Holidays——Samples Were Taken from the Migrant Youth Group in Wuhan City

    Institute of Scientific and Technical Information of China (English)

    王文卓

    2015-01-01

    The regulation about"Going home more often"was issued in the revised"Senior citizens' relative rights and in-terests protection Law of the P.R.C."in 2013, and it has drawn extensive attention and heated discussion in the whole society. How is the situation of"Going home more often"of the migrant workers? The author tried to use migrant youth group in Wuhan city as the samples to have the research about their situation of going home to visit the parents during the holidays, to analyze the results based on the current situation, and propose effective measures to solve it.%2013年新修订的《中华人民共和国老年人权益保障法》关于"常回家看看"的规定,引起了社会广泛关注和热烈讨论.外来务工者"常回家看看"情况究竟怎样?笔者以武汉市外来务工的青年群体为样本,就其节假日返乡探望父母的情况进行了调查研究,结合返乡探亲现状剖析原因,并提出了有效的解决途径.

  20. SM18 Visits and Access

    CERN Multimedia

    2012-01-01

      VISITS The rules and conditions to be followed for visits in the SM18 Hall are laid out in the EDMS 1205328 document. No visit is allowed without prior reservation.   ACCESS Special access right is needed ONLY from 7 p.m. to 7 a.m. and during week-ends. From 1 December, the current SM18 access database will be closed and a new one “SM18-OWH outside normal hours” started from scratch. Requests, via EDH SM18-OWH, will have to be duly justified.   For further information, please contact Evelyne Delucinge.

  1. Prospective study on cost-effectiveness of home-based motor assessment in Parkinson's disease.

    Science.gov (United States)

    Cubo, E; Mariscal, N; Solano, B; Becerra, V; Armesto, D; Calvo, S; Arribas, J; Seco, J; Martinez, A; Zorrilla, L; Heldman, D

    2017-02-01

    Introduction Treatment adjustments in Parkinson's disease (PD) are in part dependent on motor assessments. The aim of this study was to evaluate the cost-effectiveness of home-based motor monitoring plus standard in-office visits versus in-office visits alone in patients with advanced PD. Methods The procedures consisted of a prospective, one-year follow-up, randomized, case-control study. A total of 40 patients with advanced PD were randomized into two groups: 20 patients underwent home-based motor monitoring by using wireless motion sensor technology, while the other 20 patients had in-office visits. Motor and non-motor symptom severities, quality of life, neuropsychiatric symptoms, and comorbidities were assessed every four months. Direct costs were assessed using a standardized questionnaire. Cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER). Results Both groups of PD patients were largely comparable in their clinical and demographic variables at baseline; however, there were more participants using levodopa-carbidopa intestinal gel in the home-based motor monitoring group. There was a trend for lower Unified Parkinson's Disease Rating Scale functional status (UPDRS II) scores in the patients monitored at home compared to the standard clinical follow-up ( p = 0.06). However, UPDRS parts I, III, IV and quality-adjusted life-years scores were similar between both groups. Home-based motor monitoring was cost-effective in terms of improvement of functional status, motor severity, and motor complications (UPDRS II, III; IV subscales), with an ICER/UPDRS ranging from €126.72 to €701.31, respectively. Discussion Home-based motor monitoring is a tool which collects cost-effective clinical information and helps augment health care for patients with advanced PD.

  2. Communication between key stakeholders within a medical home: a qualitative study.

    Science.gov (United States)

    Nelson, Catherine S; Tandon, S Darius; Duggan, Anne K; Serwint, Janet R

    2009-04-01

    The objective of this study was to determine perceived benefits, detriments, and barriers to communication between pediatric providers and home visitors. The authors performed a cross-sectional, qualitative study consisting of 3 focus groups with paraprofessional home visitors (n=12), 6 with parents receiving home visiting (n=33), and 4 with pediatric providers whose patients received home visiting (n=19). Emerging themes were generated by an inductive analytic approach. Perceived benefits included home visitors assisting parents with communication, giving providers family information, and reinforcing providers' guidance. Detriments included parental concern of sharing confidential information and providers becoming aware of family issues for which they are unprepared to act. Barriers included parental consent, logistics of home visitor-provider communication, and providers' lack of knowledge about home visitor programs/roles. Greater coordination between home visitation programs and pediatric providers may strengthen home visiting services and reinforce advice and anticipatory guidance given by providers.

  3. Children’s Exposure to Secondhand and Thirdhand Smoke Carcinogens and Toxicants in Homes of Hookah Smokers

    Science.gov (United States)

    Daffa, Reem M.; Liles, Sandy; Jackson, Sheila R.; Kassem, Noura O.; Younis, Maram A.; Mehta, Setoo; Chen, Menglan; Jacob, Peyton; Carmella, Steve G.; Chatfield, Dale A.; Benowitz, Neal L.; Matt, Georg E.; Hecht, Stephen S.; Hovell, Melbourne F.

    2014-01-01

    Introduction: We examined homes of hookah-only smokers and nonsmokers for levels of indoor air nicotine (a marker of secondhand smoke) and indoor surface nicotine (a marker of thirdhand smoke), child uptake of nicotine, the carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK), and the toxicant acrolein by analyzing their corresponding metabolites cotinine, 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) and NNAL-glucuronides (total NNAL) and 3-hydroxypropylmercapturic acid. Methods: Data were collected at 3 home visits during a 7-day study period from a convenience sample of 24 households with a child 5 years or younger. Three child urine samples and 2 air and surface samples from the living room and the child bedroom were taken in homes of nonsmokers (n = 5) and hookah-only smokers (n = 19) comprised of daily hookah smokers (n = 8) and weekly/monthly hookah smokers (n = 11). Results: Nicotine levels in indoor air and on surfaces in the child bedrooms in homes of daily hookah smokers were significantly higher than in homes of nonsmokers. Uptake of nicotine, NNK, and acrolein in children living in daily hookah smoker homes was significantly higher than in children living in nonsmoker homes. Uptake of nicotine and NNK in children living in weekly/monthly hookah smoker homes was significantly higher than in children living in nonsmoker homes. Conclusions: Our data provide the first evidence for uptake of nicotine, the tobacco-specific lung carcinogen NNK, and the ciliatoxic and cardiotoxic agent acrolein in children living in homes of hookah smokers. Our findings suggest that daily and occasional hookah use in homes present a serious, emerging threat to children’s long-term health. PMID:24590387

  4. Examining the cost-effectiveness of early dental visits.

    Science.gov (United States)

    Lee, Jessica Y; Bouwens, Thomas J; Savage, Matthew F; Vann, William F

    2006-01-01

    The subject of early dental visits as an integral dimension of anticipatory guidance and the related supporting scientific evidence for this concept is a critical and timely issue for the dental profession. The purpose of this paper was to review the scientific evidence and rationale for early dental visits. In theory, early dental visits can prevent disease and reduce costs. During the age 1 dental visit, there is strong emphasis on prevention and parents are given: (1) counseling on infant oral hygiene; (2) home and office-based fluoride therapies; (3) dietary counseling; and (4) information relative to oral habits and dental injury prevention. There is evidence that the early preventive visits can reduce the need for restorative and emergency care, therefore reducing dentally related costs among high-risk children. Preschool Medicaid children who had an early preventive dental visit by age 1 were more likely to use subsequent preventive services and experienced less dentally related costs. These finding have significant policy implications, and more research is needed to examine this effect in a low-risk population.

  5. What Happens during Prenatal Visits?

    Science.gov (United States)

    ... at risk for complications? How does stress affect pregnancy? NICHD Research Information Clinical Trials Resources and Publications What happens during prenatal visits? Skip sharing on social media links Share this: Page Content What happens during ...

  6. Doctor, Clinic, and Dental Visits

    Science.gov (United States)

    ... Viral Suppression Doctor, Clinical & Dental Visits Treatment Adherence Mental Health Substance Abuse Issues Sexual Health Nutrition & Food Safety Exercise Immunizations Aging with HIV/AIDS Women’s Health Housing ...

  7. Skylab mission report, third visit

    Science.gov (United States)

    1974-01-01

    An evaluation is presented of the operational and engineering aspects of the third Skylab visit, including information on the performance of the command and service module and the experiment hardware, the crew's evaluation of the visit, and other visit-related areas of interest such as biomedical observations. The specific areas discussed are contained in the following: (1) solar physics and astrophysics investigations; (2) Comet Kohoutek experiments; (3) medical experiments; (4) earth observations, including data for the multispectral photographic facility, the earth terrain camera, and the microwave radiometer/scattermometer and altimeter; (5) engineering and technology experiments; (6) food and medical operational equipment; (7) hardware and experiment anomalies; and (8) mission support, mission objectives, flight planning, and launch phase summary. Conclusions discussed as a result of the third visit to Skylab involve the advancement of the sciences, practical applications, the durability of man and systems in space, and spaceflight effectiveness and economy.

  8. Tests and visits before surgery

    Science.gov (United States)

    Before surgery - tests; Before surgery - doctor visits ... Pre-op is the time before your surgery. It means "before operation." During this time, you will meet with one of your doctors. This may be your surgeon or primary care ...

  9. 75 FR 54447 - National Alcohol and Drug Addiction Recovery Month, 2010

    Science.gov (United States)

    2010-09-07

    ... Cancer Awareness Month, 2010 Proclamation 8552--National Prostate Cancer Awareness Month, 2010..., failure in school, job loss, child abuse, crimes, and death. I encourage all Americans to visit...

  10. Visit of Spanish Government delegation

    CERN Multimedia

    CERN PhotoLab

    1982-01-01

    A Spanish Government delegation visited CERN before Spain rejoined CERN as a Member State(in 1983). Delegates interested in advanced technologies visited the ISR workshop clean room, where Romeo Perin explained fabrication and properties of stainless steel, titanium and inconel components of vacuum chambers for experiments at the ISR. Left to right: Technical Director Giorgio Brianti, the Spanish Minister of Industry and Energy Mr.Ignacio Bayon Marine , Romeo Perin, a delegate and Director-General Herwig Schopper. See also 8202369.

  11. WILL I AM visits CERN

    CERN Multimedia

    Noemi Caraban

    2013-01-01

    Will.i.am visited CERN in December 2013, fulfilling a wish he made in a video-link appearance at TEDxCERN earlier that year http://tedxcern.web.cern.ch/video/choral-performance-reach-stars-william. During his visit, he was shown the Antimatter Decelerator, the underground ATLAS experiment cavern and the CERN Control Centre. He also took the opportunity to promote CERN’s beam line for schools competition.

  12. Researchers Night in Portugal, featuring CMS Virtual Visit

    CERN Multimedia

    Lisbon, Portugal

    2016-01-01

    Highlights from European Researchers Night in the Planetarium Calouste Gulbenkian - Ciência Viva Centre. Organised by researchers from LIP (Laboratório de Instrumentação e Física Experimental de Partículas) and including CMS Virtual Visit. During that night, André David Tinoco Mendez and José Rasteiro da Silva, based at Cessy (France) - home of the CMS detector, discussed scientific challenges with audience in Lisbon.

  13. Development of knowledge about electricity and magnetism during a visit to a science museum and related post-visit activities

    Science.gov (United States)

    Anderson, David; Lucas, Keith B.; Ginns, Ian S.; Dierking, Lynn D.

    2000-09-01

    This article reports on part of a larger study of how 11- and 12-year-old students construct knowledge about electricity and magnetism by drawing on aspects of their experiences during the course of a school visit to an interactive science museum and subsequent classroom activities linked to the science museum exhibits. The significance of this study is that it focuses on an aspect of school visits to informal learning centers that has been neglected by researchers in the past, namely the influence of post-visit activities in the classroom on subsequent learning and knowledge construction. This study provides evidence that the integrated series of post-visit activities resulted in students constructing and reconstructing their personal knowledge of science concepts and principles represented in the science museum exhibits, sometimes toward the accepted scientific understanding and sometimes in different and surprising ways. A descriptive interpretive approach was adopted, with principal data sources comprising student-generated concept maps and semistructured interviews at three stages of the study. Findings demonstrate the interrelationships between learning that occurs at school, home, and in informal learning settings. The study also underscores for classroom teachers and staff of science museums and similar centers the importance of planning pre- and post-visit activities. The importance of this planning is not only to support the development of scientific conceptions, but also to detect and respond to alternative conceptions that may be produced or strengthened during a visit to an informal learning center.

  14. 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....

  15. Indoor air quality in green-renovated vs. non-green low-income homes of children living in a temperate region of US (Ohio)

    Energy Technology Data Exchange (ETDEWEB)

    Coombs, Kanistha C. [University of Cincinnati, Department of Environmental Health, P.O. Box 670056, Cincinnati, OH (United States); Chew, Ginger L. [Centers for Disease Control and Prevention (CDC), National Center for Environmental Health, Air Pollution and Respiratory Health Branch, 4770 Buford Hwy., N.E., MS-F60, Atlanta, GA (United States); Schaffer, Christopher [University of Cincinnati, Department of Environmental Health, P.O. Box 670056, Cincinnati, OH (United States); Ryan, Patrick H. [University of Cincinnati, Department of Environmental Health, P.O. Box 670056, Cincinnati, OH (United States); Department of Pediatrics, Cincinnati Children' s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH (United States); Brokamp, Cole; Grinshpun, Sergey A. [University of Cincinnati, Department of Environmental Health, P.O. Box 670056, Cincinnati, OH (United States); Adamkiewicz, Gary [Harvard University, T.H. Chan School of Public Health, Department of Environmental Health, 401 Park Drive, Boston, MA (United States); Chillrud, Steve [Columbia University, Lamont-Doherty Earth Observatory, Geochemistry Division, P.O. Box 8000, Palisades, New York (United States); Hedman, Curtis [University of Wisconsin-Madison, Wisconsin State Laboratory of Hygiene, 465 Henry Mall, Madison, WI (United States); Colton, Meryl [Harvard University, T.H. Chan School of Public Health, Department of Environmental Health, 401 Park Drive, Boston, MA (United States); Ross, Jamie [Columbia University, Lamont-Doherty Earth Observatory, Geochemistry Division, P.O. Box 8000, Palisades, New York (United States); Reponen, Tiina [University of Cincinnati, Department of Environmental Health, P.O. Box 670056, Cincinnati, OH (United States)

    2016-06-01

    Green eco-friendly housing includes approaches to reduce indoor air pollutant sources and to increase energy efficiency. Although sealing/tightening buildings can save energy and reduce the penetration of outdoor pollutants, an adverse outcome can be increased buildup of pollutants with indoor sources. The objective of this study was to determine the differences in the indoor air quality (IAQ) between green and non-green homes in low-income housing complexes. In one housing complex, apartments were renovated using green principles (n = 28). Home visits were conducted immediately after the renovation, and subsequently at 6 months and at 12 months following the renovation. Of these homes, eight homes had pre-renovation home visits; this allowed pre- and post-renovation comparisons within the same homes. Parallel visits were conducted in non-green (control) apartments (n = 14) in a nearby low-income housing complex. The IAQ assessments included PM{sub 2.5}, black carbon, ultrafine particles, sulfur, total volatile organic compounds (VOCs), formaldehyde, and air exchange rate. Data were analyzed using linear mixed-effects models. None of the indoor pollutant concentrations were significantly different between green and non-green homes. However, we found differences when comparing the concentrations before and after renovation. Measured immediately after renovation, indoor black carbon concentrations were significantly lower averaging 682 ng/m{sup 3} in post-renovation vs. 2364 ng/m{sup 3} in pre-renovation home visits (p = 0.01). In contrast, formaldehyde concentrations were significantly higher in post-renovated (0.03 ppm) than in pre-renovated homes (0.01 ppm) (p = 0.004). Questionnaire data showed that opening of windows occurred less frequently in homes immediately post-renovation compared to pre-renovation; this factor likely affected the levels of indoor black carbon (from outdoor sources) and formaldehyde (from indoor sources) more than the renovation status

  16. 38 CFR 52.40 - Monthly payment.

    Science.gov (United States)

    2010-07-01

    ..., domiciliary or hospital care). These forms are set forth in full at 38 CFR 58.12 and 58.13, respectively. If... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Per Diem Payments § 52.40 Monthly payment. (a)(1... day health care for each day the veteran is in a facility recognized as a State home for adult...

  17. Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes.

    Science.gov (United States)

    Poss, Jeffrey W; Sinn, Chi-Ling Joanna; Grinchenko, Galina; Blums, Jane; Peirce, Tom; Hirdes, John

    2017-02-01

    We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients. Copyright © 2017 Longwoods Publishing.

  18. Palliative care team visits. Qualitative study through participant observation

    Directory of Open Access Journals (Sweden)

    María del Mar Alfaya Góngora

    2016-04-01

    Full Text Available Objectives:To describe the clinical encounters that occur when a palliative care team provides patient care and the features that influence these encounters and indicate whether they are favorable or unfavorable depending on the expectations and feelings of the various participants.Methods:A qualitative case study conducted via participant observation. A total of 12 observations of the meetings of palliative care teams with patients and families in different settings (home, hospital and consultation room were performed. The visits were follow-up or first visits, either scheduled or on demand. Content analysis of the observation was performed.Results:The analysis showed the normal follow-up activity of the palliative care unit that was focused on controlling symptoms, sharing information and providing advice on therapeutic regimens and care. The environment appeared to condition the patients' expressions and the type of patient relationship. Favorable clinical encounter conditions included kindness and gratitude. Unfavorable conditions were deterioration caused by approaching death, unrealistic family objectives and limited resources.Conclusion:Home visits from basic palliative care teams play an important role in patient and family well-being. The visits seem to focus on controlling symptoms and are conditioned by available resources.

  19. Nursing Homes

    Science.gov (United States)

    ... newsletter! Aging & Health A to Z Nursing Homes Basic Facts & Information Nursing homes have changed dramatically over the past several ... how accessible are they? How close is the nursing home to family members? How close ... much do basic services cost? What services are covered? What additional ...

  20. UN Secretary General visits CERN

    CERN Multimedia

    2008-01-01

    UN Secretary General praises CERN in recent visit. Ban Ki-moon, Robert Aymar, CERN Director-General, and Sergei Ordzhonikidze, Director-General of the United Nations Office in Geneva at the CMS site.On Sunday 31 August, Ban Ki-moon, the UN Secretary General, made an important visit to CERN. Arriving in the late afternoon, he was warmly greeted at Point 5 by Robert Aymar, the Director-General, and the Sous-préfet of Gex, Olivier Laurens-Bernard. Accompanied by a UN delegation, Ban Ki-moon was also introduced to Jos Engelen, the Chief Scientific Officer, and Jim Virdee, the CMS spokesperson. He then took the opportunity to visit CMS and the machine tunnel. At the end of his short trip, Ban Ki-moon signed the Guest Book in the tradition of important dignitaries visiting CERN. Expressing his admiration for CERN’s spirit of collaboration, Ban Ki-moon said, "I am very honored to visit CERN, an invaluable scientific institution a...

  1. A study to evaluate the intervention of a nurse visiting patients with disabling chest disease in the community.

    Science.gov (United States)

    Heslop, A P; Bagnall, P

    1988-01-01

    This paper describes the work of two nurses visiting patients with chronic respiratory disease at home. The outcome measures suggested that there were fewer deaths in the nurses' group but failed to show any changes in quality of life. The nurses chose the nursing model devised by Roper et al. as a framework for their intervention. Initial assessment by the nurses showed the patients had a number of problems which could be grouped into physical health, knowledge, psychosocial and social. The nurses' monthly visits were used to assist the patients to plan strategies for resolving their problems. Advice was directed at helping patients promote and control their own health and measurable goals were set. Most of the patients achieved the goals set, valued the visits and said they wished them to continue. Psychosocial problems proved most difficult to solve. Patients' knowledge was demonstrated to have increased. A nursing audit found the patients had received 'excellent' quality of care. The nursing method used in this study would be appropriate for such work as it focuses attention on the individual patient and his problems. Application of this approach will require education and support for nurses.

  2. Visits from Croatia and Belarus

    CERN Multimedia

    2003-01-01

    On 23 September, CERN was visited by two Ministers, Anatoly Rusetsky, Chairman of the Committee on Science and Technology of the Republic of Belarus, and Professor Gvozden Flego, Croatian Minister of Science and Technology. Mr Rusetsky met with Roger Cashmore, Research Director for Collider Programmes, and Michel Della Negra, spokesperson of the CMS experiment, and visited the CMS detector assembly hall. Professor Flego also met Mr Cashmore and visited the NA49 and CAST experiments, the LHC superconducting magnet test hall, the ALICE experiment cavern, and the assembly hall for the CMS experiment. From left to right: Nikola Godinovic, working at CMS, Jürgen Schukraft, ALICE spokesperson, Gordan Markotic, Ambassador and Permanent Representative of Croatia to the United Nations and other international organisations in Geneva, Professor Gvozden Flego, Minister of Science and Technology, Republic of Croatia.

  3. A Finnish delegation visits CERN

    CERN Multimedia

    2001-01-01

    Minister Maija Rask (front, centre) led a Finnish delegation on a visit to CERN last week. Here the delegation inspects CMS preparations with the collaboration's spokesman Michel Della Negra (front, left). On 19 February Finnish Minister of Education, Mrs Maija Rask, visited CERN. She led a delegation composed of Mr. Pekka Huttaniemi, Permanent Representative of Finland to the United Nations, Mrs Pirjo Välinoro, Ministerial Counsellor (Economic affairs), Mr Markku Linna, Director General of the Ministry of Education, and Mr Tapio Kosunen, Special Adviser at the Ministry. Accompanied by Director General Luciano Maiani, the delegation visited CMS experiment and the LHC superconducting magnet test hall, and met Finnish students and scientists at CERN.

  4. Visit of the Italian President

    CERN Document Server

    2003-01-01

    "CERN stands as the demonstration of the great results that science can achieve [...] when it succeeds in getting all the main players in international scientific cooperation involved," stated the President of the Italian Republic, Carlo Azeglio Ciampi, in front of an overcrowded and enthusiastic Main Auditorium. The President visited CERN on 2nd December, and met the CERN directorate as well as the Italians at CERN. With about 1500 Italians working at CERN, which is one sixth of the total personnel, they are the second largest nationality at CERN. The Italian President visited the CMS assembly hall and the LHC superconducting magnet test hall before meeting the CERN community, in particular Italian personnel, in the main auditorium. There he emphasised the role of CERN as a transnational model for research which not only achieved great results in science but is also a powerful vehicle for progress in other fields. President Ciampi visits the LHC superconducting test hall together with Luciano Maiani and Lu...

  5. Italy's Prime Minister visits CERN

    CERN Document Server

    Stefania Pandolfi

    2015-01-01

    On Tuesday, 7 July 2015, the Prime Minister of the Italian Republic, Matteo Renzi, visited CERN. He was accompanied by a delegation that included Italy's Minister for Education, University and Research, Stefania Giannini.   From left to right: Fernando Ferroni, President of the Istituto Nazionale di Fisica Nucleare (INFN); Sergio Bertolucci, CERN Director for Research and Scientific Computing; Stefania Giannini, Italy's Minister of Education, University and Research; Matteo Renzi, Prime Minister of the Italian Republic; Fabiola Gianotti, CERN Director-General Designate; Rolf Heuer, CERN Director-General.   The Prime Minister was welcomed by members of the CERN Management together with former CERN Director-General and Senator for Life of the Italian Republic, Carlo Rubbia. After a brief general introduction to CERN’s activities by Rolf Heuer, the Italian delegation visited LHC Point 1. After a tour of the ATLAS control room, they donned helmets to visit th...

  6. Study protocol: home-based telehealth stroke care: a randomized trial for veterans

    Directory of Open Access Journals (Sweden)

    McGee-Hernandez Nancy

    2010-06-01

    Full Text Available Abstract Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a TR; or (b Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and

  7. Indoor air quality in green-renovated vs. non-green low-income homes of children living in a temperate region of US (Ohio).

    Science.gov (United States)

    Coombs, Kanistha C; Chew, Ginger L; Schaffer, Christopher; Ryan, Patrick H; Brokamp, Cole; Grinshpun, Sergey A; Adamkiewicz, Gary; Chillrud, Steve; Hedman, Curtis; Colton, Meryl; Ross, Jamie; Reponen, Tiina

    2016-06-01

    Green eco-friendly housing includes approaches to reduce indoor air pollutant sources and to increase energy efficiency. Although sealing/tightening buildings can save energy and reduce the penetration of outdoor pollutants, an adverse outcome can be increased buildup of pollutants with indoor sources. The objective of this study was to determine the differences in the indoor air quality (IAQ) between green and non-green homes in low-income housing complexes. In one housing complex, apartments were renovated using green principles (n=28). Home visits were conducted immediately after the renovation, and subsequently at 6 months and at 12 months following the renovation. Of these homes, eight homes had pre-renovation home visits; this allowed pre- and post-renovation comparisons within the same homes. Parallel visits were conducted in non-green (control) apartments (n=14) in a nearby low-income housing complex. The IAQ assessments included PM2.5, black carbon, ultrafine particles, sulfur, total volatile organic compounds (VOCs), formaldehyde, and air exchange rate. Data were analyzed using linear mixed-effects models. None of the indoor pollutant concentrations were significantly different between green and non-green homes. However, we found differences when comparing the concentrations before and after renovation. Measured immediately after renovation, indoor black carbon concentrations were significantly lower averaging 682 ng/m(3) in post-renovation vs. 2364 ng/m(3) in pre-renovation home visits (p=0.01). In contrast, formaldehyde concentrations were significantly higher in post-renovated (0.03 ppm) than in pre-renovated homes (0.01 ppm) (p=0.004). Questionnaire data showed that opening of windows occurred less frequently in homes immediately post-renovation compared to pre-renovation; this factor likely affected the levels of indoor black carbon (from outdoor sources) and formaldehyde (from indoor sources) more than the renovation status itself. To reduce IAQ

  8. Visit of the Austrian Ambassador

    CERN Multimedia

    Patrice Loïez

    2002-01-01

    The Austrian Ambassador Wolfgang Petritsch (light raincoat) learns about superconducting magnets at the LHC magnet test facility in building SM18 during a visit to CERN. The blue pipe-like structure in the left background is String 2: the 120-m long full-scale model of an LHC cell, which is used to test LHC systems.

  9. ATLAS Visit of Indian President

    CERN Multimedia

    2005-01-01

    Welcomed by CERN's Director General, Robert Aymar, the President of India Dr. A.P.J. Abdul Kalam visited the LHC tunnel, the ATLAS experimental cavern and the test facility for the LHC magnets. There the President had the chance to meet Indian scientists working at CERN.

  10. CPAFFC Delegation Visits New Zealand

    Institute of Scientific and Technical Information of China (English)

    Xu; Fenghua

    2016-01-01

    In early December 2015,a CPAFFC delegation,with representatives from six departments,visited New Zealand at the host’s invitation.Members conducted work exchanges with the New Zealand-China Maori Friendship Trust and held talks with the

  11. Dr. John Marburger visits DESY

    CERN Multimedia

    2003-01-01

    Dr. John Marburger, Director of the United States Office of Science and Technology Policy, visited the research center DESY in Hamburg. The American physicist wanted to inform himself about the status of the TESLA X-ray laser and the TESLA linear collider as well as the international collaboration at DESY (1/2 page).

  12. Visit of UK Prime Minister

    CERN Multimedia

    1982-01-01

    Wolfgang Schnell shows a prototype LEP r.f. accelerating cavity with a superposed storage cavity to U.K. Head of Government Mrs.Margareth Thatcher during her visit to CERN. Behind Mrs.Thatcher one can see CERN Director General Herwig Schopper.

  13. A Modern Visit to Galileo

    Science.gov (United States)

    Freilich, Florence G.

    1970-01-01

    Describes the author's visit to the Italian cities where Galileo lived. Discusses the legendary swinging Cathedral lamp and the Leaning Tower of Pisa. Describes the science apparatus used by Galileo and other men of science which appear in the Museum of the History of Science in Florence. Presents six pictures of items viewed within the museum.…

  14. “VICO”, Visiting Colleagues

    CERN Multimedia

    Staff Association

    2017-01-01

    “Hello, I am your delegate” – have you heard this line? Maybe you have already had the pleasure of receiving a visit from a Staff Association delegate – then you know what this is all about. As for those of you, who have not yet heard these words, it’s time to get curious. The Staff Association has decided to embark upon an adventure called “VICO”, Visiting Colleagues. From past experience, we have understood the value of personal, direct contact with the people we represent. We believe that the best way to achieve this is to knock on your office door and pay you a short visit.  We do not want to make you fill in yet another online questionnaire and would much rather collect your feedback in a short conversation face to face. Of course, we have prepared ourselves thoroughly for these visit rounds, because we do not want to waste your time. We welcome criticism because it can make us aware of our shortcomings, tell us about how y...

  15. Gall's visit to The Netherlands

    NARCIS (Netherlands)

    Eling, Paul; Draaisma, Douwe; Conradi, Matthijs

    2011-01-01

    In March 1805, Franz Joseph Gall left Vienna to start what has become known as his cranioscopic tour. He traveled through Germany, Denmark, and The Netherlands. In this article, we will describe his visit to The Netherlands in greater detail, as it has not yet received due attention. Gall was eager

  16. Gall's Visit to The Netherlands

    NARCIS (Netherlands)

    Eling, P.A.T.M.; Draaisma, D.; Conradi, M.

    2011-01-01

    In March 1805, Franz Joseph Gall left Vienna to start what has become known as his cranioscopic tour. He traveled through Germany, Denmark, and The Netherlands. In this article, we will describe his visit to The Netherlands in greater detail, as it has not yet received due attention. Gall was eager

  17. Should Care Visits Be Enforced?

    Institute of Scientific and Technical Information of China (English)

    2011-01-01

    The China National Committee on Ageing recently announced the revision of the law which protects the rights of elderly people was completed. Among the revised sections,a provision that grown-up children will have to visit society’s elderly seniors more often was included in the draft law.

  18. President of Ecuador visits CERN

    CERN Multimedia

    Rosaria Marraffino

    2014-01-01

    On Friday, 24 October, Dr. Rafael Correa Delgado, President of the Republic of Ecuador, visited CERN.   Visiting Geneva to deliver a lecture at the UN, Ecuadorian President Rafael Correa Delgado seized the chance to have a short but intense visit of the Laboratory. The President was met at LHC Point 1 by the Director for Research and Scientific Computing Sergio Bertolucci, who gave him an introduction to CERN’s activities.He was also introduced to the Director for Accelerators and Technology, Frédérick Bordry, and Department Heads José Miguel Jiménez (TE), Livio Mapelli (PH) and Roberto Saban (EN). President Correa Delgado also met with Martijn Mulders, co-organiser of the CERN Latin America School of High-Energy Physics, which will be held in Ecuador from 4 to 17 March 2015. Shortly after that, he visited the ATLAS experimental cavern which he toured with ATLAS Collaboration Spokesperson David Charlton and Fernando Monticelli of t...

  19. [Home falls in infants before walking acquisition].

    Science.gov (United States)

    Claudet, I; Gurrera, E; Honorat, R; Rekhroukh, H; Casasoprana, A; Grouteau, E

    2013-05-01

    Minor head trauma is frequent among infants and leads to numerous visits to emergency departments for neurological assessment to evaluate the value of cerebral CT scan with the risk for traumatic brain injuries (TBI). To analyze the epidemiological characteristics of nonwalking infants admitted after falling at home and to analyze associated factors for skull fractures and TBI. Between January 2007 and December 2011, all children aged 9 months or younger and admitted after a home fall to the pediatric emergency unit of a tertiary children's hospital were included. The data collected were age, sex, weight and height, body mass index; geographic origin, referral or direct admission, mode of transportation; month, day and time of admission; causes of the fall, alleged fall height, presence of an eyewitness, type of landing surface; Glasgow Coma Scale (GCS) score, application of the head trauma protocol, location and type of injuries, cerebral CT scan results, length of hospital stay, progression, and neglect or abuse situations. DESCRIPTIVE ANALYSIS: within the study period, 1910 infants were included. Fifty-four percent of children were aged less than 6 months with a slight male prevalence (52%). Falls from parental bed and infant carriers accounted for the most frequent fall circumstances. GCS score on admission was equal to 14 or 15 in 99% of cases. A cerebral CT scan was performed in 34% of children and detected 104 skull fractures and 55 TBI. Infants aged less than 1 month had the highest rate of TBI (8.5%). Eleven percent of patients were hospitalized. A situation of abuse was identified in 51 infants (3%). UNIVARIATE ANALYSIS: Male children and infants aged less than 3 months had a higher risk of skull fractures (P = 0.03 and P = 0.0003, respectively). In the TBI group, children were younger (3.8 ± 2.6 months versus 5.4 ± 2.5 months, P walking acquisition, children are particularly vulnerable and have the highest rate of TBI after a vertical fall. In this age

  20. Home Enteral Nutrition therapy: Difficulties, satisfactions and support needs of caregivers assisting older patients.

    Science.gov (United States)

    Jukic P, Nikolina; Gagliardi, Cristina; Fagnani, Donata; Venturini, Claudia; Orlandoni, Paolo

    2017-08-01

    The purpose of this study was to comprehend and describe the views, experiences and adaptations of caregivers who assist older patients treated with Home Enteral Nutrition. The objective was to gather empirical evidence to improve the delivery of Home Enteral Nutrition for old patients taking into account the caregivers' support needs. A qualitative methodology with focus groups as data collection method was used to collect the testimonies of 30 informal and formal caregivers of older patients treated with Home Enteral Nutrition by the Clinical Nutrition Service of INRCA (Ancona) during 2014. Quantitative methodology was used to collect socio-demographic data. Partially modified Silver's "Home Enteral Nutrition Caregiver Task Checklist" was used to identify training needs. The constant comparison method was used to code and categorize data and to develop themes of focus groups. Simple descriptive statistics were used to summarize questionnaires. Five main themes were identified from focus groups: acceptance of the therapy, skill acquisition process, need for psychological and practical support at home from healthcare professionals, lifestyle adaptation, affirmation of life and family. All caregivers testified the initial fear and refusal to manage the nutrition pump and the therapy. They expressed the need to be trained gradually, starting during a patient's hospitalization, and continuing in the community. With reference to their overall QoL, it emerged that informal caregivers suffered mostly from the reduction of their free time while formal caregivers suffered social isolation and psychological burden. For both groups the monthly home visit was the most important element of the HEN service. Informal caregivers highlighted the importance of having their loved ones at home. Unsatisfied training needs were identified by the modified Silver's "Home Enteral Nutrition Caregiver Task Checklist". This qualitative study underlined the challenges and adaptations of

  1. Home front.

    Science.gov (United States)

    2001-04-04

    Ninety-year-old Ivy Tabberer protested against the closure of her care home at the Houses of Parliament last week. She was joined by fellow residents in the Havering Action Against Home Closures group and three generations of her family. Ms Tabberer is pictured with daughter Doreen Walpole (left), granddaughter Annette (far right) and great granddaughter Shereen (middle). 'If all the homes close,' said Ms Tabberer, 'where are we going to stay?'

  2. 28 CFR 540.41 - Visiting facilities.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 2 2010-07-01 2010-07-01 false Visiting facilities. 540.41 Section 540... WITH PERSONS IN THE COMMUNITY Visiting Regulations § 540.41 Visiting facilities. The Warden shall have... have a portion of the visiting room equipped and set up to provide facilities for the children of...

  3. Home Care

    Science.gov (United States)

    ... triggering an emergency response or checkup phone call. Healthcare professionals are finding that portable or mobile testing technology (home diagnostics), including x-rays and electrocardiograms (ECGs), ...

  4. Disseminating Childhood Home Injury Risk Reduction Information in Pakistan: Results from a Community-Based Pilot Study

    Directory of Open Access Journals (Sweden)

    Adnan A. Hyder

    2013-03-01

    Full Text Available Background: Most childhood unintentional injuries occur in the home; however, very little home injury prevention information is tailored to developing countries. Utilizing our previously developed information dissemination tools and a hazard assessment checklist tailored to a low-income neighborhood in Pakistan, we pilot tested and compared the effectiveness of two dissemination tools. Methods: Two low-income neighborhoods were mapped, identifying families with a child aged between 12 and 59 months. In June and July 2010, all enrolled households underwent a home hazard assessment at the same time hazard reduction education was being given using an in-home tutorial or a pamphlet. A follow up assessment was conducted 4–5 months later. Results: 503 households were enrolled; 256 received a tutorial and 247 a pamphlet. The two groups differed significantly (p < 0.01 in level of maternal education and relationship of the child to the primary caregiver. However, when controlling for these variables, those receiving an in-home tutorial had a higher odds of hazard reduction than the pamphlet group for uncovered vats of water (OR 2.14, 95% CI: 1.28, 3.58, an open fire within reach of the child (OR 3.55, 95% CI: 1.80, 7.00, and inappropriately labeled cooking fuel containers (OR 1.86, 95% CI: 1.07, 3.25. Conclusions: This pilot project demonstrates the potential utility of using home-visit tutorials to decrease home hazards in a low-income neighborhood in Pakistan. A longer-term randomized study is needed to assess actual effectiveness of the use of allied health workers for home-based injury education and whether this results in decreased home injuries.

  5. A Fleet of Low-Cost Sensor Based Air Quality Monitors Is Used to Measure Carbon Dioxide and Carbon Monoxide in Two Settings: In the Ambient Environment to Explore the Regional-Scale Spatial Variability of These Compounds Via a Distributed Network, and in Homes to Investigate How Heating during Winter Months can Impact Indoor Air Quality.

    Science.gov (United States)

    Casey, J. G.; Hannigan, M.; Collier, A. M.; Coffey, E.; Piedrahita, R.

    2016-12-01

    Affordable, small, portable, quiet tools to measure atmospheric trace gases and air quality enable novel experimental design and new findings. Members of the Hannigan Lab at the University of Colorado in Boulder have been working over the last few years to integrate emerging affordable gas sensors into such an air quality monitor. Presented here are carbon monoxide (CO) and carbon dioxide (CO2) measurements from two field experiments that utilized these tools. In the first experiment, ten air quality monitors were located northeast of Boulder throughout the Denver Julesburg oil and gas basin. The Colorado Department of Health and Environment has several air quality monitoring sites in this broader region, each in an Urban center. One goal of the experiment was to determine whether or not significant spatial variability of EPA criteria pollutants like CO, exists on a sub-regulatory monitoring grid scale. Another goal of the experiment was to compare rural sampling locations with urban sites. The monitors collected continuous data (sampling every 15 seconds) at each location over the course of several months. Our sensor calibration procedures are presented along with our observations and an analysis of the spatial and temporal variability in CO and CO2. In the second experiment, we used eight of our air quality monitors to better understand how home heating fuel type can impact indoor air quality in two communities on the Navajo Nation. We sought to compare air quality in homes using one of four different fuels for heat (wood, wood plus coal, pellet, and gas). There are many factors that contribute to indoor air quality and the impact of an emission source, like a woodstove, within a home. Having multiple, easily deployable, air quality monitors allowed us to account for many of these factors. We sampled four homes at a time, aiming for one home from each of our fuel groups in each sampling period. We sampled inside and outside of each home for a period of 3-4 days

  6. Two pioneering artists visit CERN

    CERN Multimedia

    CERN Bulletin

    2015-01-01

    On Monday, 19 January, CERN physicists welcomed musician Tim Blake - progressive rock keyboard and theremin player - and architectural lighting designer Patrice Warrener - inventor of the Chromolithe Polychromatic Illumination system, used in Lyon’s “Fête des Lumières”. Together, they make up the musical duo "Crystal Machine".   The artists visit the Antiproton Decelerator. (Image: Django Manglunki.)   Their visit began with an introduction to CERN by their friend Django Manglunki, project leader for the ion injector chain, and an improvised discussion on the LHC extraction system with Roger Barlow, kicker magnet controls expert and progressive rock fan. This was followed by a quick trip to the CCC, the server room and the SPS RF amplifiers in BA3. Next on the itinerary was a tour of the AD and anti-hydrogen experiments led by Michael Doser, AEgIS Spokesperson. A leisurely lunch followed, in the company ...

  7. An Algerian Minister visits CERN

    CERN Multimedia

    2006-01-01

    The Algerian Minister of Higher Education and Scientific Research, Rachid Haraoubia, visited CERN on 14 November. His party included the Rector of the University of Blida and the Director of the Algerian Ecole Nationale Polytechnique. Welcomed by CERN's Director-General, Robert Aymar, and Secretary-General, Maximilien Metzger, he signed the VIP Visitors' Book before going on to visit the ATLAS experiment and the LHC tunnel. He then had the opportunity to meet Algerian scientists working at CERN. Some fifteen Algerian physicists attached to European and US institutes are participating in the LHC experiments, in particular ATLAS. A formal collaboration agreement between Algeria and CERN is expected to be drawn up in the near future.

  8. CPAFFC Delegation Visits French Polynesia

    Institute of Scientific and Technical Information of China (English)

    YinShenglun

    2004-01-01

    At the invitation of Gaston Flosse, president of the Government of French Polynesia, a CPAFFC delegation headed by CPAFFC President Chen Haosu and Vice President Su Guang paid a goodwill visit to French Polynesia in September 2003. The Government of French Polynesia attached great importance to the visit. During their stay there, the delegation exchanged views with President Flosse many times on promoting friendship and cooperation between the Chinese and French Polynesian peoples. Both sides unanimously held that to promote friendship and strengthen cooperation are the common aspiration of the Chinese and French Polynesian people, which is conducive to the prosperity and development of the two sides and world peace. The delegation had extensive contacts with highranking officials and personages of various circles, and achieved its purpose of strengthening understanding, enhancing friendship and promoting cooperation.

  9. Young EIROforum prizewinner visits CERN

    CERN Multimedia

    CERN Bulletin

    2015-01-01

    On 27 to 31 July, CERN welcomed Paul Clarke, an 18-year-old Irish mathematician who won a CERN EIROforum prize (second place) at EUCYS 2014 (European Union Contest for Young Scientists).   Paul Clarke, visiting the new Microcosm exhibit. In addition to a €5000 prize, Paul visited the Laboratory and its experiments, meeting and speaking with CERN physicists and computer scientists. Paul's winning project is entitled "Contributions to cyclic graph theory." As the summary of the project suggests, graph theory is an area of pure mathematics which studies properties of linkages and networks. It has applications in several areas including computing, molecular structure, neuroscience, search engines, engineering etc. This project makes a profound contribution to the study of graphs. It identifies key concepts and provides the methodology to apply them to some long-standing major problems in the subject with great success. Paul has just finished high sc...

  10. A Croatian delegation visits CERN

    CERN Multimedia

    2001-01-01

    Professor Hrvoje Kraljeviç signing the Golden book with Professor Roger Cashmore. A Croatian delegation composed of the Minister of Science and Technology, Professor Hrvoje Kraljeviç, his deputy for international collaboration Prof. Davor Butkovic have visited CERN on the 12 and 13th of February and held talks with the CERN authorities, ALICE and CMS spokespersons on the possibilities to increase the participation of Croatia to the LHC related activities.

  11. NGO Work Committee Visits Beijing

    Institute of Scientific and Technical Information of China (English)

    1994-01-01

    ON June 27, 19 members of the Work Committee of the UN FWCW’s 1995 NGO Forum on Women arrived in Beijing. During their five-day visit in the capital they talked with representatives from the host country about preparations for the forum, the meeting place, facilities and other relevant matters. Huang Qizao, Vice-Chairperson of the FWCW’s China Organizing Committee, Committee Director of the NGO Forum and

  12. A Visit to the CPAFFC

    Institute of Scientific and Technical Information of China (English)

    2014-01-01

    <正>The participants of the China International Friendship Conference in Commemoration of the 60th Anniversary of the CPAFFC took part in the Open House activities—visiting the exhibitions on the history and the collection of paintings and art works of the CPAFFC,watching the documentary on 60 years of people-to-people diplomacy,getting together with Chinese friends old and new—at the CPAFFC compound on the afternoon of May 14.

  13. US Cub Scouts visit CERN

    CERN Multimedia

    2001-01-01

    A group of young American Cub Scouts from Den 10, Pack 130 (based in Geneva) at the Microcosm last Saturday. On their trip to CERN, which included the first Visits Service tour of the ATLAS construction site, the scouts were able to satisfy most of the requirements for the Cub Scout engineering badge. From left to right: Edouard Vincent, Ariel Litke, Alexander Richter, Antoine Vidal de Saint Phalle, Jason Iredale and Daniel Reghelini.

  14. Prospective Multicenter Study of Bronchiolitis: Predictors of an Unscheduled Visit After Discharge From the Emergency Department

    Science.gov (United States)

    Norwood, Agatha; Mansbach, Jonathan M.; Clark, Sunday; Waseem, Muhammad; Camargo, Carlos A.

    2012-01-01

    Objectives There is little evidence about which children with bronchiolitis will have worsened disease after discharge from the emergency department (ED). The objective of this study was to determine predictors of post-ED unscheduled visits. Methods The authors conducted a prospective cohort study of patients discharged from 2004 to 2006 at 30 EDs in 15 U.S. states. Inclusion criteria were diagnosis of bronchiolitis, age bronchiolitis within 2 weeks. Results Of 722 patients eligible for the current analysis, 717 (99%) had unscheduled visit data, of whom 121 (17%; 95% confidence interval [CI] = 14% to 20%) had unscheduled visits. Unscheduled visits were more likely for children age 0.10). Using multivariable logistic regression, independent predictors of unscheduled visits were age bronchiolitis, one of six children had unscheduled visits within 2 weeks of ED discharge. The three predictors of unscheduled visits were age under 2 months, male sex, and previous hospitalization. PMID:20370776

  15. Providing Prisoners' Children a Home

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    TEN years ago, Zhang Shuqin, a police inspector I in Shaanxi, visited a special family by chance. In this family, both the husband and wife were serving prison sentences, leaving five children and their 70-year-old granny at home. In their shabby cave dwelling, there was some cardboard on the bedframe instead of mattress and blankets. The old woman was coughing violently and the four-year-old girl was

  16. Referral patterns in elderly emergency department visits

    Directory of Open Access Journals (Sweden)

    Alessandra Buja

    2013-12-01

    Full Text Available OBJECTIVE: To assess elderly individuals' demand for emergency department (ED care, in terms of the characteristics, processes, outcomes, costs by referral pattern. DATA SOURCE: All ED visits involving patients aged 65 and older, extracted from the 2010 dataset of an Local Health Agency, in North-Eastern Italy (no. = 18 648. STUDY DESIGN: Retrospective cohort study. PRINCIPAL FINDINGS: Patients were referred by primary care professionals (PCPs in 43.1% of cases, 1.4% came from nursing homes (NH, and 55.5% were self-referred (SR. The SR group had a higher adjusted odds ratio (aOR for non-urgent conditions (1.98 CI 1.85-2.12, but a lower aOR for conditions amenable to ambulatory care (0.53 CI 0.48-0.59, and a lower consumption of resources. The SR group tend to occur more frequently out of hours, and to coincide with a shorter stay at the ED, lower observation unit activation rates, lower hospitalization rates and a lower consumption of services than other two groups. The average costs for all procedures were lower for the SR patients (mean = 106.04 € ± SD 84.90 € than for those referred by PCPs (mean = 138.14 € ± SD 101.17 € or NH (mean = 143.48 € ± SD 95.28 €. CONCLUSION: Elderly patients coming in ED have different characteristics, outcomes and recourses consume by referral pattern.

  17. Incorporating OASIS into the Visiting Nurses Association.

    Science.gov (United States)

    Clark, L L

    1998-01-01

    Beginning in 1994, the Visiting Nurses Association, Western Pennsylvania, began to investigate incorporating an outcome measurement system within its organization for the purposes of marketing quality results, benchmarking achievements, and defining quality of care for both internal and external review groups. In the fall of 1995, this agency was accepted into the Outcome Based Quality Improvement (OBQI) Demonstration Project, also known as the Medicare Quality Assurance Project, which the Health Care Financing Administration has funded for the purpose of measuring clinical and utilization outcomes in the home care arena. This article reviews the processes the agency used to develop and incorporate the entire OBQI process into its systems, including the incorporation of the Outcome Assessment Information Set (OASIS). The OASIS is a set of outcome measurement questions developed by Dr. Peter Shaughnessy at the Center for Health Policy Research in Denver. The process also includes training of staff and development of forms, point-of-care software with a vendor, and plans of action for improving outcomes that have been quantified through OBQI efforts.

  18. Early uptake of HIV clinical care after testing HIV-positive during home-based testing and counseling in western Kenya.

    Science.gov (United States)

    Medley, Amy; Ackers, Marta; Amolloh, Manase; Owuor, Patrick; Muttai, Helen; Audi, Beryl; Sewe, Manquins; Laserson, Kayla

    2013-01-01

    Home-based HIV testing and counseling (HBTC) has the potential to increase access to HIV testing. However, the extent to which HBTC programs successfully link HIV-positive individuals into clinical care remains unclear. To determine factors associated with early enrollment in HIV clinical care, adult residents (aged ≥13 years) in the Health and Demographic Surveillance System in Kisumu, Kenya were offered HBTC. All HIV-positive residents were referred to nearby HIV clinical care centers. Two to four months after HBTC, peer educators conducted home visits to consenting HIV-positive residents. Overall, 9,895 (82 %) of 12,035 residents accepted HBTC; 1,087 (11 %) were HIV-positive; and 737 (68 %) received home visits. Of those receiving home visits, 42 % reported HIV care attendance. Factors associated with care attendance included: having disclosed, living with someone attending HIV care, and wanting to seek care after diagnosis. Residents who reported their current health as excellent or who doubted their HBTC result were less likely to report care attendance. While findings indicate that HBTC was well-received in this setting, less than half of HIV-positive individuals reported current care attendance. Identification of effective strategies to increase early enrollment and retention in HIV clinical care is critical and will require coordination between testing and treatment program staff and systems.

  19. Interactive home telehealth and burns: A pilot study.

    Science.gov (United States)

    Hickey, Sean; Gomez, Jason; Meller, Benjamin; Schneider, Jeffery C; Cheney, Meredith; Nejad, Shamim; Schulz, John; Goverman, Jeremy

    2017-06-19

    The objective of this study is to review our experience incorporating Interactive Home Telehealth (IHT) visits into follow-up burn care. A retrospective review of all burn patients participating in IHT encounters over the course of 15 months was performed. Connections were established through secure video conferencing and call-routing software. Patients connected with a personal computer or tablet and providers connected with a desktop computer with a high-definition web camera. In some cases, high-definition digital images were emailed to the provider prior to the virtual consultation. For each patient, the following was collected: (1) patient and injury demographics (diagnosis, prognosis, and clinical management), (2) total number of encounters, (3) service for each encounter (burn, psychiatry, and rehabilitation), (4) length of visit, including travel distance and time saved and, (5) complications, including re-admissions and connectivity issues. 52 virtual encounters were performed with 31 patients during the first year of the pilot project from March 2015 to June 2016. Mean age of the participant was 44 years (range 18-83 years). Mean total burn surface area of the participant was 12% (range 1-80%). Average roundtrip travel distance saved was 188 miles (range 4-822 miles). Average round trip travel time saved was 201min (range 20-564min). There were no unplanned re-admissions and no complications. Five connectivity issues were reported, none of which prevented completion of the visit. Interactive Home Telehealth is a safe and feasible modality for delivering follow-up care to burn patients. Burn care providers benefit from the potential to improve outpatient clinic utilization. Patients benefit from improved access to multiple members of their specialized burn care team, as well as cost-reductions for patient travel expenses. Future studies are needed to ensure patient and provider satisfaction and to further validate the significance, cost-effectiveness and

  20. Newborn care practices and home-based postnatal newborn care programme – Mewat, Haryana, India, 2013

    Directory of Open Access Journals (Sweden)

    Latika Nath Sinha

    2014-09-01

    Full Text Available Background: In India, the Home Based Postnatal Newborn Care programme by Accredited Social Health Activists (ASHAs under the National Rural Health Mission was initiated in 2011 to reduce neonatal mortality rates (NMRs. ASHAs get cash incentives for six postnatal home visits for newborn care. We studied newborn care practices among mothers in Mewat, Haryana, having a high NMR and determined risk factors for unsafe practices and described the knowledge and skills of ASHAs during home visits. Methods: A cross-sectional survey was conducted among mothers who had delivered a child during the previous seven months using cluster sampling. We interviewed mothers and ASHAs in the selected subcentres using semi–structured questionnaires on the six safe newborn care practices, namely safe breastfeeding, keeping cord and eyes clean, wrapping baby, kangaroo care, delayed bathing and hand washing. Results: We interviewed 320 mothers, 61 ASHAs and observed 19 home visits. Overall, 60% of mothers adopted less than three safe practices. Wrapping newborns (96% and delayed bathing (64% were better adopted than cord care (49%, safe breastfeeding (48%, hand washing (30%, kangaroo care (20% and eye care (9%. Cultural beliefs and traditional birth attendants influenced the mother’s practices. The lack of supervision by auxiliary nurse midwives (ANM, delayed referral and transportation were the other challenges. Conclusion: Knowledge–practice gaps existed among mothers counselled by ASHAs. Poor utilization of reproductive and child health services decreased opportunities for ASHA–mother dialogue on safe practices. Recommendations included training ANMs, training TBAs as ASHAs, innovative communication strategies for ASHAs and improved referral system.

  1. A Comparison of Hospital Versus Outpatient Parenteral Antibiotic Therapy at Home for Pyelonephritis and Meningitis.

    Science.gov (United States)

    Hensey, Conor C; Sett, Arun; Connell, Tom G; Bryant, Penelope A

    2017-09-01

    Despite the benefits of home treatment with outpatient parenteral antimicrobial therapy (OPAT), children with pyelonephritis and meningitis are rarely included. We aimed to compare clinical characteristics and outcomes between hospital and home treatment for these conditions and to identify factors influencing home treatment. Children admitted to the hospital with pyelonephritis or proven and presumed bacterial meningitis from January 1, 2012, to December 31, 2013 were identified retrospectively. Patients who received any OPAT (home group) received daily visits via our Hospital-in-the-Home (HITH) program; inpatients (hospital group) received standard care. Clinical and demographic features, length of stay, readmission rate and cost were compared between hospital and home groups. One hundred thirty-nine children with pyelonephritis and 70 with meningitis were identified, of which 127 and 44 were potentially suitable for OPAT, respectively. Of these, 12 (9%) with pyelonephritis received OPAT, contrasting with 29 (66%) with meningitis. Clinical features did not differ between hospital- and home-treated patients for either condition. Patients with meningitis in the hospital group were younger than those transferred to HITH (1 vs. 2 months; P = 0.01). All patients were afebrile before transfer to HITH. Admissions for pyelonephritis were brief with inpatients having a shorter length of stay than home patients (median: 3 vs. 4.5 days; P = 0.002). Unplanned readmission rates were comparable across all groups. Transfer to HITH resulted in a saving of AU$178,180. Children with pyelonephritis and meningitis can feasibly receive OPAT. Age, treatment duration and fever influence this decision. None of these should be barriers to OPAT, and the cost savings support change in practice.

  2. Trajectories of the home learning environment across the first 5 years: associations with children's vocabulary and literacy skills at prekindergarten.

    Science.gov (United States)

    Rodriguez, Eileen T; Tamis-LeMonda, Catherine S

    2011-01-01

    Children's home learning environments were examined in a low-income sample of 1,852 children and families when children were 15, 25, 37, and 63 months. During home visits, children's participation in literacy activities, the quality of mothers' engagements with their children, and the availability of learning materials were assessed, yielding a total learning environment score at each age. At 63 months, children's vocabulary and literacy skills were assessed. Six learning environment trajectories were identified, including environments that were consistently low, environments that were consistently high, and environments characterized by varying patterns of change. The skills of children at the extremes of learning environment trajectories differed by more than 1 SD and the timing of learning experiences related to specific emerging skills.

  3. [The effect of crisis intervention by the visiting nurse with cancer patients].

    Science.gov (United States)

    Kim, C J; Yoo, J S; Park, J W

    1989-04-01

    This study was undertaken at Yonsei University Medical Center to identify the crisis responses and nursing problems of patients who had been diagnosed with cancer, and changing patterns of grieving over time periods, and to analyse the effectiveness of follow up care through home visiting nursing. This study was carried out in three stages. The 1st study data were collected from a total of 205 patients who had been diagnosed with cancer from Sept. 1 to Dec. 31, 1987 using a cross-sectional method. The 2nd study data were collected three times from 30 patients with cancer at 4 weeks intervals from March 1 to June 31, 1988 using a longitudinal method. The 3rd study data were collected from two different groups from March 1 to June 31, 1988. One was an experimental group who was visited by nurses and the other one was a control group not visited by nurses. The subjects of the 3rd study consisted of 60 patients with cancer and a Quasi-experimental research design was used. The results were as follows: 1. The patients did not experience one stage at a time among the five stages of grieving, denial, anger, bargaining, depression and acceptance, as identified by Kübler Ross. They experienced a combination of stages, especially of the bargaining and the depression stages. This stages did not change with the passing of time. 2. The patients expressed more physical and socioeconomical problems than emotional problems. And they used more problem coping methods than emotional coping methods. 3. Follow up care through home visiting nursing positively influenced the patient's quality of life, especially their physical well-being and symptom control. The patients responded positively to the home visiting nursing, stating that it was helpful to them. It was concluded that the development of a home visiting nursing program is needed for the effective home care of patients with cancer.

  4. Follow-Up Visit Patterns in an Antiretroviral Therapy (ART programme in Zomba, Malawi.

    Directory of Open Access Journals (Sweden)

    Beth Rachlis

    Full Text Available Identifying follow-up (FU visit patterns, and exploring which factors influence them are likely to be useful in determining which patients on antiretroviral therapy (ART may become Lost to Follow-Up (LTFU. Using an operation and implementation research approach, we sought 1 to describe the timing of FU visits amongst patients who have been on ART for shorter and longer periods of time; and 2 to determine the median time to late visits, and 3 to identify specific factors that may be associated with these patterns in Zomba, Malawi.Using routinely collected programme monitoring data from Zomba District, we performed descriptive analyses on all ART visits among patients who initiated ART between Jan. 1, 2007-June 30, 2010. Based on an expected FU date, each FU visit was classified as early (≥4 day before an expected FU date, on time (3 days before an expected FU date/up to 6 days after an expected FU date, or late (≥7 days after an expected FU date. In total, 7,815 patients with 76417 FU visits were included. Ninety-two percent of patients had ≥2 FU visits. At the majority of visits, patients were either on time or late. The median time to a first late visit among those with 2 or more visits was 216 days (IQR: 128-359. Various patient- and visit-level factors differed significantly across Early, On Time, and Late visit groups including ART adherence and frequency of, and type of side effects.The majority of patients do not demonstrate consistent FU visit patterns. Individuals were generally on ART for at least 6 months before experiencing their first late visit. Our findings have implications for the development of effective interventions that meet patient needs when they present early and can reduce patient losses to follow-up when they are late. In particular, time-varying visit characteristics need further research.

  5. Parental Language and Return Visits to the Emergency Department After Discharge.

    Science.gov (United States)

    Samuels-Kalow, Margaret E; Stack, Anne M; Amico, Kendra; Porter, Stephen C

    2017-06-01

    Return visits to the emergency department (ED) are used as a marker of quality of care. Limited English proficiency, along with other demographic and disease-specific factors, has been associated with increased risk of return visit, but the relationship between language, short-term return visits, and overall ED use has not been well characterized. This is a planned secondary analysis of a prospective cohort examining the ED discharge process for English- or Spanish-speaking parents of children aged 2 months to 2 years with fever and/or respiratory illness. At 1 year after the index visit, a standardized chart review was performed. The primary outcome was the number of ED visits within 72 hours of the index visit. Multivariable logistic regression was used to examine the relative importance of predictor variables and adjust for confounders. There were 202 parents eligible for inclusion, of whom 23% were Spanish speaking. In addition, 6.9% of the sample had a return visit within 72 hours. After adjustment for confounders, Spanish language was associated with return visit within 72 hours (odds ratio, 3.49; 95% confidence interval, 1.02-11.90) but decreased risk of a second visit within the year (odds ratio, 0.28; 95% confidence interval, 0.12-0.66). Spanish-speaking parents are at an increased risk of 72-hour return ED visit but do not seem to be at increased risk of ED use during the year after their ED visit.

  6. Nursing Home

    OpenAIRE

    Allocca Hernandez, Giacomo Antonio

    2016-01-01

    Getting old involves a lot of changes in life. Family and social relations change and mobility can decrease. These variations require new settings, and of course special care. A nursing home is a place dedicated to help with this situation. Sometimes nursing homes can be perceived as mere institutions by society, and even by future residents. Inside, senior citizens are suppose to spend the rest of their lives doing the same activities day after day. How can we improve these days? Archite...

  7. Development and feasibility of a home-based education model for families of children with sickle cell disease.

    Science.gov (United States)

    Hoyt Drazen, Catherine; Abel, Regina; Lindsey, Terianne; King, Allison A

    2014-02-05

    Children with sickle cell disease (SCD) commonly have cognitive deficits, even among toddlers. Much medical literature emphasizes disease-based factors to account for these deficits. However, the social environment plays a large role in child development. To address the specific needs of early childhood, a monthly hospital-based education program was initiated to educate parents about child development. Education sessions were poorly attended (20-25%) and deemed unsuccessful. This study describes the development and implementation of a home-based education service to teach parents about SCD, developmental milestones and positive parenting techniques. This was a prospective, single-arm intervention to study the feasibility of a home-based caregiver education program for families with infants and toddlers with SCD. Parents of children aged 0-3 years with SCD from one Midwestern hospital were approached to participate in a home-based program. The program followed the Born to Learn™ curriculum provided through the Parents as Teachers™ National Center. Reminder calls or texts were provided the day before each visit. Results of the first twenty-six months of the program are presented. A total of 62% (56 of 91) of families approached agreed to participate; all were African American. The majority of caregivers were single mothers with a high school education or less and whose children had Medicaid for health coverage. The phenotypes of SCD represented in this sample were similar to those in the general SCD population. Over 26 months, 39 families received at least one home visit. Parents of infants (younger than 8 months) were more likely to participate in the home-based education program than parents of older children, (Fisher's exact test, p education. About 43% of eligible families participated in the education, a two-fold increase in the poor attendance (20%) for a previous hospital-based program. A home visitation program for parents of infants with SCD could

  8. Home delivery of heat-stable vaccines in Indonesia: outreach immunization with a prefilled, single-use injection device.

    Science.gov (United States)

    Sutanto, A.; Suarnawa, I. M.; Nelson, C. M.; Stewart, T.; Soewarso, T. I.

    1999-01-01

    Extending immunization coverage to underserved populations will require innovative immunization strategies. This study evaluated one such strategy: the use of a prefilled, single-use injection device for outreach immunization by village midwives. The device, UniJect, is designed to prevent refilling or reuse. Stored at ambient temperatures for up to 1 month in midwives' homes, vaccine-filled UniJect devices were immediately available for outreach. Between July 1995 and April 1996, 110 midwives on the Indonesia islands of Lombok and Bali visited the homes of newborn infants to deliver hepatitis B vaccine to the infants and tetanus toxoid to their mothers. Observations and interviews showed that the midwives used the device properly and safely to administer approximately 10,000 sterile injections in home settings. There were no problems with excessive heat exposure during the storage or delivery of vaccine. Injection recipients and midwives expressed a strong preference for the UniJect device over a standard syringe. Use of the prefilled device outside the cold chain simplified the logistics and facilitated the speed and efficiency of home visits, while the single-dose format minimized vaccine wastage. PMID:10083709

  9. The Africentric Home Environment Inventory: An Observational Measure of the Racial Socialization Features of the Home Environment for African American Preschool Children.

    Science.gov (United States)

    Caughy, Margaret O'Brien; Randolph, Suzanne M.; O'Campo, Patricia J.

    2002-01-01

    Pilot tested the Africentric Home Environment Inventory (AHEI), an observational measure for racial socialization features of the home environment, collecting data during home visits with socioeconomically diverse, urban, African American families with preschoolers. There was a strong association between AHEI scores and family socioeconomic…

  10. Pharmaceutical care and home delivery of medication to patients with chronic myeloid leukemia

    Directory of Open Access Journals (Sweden)

    Begoña San José Ruiz

    2015-01-01

    Full Text Available Objectives: To describe the implementation of a new model face to face and remote pharmaceutical care with home delivery of tyronsine kinase inhibitors medicines for patients with chronic myeloid leukemia. Methods: Patients with chronic myeloid leukemia were selected to start this new model of care. Four characteristics were taken into account for the choice: chronicity of the disease, frequency of doctor visits, pharmaceutical care value and conservation of tyronsine kinase inhibitors medicines at room temperature. Results: Out of 68 patients with chronic myeloid leukemia and treated with tyronsine kinase inhibitors, 42 were selected due to the frequency of their hematologist visits. An introductory letter and a questionnaire about their preferences were sent to these patients.Sixteen of them expressed their desire to participate. The legal department designed a confidentiality contract, as well as a model of informed consent. A logistic distribution model based on defined routes and timetables was established. Prior to inclusion, pharmaceutical care was performed in a face to face consultation and the communication way was established for the followings remote consultations. Home delivery had a monthly cost of 13.2 € (including VAT per patient. All the patients who started this program continue in it. To date, 5 deliveries per patient have been conducted Conclusions: It is possible to establish an alternative model of pharmaceutical care with home delivery of medication, keeping the pharmacist-patient relationship, avoiding travel, ensuring the confidentiality and rationalizing the stocks

  11. Job Candidates' Views of Site Visits.

    Science.gov (United States)

    Fink, Laurence S.; And Others

    1994-01-01

    Followed 62 Master of Business Administration students through job search involving 97 site visits to determine whether site visits changed perceptions of visited companies, attitudes toward those firms, and intentions to accept job offers. Findings suggest that organizations can improve recruitment success by paying attention to how site visits…

  12. Problem visits to a family planning clinic.

    Science.gov (United States)

    Blumenthal, P D; Jacobson, J; Gaffikin, L

    1988-01-01

    In order to obtain information necessary for optimum delivery of services, data were collected on the nature of the services provided at a family planing clinic. Clinic visits were divided into initial, annual, routine, problem, supply, educational and unknown. An analysis of the "problem" visits was undertaken to assess various epidemiologic aspects of such visits and to identify areas of clinic efficiency that could be improved. Problem visits were defined as any visits for which the patient had a presenting complaint. Age, level of education, method of contraception and parity were statistically associated with problem visits. When compared to Pill users, diaphragm users, intrauterine device users and non-users had a higher-than-expected number of problem visits. Less educated women and teenagers had a lower-than-expected number of problem visits when compared to more educated and older women. Socioeconomic status and problem visits were not statistically associated. Problem visits required more time, utilized more medical services and resulted in more referrals to the gynecology clinic than did other visit types. As a result of this analysis, we have increased our educational efforts for patients at high risk of problem visits and have instituted a special problem-oriented family planning clinic in which a full complement of house staff and ancillary personnel are available. This arrangement makes the uncomplicated family planning clinic run more smoothly and efficiently and obviates the need for time-consuming and cost-ineffective referrals.

  13. Educational outreach visits: effects on professional practice and health care outcomes.

    Science.gov (United States)

    Thomson O'Brien, M A; Oxman, A D; Davis, D A; Haynes, R B; Freemantle, N; Harvey, E L

    2000-01-01

    Outreach visits have been identified as an intervention that may improve the practice of health care professionals, in particular prescribing. This type of 'face to face' visit has been referred to as university-based educational detailing, public interest detailing, and academic detailing. To assess the effects of outreach visits on improving health professional practice or patient outcomes. We searched MEDLINE up to March 1997, the Research and Development Resource Base in Continuing Medical Education, and reference lists of related systematic reviews and articles. Randomised trials of outreach visits (defined as a personal visit by a trained person to a health care provider in his or her own setting). The participants were health care professionals. Two reviewers independently extracted data and assessed study quality. Eighteen studies were included involving more than 1896 physicians. All of the outreach visit interventions consisted of several components, including written materials and conferences. Reminders or audit and feedback complemented some visits. In 13 studies, the targeted behaviours were prescribing practices. In three studies, the behaviours were preventive services, including counselling for smoking cessation. In two studies, the outreach visits were directed toward improving the general management of common problems encountered in general practice, including asthma, diabetes, otitis media, hypertension, anxiety, and acute bronchitis. All studies examined physician behaviour and in three studies other health professionals such as nurses, nursing home attendants or health care workers were targeted. Positive effects on practice were observed in all studies. Only one study measured a patient outcome. Few studies examined the cost effectiveness of outreach. Educational outreach visits, particularly when combined with social marketing, appear to be a promising approach to modifying health professional behaviour, especially prescribing. Further

  14. 42 CFR 403.770 - Payments for home services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Payments for home services. 403.770 Section 403.770 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL... of Participation, and Payment § 403.770 Payments for home services. (a) The RNHCI nursing visits...

  15. Second Home Owners, Locals and Their Perspectives on Rural Development

    Science.gov (United States)

    Farstad, Maja; Rye, Johan Fredrik

    2013-01-01

    Dominating strands within the research literature on second homes explain social conflicts between rural hosting and visiting second home populations by describing their differing perspectives on rural development. Such presentations suggest that locals are likely to welcome new developments in order to enhance the economic viability of their…

  16. Benchmarking monthly homogenization algorithms

    Directory of Open Access Journals (Sweden)

    V. K. C. Venema

    2011-08-01

    Full Text Available The COST (European Cooperation in Science and Technology Action ES0601: Advances in homogenization methods of climate series: an integrated approach (HOME has executed a blind intercomparison and validation study for monthly homogenization algorithms. Time series of monthly temperature and precipitation were evaluated because of their importance for climate studies and because they represent two important types of statistics (additive and multiplicative. The algorithms were validated against a realistic benchmark dataset. The benchmark contains real inhomogeneous data as well as simulated data with inserted inhomogeneities. Random break-type inhomogeneities were added to the simulated datasets modeled as a Poisson process with normally distributed breakpoint sizes. To approximate real world conditions, breaks were introduced that occur simultaneously in multiple station series within a simulated network of station data. The simulated time series also contained outliers, missing data periods and local station trends. Further, a stochastic nonlinear global (network-wide trend was added.

    Participants provided 25 separate homogenized contributions as part of the blind study as well as 22 additional solutions submitted after the details of the imposed inhomogeneities were revealed. These homogenized datasets were assessed by a number of performance metrics including (i the centered root mean square error relative to the true homogeneous value at various averaging scales, (ii the error in linear trend estimates and (iii traditional contingency skill scores. The metrics were computed both using the individual station series as well as the network average regional series. The performance of the contributions depends significantly on the error metric considered. Contingency scores by themselves are not very informative. Although relative homogenization algorithms typically improve the homogeneity of temperature data, only the best ones improve

  17. 76 FR 25517 - Jewish American Heritage Month, 2011

    Science.gov (United States)

    2011-05-05

    ...#0;#0; ] Proclamation 8660 of April 29, 2011 Jewish American Heritage Month, 2011 By the President of... laws of the United States, do hereby proclaim May 2011 as Jewish American Heritage Month. I call upon all Americans to visit ] www.JewishHeritageMonth.gov to learn more about the heritage...

  18. Home-based wrinkle reduction using a novel handheld multisource phase-controlled radiofrequency device.

    Science.gov (United States)

    Shemer, Avner; Levy, Hanna; Sadick, Neil S; Harth, Yoram; Dorizas, Andrew S

    2014-11-01

    In the last decade, energy-based aesthetic treatments, using light, radiofrequency (RF), and ultrasound, have gained scientific acceptance as safe and efficacious for non-invasive treatment for aesthetic skin disorders. The phase-controlled multisource radiofrequency technology (3DEEP™), which is based on the simultaneous use of multiple RF generators, was proven to allow significant pigment-independent dermal heating without pain or the need of epidermal cooling. This study was performed in order to evaluate the efficacy and safety of a new handheld device delivering multisource radiofrequency to the skin for wrinkle reduction and skin tightening in the home setting. A total of 69 participants (age 54.3 years ± 8.09; age range 37-72 years) were enrolled in the study after meeting all inclusion/exclusion criteria (100%) and providing informed consent. Participants were provided with the tested device together with a user manual and treatment diary, to perform independent treatments at home for 4 weeks. The tested device, (Newa™, EndyMed Medical, Cesarea, Israel) emits 12 W of 1Mhz, RF energy through six electrodes arranged in a linear fashion. Independent control of RF polarity through each one of the 6 electrodes allows significant reduction of energy flow through the epidermis with increased dermal penetration. Participants were instructed to perform at least 5 treatments a week, for one month. Four follow-up visits were scheduled (once a week) during the period of independent treatments at home, following 4 weeks of home treatments, 1 month follow-up visit (1 month after treatment end) and at 3 months follow-up (3 months following treatment end). Analysis of pre-and post treatment images was conducted by three uninvolved physicians experienced with the Fitzpatrick Wrinkle and Elastosis Scale. Fitzpatrick Wrinkle and Elastosis score of each time point (4 weeks following home use treatments; 1 month follow-up, 3 months follow-up) was compared to baseline

  19. [Home nursing care for depressed elderly people].

    Science.gov (United States)

    Floch, Catherine

    2011-01-01

    The freelance nurse must be adaptable and reactive in order to meet the needs of a depressed or suicidal elderly person. In addition to her own particular relationship with the patient, the nurse must activate a network of other professionals who can carry out home visits.

  20. Hanford Laboratories Operation monthly activities report, August 1959

    Energy Technology Data Exchange (ETDEWEB)

    1959-09-15

    This is the monthly report for the Hanford Laboratories Operation, August, 1959. Reactor fuels, chemistry, dosimetry, separation processes, reactor technology financial activities, visits, biology operation, physics and instrumentation research, employee relations, and operations research and synthesis operation are discussed.

  1. Hanford Laboratories Operation monthly activities report, June 1957

    Energy Technology Data Exchange (ETDEWEB)

    1957-07-15

    This is the monthly report for the Hanford Laboratories Operation, July 1957. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  2. Hanford Laboratories Operation monthly activities report, July 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-08-15

    This is the monthly report for the Hanford Laboratories Operation, July 1969. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  3. Hanford Laboratories Operation monthly activities report, November 1962

    Energy Technology Data Exchange (ETDEWEB)

    1962-12-14

    This is the monthly report for the Hanford Laboratories Operation, November 1962. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  4. Hanford Laboratories Operation monthly activities report, November 1959

    Energy Technology Data Exchange (ETDEWEB)

    1959-12-15

    This is the monthly report for the Hanford Laboratories Operation, November 1959. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  5. Hanford Laboratories Operation monthly activities report, December 1962

    Energy Technology Data Exchange (ETDEWEB)

    1963-01-15

    This is the monthly report for the Hanford Laboratories Operation, December 1962. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  6. Hanford Laboratories Operation monthly activities report, August 1957

    Energy Technology Data Exchange (ETDEWEB)

    1957-09-15

    This is the monthly report for the Hanford Laboratories Operation, September 1957. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  7. Hanford Atomic Products Operation monthly report for February 1956

    Energy Technology Data Exchange (ETDEWEB)

    1956-02-21

    This is the monthly report for the Hanford Laboratories Operation, February, 1956. Metallurgy, reactors fuels, chemistry, dosimetry, separation processes, reactor technology financial activities, visits, biology operation, physics and instrumentation research, employee relations are discussed.

  8. Hanford Laboratories Operation monthly activities report, March 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-04-15

    This is the monthly report for the Hanford Laboratories Operation, April 1961. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  9. Hanford Laboratories Operation monthly activities report, May 1957

    Energy Technology Data Exchange (ETDEWEB)

    1957-06-15

    This is the monthly report for the Hanford Laboratories Operation, May, 1957. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  10. Hanford Laboratories Operation monthly activities report, July 1959

    Energy Technology Data Exchange (ETDEWEB)

    1959-08-15

    This is the monthly report for the Hanford Laboratories Operation, July, 1959. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  11. Hanford Laboratories Operation monthly activities report, February 1960

    Energy Technology Data Exchange (ETDEWEB)

    1960-03-15

    This is the monthly report for the Hanford Laboratories Operation, February, 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  12. Hanford Laboratories Operation monthly activities report, March 1958

    Energy Technology Data Exchange (ETDEWEB)

    Parker, H.M.

    1958-04-15

    This is the monthly report for the Hanford Laboratories Operation, March, 1958. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  13. Hanford Laboratories Operation monthly activities report, April 1958

    Energy Technology Data Exchange (ETDEWEB)

    1958-05-15

    This is the monthly report for the Hanford Laboratories Operation, May, 1958. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  14. Hanford Laboratories Operation monthly activities report, September 1959

    Energy Technology Data Exchange (ETDEWEB)

    1959-10-15

    This is the monthly report for the Hanford Laboratories Operation, October 1959. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  15. Hanford Laboratories Operation monthly activities report, June 1960

    Energy Technology Data Exchange (ETDEWEB)

    1960-07-15

    This is the monthly report for the Hanford Laboratories Operation, July 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities,, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  16. Hanford Laboratories Operation monthly activities report, January 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-02-15

    This is the monthly report for the Hanford Laboratories Operation, January 1961. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  17. Hanford Laboratories Operation monthly activities report, December 1959

    Energy Technology Data Exchange (ETDEWEB)

    1960-01-15

    This is the monthly report for the Hanford Laboratories Operation, January 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  18. Hanford Laboratories Operation monthly activities report, April 1961

    Energy Technology Data Exchange (ETDEWEB)

    1961-05-15

    This is the monthly report for the Hanford Laboratories Operation, April 1961. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  19. Hanford Laboratories Operation monthly activities report, September 1960

    Energy Technology Data Exchange (ETDEWEB)

    1960-10-15

    This is the monthly report for the Hanford Laboratories Operation, October, 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.

  20. Hanford Laboratories Operation monthly activities report, November 1960

    Energy Technology Data Exchange (ETDEWEB)

    Sale, W.

    1960-12-15

    This is the monthly report for the Hanford Laboratories Operation, November 1960. Metallurgy, reactor fuels, chemistry, dosimetry, separation processes, reactor technology, financial activities, visits, biology operation, physics and instrumentation research, and employee relations are discussed.