Nurture affects gender differences in spatial abilities.

Science.gov (United States)

Hoffman, Moshe; Gneezy, Uri; List, John A

2011-09-06

Women remain significantly underrepresented in the science, engineering, and technology workforce. Some have argued that spatial ability differences, which represent the most persistent gender differences in the cognitive literature, are partly responsible for this gap(.) The underlying forces at work shaping the observed spatial ability differences revolve naturally around the relative roles of nature and nurture. Although these forces remain among the most hotly debated in all of the sciences, the evidence for nurture is tenuous, because it is difficult to compare gender differences among biologically similar groups with distinct nurture. In this study, we use a large-scale incentivized experiment with nearly 1,300 participants to show that the gender gap in spatial abilities, measured by time to solve a puzzle, disappears when we move from a patrilineal society to an adjoining matrilineal society. We also show that about one-third of the effect can be explained by differences in education. Given that none of our participants have experience with puzzle solving and that villagers from both societies have the same means of subsistence and shared genetic background, we argue that these results show the role of nurture in the gender gap in cognitive abilities.

Nurturing Good Ideas

NARCIS (Netherlands)

J.C.M. van den Ende (Jan); R.C. Kijkuit (Bob)

2009-01-01

textabstractManagers know that simply generating lots of ideas doesn’t necessarily produce good ones. What companies need are systems that nurture good ideas and cull bad ones—before they ever reach the decision maker’s desk. Our research shows that tapping the input of many people early in the

An Adult Protective Services' view of collaboration with Mental Health Services.

Science.gov (United States)

Teaster, Pamela B; Stansbury, Kim L; Nerenberg, Lisa; Stanis, Patricia

2009-10-01

Mental Health Services (MHS) meet mental health needs of older adults through active, outpatient, community-based care. Adult Protective Services (APS) are involved with needs of older adults who have mental disability and mental illness. Adult Protective Services and MHS staff may to work together when they respond to the needs of victims and adults at risk for abuse, neglect, self-neglect, and exploitation. The purpose of this study was to understand effective APS-MHS collaborations (e.g., leadership, organizational culture, administration, and resources in predicting success). A survey that was sent to members of the National Adult Protective Services Association (NAPSA) revealed that both APS and MHS have strong commitments to protecting clients' rights and autonomy, but there appear to be differences between the two with regard to implementation, apparent in cases involving clients with diminished mental capacity who are at imminent risk, but who refuse help. Strengths of APS-MHS collaborations included improved communication and better service for at-risk clients.

Gender and nurturance in families of children with neurodevelopmental conditions.

Science.gov (United States)

Shapiro, Danielle N; Dixon-Thomas, Pamela; Warschausky, Seth

2014-05-01

This study tested the hypothesis that gender differences in parent-reported nurturance of children would be attenuated in families of children with neurodevelopmental conditions (NDCs). In this cross-sectional study, participants included 49 (29 male) children diagnosed with an NDC and 60 (30 male) typically developing (TD) children. Children in the NDC group had a diagnosis of cerebral palsy (CP; n = 41) or spina bifida (SB; n = 8). Parental nurturance was measured using the nurturance subscale of the Parenting Dimensions Inventory (PDI; Power, 1991). Data were analyzed using a 2 × 2 (gender × diagnosis) analysis of covariance (ANCOVA) with child age as the covariate. As a simple main effect, parents reported more nurturing behavior toward TD girls than TD boys. However, girls with an NDC received less nurturance, thereby eliminating the gender difference in parental nurturance in the NDC sample. This pattern was reflected in the larger ANCOVA as a 2-way interaction between diagnosis and gender. Group differences in other PDI subscales were not statistically significant. This pattern of results suggests that the parents of girls with NDCs may be less nurturing toward them, thereby attenuating gender differences observed in families with TD children. Findings highlight the need for more research on the gendered dynamics in families with a child with an NDC to develop systemic models of family functioning and targeted parenting interventions for this group. (c) 2014 APA, all rights reserved.

Nature, Nurture and Epigenetics

Science.gov (United States)

Crews, David; Gillette, Ross; Miller-Crews, Isaac; Gore, Andrea C.; Skinner, Michael K.

2015-01-01

Real life by definition combines heritability (e.g., the legacy of exposures) and experience (e.g. stress during sensitive or ‘critical’ periods), but how to study or even model this interaction has proven difficult. The hoary concept of evaluating traits according to nature vs. nurture continues to persist despite repeated demonstrations that it retards, rather than advances, our understanding of biological processes. Behavioral genetics has proven the obvious, that genes influences behavior and, vice versa, that behavior influences genes. The concept of Genes X Environment (G X E) and its modern variants was viewed as an improvement on nature-nurture but has proven that, except in rare instances, it is not possible to fractionate phenotypes into these constituent elements. The entanglement inherent in terms such as nature-nurture or GXE is a Gordian knot that cannot be dissected or even split. Given that the world today is not what it was less than a century ago, yet the arbitrator (differential survival and reproduction) has stayed constant, de novo principles and practices are needed to better predict what the future holds. Put simply, the transformation that is now occurring within and between individuals as a product of global endocrine disruption is quite independent of what has been regarded as evolution by selection. This new perspective should focus on how epigenetic modifications might revise approaches to understand how the phenotype and, in particular its components, is shaped. In this review we summarize the literature in this developing area, focusing on our research on the fungicide vinclozolin. PMID:25102229

Nature versus Nurture in Determining Athletic Ability.

Science.gov (United States)

Yan, Xu; Papadimitriou, Ioannis; Lidor, Ronnie; Eynon, Nir

2016-01-01

This overview provides a general discussion of the roles of nature and nurture in determining human athletic ability. On the nature (genetics) side, a review is provided with emphasis on the historical research and on several areas which are likely to be important for future research, including next-generation sequencing technologies. In addition, a number of well-designed training studies that could possibly reveal the biological mechanism ('cause') behind the association between gene variants and athletic ability are discussed. On the nurture (environment) side, we discuss common environmental variables including deliberate practice, family support, and the birthplace effect, which may be important in becoming an elite athlete. Developmental effects are difficult to disassociate with genetic effects, because the early life environment may have long-lasting effects in adulthood. With this in mind, the fetal programming hypothesis is also briefly reviewed, as fetal programming provides an excellent example of how the environment interacts with genetics. We conclude that the traditional argument of nature versus nurture is no longer relevant, as it has been clearly established that both are important factors in the road to becoming an elite athlete. With the availability of the next-generation genetics (sequencing) techniques, it is hoped that future studies will reveal the relevant genes influencing performance, as well as the interaction between those genes and environmental (nurture) factors. © 2016 S. Karger AG, Basel.

Nature, nurture and epigenetics.

Science.gov (United States)

Crews, David; Gillette, Ross; Miller-Crews, Isaac; Gore, Andrea C; Skinner, Michael K

2014-12-01

Real life by definition combines heritability (e.g., the legacy of exposures) and experience (e.g. stress during sensitive or 'critical' periods), but how to study or even model this interaction has proven difficult. The hoary concept of evaluating traits according to nature versus nurture continues to persist despite repeated demonstrations that it retards, rather than advances, our understanding of biological processes. Behavioral genetics has proven the obvious, that genes influence behavior and, vice versa, that behavior influences genes. The concept of Genes X Environment (G X E) and its modern variants was viewed as an improvement on nature-nurture but has proven that, except in rare instances, it is not possible to fractionate phenotypes into these constituent elements. The entanglement inherent in terms such as nature-nurture or G X E is a Gordian knot that cannot be dissected or even split. Given that the world today is not what it was less than a century ago, yet the arbitrator (differential survival and reproduction) has stayed constant, de novo principles and practices are needed to better predict what the future holds. Put simply, the transformation that is now occurring within and between individuals as a product of global endocrine disruption is quite independent of what has been regarded as evolution by selection. This new perspective should focus on how epigenetic modifications might revise approaches to understand how the phenotype and, in particular its components, is shaped. In this review we summarize the literature in this developing area, focusing on our research on the fungicide vinclozolin. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Parental authority, nurturance, and two-dimensional self-esteem.

Science.gov (United States)

Tafarodi, Romin W; Wild, Nicole; Ho, Caroline

2010-08-01

This study examined the relations of parental permissiveness, authoritativeness, authoritarianism, and nurturance with two dimensions of self-esteem - self-liking and self-competence. In a sample of 207 two-parent families, university students and both their parents provided independent reports on all the above variables. Covariance structure analysis was used to eliminate reporter-specific bias and unreliability in predicting student self-esteem from parenting behavior. The results revealed highly redundant positive associations of mothers' and fathers' authoritativeness and nurturance with both self-liking and self-competence. The pattern of these associations suggests that the significance of parental authoritativeness for the child's self-esteem is due mainly to the nurturance it provides. Contrary to expectation, mothers' and fathers' authoritarianism was also positively associated with self-liking. As discussed, however, this is likely to be an artifact of the specific measures and testing methods used.

'Mind the gap'--mapping services for young people with ADHD transitioning from child to adult mental health services.

Science.gov (United States)

Hall, Charlotte L; Newell, Karen; Taylor, John; Sayal, Kapil; Swift, Katie D; Hollis, Chris

2013-07-10

Once considered to be a disorder restricted to childhood, Attention Deficit/Hyperactivity Disorder (ADHD) is now recognised to persist into adult life. However, service provision for adults with ADHD is limited. Additionally, there is little guidance or research on how best to transition young people with ADHD from child to adult services. We report the findings of a survey of 96 healthcare professionals working in children's (Child and Adolescent Mental Health Services and Community Paediatrics) and adult services across five NHS Trusts within the East Midlands region of England to gain a better understanding of the current provision of services for young people with ADHD transitioning into adult mental health services. Our findings indicate a lack of structured guidelines on transitioning and little communication between child and adult services. Child and adult services had differing opinions on what they felt adult services should provide for ADHD cases. Adult services reported feeling ill-prepared to deal with ADHD patients, with clinicians in these services citing a lack of specific knowledge of ADHD and a paucity of resources to deal with such cases. We discuss suggestions for further research, including the need to map the national provision of services for adults with ADHD, and provide recommendations for commissioned adult ADHD services. We specifically advocate an increase in ADHD-specific training for clinicians in adult services, the development of specialist adult ADHD clinics and greater involvement of Primary Care to support the work of generic adult mental health services in adult ADHD management.

Nurturing gerontology students' intrinsic motivation to cocreate: The design of a powerful learning environment.

Science.gov (United States)

Jukema, Jan S; Veerman, Mieke; Van Alphen, Jacqueline; Visser, Geraldine; Smits, Carolien; Kingma, Tineke

2017-09-21

Professionals such as gerontologists play an important role in the design, development and implementation of age-friendly services. and products, by using working methods and principles of co-creation. A Dutch undergraduate applied gerontology programme aims to train students in the why, how and what of co-creation. The degree to which students are intrinsically motivated to develop competencies depends on how their psychological needs are met. These needs are autonomy, an awareness of competence and a sense of relatedness, as described in the self-determination theory. To nurture the intrinsic motivation of the applied gerontology students, a realistic, powerful learning environment called the Living Lab Applied Gerontology was designed and implemented. The aim of this paper is to present the design of this powerful learning environment and to discuss its value for nurturing the students' intrinsic motivation for co-creation. Based on a focus group with eight students, we identify directions for further research and development of living labs.

Buffering effects of safe, supportive, and nurturing relationships among women with childhood histories of maltreatment.

Science.gov (United States)

Jaffee, S R; Takizawa, R; Arseneault, L

2017-11-01

Adults who were victims of childhood maltreatment tend to have poorer health compared with adults who did not experience abuse. However, many are in good health. We tested whether safe, supportive, and nurturing relationships buffer women with a history of childhood maltreatment from poor health outcomes in later life. Participants included women from the Environmental Risk (E-Risk) Longitudinal Twin Study who were involved in an intimate relationship at some point by the time their twin children were 10 years old. Women were initially interviewed in 1999-2000 (mean age = 33 years) and 2, 5, and 7 years later. They reported on their physical and mental health, and their health-risk behaviours. Compared with women who did not experience abuse in childhood, women with histories of maltreatment were at elevated risk for mental, physical, and health-risk behaviours, including major depressive disorder, sleep, and substance use problems. Cumulatively, safe, supportive, and nurturing relationships characterized by a lack of violence, emotional intimacy, and social support buffered women with a history of maltreatment from poor health outcomes. Our findings emphasize that negative social determinants of health - such as a childhood history of maltreatment - confer risk for psychopathology and other physical health problems. If, however, a woman's current social circumstances are sufficiently positive, they can promote good health, particularly in the face of past adversity.

Nature or Nurture – Will Epigenomics Solve the Dilemma?

OpenAIRE

Płonka Beata

2016-01-01

The concept of “nature and nurture” is used to distinguish between genetic and environmental influences on the formation of individual, mainly behavioral, traits. Different approaches that interpret nature and nurture as completely opposite or complementary aspects of human development have been discussed for decades. The paper addresses the most important points of nature vs nurture debate from the perspective of biological research, especially in the light of the recent findings in the fiel...

PARENT NURTURE MODEL IN SHAPING BEHAVIOR OF ADOLESCENCE 12-15 AGES

Directory of Open Access Journals (Sweden)

Dimas Hadi Prayoga

2017-02-01

Full Text Available Introduction: The deviation problem of smoking activity an adolescent is come to anxious level for parents, teachers, and society. The correlation between parents nurture model and smoking activity of adolescent needs to be examined further. The purpose of this study was to analyze the correlation between parents nurture model with smoking activity of adolescent (12-15 years old. Method: This was correlational research with cross sectional approach. The sample were 84 adolescent (12-15 years old at MTs Mojosari Nganjuk. The independent variables was parents nurture model and the dependent variable was adolescent smoking activity. Data were collected by using questionnare, then examined by using chi square with the level of significant α=0,05. Result: Statistical analysis had showed the low correlation between permissive parents nurture model with smoking activity of adolescent (12-15 years old at MTs Mojosari Nganjuk (p=0,049; r = 0,210 and no correlation between democratic nurture model (p=0,554 and authoritative nurture model (p=0,418 with smoking activity of adolescent (12-15 years old at MTs Mojosari Nganjuk, but only permissive model which correlate with smoking activity. The permissive parents with no control and demand caused adolescent to be feeling unimpeded to do smoking activity since there is no warning and punishment from the parents. Discussion: So that, School nurses should provide health promotion to parents in making appropriate parenting in adolescence. Parents should have the right parenting provided in accordance with the age and development of adolescents because appropriate parenting will have a positive impact on adolescent behavior. Further research on parenting questionnaires must be checked for cross-compatibility between questionnaire answers given adolescent and parents to know the truth in filling out the questionnaire. The differences in this study compared to previous studies is the researcher doing research in

The Unnatural Nature of Nature and Nurture: Questioning the Romantic Heritage

Science.gov (United States)

Stables, Andrew

2009-01-01

From a cultural-historical perspective, nature and nurture (and thus education) are contested concepts. The paper focuses on the nature/nurture debate in the work of William Shakespeare (influenced by Montaigne) and in the Romantic tradition (evidenced by Rousseau and Wordsworth), and argues that while our Romantic inheritance (still highly…

Management Matters. Nurture Your Vision

Science.gov (United States)

Pappas, Marjorie L.

2005-01-01

In many professional roles, long-term vision may help guide short-term decisions. This is especially true for school library professionals as library media programs are constantly evolving. This author suggests strategies to assist library media specialists to nurture their vision and provides reviews of several sources and experts in the field…

Nurture of human resources for geological repository program

International Nuclear Information System (INIS)

Fujiwara, A.

2004-01-01

The Japanese geological repository program entered the implementing stage in 2002. At the implementing stage of the program, different sectors need various human resources to conduct their functions. This paper discusses a suitable framework of nurture of the human resources to progress the geological repository program. The discussion is based on considering of specific characters involved in the program and of the multidisciplinary knowledge related to geological disposal. Considering the specific characters of the project, two types of the human resources need to be nurtured. First type is the core persons with the highest knowledge on geological disposal. They are expected to communicate with the various stakeholders and pass down the whole knowledge of the project to the next generation. Another is to conduct the project as the managers, the engineers and the workers. The former human resources can be developed through the broad practice and experience in each sector. The latter human resources can be effectively developed by training of the fundamental knowledge on geological disposal at training centers as well as by conventional on-the-job training. The sectors involved in the program need to take their own roles in the nurture of these human resources. (author)

Nurturing Care for China's Orphaned Children

Science.gov (United States)

Cotton, Janice N.; Edwards, Carolyn Pope; Zhao, Wen; Gelabert, Jeronia Muntaner

2007-01-01

Half the Sky, an international NGO, works in partnership with Chinese national and provincial governments inside state-run orphanages (welfare institutions). Through their infant nurture programs infants and toddlers in institutions begin to thrive through primary relationship-based care by trained community paraprofessionals. In preschool…

Nature vs. nurture: a case report.

Science.gov (United States)

Sandhu, Jagwinder S; Kuprevich, Carol L

2006-11-01

This case report of a young adult male, Mr. A., describes the vulnerability and effects of genetic and environmental factors on the development of psychopathology that can lead to long-term in-patient stays. Mr. A. was born to a mother who had untreated mental and substance use conditions. After a premature birth his brain suffered a significant insult as a result of hypoxia and hypoglycemia, and he remained in a neonatal intensive care unit for three weeks. His early childhood was spent in a chaotic and socioeconomically poor environment with a minimally involved mother and father. During childhood, latency, and adolescence Mr. A. experienced significant interpersonal issues. Mr. A. lived primarily with an aunt. He was unable to maintain employment. He is hospitalized in a public facility, is on multiple medications, and has had unsuccessful attempts to maintain community living. The person to whom he refers to as important in his life is his mother, who remains noninvolved. We present this case to illustrate how genetic and environmental influences interact to impact normal developmental pathways. Has nature or nurture played the strongest role in the life of Mr. A.?

Progress on nature and nurture: Commentary on Granqvist and Nkara's 'Nature meets nurture in religious and spiritual development'.

Science.gov (United States)

Boyatzis, Chris J

2017-03-01

This commentary addresses several key ideas in the Granqvist and Nkara (this issue) conceptual piece on the need for a more sophisticated understanding of how nature and nurture interact to influence religious and spiritual development. Cultural and genetic factors are explored. © 2017 The British Psychological Society.

Nature versus Nurture: The Simple Contrast

Science.gov (United States)

Davidoff, Jules; Goldstein, Julie; Roberson, Debi

2009-01-01

We respond to the commentary of Franklin, Wright, and Davies ("Journal of Experimental Child Psychology, 102", 239-245 [2009]) by returning to the simple contrast between nature and nurture. We find no evidence from the toddler data that makes us revise our ideas that color categories are learned and never innate. (Contains 1 figure.)

Nurturing care: promoting early childhood development.

Science.gov (United States)

Britto, Pia R; Lye, Stephen J; Proulx, Kerrie; Yousafzai, Aisha K; Matthews, Stephen G; Vaivada, Tyler; Perez-Escamilla, Rafael; Rao, Nirmala; Ip, Patrick; Fernald, Lia C H; MacMillan, Harriet; Hanson, Mark; Wachs, Theodore D; Yao, Haogen; Yoshikawa, Hirokazu; Cerezo, Adrian; Leckman, James F; Bhutta, Zulfiqar A

2017-01-07

The UN Sustainable Development Goals provide a historic opportunity to implement interventions, at scale, to promote early childhood development. Although the evidence base for the importance of early childhood development has grown, the research is distributed across sectors, populations, and settings, with diversity noted in both scope and focus. We provide a comprehensive updated analysis of early childhood development interventions across the five sectors of health, nutrition, education, child protection, and social protection. Our review concludes that to make interventions successful, smart, and sustainable, they need to be implemented as multi-sectoral intervention packages anchored in nurturing care. The recommendations emphasise that intervention packages should be applied at developmentally appropriate times during the life course, target multiple risks, and build on existing delivery platforms for feasibility of scale-up. While interventions will continue to improve with the growth of developmental science, the evidence now strongly suggests that parents, caregivers, and families need to be supported in providing nurturing care and protection in order for young children to achieve their developmental potential. Copyright © 2017 Elsevier Ltd. All rights reserved.

Autism spectrum disorder in adults: diagnosis, management, and health services development

Science.gov (United States)

Murphy, Clodagh M; Wilson, C Ellie; Robertson, Dene M; Ecker, Christine; Daly, Eileen M; Hammond, Neil; Galanopoulos, Anastasios; Dud, Iulia; Murphy, Declan G; McAlonan, Grainne M

2016-01-01

Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological), development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude that health services research for adults with ASD is urgently warranted. In particular, research is required to better understand the needs of adults with ASD, including health, aging, service development, transition, treatment options across the lifespan, sex, and the views of people with ASD. Additionally, the outcomes of recent international legislative efforts to raise awareness of ASD and service provision for adults with ASD are to be determined. Future research is required to identify high-quality, evidence-based, and cost-effective models of care. Furthermore, future health services research is also required at the beginning and end of adulthood, including improved transition from youth to adult health care and increased understanding of aging and health in older adults with ASD. PMID:27462160

Introduction of a university-based counselling service for older adults.

Science.gov (United States)

Bhar, Sunil S; Silver, Mark

2014-03-01

Despite the growing number of older adults in Australia, many do not access counselling, partly because of the lack of trained mental health professionals for older people. This paper describes an innovative solution for providing counselling services to older adults, and geropsychology training to postgraduate psychology students. A university-based counselling clinic for older adults was described – an outreach service for older adults living in the community or in residential aged care facilities in metropolitan Melbourne, Australia. Over its first 13 months, the clinic provided a total of 266 sessions of counselling to 57 clients (41 living in residential aged care), and involved six postgraduate students. This paper describes the potential benefits of the clinic for clients and students and the resources needed to support this model of service delivery. Thus, it provides a blueprint for other universities for developing similar services for older adults.

[Influence of home nurture environment on language development and social emotion in children with developmental language disorder].

Science.gov (United States)

Li, Guo-Kai; Liu, Gui-Hua; Qian, Qin-Fang; Ge, Pin; Xie, Yan-Qin; Yang, Min-Yan; Wang, Zhang-Qiong; Ou, Ping

2017-05-01

To investigate the influence of home nurture environment on language development and social emotion in children with developmental language disorder (DLD). The 1-3 Years Child Home Nurture Environment Scale, Gesell Developmental Scale, and Infant-Toddler Social and Emotional Assessment Scale were used for the evaluation of 125 children with DLD. A total of 130 children with normal language development matched for age and sex were enrolled as control group. Compared with the control group, the DLD group had a significantly higher proportion of children in a bad home nurture environment and significantly lower scores of all domains of home nurture environment (Pnurture environment score was positively correlated with the level of language development (r=0.536, Pnurture environment had direct influence on language development in children with DLD and affected their language development via the mediating effect of social emotion. Home nurture environment influences language development and social emotion in children with DLD, and social emotion has a partial mediating effect between home nurture environment and language development.

From Survival to Sustainability : Nurturing Adaptive Livelihood ...

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

2005-10-08

From Survival to Sustainability : Nurturing Adaptive Livelihood Strategies in Pakistan. On October 8, 2005, an earthquake destroyed 90% of the town of tehsil Balakot, Mansehra district, Pakistan. According to the Earthquake Reconstruction and Rehabilitation Authority (ERRA) the earthquake left a total of 24 511 dead and ...

Nurturing the Respectful Community through Practical Life

Science.gov (United States)

Bettmann, Joen

2015-01-01

Joen Bettmann's depiction of practical life exercises as character-building reveals how caring, careful, and independent work leads to higher self-esteem, more concern for others, better understanding for academic learning, and a self-nurturing, respectful classroom community. Particular aspects of movement and silence exercises bring out what…

Nature and nurture in the family physician's choice of practice location.

Science.gov (United States)

Orzanco, Maria Gabriela; Lovato, Chris; Bates, Joanna; Slade, Steve; Grand'Maison, Paul; Vanasse, Alain

2011-01-01

An understanding of the contextual, professional, and personal factors that affect choice of practice location for physicians is needed to support successful strategies in addressing geographic maldistribution of physicians. This study compared two categories of predictors of family practice location in non-metropolitan areas among undergraduate medical students: individual characteristics (nature), and the rural program component of their training program (nurture). The study aimed to identify factors that predict the location of practice 2 years post-residency training and determine the predictive value of combining nature and nurture variables using administrative data from two undergraduate medical education programs. Databases were developed from available administrative sources for a retrospective analysis of two undergraduate medical education programs in Canada: Université de Sherbrooke (UdeS) and University of British Columbia (UBC). Both schools have a strong mandate to evaluate the impact of their programs on physician distribution. The dependent variable was location of practice 2 years after completing postgraduate training in family medicine. Independent variables included individual and program characteristics. Separate analyses were conducted for each program using multiple logistic regression. The nature and nurture variables considered in the models explained only 21% to 27% of the variance in the eventual location of practice of family physician graduates. For UdeS, having an address in a rural/small-town environment at application to medical school (OR=2.61, 95% CI: 1.24-6.06) and for UBC, location of high school in a rural/small town (OR=4.03, 95% CI: 1.05-15.41), both increased the chances of practicing in a non-metropolitan area. For UdeS the nurture variable (ie length of clerkship in a non-metropolitan area) was the most significant predictor (OR=1.14, 95% CI: 1.067-1.22). For both medical schools, adding a single nurture variable to the

Book Display as Adult Service

Directory of Open Access Journals (Sweden)

Matthew S. Moore

1997-03-01

Full Text Available 無Book display as an adult service is defined as choosing and positioning adult books from the collection to increase their circulation. The author contrasts bookstore arrangement for sales versus library arrangement for access. The paper considers the library-as-a-whole as a display, examines the right size for an in-library display, and discusses mass displays, end-caps, on-shelf displays, and the Tiffany approach. The author proposes that an effective display depends on an imaginative, unifying theme, and that book displays are part of the joy of libraries.

Reflections from Graduate Adult Learners about Service Learning

Science.gov (United States)

Alston, Geleana Drew; Clegg, T. E.; Clodfelter, Roy J., Jr.; Drye, Kimberly C.; Farrer, J. V.; Gould, Derek; Mohsin, Nidhal M.; Rankin, Tomiko N.; Ray, Sherri L.

2016-01-01

Adult education is grounded in responding to the needs of others, and the field places emphasis on adult learning theories such as transformative learning and experiential learning. Service learning is an educational approach that balances formal instruction and direction with the opportunity for adult learners to serve in the community as a…

Transition from children's to adult services for young adults with life-limiting conditions: A realist review of the literature.

Science.gov (United States)

Kerr, Helen; Price, Jayne; Nicholl, Honor; O'Halloran, Peter

2017-11-01

Improvements in care and treatment have led to more young adults with life-limiting conditions living beyond childhood, which means they must make the transition from children's to adult services. This has proved a challenging process for both young adults and service providers, with complex transition interventions interacting in unpredictable ways with local contexts. To explain how intervention processes interact with contextual factors to help transition from children's to adult services for young adults with life-limiting conditions. Systematic realist review of the literature. Literature was sourced from four electronic databases: Embase, MEDLINE, Science Direct and Cochrane Library from January 1995 to April 2016. This was supplemented with a search in Google Scholar and articles sourced from reference lists of included papers. Data were extracted using an adapted standardised data extraction tool which included identifying information related to interventions, mechanisms, contextual influences and outcomes. Two reviewers assessed the relevance of papers based on the inclusion criteria. Methodological rigor was assessed using the relevant Critical Appraisal Skills Programme tools. 78 articles were included in the review. Six interventions were identified related to an effective transition to adult services. Contextual factors include the need for children's service providers to collaborate with adult service providers to prepare an environment with knowledgeable staff and adequate resources. Mechanisms triggered by the interventions include a sense of empowerment and agency amongst all stakeholders. Early planning, collaboration between children's and adult service providers, and a focus on increasing the young adults' confidence in decision-making and engaging with adult services, are vital to a successful transition. Interventions should be tailored to their context and focused not only on organisational procedures but on equipping young adults, parents

Parental Nurturance and the Mental Health and Parenting of Urban African American Adolescent Mothers

Science.gov (United States)

Lewin, Amy; Mitchell, Stephanie J.; Hodgkinson, Stacy; Burrell, Lori; Beers, Lee S. A.; Duggan, Anne K.

2011-01-01

This study examined the relationship between a teen mother's perceptions of nurturance from her mother and father and her mental health and parenting attitudes. One-hundred and thirty-eight urban, primarily African American adolescent mothers were interviewed. Multivariate results indicate that teen mothers who felt nurtured by their mothers had…

Autism spectrum disorder in adults: diagnosis, management, and health services development

Directory of Open Access Journals (Sweden)

Murphy CM

2016-07-01

Full Text Available Clodagh M Murphy,1,2 C Ellie Wilson,1–3 Dene M Robertson,1,2 Christine Ecker,1,4 Eileen M Daly,1,2 Neil Hammond,1,2 Anastasios Galanopoulos,1,2 Iulia Dud,1,2 Declan G Murphy,1,2 Grainne M McAlonan1,2 1Sackler Institute for Translational Neurodevelopment, Department of Forensic and Neurodevelopmental Sciences, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, 2Behavioural and Developmental Psychiatry Clinical Academic Group, Behavioural Genetics Clinic, National Adult Autism Service, South London and Maudsley Foundation NHS Trust, London, UK; 3Individual Differences, Language and Cognition Lab, Department of Developmental and Educational Psychology, University of Seville, Spain; 4Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital, Goethe-University, Frankfurt am Main, Germany Abstract: Autism spectrum disorder (ASD is a common neurodevelopmental disorder characterized by pervasive difficulties since early childhood across reciprocal social communication and restricted, repetitive interests and behaviors. Although early ASD research focused primarily on children, there is increasing recognition that ASD is a lifelong neurodevelopmental disorder. However, although health and education services for children with ASD are relatively well established, service provision for adults with ASD is in its infancy. There is a lack of health services research for adults with ASD, including identification of comorbid health difficulties, rigorous treatment trials (pharmacological and psychological, development of new pharmacotherapies, investigation of transition and aging across the lifespan, and consideration of sex differences and the views of people with ASD. This article reviews available evidence regarding the etiology, legislation, diagnosis, management, and service provision for adults with ASD and considers what is needed to support adults with ASD as they age. We conclude

Nature, Nurture, and Attention Deficit Hyperactivity Disorder.

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Faraone, Stephen V.; Biederman, Joseph

2000-01-01

Comments on Joseph's review of the genetics of attention deficit disorder, demonstrating errors of scientific logic and oversight of relevant research in Joseph's argument. Argues for the validity of twin studies in supporting a genetic link for ADHD and for the complementary role of nature and nurture in the etiology of the disorder. (JPB)

Chronic obstructive pulmonary disease: nature-nurture interactions.

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Clancy, John; Nobes, Maggie

A person's health status is rarely constant, it is usually subject to continual change as a person moves from health to illness and usually back to health again; the health-illness continuum illustrates this dynamism. This highlights the person's various states of health and illness (ranging from extremely good health to clinically defined mild, moderate and severe illness) and their fluctuations throughout the life span, until ultimately leading to the pathology associated with the person's death. Maintenance of a stable homeostatic environment within the body to support the stability of this continuum depends on a complex series of ultimately intracellular chemical reactions. These reactions are activated by environmental factors that cause the expression of genes associated with healthy phenotypes as well as illness susceptibility genes associated with homeostatic imbalances. Obviously, the body aims to support intracellular and extracellular environments allied with health; however, the complexity of these nature-nurture interactions results in illness throughout an individual's life span. This paper will discuss the nature-nurture interactions of chronic obstructive pulmonary disease.

More Rhode Island Adults Have Dental Coverage After the Medicaid Expansion: Did More Adults Receive Dental Services? Did More Dentists Provide Services?

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Zwetchkenbaum, Samuel; Oh, Junhie

2017-10-02

Under the Affordable Care Act (ACA) Medicaid expansion since 2014, 68,000 more adults under age 65 years were enrolled in Rhode Island Medicaid as of December 2015, a 78% increase from 2013 enrollment. This report assesses changes in dental utilization associated with this expansion. Medicaid enrollment and dental claims for calendar years 2012-2015 were extracted from the RI Medicaid Management Information System. Among adults aged 18-64 years, annual numbers and percentages of Medicaid enrollees who received any dental service were summarized. Additionally, dental service claims were assessed by provider type (private practice or health center). Although 15,000 more adults utilized dental services by the end of 2015, the annual percentage of Medicaid enrollees who received any dental services decreased over the reporting periods, compared to pre-ACA years (2012-13: 39%, 2014: 35%, 2015: 32%). From 2012 to 2015, dental patient increases in community health centers were larger than in private dental offices (78% vs. 34%). Contrary to the Medicaid population increase, the number of dentists that submitted Medicaid claims decreased, particularly among dentists in private dental offices; the percentage of RI private dentists who provided any dental service to adult Medicaid enrollees decreased from 29% in 2012 to 21% in 2015. Implementation of Medicaid expansion has played a critical role in increasing the number of Rhode Islanders with dental coverage, particularly among low-income adults under age 65. However, policymakers must address the persistent and worsening shortage of dental providers that accept Medicaid to provide a more accessible source of oral healthcare for all Rhode Islanders. [Full article available at http://rimed.org/rimedicaljournal-2017-10.asp].

Nature or Nurture? Gender Roles Scavenger Hunt

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Whalen, Shannon; Maurer-Starks, Suanne

2008-01-01

The examination of gender roles and stereotypes and their subsequent impact on sexual behavior is a concept for discussion in many sex education courses in college and sex education units in high school. This analysis often leads to a discussion of the impact of nature vs. nurture on gender roles. The gender roles scavenger hunt is an interactive…

Issues in Sociobiology: The Nature vs. Nurture Debate.

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Lorenzen, Eric

2001-01-01

Explains the two theories on the origins of human and animal behavior. Introduces the new discipline of sociobiology, a merging of biology and sociology. Describes the central dogma of sociobiology and its societal implications, and discusses criticism of sociobiology. Presents the nature vs. nurture debate. (YDS)

Women Nurturing Women: A Woman's Group Using Hypnotherapy.

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Forester-Miller, Holly

1999-01-01

Provides information regarding rationale, objectives, format, and insights from a women's psychotherapy group where self-hypnosis and working in trance were major components. The group was designed to promote emotional, psychological, and physiological healing, and to facilitate women in learning how to give and receive nurturing. Describes…

Nurse-led liaison mental health service for older adults: service development using lean thinking methodology.

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Atkinson, Paula; Mukaetova-Ladinska, Elizabeta B

2012-04-01

Liaison Psychiatric Services for Older Adults in the UK have been established over the last decade, with rather divergent team composition and involvement. The latest documents (National Dementia Strategy, Who Cares Wins) set the gold standard for liaison services for older adults in England, requiring a proactive approach to services and integrating assessment and treatment of mental disorder into routine general hospital practice. This requires a physical presence of liaison services in the hospital, with collaboration with medical colleagues. We have adopted the above strategy in a nurse-led liaison service working in a General District Hospital, and used the Toyota Production System. In the current study we reflect on the 5 day rapid progress improvement workshops event for the liaison branch of the project, and describe the process of identifying real situation problems for the care of the medically ill, the involvement of the liaison team in their clinical care, and a feedback on the change in practice. The novel approach of identifying areas for change in an ongoing nurse-led Liaison service for Older Adults resulted in improving access to mental health services for elderly medically ill inpatients and improved quality of their overall care. Copyright © 2011 Elsevier Inc. All rights reserved.

Nurturing Your Child's Development from 24 to 36 Months

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... lots of conversations with your child. This will boost his language skills, introduce him to the pleasure ... self-confidence, and lang… Explore more from Healthy Minds: Nurturing Your Child's Development Resource | Disponible en español ...

The nature of nurture: Effects of parental genotypes.

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Kong, Augustine; Thorleifsson, Gudmar; Frigge, Michael L; Vilhjalmsson, Bjarni J; Young, Alexander I; Thorgeirsson, Thorgeir E; Benonisdottir, Stefania; Oddsson, Asmundur; Halldorsson, Bjarni V; Masson, Gisli; Gudbjartsson, Daniel F; Helgason, Agnar; Bjornsdottir, Gyda; Thorsteinsdottir, Unnur; Stefansson, Kari

2018-01-26

Sequence variants in the parental genomes that are not transmitted to a child (the proband) are often ignored in genetic studies. Here we show that nontransmitted alleles can affect a child through their impacts on the parents and other relatives, a phenomenon we call "genetic nurture." Using results from a meta-analysis of educational attainment, we find that the polygenic score computed for the nontransmitted alleles of 21,637 probands with at least one parent genotyped has an estimated effect on the educational attainment of the proband that is 29.9% ( P = 1.6 × 10 -14 ) of that of the transmitted polygenic score. Genetic nurturing effects of this polygenic score extend to other traits. Paternal and maternal polygenic scores have similar effects on educational attainment, but mothers contribute more than fathers to nutrition- and heath-related traits. Copyright © 2018, The Authors, some rights reserved; exclusive licensee American Association for the Advancement of Science. No claim to original U.S. Government Works.

Piloting the older adult financial exploitation measure in adult safeguarding services.

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Phelan, A; Fealy, G; Downes, C

Financial abuse is arguably the most complex form of elder abuse as it may occur remote to the older person and it is impacted by issues such as cultural values, perpetrator intent and family expectations. Financial abuse may not be recognised by either the older person or the perpetrator, thus, its prevention, early identification and amelioration are important. The (Irish) National Centre for the Protection of Older People undertook a study to determine the appropriateness of the Older Adult Financial Exploitation Measure for use by the national safeguarding older person services. Findings from a small pilot study involving 16 safeguarding staff's use of the Older Adult Financial Exploitation Measure with 52 community dwelling older people referred to their service demonstrate a higher suspicion of financial abuse as well as identifying multiple instances of possible financial exploitation in a single individual. Thus, the Older Adult Financial Exploitation Measure is considered appropriate to assist safeguarding personnel's assessment of older people related to a suspicion of financial abuse. Copyright © 2017 Elsevier B.V. All rights reserved.

NEWPATH: An Innovative Program to Nurture IT Entrepreneurs

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Soundarajan, Neelam; Camp, Stephen M.; Lee, David; Ramnath, Rajiv; Weide, Bruce W.

2016-01-01

The number of freshmen interested in entrepreneurship has grown dramatically in the last few years. In response, many universities have created entrepreneurship programs, including ones focused on engineering entrepreneurship. In this paper, we report on NEWPATH, an innovative NSF-supported program at Ohio State, designed to nurture students to…

Nurturer, Victim, Seductress: Gendered Roles in Terrorism

Science.gov (United States)

2018-04-20

Becomes Her: The Changing Roles of Women’s Role in Terror." Georgetown Journal of International Affairs, Winter/Spring 2010: 91-98. ———. Dying to Kill...ORGANIZATION NAME(S) AND ADDRESS(ES) 8. PERFORMING ORGANIZATION . REPORT NUMBER Joint Forces Staff College Joint Advanced Warflghting School 7800 Hampton Blvd...STAFF COLLEGE JOINT ADVANCED WARFIGHTING SCHOOL Nurturer, Victim, Seductress: Gendered Roles in

Nurturing ECSU Research Talent (NERT & AASERT) 1997-98 Annual Report

National Research Council Canada - National Science Library

Hayden, Linda

1998-01-01

This report documents the activities of the Augmentation Award for Science and Engineering Research Training Program as well as the activities of the parent grant entitled Nurturing ECSU Research Talent...

Musical Nurture in the Early Years of Children.

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Miller, Samuel D.

Children are naturally musical and should be musically educated. Music provides a unique way for children to grow intellectually, emotionally and socially. Music fulfills an inner drive to express feelings and experiences in a symbolic, abstract, creative, and acceptable manner which is positive and valued. Musical nurture should begin within the…

The continuing legacy of nature versus nurture in biolinguistics.

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Bowling, Daniel L

2017-02-01

Theories of language evolution that separate biological and cultural contributions perpetuate a false dichotomy between nature and nurture. The explanatory power of future theories will depend on acknowledging the reality of gene-culture interaction and how it makes language possible.

The Effects of Medicaid Policy Changes on Adults Service...

Data.gov (United States)

U.S. Department of Health & Human Services — The Effects of Medicaid Policy Changes on Adults Service Use Patterns in Kentucky and Idaho According to findings reported in The Effects of Medicaid Policy Changes...

Willingness to Pay for Home-Based Rehabilitation Service Among Older Adults.

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Li, Xuemei; Wan, Xia; Pang, Yajuan; Zhou, Lanshu

2018-06-18

This study aims to investigate the willingness to pay (WTP) for a home-based rehabilitation service and explore the influencing factors of WTP among older adults in Shanghai, China. A cross-sectional design was used. A questionnaire survey based on the contingent valuation method was conducted by face-to-face survey over 3 months. Only 242 (44%) participants were willing to pay for a home-based rehabilitation service. The median amount they were willing to pay was RMB 8 (US$1.15) per visit. Older adults who had higher monthly income, had at least one partner who worked, and had medical insurance were willing to pay more for the service. Older adults showed low WTP for a home-based rehabilitation service. Economic status and health condition are the significant influencing factors of WTP. Studies on recipients' precise needs and ability to pay are required before home-based services are implemented.

Neural networks of human nature and nurture

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Daniel S. Levine

2009-11-01

Full Text Available Neural network methods have facilitated the unification of several unfortunate splits in psychology, including nature versus nurture. We review the contributions of this methodology and then discuss tentative network theories of caring behavior, of uncaring behavior, and of how the frontal lobes are involved in the choices between them. The implications of our theory are optimistic about the prospects of society to encourage the human potential for caring.

Mental Health Service Use Among Lesbian, Gay, and Bisexual Older Adults.

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Stanley, Ian H; Duong, Jeffrey

2015-07-01

Empirical efforts to measure use of mental health services among lesbian, gay, and bisexual (LGB) older adults have been notably lacking. Thus this study assessed associations between sexual orientation and mental health service use among older adults and determined the mediating role of nonspecific psychological distress, excessive alcohol use, and self-perceived poor general medical health. Data from the 2011 New York City Community Health Survey were analyzed. The analytic sample comprised 5,138 adults ages 50 and over. Logistic regression modeling was used to examine associations between sexual orientation (LGB versus heterosexual) and past-year mental health service use (counseling or medication), adjusting for sociodemographic and clinical characteristics. Mediation analyses using bootstrapping were conducted. Among LGB older adults, 23.9% reported receiving counseling, and 23.4% reported taking psychiatric medication in the past year. LGB respondents were significantly more likely than heterosexuals to have received counseling (adjusted odds ratio [AOR]=2.16, 95% confidence interval [CI]=1.49-3.13) and psychiatric medication (AOR=1.97, CI=1.36-2.86). Psychological distress, excessive alcohol use, and self-perceived poor general medical health did not mediate the association between sexual orientation and mental health service use. LGB older adults were more likely than heterosexuals to utilize mental health services, and this association was not explained by indicators of general medical, mental, or behavioral health.

Comprehensive services delivery and emergency department use among chronically homeless adults.

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Moore, David T; Rosenheck, Robert A

2017-05-01

Homeless adults use emergency department (ED) services more frequently than other adults, but the relationships between homelessness, health status, outpatient service use, and ED utilization are poorly understood. Data from the Collaborative Initiative to Help End Chronic Homelessness (CICH) were used to compare ED use among chronically homeless adults receiving comprehensive housing, case management, mental health, addiction, and primary care services through CICH at 5 U.S. sites (n = 274) and ED use among comparison group clients receiving generally available community services (n = 116) at the same sites. Multiple imputation was used to account for missing data and differential rates of attrition between the cohorts. Longitudinal models were constructed to compare ED use between the 2 groups during the first year after initiation of CICH services. A mediation analysis was performed to determine the relative contributions of being housed, the receipt of outpatient services, and health status to group differences in ED utilization. Participants receiving CICH services were significantly less likely to report ED use (odds ratio = 0.78, 95% confidence interval [0.65, 0.93]) in the year after program entry. Decreased ED use was primarily mediated by decreased homelessness-not by increased access to other services or health status. This suggests that becoming housed is a key driver of reduced ED utilization and that efforts to provide housing for homeless adults may result in significantly decreased ED use. Further research is needed to determine the long-term effects of housing on health status and to develop services to improve health outcomes. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Examining Unproven Assumptions of Galton's Nature-Nurture Paradigm

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McLafferty, Charles L.

2006-01-01

Sir Francis Galton's (1869/1892) notion of nature versus nurture is a cornerstone of psychology: It was recently featured in two issues of the Monitor (March and April 2004) and was infused throughout the January 2005 issue of the American Psychologist. R. L. Sternberg, E. L. Grigorenko, and K. K. Kidd offered keen insights into the pitfalls in…

The "enduring mission" of Zing-Yang Kuo to eliminate the nature-nurture dichotomy in psychology.

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Honeycutt, Hunter

2011-05-01

This paper reviews the arguments against the instinct concept and the nature-nurture dichotomy put forward by Zing-Yang Kuo (1898-1970) during the 1920s. Kuo insisted that nativism represented a kind of finished psychology, and that the labels of nature and nurture reflected and promoted one's ignorance of the development of a trait. Also discussed are his lesser known lines of research on the origins of the so-called rat-killing instinct in cats and his analysis on the determinants of animal fighting. His research illustrated the shortcomings of a nature-nurture framework and highlighted the necessity of his developmentally grounded alternative to studying behavior. Reasons for why Kuo's work has been marginalized in modern histories of psychology are also discussed. Copyright © 2011 Wiley Periodicals, Inc.

[Adult twins].

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Charlemaine, Christiane

2006-12-31

This paper explores the deep roots of closeness that twins share in their youngest age and their effect on their destiny at the adult age. Psychologists believe the bond between twins begins in utero and develops throughout the twins' lives. The four patterns of twinship described show that the twin bond is determined by the quality of parenting that twins receive in their infancy and early childhood. Common problems of adult twins bring about difficulties to adapt in a non-twin world. The nature versus nurture controversy has taken on new life focusing on inter-twin differences and the importance of parent-child interaction as fundamental to the growth and development of personality.

Ideas worth nurturing

CERN Multimedia

Antonella Del Rosso

2014-01-01

Originally created in response to requests from experimentalists working in the collaborations, IdeaSquare has evolved into a place where innovative ideas meet established expertise. Although the project is still in its pilot phase, two EU-funded projects have found their home in the IdeaSquare building and 46 students have already participated in the Challenge-Based Innovation courses based there. More to come…   IdeaSquare, which will be inaugurated on 9 December, is the name given to the B3179 refurbished building at LHC Point 1. More importantly, IdeaSquare is the name of a project designed to nurture innovation at CERN. “The scope of the project is to bring together researchers, engineers, people from industry and young students and encourage them to come up with new ideas that are useful for society, inspired by CERN’s ongoing detector R&D and upgrade projects,” explains Markus Nordberg who, together with Marzio Nessi, set up IdeaSquare withi...

Regular use of dental services among adults and older adults in a vulnerable region in Southern Brazil.

Science.gov (United States)

Machado, Luciene Petcov; Camargo, Maria Beatriz Junqueira; Jeronymo, José Carlos Milanez; Bastos, Gisele Alsina Nader

2012-06-01

To estimate the prevalence of regular use of dental care services by adults and older adults residing in vulnerable community and to identify associated factors. A population-based cross-sectional study was carried out with 3,391 adults and older adults residing in areas of social vulnerability in Porto Alegre, Southern Brazil, from July to December of 2009. A systematic sampling method was used the selection probability proportional to the population of each of the the 121 census sectors. The outcome for regular use of dental care services was defined as regular use of dental services, regardless of the presence of dental problems. A standardized questionnaire was administered, which included demographic, socioeconomic, type of dental care services, self-perception of dental health and self-perceived needs variables. A chi-square test for heterogeneity was used for bivariate analyses, and a Poisson regression with a robust variance and Wald tests were performed for the adjusted analysis. The prevalence of regular use of dental services was 25.7%. The prevalence was higher among people with >12 years schooling (PR 2.48 [95%CI:1.96;3.15]), higher income (PR 1.95[95%CI: 1.03;1.53]), use of private health services (PR 1.43 [95%CI: 1.20;1.71]),excellent self-perceived oral health (PR 4.44 [95%CI: 3.07;6.42]) and a self-perceived need for consultation related to routine checkup (RP 2.13 [95%CI: 1.54;2.96]). Inequalities were found in the regular use of dental services. Integrated approaches that raise awareness of oral health, improve self-care and expand access to dental services, may contribute to increase the use of dental services on a regular basis.

Introduction. Back to nurture: cross-cultural research as a paradigm for understanding bio-cultural dynamics of cognitive ageing.

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Luszcz, Mary

2006-01-01

One of the earliest and most persistent inquiries in developmental psychology is that of the relative contributions of nature and nurture to human ontogeny. One way of studying this distinction is by doing cross-cultural studies, in which culture provides a powerful way to operationalize the influence of nurture. The purpose is to provide some background to the emergence of the field of cross-cultural gerontological research, as a prelude to the special series of papers on cognitive ageing and culture from the laboratory of Park and Nisbett and their colleagues. A qualitative review of theoretical notions about cross-cultural differences provides an introduction and orientation to papers dealing with aspects of cognitive ageing, including picture naming specificity, source memory, use of categorical information in free recall, and perceptions of stereotypes of older and younger adults. Most of the research on cognitive ageing has focused on Western cultures and has assumed universality in the operation of the cognitive system. If culture makes a difference, a plausible hypothesis might be that, with ageing, any effects of culture on cognitive processes would become more apparent, due to older adults' increased exposure to their culture, and that these might be limited to the pragmatics of intelligence or crystallized abilities. The papers presented demonstrate that for some cognitive processes, i.e., source memory and free recall, cultural invariance, or universality of cognitive ageing, was observed. Further, stereotypes of both cultures shifted with advancing age from positive to increasingly negative views for mental and physical domains. A modest interaction of age and culture was observed in social and emotional domains, where stereotypes were relatively neutral, except for a small positive bias among the young Chinese participants for both older and younger adults. Marked cultural differences were seen in naming specificity and in the use of categories to

The Nature-Nurture Debates: 25 Years of Challenges in Understanding the Psychology of Gender.

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Eagly, Alice H; Wood, Wendy

2013-05-01

Nature-nurture debates continue to be highly contentious in the psychology of gender despite the common recognition that both types of causal explanations are important. In this article, we provide a historical analysis of the vicissitudes of nature and nurture explanations of sex differences and similarities during the quarter century since the founding of the Association for Psychological Science. We consider how the increasing use of meta-analysis helped to clarify sex difference findings if not the causal explanations for these effects. To illustrate these developments, this article describes socialization and preferences for mates as two important areas of gender research. We also highlight developing research trends that address the interactive processes by which nature and nurture work together in producing sex differences and similarities. Such theorizing holds the promise of better science as well as a more coherent account of the psychology of women and men that should prove to be more influential with the broader public. © The Author(s) 2013.

Religious and spiritual development are determined 100% by nature, and 100% by nurture: A playful response to Boyatzis.

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Granqvist, Pehr; Nkara, Frances

2017-03-01

In this response, we respond to Boyatzis' commentary to our paper 'Nature meets nurture in religious and spiritual development'. We also provide additional elaborations on how nurture might co-sculpt nature in the context of religious and spiritual development. © 2017 The British Psychological Society.

Nurturing Positive Mental Health: Mindfulness for Wellbeing in Counseling

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Rybak, Christopher

2013-01-01

As increasing attention has been given in the past decade to positive psychology, this has likewise been directed toward understanding methods of nurturing positive mental health. These methods have moved toward empowering clients in the development of skills to enhance their own sense of wellbeing (Khong, Counseling and Spirituality, 25, 67-84,…

The epigenome and nature/nurture reunification: a challenge for anthropology.

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Lock, Margaret

2013-01-01

Recognition among molecular biologists of variables external to the body that can bring about hereditable changes in gene expression or cellular phenotypes has reignited nature/nurture discussion. These epigenetic findings may well set off a new round of somatic reductionism because research is confined largely to the molecular level. A brief review of the late nineteenth-century formulation of the nature/nurture concept is followed by a discussion of the positions taken by Boas and Kroeber on this matter. I then illustrate how current research into Alzheimer's disease uses a reductionistic approach, despite epigenetic findings in this field that make the shortcomings of reductionism clear. In order to transcend the somatic reductionism associated with epigenetics, drawing on concepts of local biologies and embedded bodies, anthropologists can carry out research in which epigenetic findings are contextualized in the specific historical, socio/political, and environmental realities of lived experience.

RUSSIAN NATIONAL TALE IN NURTURING CHILD AS AN ASPECT OF THE FORMATION OF HIS PERSONALITY

Directory of Open Access Journals (Sweden)

Nikolay Govorov

2015-09-01

Full Text Available The article deals with the problem of children nurturing. Given the provisions of the recommended use of Russian national fairy tales in children nurturing. We consider the role of a fairy tale, as an aspect of the success of educational processes in a child immersed in the atmosphere of a modern cyber information of his being. It rips the need to address the problem of writing the words of imagery of Russian fairy tales.

“A house of prayer in the heart”: How homiletics nurtures the church’s spirituality

Directory of Open Access Journals (Sweden)

Thomas H. Troeger

2006-10-01

Full Text Available Prayer, whatever form it takes, represents a living relationship with God. In the article it is argued that the goal of preaching is the vitalizing, nurturing, enriching, deepening, broadening, and heightening of believers’ relationship with God. To participate in this dynamic divine/human relationship, is a form of spirituality. Therefore, if the sermon ends with prayer, it follows that the purpose of preaching is – at least in part – the nurture of spirituality.

Impact of international humanitarian service-learning on emerging adult social competence: A mixed-methods evaluation

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Paul Schvaneveldt

2016-09-01

Full Text Available This article presents the results from a study into international humanitarian service-learning experiences on young adult volunteers. Specifically, the service-learning experiences of emerging adults who had served in orphanages in Latin America were assessed, in a pre- and post-test design, for their development in areas of social competency such as identity, self-efficacy, self-esteem and ethnocentric attitudes. A mixed-methods design using both qualitative and quantitative measures was used. Both qualitative and quantitative results identified significant and important impacts on the development of the social competencies of these emerging adults. In addition, several qualitative themes illustrated that longer term international service-learning experiences have a profound impact on the social competence of emerging adults. Keywords: International humanitarian service, service-learning, emerging adult competency

Nature or Nurture – Will Epigenomics Solve the Dilemma?

Directory of Open Access Journals (Sweden)

Płonka Beata

2016-06-01

Full Text Available The concept of “nature and nurture” is used to distinguish between genetic and environmental influences on the formation of individual, mainly behavioral, traits. Different approaches that interpret nature and nurture as completely opposite or complementary aspects of human development have been discussed for decades. The paper addresses the most important points of nature vs nurture debate from the perspective of biological research, especially in the light of the recent findings in the field of epigenetics. The most important biological concepts, such as the trait, phenotype and genotype, as well as the evolution of other crucial notions are presented. Various attempts to find the main source of human variation are discussed - mainly the search for structural variants and the genome-wide association studies (GWAS. A new approach resulting from the discovery of “missing heritability”, as well as the current knowledge about the possible influence of epigenetic mechanisms on human traits are analyzed. Finally, the impact of epigenetic revolution on the society (public attitude, health policy, human rights etc. is discussed.

PROBLEM DEFINISI GENDER: KAJIAN ATAS KONSEP NATURE DAN NURTURE

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Moh. Khuza’i

2012-03-01

Full Text Available There are three things examined in this article, the definition of gender, the concept of nature, and the concept of nurture. These three things need to be studied, because they are the keywords for feminists to spread their ideas to the world of Islam. The existence of feminism should be criticized, as historically this understanding did not make women better in running their lives. That because of problems in the concept of feminism and itsnegative effect. The caution is needed, because the gender activists often point to the backwardness of women and the suppression of them by showing the incorrect reasons. In addressing the differences between men and women, Islam has a better concept than feminism. Islam has a concept of fitrah and amanah. This paper tries to study theconcept of nature and nurture in the Islamic perspective, tries to present an alternative in addressing the differences between men and women, also tries to shows the proof whether Islam leans to the one of two concepts being debated.

In the Eye of the Beholder: Self-Esteem and Children's vs. Parents' Assessments of Parental Nurturance and Discipline.

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Buri, John R.; Mueller, Rebecca A.

Past research has implicated the familial variables of parental nurturance and parental discipline in the development of global self-esteem in children. This study examined college students' levels of self-esteem as a function of their own versus their parents' appraisals of parental nurturance and parental authority. Subjects were 128 college…

Nurturing Ethical Values in the 21st Century Adolescent

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Kuttner, Joanne Fitzmaurice

2009-01-01

There is a wise proverb that insists it takes a whole village to raise a child to adulthood. In light of the expanding convolution of contemporary values, it is especially important to attentively nurture the inherent desire in each developing human person to seek good and avoid evil, especially during the critical years of adolescent formation.…

The Biological Implausibility of the Nature-Nurture Dichotomy & What It Means for the Study of Infancy.

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Lewkowicz, David J

2011-01-01

Since the time of the Greeks, philosophers and scientists have wondered about the origins of structure and function. Plato proposed that the origins of structure and function lie in the organism's nature whereas Aristotle proposed that they lie in its nurture. This nature/nurture dichotomy and the emphasis on the origins question has had a powerful effect on our thinking about development right into modern times. Despite this, empirical findings from various branches of developmental science have made a compelling case that the nature/nurture dichotomy is biologically implausible and, thus, that a search for developmental origins must be replaced by research into developmental processes. This change in focus recognizes that development is an immensely complex, dynamic, embedded, interdependent, and probabilistic process and, therefore, renders simplistic questions such as whether a particular behavioral capacity is innate or acquired scientifically uninteresting.

Older Californians and the Mental Health Services Act: Is an Older Adult System of Care Supported?

Science.gov (United States)

Kietzman, Kathryn G; Dupuy, Danielle; Damron-Rodriguez, JoAnn; Palimaru, Alina; del Pino, Homero E; Frank, Janet C

2018-01-01

This policy brief summarizes findings from the first study to evaluate how California's public mental health delivery system has served older adults (60 years of age and over) since the passage of the Mental Health Services Act (MHSA) in 2004. Study findings indicate that there are unmet needs among older adults with mental illness in the public mental health delivery system. There are deficits in the involvement of older adults in the required MHSA planning processes and in outreach and service delivery, workforce development, and outcomes measurement and reporting. There is also evidence of promising programs and strategies that counties have advanced to address these deficits. Recommendations for improving mental health services for older adults include designating a distinct administrative and leadership structure for older adult services in each county; enhancing older adult outreach and documentation of unmet need; promoting standardized geriatric training of providers; instituting standardized data-reporting requirements; and increasing service integration efforts, especially between medical, behavioral health, aging, and substance use disorder services.

Gender Differences in Perceptions of Grandchildren towards Grandparent Nurturing

OpenAIRE

Yusuf, Muhammed; Mai, Mohammed Y. M.; Salih, Maria

2016-01-01

Persisting writing on grandparents' enthusiasm towards grandchildren’s development shows that numerous grandparents take part in raising their grandchildren at a young age and preparing them for a better future. Grandparents motivate their grandchildren to excel scholastically and morally. The present study investigates grandchildren’s perceptions towards their grandparents’ nurturing educationally, culturally, socially, and religiously. One hundred and eighty one grandchildren from two ...

Characteristics and Service Use of Older Adults with Schizoaffective Disorder Versus Older Adults with Schizophrenia and Bipolar Disorder.

Science.gov (United States)

Rolin, Stephanie A; Aschbrenner, Kelly A; Whiteman, Karen L; Scherer, Emily; Bartels, Stephen J

2017-09-01

The purpose of this study was to determine if schizoaffective disorder in older adults is differentiated from schizophrenia and bipolar disorder with respect to community functioning, cognitive functioning, psychiatric symptoms, and service use. Secondary analysis of baseline data collected from the Helping Older People Experience Success psychosocial skills training and health management study. Three community mental health centers in New Hampshire and Massachusetts. Adults over the age of 50 (N = 139, mean age: 59.7 years, SD: 7.4 years) with persistent functional impairment and a diagnosis of schizoaffective disorder (N = 52), schizophrenia (N = 51), or bipolar disorder (N = 36). Health status (36-Item Short Form Health Survey [SF-36]), performance-based community living skills (UCSD Performance-Based Skills Assessment), neuropsychological functioning (Delis-Kaplan Executive Functioning subtests), psychiatric symptoms (Brief Psychiatric Rating Scale, Center for Epidemiologic Studies Depression Scale, Scale for the Assessment of Negative Symptoms), medical severity (Charlson comorbidity index), and acute service use. Older adults with schizoaffective disorder had depressive symptoms of similar severity to bipolar disorder, and thought disorder symptoms of similar severity to schizophrenia. Schizoaffective disorder compared with schizophrenia was associated with better community functioning, but poorer subjective physical and mental health functioning as measured by the SF-36. Older adults with schizoaffective disorder had greater acute hospitalization compared with adults with schizophrenia, though their use of acute care services was comparable to individuals with bipolar disorder. Findings from this study suggest that schizoaffective disorder in older adults occupies a distinct profile from either schizophrenia or bipolar disorder with respect to community functional status, symptom profile, and acute services utilization. Copyright © 2017

Nature and Nurture of Human Pain

Directory of Open Access Journals (Sweden)

Inna Belfer

2013-01-01

Full Text Available Humans are very different when it comes to pain. Some get painful piercings and tattoos; others can not stand even a flu shot. Interindividual variability is one of the main characteristics of human pain on every level including the processing of nociceptive impulses at the periphery, modification of pain signal in the central nervous system, perception of pain, and response to analgesic strategies. As for many other complex behaviors, the sources of this variability come from both nurture (environment and nature (genes. Here, I will discuss how these factors contribute to human pain separately and via interplay and how epigenetic mechanisms add to the complexity of their effects.

Nurturing Environments for Boys and Men of Color with Trauma Exposure.

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Graham, Phillip W; Yaros, Anna; Lowe, Ashley; McDaniel, Mark S

2017-06-01

Boys and men of color are exposed to traumatic experiences at significantly higher rates than are other demographic groups. To understand and address the mental and behavioral health effects of trauma, including violent incidents, on this population, we review the literature showing the context for, outcomes of, and potential responses to trauma exposure. We present the existing research about the unique challenges and associated negative outcomes for boys and men of color, as well as identify the gaps in the literature. We present the potential nurturing responses by systems such as schools, law enforcement, and communities to trauma-exposed boys and men of color, and we describe evidence-based programs and practices that directly address trauma. Finally, we argue that, rather than using a deficit model, a model of optimal development can be used to understand how to support and protect boys and men of color through nurturing environments.

Revisiting Nature vs. Nurture: Implications for the Teaching/Learning Process.

Science.gov (United States)

French, Fred

2003-01-01

Child development theories conclude that nature and nurture interactively shape individual development. Implications for education are that children learn better when they feel wanted and are in a supportive environment. Teaching needs to go beyond pure content and focus on learning how to learn. Assessment should focus on the use of knowledge…

Perceived Parental Relationships and Health-Risk Behaviors in College-Attending Emerging Adults

Science.gov (United States)

Schwartz, Seth J.; Zamboanga, Byron L.; Ravert, Russell D.; Kim, Su Yeong; Weisskirch, Robert S.; Williams, Michelle K.; Bersamin, Melina; Finley, Gordon E.

2009-01-01

The present study investigated the association of perceived parenting with health-risk behaviors in an ethnically diverse sample of 1,728 college-attending emerging adults. Participants completed retrospective measures of perceived maternal and paternal nurturance, connection, psychological control, and disrespect and reported their frequency of…

Review: the Contribution of both Nature and Nurture to Carcinogenesis and Progression in Solid Tumours.

Science.gov (United States)

Hyndman, Iain Joseph

2016-04-01

Cancer is a leading cause of mortality worldwide. Cancer arises due to a series of somatic mutations that accumulate within the nucleus of a cell which enable the cell to proliferate in an unregulated manner. These mutations arise as a result of both endogenous and exogenous factors. Genes that are commonly mutated in cancer cells are involved in cell cycle regulation, growth and proliferation. It is known that both nature and nurture play important roles in cancer development through complex gene-environment interactions; however, the exact mechanism of these interactions in carcinogenesis is presently unclear. Key environmental factors that play a role in carcinogenesis include smoking, UV light and oncoviruses. Angiogenesis, inflammation and altered cell metabolism are important factors in carcinogenesis and are influenced by both genetic and environmental factors. Although the exact mechanism of nature-nurture interactions in solid tumour formation are not yet fully understood, it is evident that neither nature nor nurture can be considered in isolation. By understanding more about gene-environment interactions, it is possible that cancer mortality could be reduced.

Nurturing gifted learners in Mainland China

DEFF Research Database (Denmark)

Shi, Jiannong; Zhang, X.; Chen, N.

2013-01-01

-socio-intellectual model, illustrated the nature of human being and the nature of gifted learners. From the perspective of the BSI model, the authors suggested three aspects are very critical to curriculum design to meet the needs of gifted education: physical maturation or physical development, social maturation......In this article, based on the previous researches on the development of gifted learners, the authors summarized the problems in nurturing gifted learners due to lacking of the appropriate educational philosophy and educational methodology in Mainland China. The authors proposed the Bio...... or social and interpersonal development, and mental maturation or intellectual development. It was proved that BSI model has its theoretical rationality and practical validity in Mainland China...

Youth with special health care needs: transition to adult health care services.

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Oswald, Donald P; Gilles, Donna L; Cannady, Mariel S; Wenzel, Donna B; Willis, Janet H; Bodurtha, Joann N

2013-12-01

Transition to adult services for children and youth with special health care needs (CYSHCN) has emerged as an important event in the life course of individuals with disabilities. Issues that interfere with efficient transition to adult health care include the perspectives of stakeholders, age limits on pediatric service, complexity of health conditions, a lack of experienced healthcare professionals in the adult arena, and health care financing for chronic and complex conditions. The purposes of this study were to develop a definition of successful transition and to identify determinants that were associated with a successful transition. The 2007 Survey of Adult Transition and Health dataset was used to select variables to be considered for defining success and for identifying predictors of success. The results showed that a small percentage of young adults who participated in the 2007 survey had experienced a successful transition from their pediatric care.

Teaching caring and competence: Student transformation during an older adult focused service-learning course.

Science.gov (United States)

Brown, Karen M; Bright, Leslie M

2017-11-01

Innovative teaching strategies develop nurses' knowledge, skills, and attitudes while simultaneously integrating the art of caring and transforming attitudes toward adults over age 65. The study's purpose was to explore students' experiences and attitudes toward older adults with cognitive and/or physical limitations as well as the effects on students' knowledge and skills during a baccalaureate nursing, course which included a service-learning experience. Service-learning synthesizes meaningful community service, academic instruction, and reflection. Participants included baccalaureate students enrolled in a service-learning nursing course focused on older adults. This retrospective, qualitative, phenomenological study used reflective journals and an online survey to explore baccalaureate nursing students' experiences toward older adults with cognitive and/or physical limitations. Themes included initial attitudes of anticipation, apprehension, anxiety, and ageist stereotypes. Final attitudes included a "completely changed perspective" of caring, compassion, and respect indicative of a rewarding, "life-changing" experience. Participants cited enhanced learning, especially in the areas of patient-centered care, collaboration, communication, advocacy, empathy, assessment skills, and evidence-based practice. This innovative teaching strategy led to transformed attitudes toward older adults, reduced fear of older adult populations, an increased desire to work with older adults, and the ability to form a transpersonal, caring relationship while enhancing nursing knowledge and skills. Copyright © 2017 Elsevier Ltd. All rights reserved.

Place-Based Stewardship Education: Nurturing Aspirations to Protect the Rural Commons

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Gallay, Erin; Marckini-Polk, Lisa; Schroeder, Brandon; Flanagan, Constance

2016-01-01

In this mixed-methods study, we examine the potential of place-based stewardship education (PBSE) for nurturing rural students' community attachment and aspirations to contribute to the preservation of the environmental "commons." Analyzing pre- and post-experience surveys (n = 240) and open-ended responses (n = 275) collected from…

Under what conditions can local government nurture indigenous people’s democratic practice?

DEFF Research Database (Denmark)

Sareen, Siddharth; Nathan, Iben

2017-01-01

This paper asks whether and under what conditions participatory local government can best nurture indigenous peoples’ democratic practice. Based on fieldwork in two similar Ho communities in the Indian state Jharkhand, we show that their village assemblies function differently with regard...

Caries experience and use of dental services in rural and urban adults and older adults from central Chile.

Science.gov (United States)

Quinteros, Maria E; Cáceres, Dante D; Soto, Alex; Mariño, Rodrigo J; Giacaman, Rodrigo A

2014-10-01

To determine whether there is a relationship between the use of dental services and caries experience in adults and older adults from central Chile. A sample of 453 adults, 35-44 years of age, and 438 older adults, 65-74 years of age, was interviewed and examined using World Health Organisation (WHO) methods. Sociodemographic variables were also registered. Caries experience was assessed using the Decayed, Missing and Filled teeth (DMFT) index. Multiple linear regression models were used to determine whether there was an association between the independent variables and caries experience. Caries prevalence was 99.6% for adults [DMFT score = 14.89 (±6.16)] and 99.8% for older adults [DMFT score = 25.68 (±6.49)]. Less than half of the population - 41.7% of adults and 31.5% of older adults - received dental care. Regardless of the age group, there were no differences in the DMFT score between those who received and those who did not receive attention (P > 0.05). When the DMFT findings were analysed in greater detail, people who received dental care and urban participants had more fillings (P dental damage from caries. Although rurality and use of services do not seem to affect caries experience, they are associated with differences in fillings and missing teeth. © 2014 FDI World Dental Federation.

Nature, Nurture and Neuroscience: Some Future Directions for Historians of Education

Science.gov (United States)

Aldrich, Richard

2014-01-01

Following a short introduction this article is divided into three main sections. The first provides definitions and brief histories of the nature-nurture debate and of neuroscience. The second section shows how in recent decades neuroscientific research has impacted on the debate with particular reference to our understanding of human intelligence…

Nurturing the brain nutritionally and emotionally from before conception to late adolescence.

Science.gov (United States)

House, Simon H

2007-01-01

Sound nurture requires skills concerning nutrition and emotions, skills that are particularly important in key stages relating to brain development. We are recognizing more clearly the way that serious changes from our hunter-gatherer waterside lifestyle are affecting both our diet and our emotional relationships: first the changes a few hundred generations ago in the agricultural revolution: and more recently in the industrial revolution. These effects have been aggravated in the last century by excessively profit-driven intensive farming, and recently by intensive food-marketing--particularly to children. People are gradually becoming aware how very susceptible is the most vulnerable stage of the lifecycle, the reproductive phase. From long before fertilization and conception, parental nutrition affects a person's development and health for life. Controlled trials show marked effects of nurture on the brain's subsequent acuity. Brain structure throughout development has become visible through modern scans, and also brain activity and mental response. The neural tube, forming at around 3 weeks, if undernourished may be inadequately sealed and demarcated, leading to incomplete interconnection between brain regions. Results vary, but can emanate as: autism or attention-deficit/hyperactivity-disorder (AD/HD); difficulty with relationships and social sense; poor self-control, with risk of violence. Evidence indicates that over 80% of current reproductive hazards, including infertility and malformations, might be prevented purely by sound all-round nurture. Between the embryonic stage and adulthood the brain makes several developmental spurts. Particularly during these spurts, sound nutrition and activity help the brain reach its full genetic potential for capacity, acuity, and connections between regions. From the beginning, hormones and nutrients, or their deficits, are setting gene-switches for life. Good bonding and feeding sets gene-switches positively; shock

In Need of Creative Mobile Service Ideas? Forget Adults and Ask Young Children

Directory of Open Access Journals (Sweden)

Ilona Kuzmickaja

2015-08-01

Full Text Available It is well acknowledged that innovation is a key success factor in the mobile service domain. Having creative ideas is the first critical step in the innovation process. Many studies suggest that customers are a valuable source of creative ideas. However, the literature also shows that adults may be constrained by existing technology frames, which are known to hinder creativity. Instead young children (aged 7-12 are considered digital natives yet are free from existing technology frames. This led us to study them as a potential source for creative mobile service ideas. A set of 41,000 mobile ideas obtained from a research project in 2006 granted us a unique opportunity to study the mobile service ideas from young children. We randomly selected two samples of ideas (N = 400 each; one contained the ideas from young children, the other from adults (aged 17-50. These ideas were evaluated by several evaluators using an existing creativity framework. The results show that the mobile service ideas from the young children are significantly more original, transformational, implementable, and relevant than those from the adults. Therefore, this study shows that young children are better sources of novel and quality ideas than adults in the mobile services domain. This study bears significant contributions to the creativity and innovation research. It also indicates a new and valuable source for the companies that seek creative ideas for innovative products and services.

Determining Factors for Utilization of Preventive Health Services among Adults with Disabilities in Taiwan

Science.gov (United States)

Kung, Pei-Tseng; Tsai, Wen-Chen; Li, Ya-Hsin

2012-01-01

Taiwan has provided free health checks for adults since 1995. However, very little previous research has explored the use of preventive health services by physically and mentally disabled adults. The present study aimed to understand this use of preventive health services and the factors that influence it. Research participants included disabled…

A prospective cohort study of deficient maternal nurturing attitudes predicting adulthood work stress independent of adulthood hostility and depressive symptoms.

Science.gov (United States)

Hintsanen, M; Kivimäki, M; Hintsa, T; Theorell, T; Elovainio, M; Raitakari, O T; Viikari, J S A; Keltikangas-Järvinen, L

2010-09-01

Stressful childhood environments arising from deficient nurturing attitudes are hypothesized to contribute to later stress vulnerability. We examined whether deficient nurturing attitudes predict adulthood work stress. Participants were 443 women and 380 men from the prospective Cardiovascular Risk in Young Finns Study. Work stress was assessed as job strain and effort-reward imbalance in 2001 when the participants were from 24 to 39 years old. Deficient maternal nurturance (intolerance and low emotional warmth) was assessed based on mothers' reports when the participants were at the age of 3-18 years and again at the age of 6-21 years. Linear regressions showed that deficient emotional warmth in childhood predicted lower adulthood job control and higher job strain. These associations were not explained by age, gender, socioeconomic circumstances, maternal mental problems or participant hostility, and depressive symptoms. Deficient nurturing attitudes in childhood might affect sensitivity to work stress and selection into stressful work conditions in adulthood. More attention should be paid to pre-employment factors in work stress research.

Geography of Service Delivery: On the Role of Mental Health Service Structure in Community Senior Services for Puerto Rican Older Adults

Science.gov (United States)

Velez Ortiz, Daniel

2009-01-01

The main purpose of this study was to examine the role of mental health services structure in community senior centers and how it interacts with Puerto Rican older adults' historical, social, and cultural experiences to relate to their perceptions, awareness, and utilization of mental health services. The study was carried out within a concurrent…

Effects of Aging and Adult Development Education and Service Learning on Attitude, Anxiety, and Occupational Interest

Science.gov (United States)

Boswell, Stefanie S.

2015-01-01

This study investigated the effect of a semester-long aging and adult development course that included an intergenerational, service-learning component on attitudes toward older adult men and women, aging anxiety, and interest in occupations that serve older adults among individuals training for careers in healthcare and social services. It also…

Nature and nurture in the development of postural control in human infants

NARCIS (Netherlands)

HaddersAlgra, M; Brogren, E; Forssberg, H

Nowadays, the controversy on ''nature'' and ''nurture'' in motor development focuses on the development of automatic motor patterns. The present paper discusses this issue within the framework of a recent study on the effect of maturation and training on the development of postural adjustments in

Examining Fall Recurrence Risk of Homebound Hispanic Older Adults Receiving Home Care Services.

Science.gov (United States)

Solis, Guillermina R; Champion, Jane Dimmitt

2017-03-01

Unintentional falls and injuries is a major problem among older adults and the fourth cause of death in the United States. A previous fall event doubles the risk of recurrence and lessens the person's quality of life. Hispanic older adults have higher rates of disability and lower independent functioning due to poor medical health and risk for fall recurrence. Most fall studies focus on fall risk with few studies on fall recurrence in older adults receiving home health care services unrelated to fall incident. A descriptive pilot study of 30 homebound Hispanic older adults receiving home care services who reported a fall within 3 months was conducted by a multidisciplinary team to evaluate risk of fall recurrence. A heightened risk for fall recurrence was identified with high number of chronic illnesses, high intake of medications, vision problems, and prevalence of urinary incontinence. Findings highlight significant number of intrinsic factors for fall risk recurrence and injuries in a Hispanic older adults population that is homebound and receiving home care services. A multidisciplinary evaluation and culturally appropriate interventions to lessen the risk of fall recurrence are recommended.

Nature plus nurture: the triggering of multiple sclerosis.

Science.gov (United States)

Wekerle, Hartmut

2015-01-01

Recent clinical and experimental studies indicate that multiple sclerosis develops as consequence of a failed interplay between genetic ("nature") and environmental ("nurture") factors. A large number of risk genes favour an autoimmune response against the body's own brain matter. New experimental data indicate that the actual trigger of this attack is however provided by an interaction of brain-specific immune cells with components of the regular commensal gut flora, the intestinal microbiota. This concept opens the way for new therapeutic approaches involving modulation of the microbiota by dietary or antibiotic regimens.

Interaction patterns of nurturant support exchanged in online health social networking.

Science.gov (United States)

Chuang, Katherine Y; Yang, Christopher C

2012-05-03

Expressing emotion in online support communities is an important aspect of enabling e-patients to connect with each other and expand their social resources. Indirectly it increases the amount of support for coping with health issues. Exploring the supportive interaction patterns in online health social networking would help us better understand how technology features impacts user behavior in this context. To build on previous research that identified different types of social support in online support communities by delving into patterns of supportive behavior across multiple computer-mediated communication formats. Each format combines different architectural elements, affecting the resulting social spaces. Our research question compared communication across different formats of text-based computer-mediated communication provided on the MedHelp.org health social networking environment. We identified messages with nurturant support (emotional, esteem, and network) across three different computer-mediated communication formats (forums, journals, and notes) of an online support community for alcoholism using content analysis. Our sample consisted of 493 forum messages, 423 journal messages, and 1180 notes. Nurturant support types occurred frequently among messages offering support (forum comments: 276/412 messages, 67.0%; journal posts: 65/88 messages, 74%; journal comments: 275/335 messages, 82.1%; and notes: 1002/1180 messages, 84.92%), but less often among messages requesting support. Of all the nurturing supports, emotional (ie, encouragement) appeared most frequently, with network and esteem support appearing in patterns of varying combinations. Members of the Alcoholism Community appeared to adapt some traditional face-to-face forms of support to their needs in becoming sober, such as provision of encouragement, understanding, and empathy to one another. The computer-mediated communication format may have the greatest influence on the supportive interactions

How do educators in one New Zealand undergraduate Bachelor of Oral Health course teach and nurture professionalism?

Science.gov (United States)

Smith, L; Adam, L; Moffat, S; Meldrum, A; Ahmadi, R

2018-05-01

Research on integrated dental hygiene and dental therapy courses is scarce; studies reporting on how staff in these combined scope courses teach professionalism are even more scarce. This study aimed to partially fill these research gaps. In 2016, online surveys were sent to 34 staff members who taught into the integrated Bachelor of Oral Health (BOH) course at the University of Otago's Faculty of Dentistry; 13 were returned. Two focus groups were conducted with six BOH educators. Aspects of professionalism were taught and nurtured in the formal curriculum, the clinic and the informal curriculum. In the formal curriculum, policies outlining the professional standards of behaviour expected of oral health practitioners and students in New Zealand and the Faculty were discussed. In the clinic, educators taught professionalism through modelling clinical skills, assessing students' performance and commenting on their reflective logbooks. In the informal curriculum, BOH teachers nurtured professionalism through discussions about standards of behaviour outside of the university. Role modelling was the most common method that participants reported they taught or nurtured professionalism in their students. Professionalism is a complex concept that is taught and nurtured in a number of ways over all aspects of the course. Oral Health educators need to maintain a high standard of professionalism when interacting with students and patients, as well as in public spaces, in order to model professionalism to their students. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Nurturing Diversified Farming Systems in Industrialized Countries: How Public Policy Can Contribute

Directory of Open Access Journals (Sweden)

Alastair Iles

2012-12-01

Full Text Available If diversified farming systems (DFS are to thrive again in the United States, policies and preferences must evolve to reward the environmental and social benefits of sustainable farming and landscape management. Compared with conventional agricultural policies, policies aiding ecological diversification are underdeveloped and fragmented. We consider several examples of obstacles to the adoption and spread of diversified farming practices in the U.S. industrialized agricultural system. These include the broader political economic context of industrialized agriculture, the erosion of farmer knowledge and capacity, and supply chain and marketing conditions that limit the ability of farmers to adopt sustainable practices. To overcome these obstacles and nurture DFS, policy makers, researchers, industry, farmers, consumers, and local communities can play pivotal roles to transform agricultural research, develop peer-to-peer learning processes, support the recruitment and retention of new farmers through access to credit and land, invest in improved agricultural conservation programs, provide compensation for provision of ecological services in working landscapes, and develop links to consumer and institutional markets.

Allocation of Rehabilitation Services for Older Adults in the Ontario Home Care System.

Science.gov (United States)

Armstrong, Joshua J; Sims-Gould, Joanie; Stolee, Paul

Background: Physiotherapy and occupational therapy services can play a critical role in maintaining or improving the physical functioning, quality of life, and overall independence of older home care clients. Despite their importance, however, there is limited understanding of the factors that influence how rehabilitation services are allocated to older home care clients. The aim of this pilot study was to develop a preliminary understanding of the factors that influence decisions to allocate rehabilitation therapy services to older clients in the Ontario home care system, as perceived by three stakeholder groups. Methods: Semi-structured interviews were conducted with 10 key informants from three stakeholder groups: case managers, service providers, and health system policymakers. Results: Drivers of the allocation of occupational therapy and physiotherapy for older adults included functional needs and postoperative care. Participants identified challenges in providing home care rehabilitation to older adults, including impaired cognition and limited capacity in the home care system. Conclusions: Considering the changing demands for home care services, knowledge of current practices across the home care system can inform efforts to optimize rehabilitation services for the growing number of older adults. Further research is needed to advance the understanding of, and optimize rehabilitation service allocation to, older frail clients with multiple morbidities. Developing novel decision-support mechanisms and standardized clinical care pathways for older client populations may be beneficial.

Immigrants to the United States and Adult Education Services

Science.gov (United States)

Larrotta, Clarena

2017-01-01

This chapter describes documented and undocumented immigrant populations in the United States. It discusses salient factors influencing their status as immigrants as well as adult education services available to them through publicly funded programs, social units, and community centers, especially churches and libraries.

Nature and nurture: environmental influences on a genetic rat model of depression.

Science.gov (United States)

Mehta-Raghavan, N S; Wert, S L; Morley, C; Graf, E N; Redei, E E

2016-03-29

In this study, we sought to learn whether adverse events such as chronic restraint stress (CRS), or 'nurture' in the form of environmental enrichment (EE), could modify depression-like behavior and blood biomarker transcript levels in a genetic rat model of depression. The Wistar Kyoto More Immobile (WMI) is a genetic model of depression that aided in the identification of blood transcriptomic markers, which successfully distinguished adolescent and adult subjects with major depressive disorders from their matched no-disorder controls. Here, we followed the effects of CRS and EE in adult male WMIs and their genetically similar control strain, the Wistar Kyoto Less Immobile (WLI), that does not show depression-like behavior, by measuring the levels of these transcripts in the blood and hippocampus. In WLIs, increased depression-like behavior and transcriptomic changes were present in response to CRS, but in WMIs no behavioral or additive transcriptomic changes occurred. Environmental enrichment decreased both the inherent depression-like behavior in the WMIs and the behavioral difference between WMIs and WLIs, but did not reverse basal transcript level differences between the strains. The inverse behavioral change induced by CRS and EE in the WLIs did not result in parallel inverse expression changes of the transcriptomic markers, suggesting that these behavioral responses to the environment work via separate molecular pathways. In contrast, 'trait' transcriptomic markers with expression differences inherent and unchanging between the strains regardless of the environment suggest that in our model, environmental and genetic etiologies of depression work through independent molecular mechanisms.

Personality assessment of homeless adults as a tool for service planning.

Science.gov (United States)

Tolomiczenko, G S; Sota, T; Goering, P N

2000-01-01

The psychiatric status of homeless adults has been described primarily in terms of Axis I disorders. By adding a subset of the Personality Assessment Inventory, this study tests the feasibility and usefulness of a brief, self-administered questionnaire to obtain scores on several dimensions of personality. Cluster analysis sorted 112 tested subjects into four groups characterized by distinct profiles. Two of these were characterized by extreme scores on pathological dimensions of personality (borderline features, antisocial traits, and aggressivity) and differed primarily on the dimension of suicidality. The third reflected moderate levels of personality dysfunction and the fourth did not deviate from adult nonclinical norms. The validity of the clusters was supported by demographic, background, and diagnostic subgroup differences. Brief personality assessment can be a cost-effective approach to matching services with clinical needs of homeless adults by attending to interpersonal dimensions that will likely affect service provision.

An Information Needs Profile of Israeli Older Adults, regarding the Law and Services

Science.gov (United States)

Getz, Irith; Weissman, Gabriella

2010-01-01

Based on Nicholas' framework for assessing information needs, this research aims to construct a profile of both Israeli older adults and their information needs regarding laws and social services. Data were collected by questionnaires answered by 200 older adults, born in Europe, Asia and Africa, who attended social clubs for older adults. The…

"'I Am Canada': Exploring Social Responsibility in Social Studies Using Young Adult Historical Fiction"

Science.gov (United States)

Horton, Todd A.

2014-01-01

This paper explores educating for democratic citizenship with a focus on the intersection between reading and values, specifically the nurturing of social responsibility. Using a pre-designed framework for teaching for social responsibility, excerpts from a young adult historical fiction series are used to consider learning possibilities in the…

Web-Browsing Competencies of Pre-Service Adult Facilitators: Implications for Curriculum Transformation and Distance Learning

Science.gov (United States)

Theresa, Ofoegbu; Ugwu, Agboeze Matthias; Ihebuzoaju, Anyanwu Joy; Uche, Asogwa

2013-01-01

The study investigated the Web-browsing competencies of pre-service adult facilitators in the southeast geopolitical zone of Nigeria. Survey design was adopted for the study. The population consists of all pre-service adult facilitators in all the federal universities in the southeast geopolitical zone of Nigeria. Accidental sampling technique was…

Visual analysis of geocoded twin data puts nature and nurture on the map.

Science.gov (United States)

Davis, O S P; Haworth, C M A; Lewis, C M; Plomin, R

2012-09-01

Twin studies allow us to estimate the relative contributions of nature and nurture to human phenotypes by comparing the resemblance of identical and fraternal twins. Variation in complex traits is a balance of genetic and environmental influences; these influences are typically estimated at a population level. However, what if the balance of nature and nurture varies depending on where we grow up? Here we use statistical and visual analysis of geocoded data from over 6700 families to show that genetic and environmental contributions to 45 childhood cognitive and behavioral phenotypes vary geographically in the United Kingdom. This has implications for detecting environmental exposures that may interact with the genetic influences on complex traits, and for the statistical power of samples recruited for genetic association studies. More broadly, our experience demonstrates the potential for collaborative exploratory visualization to act as a lingua franca for large-scale interdisciplinary research.

"Nothing I Ever Do Seems to Please My Parents": Female and Male Self-Esteem as a Function of Mother's and Father's Nurturance.

Science.gov (United States)

Buri, John R.; And Others

Parents are the primary agents in the development and definition of the self. Previous research has reported nurturance as the most notable parental factor in global self-esteem. This study examined the relationship of parental nurturance to self-esteem for the first time with subjects older than high school students. College students (N=333)…

Re-Imagining Specialized STEM Academies: Igniting and Nurturing "Decidedly Different Minds", by Design

Science.gov (United States)

Marshall, Stephanie Pace

2010-01-01

This article offers a personal vision and conceptual design for reimagining specialized science, technology, engineering, and mathematics (STEM) academies designed to nurture "decidedly different" STEM minds and ignite a new generation of global STEM talent, innovation, and entrepreneurial leadership. This design enables students to engage…

Providing Competent and Affirming Services for Transgender and Gender Nonconforming Older Adults.

Science.gov (United States)

Porter, Kristen E; Brennan-Ing, Mark; Chang, Sand C; Dickey, Lore M; Singh, Anneliese A; Bower, Kyle L; Witten, Tarynn M

2016-01-01

Despite the growing visibility and acceptance of transgender and gender nonconforming (TGNC) individuals, TGNC older adults experience many barriers in accessing competent and affirming health and social services due to anti-TGNC prejudice, discrimination, and lack of competent healthcare training on the part of healthcare workers. Clinical gerontologists and geriatricians will likely encounter TGNC adults in their practice given population aging and greater numbers of TGNC people who are living in their affirmed gender identities. The American Psychological Association recently published its Guidelines for Psychological Practice with Transgender and Gender Nonconforming People, which document the unique needs of TGNC individuals and outlines approaches for competent and affirming service provision (APA, 2015). We interpret these Guidelines using a gerontological lens to elucidate specific issues faced by the TGNC older adult along with the practice and policy implications for this population.

Nurturing Young Children's Moral Development through Literature in Japan and the USA

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Izumi-Taylor, Satomi; Scott, Jerrie C.

2013-01-01

The purpose of this study was to examine the views of American and Japanese early childhood teachers regarding the nurturing of young children's moral development using literature. The data consisted of responses to a questionnaire and written explanations of 36 American and 36 Japanese teachers. By comparing responses of the two groups, it was…

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

Directory of Open Access Journals (Sweden)

Heidi H. Ewen

2017-03-01

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

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

Science.gov (United States)

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

2017-01-01

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

Older adults and the emerging digital service delivery

DEFF Research Database (Denmark)

Siren, Anu; Knudsen, Sine Grønborg

2017-01-01

Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were...... associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use...... it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability....

Beloved Women: Nurturing the Sacred Fire of Leadership from an American Indian Perspective

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Portman, Tarrell Awe Agahe; Garrett, Michael Tlanusta

2005-01-01

American Indian women have been consistently involved in leadership throughout indigenous history. Their leadership provides a strong, nurturing influence passed down from generation to generation. In the U.S. society, this type of leadership style is recognized among contemporary authors of leadership manuals as relational and is attributed to…

The role of academia and industry in nurturing women in physics in Kenya

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Nyamwandha, Cecilia A.; Kasina, Angeline; Muthui, Zipporah W.; Awuor, Emily; Baki, Paul

2015-12-01

The authors look at some of the primary initiatives taken by the government, academia, and industry to nurture the goals and dreams of Kenyan women physicists. They discuss key transformative lines of progress as evidenced by statistics, and the enabling environments and platforms upon which these were made possible.

PARAFILIA: NATURE ATAU NURTURE? TINJAUAN TEOLOGIS DAN PSIKOLOGIS

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Fathonah K. Daud

2016-11-01

Full Text Available The discourse of paraphilia has become public attention. Enforcing religious values and sex education since on the early stage is an inevitable need by the society. Theologically and psychologically, there are paraphilia which characteristically given (nature and also nurture or affected by its environment. This article tries to explore the existence of paraphilia, theologically based on Islamic law and physiologically, which is for longtime based on the societal norm judged as deviant, but today the norm was questioned, even criticized through the reason of human right. Even theologically, Islamic teaching has clearly prohibited sexual relation which is not properly following the sharia law.

NURTURE: Development and Pilot Testing of a Novel Parenting Intervention for Mothers with Histories of an Eating Disorder

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Runfola, Cristin D.; Zucker, Nancy L.; Von Holle, Ann; Mazzeo, Suzanne; Hodges, Eric A.; Perrin, Eliana M.; Bentley, Margaret E.; Ulman, T. Frances; Hoffman, Elizabeth R.; Forsberg, Sarah; Ålgars, Monica; Zerwas, Stephanie; Pisetsky, Emily M.; Taico Colie, L.C.S.W.; Kuhns, Rebecca A.; Hamer, Robert M.; Bulik, Cynthia M.

2014-01-01

Objective To describe the treatment development and pilot testing of a group parenting intervention, NURTURE (Networking, Uniting, and Reaching out To Upgrade Relationships and Eating), for mothers with histories of eating disorders. Method Based on focus group findings, extant research, and expert opinion, NURTURE was designed to be delivered weekly over 16 (1.5 hour) sessions via an interactive web conferencing forum. It comprises four modules: 1) laying the foundation, 2) general parenting skills, 3) eating and feeding, and 4) breaking the cycle of risk. Pilot testing was conducted with three groups of 3–6 mothers (N = 13) who had children ages 0–3 years to determine feasibility (e.g., retention), acceptability (e.g., feedback questionnaire responses), and preliminary efficacy. Maternal satisfaction with NURTURE and changes in mother-child feeding relationship measures, maternal feeding style, maternal self-efficacy, and maternal psychopathology (eating disorder, depression, and anxiety symptoms) across three time points (baseline, post-treatment, 6-month follow-up) were examined. All outcomes were exploratory. Results The intervention was well tolerated with a 100% retention rate. Feedback from mothers was generally positive and indicated that the groups provided an engaging, supportive experience to participants. We observed changes suggestive of improvement in self-reported maternal self-efficacy and competence with parenting. There were no notable changes in measures of maternal feeding style or psychopathology. Discussion NURTURE is a feasible, acceptable, and potentially valuable intervention for mothers with eating disorder histories. Results of this pilot will inform a larger randomized-controlled intervention to determine efficacy and impact on child outcomes. PMID:23983082

NURTURE: development and pilot testing of a novel parenting intervention for mothers with histories of an eating disorder.

Science.gov (United States)

Runfola, Cristin D; Zucker, Nancy L; Von Holle, Ann; Mazzeo, Suzanne; Hodges, Eric A; Perrin, Eliana M; Bentley, Margaret E; Ulman, T Frances; Hoffman, Elizabeth R; Forsberg, Sarah; Algars, Monica; Zerwas, Stephanie; Pisetsky, Emily M; Taico, Colie; Kuhns, Rebecca A; Hamer, Robert M; Bulik, Cynthia M

2014-01-01

To describe the treatment development and pilot testing of a group parenting intervention, NURTURE (Networking, Uniting, and Reaching out To Upgrade Relationships and Eating), for mothers with histories of eating disorders. Based on focus group findings, extant research, and expert opinion, NURTURE was designed to be delivered weekly over 16 (1.5 h) sessions via an interactive web conferencing forum. It comprises four modules: (1) laying the foundation, (2) general parenting skills, (3) eating and feeding, and (4) breaking the cycle of risk. Pilot testing was conducted with three groups of 3-6 mothers (N = 13) who had children ages 0-3 years to determine feasibility (e.g., retention), acceptability (e.g., feedback questionnaire responses), and preliminary efficacy. Maternal satisfaction with NURTURE and changes in mother-child feeding relationship measures, maternal feeding style, maternal self-efficacy, and maternal psychopathology (eating disorder, depression, and anxiety symptoms) across three time points (baseline, post-treatment, 6-month follow-up) were examined. All outcomes were exploratory. The intervention was well tolerated with a 100% retention rate. Feedback from mothers was generally positive and indicated that the groups provided an engaging, supportive experience to participants. We observed changes suggestive of improvement in self-reported maternal self-efficacy and competence with parenting. There were no notable changes in measures of maternal feeding style or psychopathology. NURTURE is a feasible, acceptable, and potentially valuable intervention for mothers with eating disorder histories. Results of this pilot will inform a larger randomized-controlled intervention to determine efficacy and impact on child outcomes. Copyright © 2013 Wiley Periodicals, Inc.

Attitudes of GPs towards Older Adults Psychology Services in the Scottish Highlands.

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Todman, Jonathan P F; Law, Jim; MacDougall, Andrew

2011-01-01

The mental health of older adults is of increasing concern in an aging population and GPs are frequently the gatekeepers to specialist mental health services. Psychotherapy, social interventions and bibliotherapy all have an evidence-base for treating depression and anxiety in the elderly, as does pharmacological treatment. However, the referral rate from GPs for an Older Adults Clinical Psychology service in the Scottish Highlands in the months prior to the study had been very low and the reasons for this were not clear. General practitioners may have felt that depression and anxiety are 'understandable' in older adults and are therefore unsuitable for treatment, or they may have felt that psycho-pharmacotherapy treatments are more effective than the psychotherapy treatment options. Alternatively, local issues associated with the remote location of many NHS Highland GP practices and patients may have prevented them referring. Therefore, the current study aimed to elicit the therapeutic preferences of Highland GPs, the perceived availability of these options and an estimate of the prevalence of older adults in the area suffering from mild or moderate mental health problems. Questionnaires including brief quantitative and qualitative questions were sent to all 284 GPs in the area with 119 (46%) were completed and returned. Responses from GPs suggested that many patients with depression or anxiety may not be referred. The GPs indicated that social therapeutic options are seen to be as effective as pharmacological options and more effective than other psychological and bibliotherapy options. However, GPs indicated that they were substantially more likely to prescribe pharmacological options than other forms of therapy. The GPs suggested that lower waiting times and a more localised service would increase the likelihood of a referral being made. The current study suggests that low awareness of psychological service provision among GPs may have resulted in fewer

Classification trees for identifying non-use of community-based long-term care services among older adults.

Science.gov (United States)

Penkunas, Michael James; Eom, Kirsten Yuna; Chan, Angelique Wei-Ming

2017-10-01

Home- and center-based long-term care (LTC) services allow older adults to remain in the community while simultaneously helping caregivers cope with the stresses associated with providing care. Despite these benefits, the uptake of community-based LTC services among older adults remains low. We analyzed data from a longitudinal study in Singapore to identify the characteristics of individuals with referrals to home-based LTC services or day rehabilitation services at the time of hospital discharge. Classification and regression tree analysis was employed to identify combinations of clinical and sociodemographic characteristics of patients and their caregivers for individuals who did not take up their referred services. Patients' level of limitation in activities of daily living (ADL) and caregivers' ethnicity and educational level were the most distinguishing characteristics for identifying older adults who failed to take up their referred home-based services. For day rehabilitation services, patients' level of ADL limitation, home size, age, and possession of a national medical savings account, as well as caregivers' education level, and gender were significant factors influencing service uptake. Identifying subgroups of patients with high rates of non-use can help clinicians target individuals who are need of community-based LTC services but unlikely to engage in formal treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Adult Day Services

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... Home Health Aide Semi Private Private $25,000 Adult Day Servi Acesssisted Living Home Care Nursing Homes $0 1. General information based on industry views of various members of the National Adult ...

Access to Employee Wellness Programs and Use of Preventive Care Services Among U.S. Adults.

Science.gov (United States)

Isehunwa, Oluwaseyi O; Carlton, Erik L; Wang, Yang; Jiang, Yu; Kedia, Satish; Chang, Cyril F; Fijabi, Daniel; Bhuyan, Soumitra S

2017-12-01

There is little research at the national level on access to employee wellness programs and the use of preventive care services. This study examined the use of seven preventive care services among U.S working adults with access to employee wellness programs. The study population comprised 17,699 working adults aged ≥18 years, obtained from the 2015 National Health Interview Survey. Multivariate logistic regression models examined the relationship between access to employee wellness programs and use of seven preventive care services: influenza vaccination, blood pressure check, diabetes check, cholesterol check, Pap smear test, mammogram, and colon cancer screening. Data analysis began in Fall 2016. Overall, 46.6% of working adults reported having access to employee wellness programs in 2015. Working adults with access to employee wellness programs had higher odds of receiving influenza vaccination (OR=1.57, 95% CI=1.43, 1.72, pemployee wellness programs and the use of Pap smear test and colon cancer screening services. Using a nationally representative sample of individuals, this study found a positive association between access to employee wellness programs and the use of preventive care services. The results support favorable policies to encourage implementing wellness programs in all worksites, especially those with employees. Copyright © 2017 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

A 12-Words-for-Life-Nurturing Exercise Program as an Alternative Therapy for Cervical Spondylosis: A Randomized Controlled Trial

Directory of Open Access Journals (Sweden)

Zhijun Hu

2014-01-01

Full Text Available In this paper, we carried out a randomized controlled clinical trial to explore the effect of 12-words-for-life-nurturing exercise on patients presenting with cervical spondylosis. After exercise intervention, the mean VAS and NDI scores of the patients decreased significantly and the scores of BP, VT, and MH in SF-36 Health Questionnaire were significantly higher. Exercise therapy showed significant effect on relieving pain and improving vitality and mental health. The 12-words-for-life-nurturing exercise may be a potential effective therapy for patients with cervical spondylosis.

20 CFR 663.115 - What are the eligibility criteria for core services for dislocated workers in the adult and...

Science.gov (United States)

2010-04-01

... services for dislocated workers in the adult and dislocated worker programs? 663.115 Section 663.115 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR ADULT AND DISLOCATED WORKER ACTIVITIES UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT Delivery of Adult and Dislocated Worker Services...

Behavioral health service utilization and preferences of older adults receiving home-based aging services.

Science.gov (United States)

Gum, Amber M; Iser, Lindsay; Petkus, Andrew

2010-06-01

To examine use of behavioral health services, treatment preferences, and facilitators and barriers to service use in older adults receiving home-based services within the aging network. Cross-sectional survey. Interviews were conducted in participants' homes. One hundred forty-two clients receiving home-based aging services. Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; Brief Symptom Inventory-18; Discrimination-Devaluation Scale; utilization of behavioral health services; and preferences, facilitators, and barriers for behavioral health services. Use of psychotropic medication was high (54.2%), primarily received in primary care settings (58.8%), with a few visits a year (54.0%). Participants were more likely to be taking psychotropic medication if they were younger and white. Approximately one-third of participants on antidepressant or antianxiety medication still met criteria for an Axis I disorder. Twenty-one participants (14.8%) reported receiving counseling within the past year, with a few visits or less a year for most (57.1%). Almost all were willing to see at least one professional (97.2%) and try prescribed medications or counseling (90.1%). The most common barriers to service use were practical: affordability (71.8%), difficulty traveling (62.7%), and lack of transportation (45.8%). Aging network clients receiving home-based services have ready access to psychotropic medications but receive very few specialty behavioral health services and medication monitoring visits. They are willing to use a variety of behavioral health services and perceive mainly practical barriers to using services. The aging network has significant potential to enhance access to service utilization; strategies for integrating behavioral health services in the aging network are discussed.

Drawing as Driver of Creativity: Nurturing an Intelligence of Seeing in Art Students

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Riley, Howard

2017-01-01

The article reasserts the primacy of drawing as a driver of creativity within art schools. It reviews specific aspects of visual perception theory and visual communication theory relevant to a pedagogical strategy as a means of nurturing an "intelligence of seeing" in art students. The domain of drawing is theorised as a…

A Comparison of Learning Outcomes for Adult Students in On-Site and Online Service-Learning

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Schwehm, Jeremy S.; Lasker-Scott, Tennille; Elufiede, Oluwakemi

2017-01-01

As noted by Kolb's (1984) experiential learning theory, adults learn best through experiences. Typically delivered in a traditional, face-to-face classroom setting, service-learning integrates the knowledge learned in the classroom with real-world experience and community service. E-service-learning, service-learning delivered in part or entirely…

Child discipline and nurturing practices among a cohort of Pacific mothers living in New Zealand.

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Cowley-Malcolm, Esther Tumama; Fairbairn-Dunlop, Tagaloa Peggy; Paterson, Janis; Gao, Wanzhen; Williams, Maynard

2009-02-01

The Pacific Islands Families (PIF) study is a longitudinal investigation of a cohort (N=1376) of Pacific infants born in New Zealand (NZ), and their mothers and fathers. The PIF study aimed to determine: (1) the prevalence of disciplinary and nurturing parenting practices used with children at 12 months of age, and (2) the demographic, maternal and lifestyle factors associated with parenting practices. At the 12-month measurement point, mothers (N=1207) were interviewed about their parenting practices using a modified version of the Parent Behaviour Checklist. High nurturance was significantly associated with Samoan ethnicity and post school qualifications, and low nurturance was significantly associated with post-natal depression, alcohol consumption and gambling. At the univariate level, high discipline scores were significantly associated with gambling, postnatal depression and lack of alignment to either Pacific or to European traditions. However the strongest association with discipline was the ethnicity variable with Tongan mothers reporting significantly higher disciplinary behaviours that all other ethnicities. It is clear that there are a number of common underlying lifestyle issues that need to be considered when dealing with parenting problems in families with young children. However specific to Pacific families, is Tongan ethnicity accounting for a strong cultural effect on parenting style, in particular high discipline scores relative to other Pacific groups. This important finding may be used to guide social policy and prevention programmes that are focused on the wellbeing of Pacific mothers and their children.

Nurture or nature? The growth paradox of research-based spin-offs

OpenAIRE

Zerbinati, S.; Souitaris, V.; Moray, N.

2012-01-01

This study explores the effect of institutional origin (‘nurture’) and economic context (‘nature’) on the financial resource endowment and subsequent early employment growth of research-based spin-offs (RBSOs). The nurture dimensions capture the relationship between the parent research institution and the RBSO during the start-up phase: the type of incubation model, the formal vs informal transfer of technology and the extent of inventors’ involvement with the firm. The nature dimensions incl...

Child responsible personnel in adult mental health services.

Science.gov (United States)

Lauritzen, Camilla; Reedtz, Charlotte

2016-01-01

Children who have parents with mental health problems are a vulnerable group. Intervening early to support parents with a mental illness can contribute to improve outcomes for children. Rigging the adult mental health system in such a manner that child responsible personnel are designated in wards is a strategy to systematically address the needs of families. It has since 2010 been mandatory for Norwegian hospitals to appoint such personnel in all hospital wards. The current study aimed to investigate the appointment of child responsible personnel in the adult mental health services in a regional hospital with local clinics. Additionally, to describe the characteristics of child responsible staff in terms of gender and educational background, their competence, clinical practice and knowledge about parental mental illness. A final aim was to study whether or not the clinics had established collaboration with other services concerning follow-up for the children of parents with mental illness. Participants in this study are the staff at psychiatric clinics in a large university hospital in Norway. Practitioners were asked to answer a questionnaire prior to the initial process of implementing the new legislation in 2010 (N = 219). After a three-year period of implementing routines to adopt the new law in the clinic, the same survey was sent out to the staff in 2013 (N = 185) to monitor if changes were taking place. To study if the changes were sustained within the clinics, we conducted a two-year follow up in 2015 (N = 108). The results indicated that the systematic work to change clinical practice in the participating hospital had made a difference. Routines to follow up children's patients after the new legislation had to some extent been implemented. The child responsible personnel had more knowledge and awareness about the consequences of parental mental illness for children. The results of this study suggested that the systems change of establishing child

The Socioculturally Constructed Multivoiced Self as a Framework for Christian Education of Second-Generation Korean American Young Adults

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Kang, S. Steve

2002-01-01

This article proposes a new framework for theory and practice of Christian education for second-generation Korean American young adults using the literature of sociocultural constructionism and the multivoiced self. This framework can provide holistic nurture and future trajectories in which to encourage a reflexive, praxis-generating faith. The…

Assessing Capacity for Providing Culturally Competent Services to LGBT Older Adults

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Portz, Jennifer Dickman; Retrum, Jessica H.; Wright, Leslie A.; Boggs, Jennifer M.; Wilkins, Shari; Grimm, Cathy; Gilchrist, Kay; Gozansky, Wendolyn S.

2014-01-01

This qualitative, interview-based study assessed the cultural competence of health and social service providers to meet the needs of LGBT older adults in an urban neighborhood in Denver, Colorado, known to have a large LGBT community. Only 4 of the agencies were categorized as “high competency” while 12 were felt to be “seeking improvement” and 8 were considered “not aware.” These results indicate significant gaps in cultural competency for the majority of service providers. Social workers are well-suited to lead efforts directed at improving service provision and care competencies for the older LGBT community. PMID:24798180

Transitions between child and adult mental health services: service design, philosophy and meaning at uncertain times.

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Murcott, W J

2014-09-01

A young person's transition of care from child and adolescent mental health services to adult mental health services can be an uncertain and distressing event that can have serious ramifications for their recovery. Recognition of this across many countries and recent UK media interest in the dangers of mental health services failing young people has led practitioners to question the existing processes. This paper reviews the current theories and research into potential failings of services and encourages exploration for a deeper understanding of when and how care should be managed in the transition process for young people. Mental health nurses can play a vital role in this process and, by adopting the assumptions of this paradigm, look at transition from this unique perspective. By reviewing the current ideas related to age boundaries, service thresholds, service philosophy and service design, it is argued that the importance of the therapeutic relationship, the understanding of the cultural context of the young person and the placing of the young person in a position of autonomy and control should be central to any decision and process of transfer between two mental health services. © 2014 John Wiley & Sons Ltd.

Using storytelling with adult EFL learners: an enriching classroom experience

OpenAIRE

Adriana Vecino

2016-01-01

Storytelling has obvious benefits in the development of speaking and listening skills, vocabulary and memory abilities. It also nurtures reading and writing skills and offers learners opportunities to increase their confidence. Given the great value in employing storytelling as a support when learning a foreign language, I decided to use this technique with one of my adult EFL classrooms and observe the benefits and possible constraints. This paper presents the theoretical foundat...

A Developmental Perspective in Mental Health Services Use Among Adults with Mental Disorders.

Science.gov (United States)

Huỳnh, Christophe; Caron, Jean; Pelletier, Marilou; Liu, Aihua; Fleury, Marie-Josée

2018-07-01

This study examined factors associated with mental health services (MHS) use by individuals with mental disorders within a developmental perspective of adulthood. Bivariate and multivariate analyses were conducted separately for each developmental stage on independent variables using the Andersen's behavioral health service model. For 18-29-year-old emerging adults (n = 141), autonomy, daily life/relations, Internet searching, alcohol dependence, cognitive impulsiveness, number of stressful events, and self-harm were associated with MHS use. For 30-49-year olds (n = 292), being female, country of origin, being on welfare, social integration, Internet searching, and number of stressful events were associated with MHS use. For 50-64-year-old middle-aged adults (n = 126), current occupation was associated with MHS use. Developing online resources for emerging adults may increase MHS use. For 30-49-year olds, outreach should target male, immigrants, and individuals less socially integrated and on welfare. For middle-aged adults, workplace programs that reduce stigma and offer psychological help could increase MHS use.

Triage in an adult emergency service: patient satisfaction

Directory of Open Access Journals (Sweden)

Pollyane Liliane Silva

2016-06-01

Full Text Available Abstract OBJECTIVE Assess the degree of patient satisfaction with triage in the adult emergency service of a public hospital. METHOD Exploratory, descriptive, cross-sectional study with a quantitative approach. Three hundred patients were interviewed and the data were analyzed using descriptive statistics based on sociodemographic variables and those related to patient satisfaction. RESULTS There was a predominance of women, with elementary education and a mean age of 41 years. Most of the interviewees reported being satisfied in regard to the following items: timely service, embracement, trust, environment (comfort, cleanliness and signage, humanization (courtesy, respect, and interest, timely referral/scheduling of appointments and care expectations. CONCLUSION There was a high level of patient satisfaction, evidenced by the strong association of user satisfaction with the items investigated.

"Going Going....." Why Are Males Underrepresented in Pre-Service Primary Education Courses at University?

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Lovett, Trevor

2014-01-01

This sociological qualitative study identifies reasons why female pre-service teachers believe males are underrepresented in primary education courses at Australian universities. The findings of the study suggest that the nineteenth century naturalistic discourse of nurturance continues to sustain the notion that primary school teaching is a…

What prompts young adults in Ireland to attend health services for STI testing?

LENUS (Irish Health Repository)

Balfe, Myles

2009-01-01

BACKGROUND: In-depth understanding of the factors that prompt young adults to attend health services for sexually transmitted infection (STI) testing are needed to underpin sexual health programes. We conducted a qualitative study to identify and explore why young adults (18-29 years) in Ireland attended specialist and community health services for STI testing; the factors that supported\\/undermined their decisions to seek STI testing; and any factors that led to delay in seeking STI testing. METHODS: Semi-structured interviews with 30 adults (21 women, 9 men). Young adults were recruited from General Practice (GP) practices, Third Level College health services, Family Planning clinics and specialist STI treatment services for men who have sex with men (MSM). Interview questions examined why respondents decided to go for STI testing, whether they acted upon this desire immediately or decided to wait, and what they felt were important barriers\\/enablers to their health-seeking attempts. Interviews were thematically analyzed using standard qualitative techniques. RESULTS: Respondents sought STI testing for one of four reasons: they had reached a transitional moment in their lives (they were either about to stop using condoms with their sexual partner or were emerging from a period of their lives where they had a series of risky sexual relationships); they had had unprotected sex with a casual partner; they had symptoms of infection; and\\/or they were required to do so by their employer. Catalytic factors included media and government health promotion campaigns and knowing someone with an STI. However, many respondents delayed seeking testing. Reasons included respondents\\' concerns about stigma and that they would be judged by healthcare professionals, and feelings of invulnerability. Importantly, several respondents who waited up to four weeks to make an appointment after their initial decision to seek STI testing did not view this as delay. CONCLUSION: Sexual

Predicting Perceived Isolation among Midlife and Older LGBT Adults: The Role of Welcoming Aging Service Providers.

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Yang, Jie; Chu, Yoosun; Salmon, Mary Anne

2017-06-16

Older lesbian, gay, bisexual, and transgender (LGBT) adults are more likely to live alone and less likely to have children compared with their heterosexual counterparts. The lack of immediate family system can render older LGBT adults particularly vulnerable to social isolation and its consequences. The current study utilizes social exclusion theory, which asserts that not only material resources but also engagement with and inclusion into the society are necessary for marginalized people to be integrated into the mainstream. The study examines whether aging service providers (e.g., senior centers, adult day care, transportation, employment services) who are perceived by older LGBT adults as welcoming to LGBT people may reduce this population's perceived isolation. Data were collected through a needs assessment survey designed for the aging LGBT community in North Carolina. Adults aged 45 and over who self-identified as LGBT were recruited at several formal and informal groups. The survey yielded 222 valid responses. The outcome variable was perceived isolation. Key independent variables included having experienced welcoming aging service providers and living alone. After controlling for potential confounders and demographics, logistic regression results showed that having experienced welcoming aging service providers was a protective factor against perceived isolation and it also buffered the negative impact of living alone. The findings provided preliminary evidence for a new direction of intervention research-targeting LGBT cultural competence training for medical and social service providers. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A PROGRAM OF ADULT EDUCATION FOR THE MARSHALL COUNTY HIGH SCHOOL SERVICE AREA, LEWISBURG, TENNESSEE.

Science.gov (United States)

BARNES, JOHN O., JR.

THE NEED FOR AN ADULT EDUCATION PROGRAM IN THE MARSHALL COUNTY (TENNESSEE) HIGH SCHOOL SERVICE AREA WAS STUDIED THROUGH QUESTIONNAIRES COMPLETED BY 207 ADULTS, EXAMINATION OF SCHOOL AND GOVERNMENT RECORDS, AND PERSONAL INTERVIEWS. IT WAS FOUND THAT OVER HALF OF THE AREA RESIDENTS WERE NOT HIGH SCHOOL GRADUATES, AND THAT MANY ADULTS DESIRED MORE…

Predictors of Maternal and Early Adolescent Attitudes Toward Children's Nurturance and Self-Determination Rights

Science.gov (United States)

Peterson-Badali, Michele; Morine, Stephany L.; Ruck, Martin D.; Slonim, Naomi

2004-01-01

Children's rights to nurturance and self-determination have been included in social policy agendas for many years. Children's and parents' attitudes concerning children's rights are likely an important determinant of whether rights on paper actually serve to protect the well-being of children, yet there is little research on factors associated…

Children with Specific Language Impairment and Their Families: A Future View of Nature Plus Nurture and New Technologies for Comprehensive Language Intervention Strategies.

Science.gov (United States)

Rice, Mabel L

2016-11-01

Future perspectives on children with language impairments are framed from what is known about children with specific language impairment (SLI). A summary of the current state of services is followed by discussion of how these children can be overlooked and misunderstood and consideration of why it is so hard for some children to acquire language when it is effortless for most children. Genetic influences are highlighted, with the suggestion that nature plus nurture should be considered in present as well as future intervention approaches. A nurture perspective highlights the family context of the likelihood of SLI for some of the children. Future models of the causal pathways may provide more specific information to guide gene-treatment decisions, in ways parallel to current personalized medicine approaches. Future treatment options can build on the potential of electronic technologies and social media to provide personalized treatment methods available at a time and place convenient for the person to use as often as desired. The speech-language pathologist could oversee a wide range of treatment options and monitor evidence provided electronically to evaluate progress and plan future treatment steps. Most importantly, future methods can provide lifelong language acquisition activities that maintain the privacy and dignity of persons with language impairment, and in so doing will in turn enhance the effectiveness of speech-language pathologists. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Nature vs. Nurture: The Role of Environmental Resources in Evolutionary Deep Intelligence

OpenAIRE

Chung, Audrey G.; Fieguth, Paul; Wong, Alexander

2018-01-01

Evolutionary deep intelligence synthesizes highly efficient deep neural networks architectures over successive generations. Inspired by the nature versus nurture debate, we propose a study to examine the role of external factors on the network synthesis process by varying the availability of simulated environmental resources. Experimental results were obtained for networks synthesized via asexual evolutionary synthesis (1-parent) and sexual evolutionary synthesis (2-parent, 3-parent, and 5-pa...

Nurturing Reading Proficiency of Pupils through Phonics: Entrepreneurial Opportunities for Early Childhood Educators in Nigeria

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Shoaga, Opeyemi; Akintola, Olugbenga Adeyanju; Okpor, Christiana Isiwat

2017-01-01

Nurturing reading proficiency among the Nigerian children has become pivotal to a functional and development-oriented education. The place of phonics in achieving this strategic goal seems unquestionable with attendant entrepreneurial opportunities for early childhood educators. This study therefore, investigates the influence of phonics in…

Nurture Groups in a Scottish Secondary School: Purpose, Features, Value and Areas for Development

Science.gov (United States)

Kourmoulaki, Athina

2013-01-01

Nurture groups (NGs) are increasingly being established in Scottish secondary schools yet research in this context is limited. The current study explores the purpose, features and value of two NGs in a Scottish secondary school through interviewing current and former NG members, parents/carers, NG staff and other school staff. A thematic analysis…

Youth and young adults with cerebral palsy: their use of physician and hospital services.

Science.gov (United States)

Young, Nancy L; Gilbert, Thomas K; McCormick, Anna; Ayling-Campos, Anne; Boydell, Katherine; Law, Mary; Fehlings, Darcy L; Mukherjee, Shubhra; Wedge, John H; Williams, Jack I

2007-06-01

To examine patterns of health care utilization among youth and young adults who have cerebral palsy (CP) and to provide information to guide the development of health services for adults who have CP. This study analyzed health insurance data for outpatient physician visits and hospital admissions for a 4-year period. Six children's treatment centers in Ontario, Canada. The sample included 587 youth and 477 adults with CP identified from health records. Youths were 13 to 17 years of age, and adults were 23 to 32 years of age at the end of the data range. Not applicable. We computed the annual rates of outpatient physician visits and hospitalizations per 1000 persons and compared these with rates for the general population. Annual rates of outpatient physician visits were 6052 for youth and 6404 for adults with CP, 2.2 times and 1.9 times higher, respectively, than rates for age-matched peers (P<.01). Specialists provided 28.4% of youth visits but only 18.8% of adult visits. Annual hospital admission rates were 180 for youth and 98 for adults with CP, 4.3 times and 10.6 times higher, respectively, than rates for age-matched peers (P<.01). It appears that youth and adults with CP continue to have complex care needs and rely heavily on the health care system. Comprehensive services are essential to support their health as they move into youth and adulthood. However, there appear to be gaps in the adult health care system, such as limited access to specialist physicians.

Understanding of how older adults with low vision obtain, process, and understand health information and services.

Science.gov (United States)

Kim, Hyung Nam

2017-10-16

Twenty-five years after the Americans with Disabilities Act, there has still been a lack of advancement of accessibility in healthcare for people with visual impairments, particularly older adults with low vision. This study aims to advance understanding of how older adults with low vision obtain, process, and use health information and services, and to seek opportunities of information technology to support them. A convenience sample of 10 older adults with low vision participated in semi-structured phone interviews, which were audio-recorded and transcribed verbatim for analysis. Participants shared various concerns in accessing, understanding, and using health information, care services, and multimedia technologies. Two main themes and nine subthemes emerged from the analysis. Due to the concerns, older adults with low vision tended to fail to obtain the full range of all health information and services to meet their specific needs. Those with low vision still rely on residual vision such that multimedia-based information which can be useful, but it should still be designed to ensure its accessibility, usability, and understandability.

The threshold hypothesis: solving the equation of nurture vs nature in type 1 diabetes.

Science.gov (United States)

Wasserfall, C; Nead, K; Mathews, C; Atkinson, M A

2011-09-01

For more than 40 years, the contributions of nurture (i.e. the environment) and nature (i.e. genetics) have been touted for their aetiological importance in type 1 diabetes. Disappointingly, knowledge gains in these areas, while individually successful, have to a large extent occurred in isolation from each other. One reason underlying this divide is the lack of a testable model that simultaneously considers the contributions of genetic and environmental determinants in the formation of this and potentially other disorders that are subject to these variables. To address this void, we have designed a model based on the hypothesis that the aetiological influences of genetics and environment, when evaluated as intersecting and reciprocal trend lines based on odds ratios, result in a method of concurrently evaluating both facets and defining the attributable risk of clinical onset of type 1 diabetes. The model, which we have elected to term the 'threshold hypothesis', also provides a novel means of conceptualising the complex interactions of nurture with nature in type 1 diabetes across various geographical populations.

Nurturing Opportunity Identification for Business Sophistication in a Cross-disciplinary Study Environment

OpenAIRE

Karine Oganisjana; Tatjana Koke

2012-01-01

Opportunity identification is the key element of the entrepreneurial process; therefore the issue of developing this skill in students is a crucial task in contemporary European education which has recognized entrepreneurship as one of the lifelong learning key competences. The earlier opportunity identification becomes a habitual way of thinking and behavior across a broad range of contexts, the more likely that entrepreneurial disposition will steadily reside in students. In order to nurtur...

Contextual and individual factors associated with dental services utilisation by Brazilian adults: A multilevel analysis.

Science.gov (United States)

Herkrath, Fernando José; Vettore, Mario Vianna; Werneck, Guilherme Loureiro

2018-01-01

Inequalities in the utilisation of dental services in Brazil are remarkable. The aim of this study was to evaluate the association of contextual and individual factors with the utilisation of dental services by Brazilian adults using the Andersen's behavioural model. Individual-level data from 27,017 adults residents in the State capitals who were interviewed in the 2013 Brazilian National Health Survey were pooled with contextual city-level data. The outcomes were non-utilisation of dental services and last dental visit over 12 months ago. Individual predisposing variables were age, sex, race/skin colour, schooling and social network. Individual enabling variables included income, health insurance and registration in primary health care. Individual need variables were self-perceived dental health and self-reported missing teeth. Multilevel logistic regression models were performed to estimate odds ratio (OR) and 95% confidence intervals (95% CIs) of the association of contextual and individual predisposing, enabling and need-related variables with dental services outcomes. Predisposing (OR = 0.89; 95% CI 0.81-0.97) and enabling (OR = 0.90; 95% CI 0.85-0.96) contextual factors were associated with non-utilisation of dental services. Individual predisposing (sex, race/skin colour, schooling), enabling (income, health insurance) and need (self-perceived oral health, missing teeth) were associated with non-utilisation of dental services and last dental visit over 12 months ago. The latter was also associated with other individual predisposing (age, social network) and need (eating difficulties due to oral problems) characteristics. Individual and contextual determinants influenced dental services utilisation in Brazilian adults. These factors should be on the policy agenda and considered in the organisation of health services aiming to reduce oral health inequalities related to access and utilisation of dental services.

"Monkeys, babies, idiots" and "primitives": nature-nurture debates and philanthropic foundation support for American anthropology in the 1920s and 1930s.

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Biehn, Kersten Jacobson

2009-01-01

There has been a long discussion among historians about the impact that foundation policies had on the development of the social sciences during the interwar era. This discussion has centered on the degree to which foundation officers, particularly from the Rockefeller boards, exercised a hegemonic influence on research. In this essay, I argue that the field of American cultural anthropology has been neglected and must be reconsidered as a window into foundation intervention in nature-nurture debates. Despite foundation efforts to craft an anthropology policy that privileged hereditarian explanations, I contend that cultural anthropologists were committed to proving the primacy of "nurture," even when that commitment cost them valuable research dollars. It was this commitment that provided an essential bulwark for the discipline. Ironically, it was the need to negotiate with foundations about the purpose of their research that helped cultural anthropologists to articulate their unique, and thus intrinsically valuable, approach to nature-nurture debates.

Advancing services for adult ADHD: the development of the ADHD Star as a framework for multidisciplinary interventions

Directory of Open Access Journals (Sweden)

Marios Adamou

2016-11-01

Full Text Available Abstract Background Attention Deficit Hyperactivity Disorder is prevalent in adulthood, resulting in serious impairment across multiple domains of living. Despite clinical guidance recommendations, the relative infancy of research on service provision for adults with ADHD, along with the evidence transfer gap, means that there is a lack of specific frameworks for service delivery. Igniting research and developing service delivery frameworks within adult ADHD is an essential step in the provision of effective services for adults with ADHD. Method Following the methodology used in previous related research that utilises a Participatory Action Research approach, we gathered data from clinicians and service users on the domains of living in which they wish to create change, and the steps and end point of the change process. This data was utilised, alongside data gathered from previous research and policies, to develop the domains of assessment for the ADHD Star, and the scale on which change is assessed. Results The resulting tool, the ADHD Star, consists of eight domains: understanding your ADHD, focus and attention, organising yourself, friends and social life, thinking and reacting, physical health, how you feel and meaningful use of time. Each domain is rated on a five-point scale, the ‘ladder of change’, ranging from ‘stuck’ to ‘choice’. Conclusions The ADHD Star offers a guiding framework for the development of care pathways and subsequent service provision for adults with ADHD, based on multi-disciplinary, holistic and person-centred care.

[Determining Factors in the Access to Mental Health Services by the Adult Colombian Population].

Science.gov (United States)

González, Lina María; Peñaloza, Rolando Enrique; Matallana, María Alexandra; Gil, Fabián; Gómez-Restrepo, Carlos; Landaeta, Angela Patricia Vega

2016-12-01

Access to mental health services by people with mental disorders has traditionally been limited, and is associated with attitudinal, social, and structural variables. To analyse the factors that determine access to mental health services by the adult population (18-44 years old) in Colombia, from the results obtained in the 2015 National Mental Health Survey. Analysis of variables of access to attention in mental health care for adults. The reasons for not consulting were classified as barriers of behavioural supply and demand. To analyse the factors associated with access to mental health services in the Colombian adult population, the use of health services in the last 12 months for emotional, nervous or mental health problems was taken into account, as well as associated variables such as demographic characteristics, occupational activity, affiliation to social security, and health status variables. The relationships between these variables were estimated using bivariate multinomial logistic regression models. Rural residence, being married, and having a chronic disease were associated with the decision to consult or not to consult the doctor. Further studies should be conducted to evaluate the situation as regards mental health care access, as well as to determine the potential factors associated with these limitations. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Nurturing the Young Shoots of Talent: Using Action Research for Exploration and Theory Building

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Koshy, Valsa; Pascal, Christine

2011-01-01

This paper reports the outcomes of a set of action research projects carried out by teacher researchers in 14 local education authorities in England, working collaboratively with university tutors, over a period of three years. The common aim of all the projects was to explore practical ways of nurturing the gifts and talents of children aged…

The exhausting dilemmas faced by home-care service providers when enhancing participation among older adults receiving home care.

Science.gov (United States)

Vik, Kjersti; Eide, Arne H

2012-09-01

Older adults wish to stay at home, participate in society and manage on their own as long as possible. Many older adults will, however, eventually become dependent on care and help to maintain their daily living. Thus, to enhance activity and participation also among older adults that receive home-based services, there is a strong need for development of knowledge-based practice regarding participation. The specific aim of this study is to explore how service providers perceive that their working conditions influence on their possibilities to promote participation among older adults, and more specifically, how they perceive the influence of their working conditions. A purposeful sampling strategy was applied, and six focus groups with professionals in two municipalities were conducted. The focus groups comprised four and six participants of varying ages, length of working experience and professions. A total of 30 service providers participated. The data were analysed by a constant comparative method following the guidelines from Grounded Theory. The analysis identified the categories 'encountering needs that cannot be met', 'expectations about participation', 'organisation of services' and 'professional standards' influencing the service delivery. During this analytical process, 'being on the verge' emerged as a core category that describes the service providers' experience of a stressful workday, i.e. when they had the feeling of working against their own professional standards and being pushed to their limits. The findings indicate how the professional standards of service providers on the whole are in line with health policy for in-home services. Policy objectives are, however, not always followed owing to different constraints at the level of service delivery. Along the path from political ideals to the practical execution of services, external circumstances related to the organisation of services are perceived as crucial. © 2012 The Authors. Scandinavian

Assessing the Relationship between Physical Illness and Mental Health Service Use and Expenditures among Older Adults from Racial/Ethnic Minority Groups

Science.gov (United States)

Jimenez, Daniel E; Cook, Benjamin; Kim, Giyeon; Reynolds, Charles F.; Alegria, Margarita; Coe-Odess, Sarah; Bartels, Stephen J.

2015-01-01

Objective The association of physical illness and mental health service use in older adults from racial/ethnic minority groups is an important area of study given the mental and physical health disparities and the low use of mental health services in this population. The purpose of this study is to describe the impact of comorbid physical illness on mental health service use and expenditures in older adults; and to evaluate disparities in mental health service use and expenditures among a racially/ethnically diverse sample of older adults with and without comorbid physical illness. Methods Data were obtained from the Medical Expenditure Panel Survey (years 2004–2011). The sample included 1563 whites, 519 African-Americans, and 642 Latinos and (N=2,724) aged 65+ with probable mental illness. Using two-part generalized linear models, we estimated and compared mental health service use among those with and without a comorbid physical illness. Results Mental health service use was greater for older adults with comorbid physical illness compared to those without a comorbid physical illness. Once mental health services were accessed, no differences in mental health expenditures were found. Comorbid physical illness increased the likelihood of mental health service use in older whites and Latinos. However, the presence of a comorbidity did not impact racial/ethnic disparities in mental health service use. Conclusions This study highlighted the important role of comorbid physical illness as a potential contributor to using mental health services and suggests intervention strategies to enhance engagement in mental health services by older adults from racial/ethnic minority groups. PMID:25772763

Examining a conceptual model of parental nurturance, parenting practices and physical activity among 5-6 year olds.

Science.gov (United States)

Sebire, Simon J; Jago, Russell; Wood, Lesley; Thompson, Janice L; Zahra, Jezmond; Lawlor, Deborah A

2016-01-01

Parenting is an often-studied correlate of children's physical activity, however there is little research examining the associations between parenting styles, practices and the physical activity of younger children. This study aimed to investigate whether physical activity-based parenting practices mediate the association between parenting styles and 5-6 year-old children's objectively-assessed physical activity. 770 parents self-reported parenting style (nurturance and control) and physical activity-based parenting practices (logistic and modeling support). Their 5-6 year old child wore an accelerometer for five days to measure moderate-to-vigorous physical activity (MVPA). Linear regression was used to examine direct and indirect (mediation) associations. Data were collected in the United Kingdom in 2012/13 and analyzed in 2014. Parent nurturance was positively associated with provision of modeling (adjusted unstandardized coefficient, β = 0.11; 95% CI = 0.02, 0.21) and logistic support (β = 0.14; 0.07, 0.21). Modeling support was associated with greater child MVPA (β = 2.41; 0.23, 4.60) and a small indirect path from parent nurturance to child's MVPA was identified (β = 0.27; 0.04, 0.70). Physical activity-based parenting practices are more strongly associated with 5-6 year old children's MVPA than parenting styles. Further research examining conceptual models of parenting is needed to understand in more depth the possible antecedents to adaptive parenting practices beyond parenting styles. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

[Effects of Home Care Services Use by Older Adults on Family Caregiver Distress].

Science.gov (United States)

Kim, Jiyeon; Kim, Hongsoo

2016-12-01

The purpose of this study was to examine the association between utilization of home care services under the national long-term care insurance system and family caregiver distress. A secondary data analysis was conducted in this study using data collected in 2011 and 2012 from the Korean version of International Resident Assessment Instrument (interRAI) Home Care assessment system. The study sample included 228 clients receiving community based home care and their family caregivers in Korea. Descriptive statistics, χ² test, t-test, and Heckman selection model analysis were conducted using SAS 9.3. Presence of family caregiver distress was significantly associated with days of nurse visits (β=-.89, p=caregiver distress was also significantly associated with days of nurse visits (β=-.66, p=.028). Other factors which were significantly associated with caregiver distress were depression, cognitive function, inadequate pain control, social support for older adult, and caregiver relationship to the older adult. The results of this study show that visiting nurse service and appropriate support programs for Older Adults and family caregivers experiencing caregiver distress should be developed and provided to families based on the health care needs of older adults and their family caregivers for effective and sustainable home care.

The Development Model of Knowledge Management via Web-Based Learning to Enhance Pre-Service Teacher's Competency

Science.gov (United States)

Rampai, Nattaphon; Sopeerak, Saroch

2011-01-01

This research explores that the model of knowledge management and web technology for teachers' professional development as well as its impact in the classroom on learning and teaching, especially in pre-service teacher's competency and practices that refer to knowledge creating, analyzing, nurturing, disseminating, and optimizing process as part…

76 FR 23479 - Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Young Adult

Science.gov (United States)

2011-04-27

... 0720-AB48] Civilian Health and Medical Program of the Uniformed Services (CHAMPUS); TRICARE Young Adult... Year 2011 (NDAA for FY11). It establishes the TRICARE Young Adult (TYA) program to provide an extended.... The TRICARE Young [[Page 23480

Nature, Nurture and Evolution of Intra-Species Variation in Mosquito Arbovirus Transmission Competence

OpenAIRE

Tabachnick, Walter J.

2013-01-01

Mosquitoes vary in their competence or ability to transmit arthropod-borne viruses (arboviruses). Many arboviruses cause disease in humans and animals. Identifying the environmental and genetic causes of variation in mosquito competence for arboviruses is one of the great challenges in public health. Progress identifying genetic (nature) and environmental (nurture) factors influencing mosquito competence for arboviruses is reviewed. There is great complexity in the various traits that compris...

Informal Adult Learning and Emotion Work of Service Providers for Refugee Claimants

Science.gov (United States)

Brigham, Susan M.; Baillie Abidi, Catherine; Tastsoglou, Evangelia; Lange, Elizabeth

2015-01-01

Like the immigrant clients they serve, service providers have been overlooked in adult education literature, yet their roles are crucial for addressing the serious concerns of refugees and refugee claimants who flee their home countries hoping to find safe refuge in another country.

Use of health services by adult Latin American immigrants residing in Seville

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José Rafael González-López

2014-07-01

Full Text Available Objective. This work sought to describe the use of health services by adult Latin American immigrants from Seville. Methodology. This was a descriptive cohort study with the participation of 190 adult Latin American immigrants from 25 to 44 years of age, residing in the city of Seville (Spain in 2011. A self-report survey was applied. Results. Within the past year, 67% of the individuals have visited a physician and 23% have attended nursing consultation. A total of 14% of the immigrants who called on a healthcare center reported that their experience was worse than that of others. La annual prevalence by accidents was: 10% domestic, 4% traffic-related and 9% occupational; nearly half these accidents justified emergency care or hospitalization due to their severity. The logistic regression model revealed that health services were used mostly by: women, those in poor self-perceived health status, those with secondary level of education, the elderly, and those who were single. Conclusion. The population studied presents adequate use of health services, although it would be recommendable to implement prevention activities by nurses in the immigrant's work and family environment to reduce the accident incidence described by this group.

Text and Mobile Media Smoking Cessation Service for Young Adults in South Texas: Operation and Cost-Effectiveness Estimation.

Science.gov (United States)

Ramirez, Amelie G; Chalela, Patricia; Akopian, David; Munoz, Edgar; Gallion, Kipling J; Despres, Cliff; Morales, Jafet; Escobar, Rodrigo; McAlister, Alfred L

2017-07-01

To realize the promising potential of services delivered via smart phones to help young adults quit smoking at a high level of cost-efficiency, we constructed a texting and mobile media system that was promoted in South Texas via social media advertising and other recruitment channels. During the 6-month service period described here, enrollments were achieved for 798 participants with a mean age of 29.3 years. Seven-month texted follow-up found that 21% (171) of the enrollees reported abstinence at that point. This is consistent with high rates of success found in studies of telephone counseling for young adults and confirms that text and mobile media service specifically designed for young adults provide a feasible and potentially cost-effective approach to promoting cessation.

Supporting Parents to Provide Nurturing Care for Young Children: The Fundamental Ingredients for a Better World

Science.gov (United States)

Richter, Linda M.

2018-01-01

The global community is recognizing how "nurturing care" is critical for the developing child. The term encompasses health and nutrition, safety and security, responsive caregiving, and opportunities for inclusive early learning, all of which are afforded by loving parents and families and supportive communities. Public policies and…

Nurture versus nature

DEFF Research Database (Denmark)

Klöppel, Stefan; Mangin, Jean-Francois; Vongerichten, Anna

2010-01-01

Does a conflict between inborn motor preferences and educational standards during childhood impact the structure of the adult human brain? To examine this issue, we acquired high-resolution T1-weighted magnetic resonance scans of the whole brain in adult "converted" left-handers who had been forced...

Transitioning adolescent and young adults with chronic disease and/or disabilities from paediatric to adult care services - an integrative review.

Science.gov (United States)

Zhou, Huaqiong; Roberts, Pamela; Dhaliwal, Satvinder; Della, Phillip

2016-11-01

This paper aims to provide an updated comprehensive review of the research-based evidence related to the transitions of care process for adolescents and young adults with chronic illness/disabilities since 2010. Transitioning adolescent and young adults with chronic disease and/or disabilities to adult care services is a complex process, which requires coordination and continuity of health care. The quality of the transition process not only impacts on special health care needs of the patients, but also their psychosocial development. Inconsistent evidence was found regarding the process of transitioning adolescent and young adults. An integrative review was conducted using a five-stage process: problem identification, literature search, data evaluation, data analysis and presentation. A search was carried out using the EBSCOhost, Embase, MEDLINE, PsycINFO, and AustHealth, from 2010 to 31 October 2014. The key search terms were (adolescent or young adult) AND (chronic disease or long-term illness/conditions or disability) AND (transition to adult care or continuity of patient care or transfer or transition). A total of 5719 records were initially identified. After applying the inclusion criteria a final 61 studies were included. Six main categories derived from the data synthesis process are Timing of transition; Perceptions of the transition; Preparation for the transition; Patients' outcomes post-transition; Barriers to the transition; and Facilitating factors to the transition. A further 15 subcategories also surfaced. In the last five years, there has been improvement in health outcomes of adolescent and young adults post-transition by applying a structured multidisciplinary transition programme, especially for patients with cystic fibrosis and diabetes. However, overall patients' outcomes after being transited to adult health care services, if recorded, have remained poor both physically and psychosocially. An accurate tracking mechanism needs to be

AGING ADULTS WITH INTELLECTUAL DISABILITIES: PERSPECTIVES ON EMERGING SERVICE CONCERNS

Directory of Open Access Journals (Sweden)

Matthew P. JANICKI

2010-04-01

Full Text Available With improved general health status many adults with intellectual disabilities (ID are living to old age, much like other adults. The World Health Organization has recognized the needs of this older population and identified the challenges they pose for governmental ministries and non-governmental organizations charged with planning, advocacy, financing, and delivery of specialty lifecare services and rehabilitation programs. These challenges include a range of issues normally confronting older adults, such as pensioning and financial security, changes in lifestyles associated with retirement and adaptations to living arrangements and housing, modifications in daily activities and community inclusion, changing physical and sensory abilities, and greater demands for support for aging families and other carers. As older adults with ID may also be affected by latelife or age-related conditions and begin to experience secondary impairments, these challenges may be more pronounced when encountered by NGOs located in countries with developing market economies. In these instances, the onus on promoting healthy aging will fall upon national entities which are responsible for targeting people with disabilities from infancy and childhood, and providing lifelong supports for adolescents, adults, and families. Ideally, if such efforts are undertaken early, they will lead to actions that can be undertaken to promote better health as people with ID age and ensure that the latter part of their lives are experienced as ‘quality of life years.’

Linking a research register to clinical records in older adults' mental health services: a mixed-methods study.

Science.gov (United States)

Robotham, Dan; Evans, Joanne; Watson, Andrew; Perdue, Iain; Craig, Thomas; Rose, Diana; Wykes, Til

2015-01-01

Patients can provide consent to have their clinical records linked to a research register, a process known as consent for contact (C4C). There is evidence about how to engage people with mental illness in C4C, but nothing specific to older adults. This is a priority area for research (for example, dementia trials), although sign-up rates to C4C are lower than for younger populations. Through this study we seek to understand these disparities. This was a two-stage cross-sectional observational study. In phase one, focus groups with service users, carers and clinicians informed a framework for clinicians to explain C4C to those on their caseload. In phase two, clinicians explained C4C to 26 service users (and carers where applicable). These conversations were recorded, and their content was analysed. Service users and carers were then interviewed to provide further feedback on their conversations with clinicians. A total of 31 service users, 24 carers and 13 clinical staff took part across the two phases. In phase one, service users and carers sought assurance of the right to refuse participation in further studies (after joining C4C). Clinicians expressed concerns over legal and practical implications of ascertaining mental capacity and best interest. In phase two, clinicians' explanations were less thorough than similar explanations given to younger adults with psychosis. Clinicians omitted details of service users' right to stipulate contact arrangements, which was significantly associated with whether service users/carers agreed to join. Common reasons for joining C4C included altruism and the chance to speak to new people. Few participants refused to join, but reasons included avoidance of stress (potentially alleviated through the presence of a carer). Implementing C4C in older adults' services requires clinicians to deliver concise, simple explanations to individuals and their carers where applicable. Older adults can be suspicious of unsolicited contact; thus

Building the adult protective services system of tomorrow: The role of the APS national voluntary consensus guidelines.

Science.gov (United States)

Bobitt, Julie; Kuhne, Jamie; Carter, Julie; Whittier Eliason, Stephanie; Twomey, Mary

2018-01-01

In 2015, the Administration for Community Living (ACL) established the first federal "home" for Adult Protective Services (APS). This leadership has included working collaboratively with state Adult Protective Service systems to ensure that older adults and adults with disabilities are afforded the same protections against abuse, neglect, and financial exploitation regardless of where in the country they live. As part of that leadership, ACL created draft Voluntary Consensus Guidelines for State APS Systems. ACL undertook a process of public and stakeholder engagement and analyzed the resulting comments to improve upon the initial draft of the draft to arrive at the final version. This article examines the comments, including the concerns raised by the commenters about specific areas of the Guidelines, areas identified for future research, and reflections and opinions on the role of the federal government in guiding the development of the field of adult protection.

A unified theory of development: a dialectic integration of nature and nurture.

Science.gov (United States)

Sameroff, Arnold

2010-01-01

The understanding of nature and nurture within developmental science has evolved with alternating ascendance of one or the other as primary explanations for individual differences in life course trajectories of success or failure. A dialectical perspective emphasizing the interconnectedness of individual and context is suggested to interpret the evolution of developmental science in similar terms to those necessary to explain the development of individual children. A unified theory of development is proposed to integrate personal change, context, regulation, and representational models of development.

Promoting Social Nurturance and Positive Social Environments to Reduce Obesity in High-Risk Youth.

Science.gov (United States)

Wilson, Dawn K; Sweeney, Allison M; Kitzman-Ulrich, Heather; Gause, Haylee; St George, Sara M

2017-03-01

Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth's behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at-risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family, and social-environmental-level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and healthcare providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth.

Using Service-Learning to Educate Students about Stakeholder Involvement

Directory of Open Access Journals (Sweden)

Beth Walter Honadle

2012-04-01

Full Text Available Using Lee’s definition of service-learning as “an instructional method in which students learn course content by actively participating in thoughtfully organized service experiences related to that content”, this article offers a case of action-oriented service- learning. It shows one way to combine traditional teaching methods with an action-oriented approach to service-learning that benefits both the community and imparts critical know-how into the education of planning students. Through service-learning students acquire valuable skills and also increase their competence as practitioners and increase their confidence in their field in a way that nurtures their abilities and provides minimal risk to the clientele because the students are working under the guidance of faculty. As previous research from diverse fields have shown, service-learning benefits the students and the groups they encounter through their projects. KEYWORDSservice-learning, civic engagement, community development

Translation and equivalence assessment for a Japanese version of the modified Parental Nurturance Scale: a comparative study

Directory of Open Access Journals (Sweden)

Griffiths Peter

2007-01-01

Full Text Available Abstract Background This paper reports on the modification of the Parental Nurturance Scale (PNS, translation of the modified version (PNSM from English to Japanese, and equivalence assessment between the PNSM and the translated version (PNSM-J. The PNS was modified so as to enable its use in nurturance studies where the prime source of nurturance might vary between respondents. Method It was translated into Japanese through the forward-backward translation procedure. With attempting to enhance representativeness of language in the target populations, translators used were married couples that consisted of a native English speaker and a native Japanese speaker. Multiple translations were produced and used to make a single Japanese version. A panel of reviewers identified problems in conceptual and semantic equivalence between the original and the translated versions. The Japanese version was altered accordingly with reference to alternate Japanese forms from the original English to Japanese translations. The altered translation was again re-translated into English and problematic differences were checked. This forward-backward process was repeated until satisfactory agreement was attained. The PNSM was administered to 222 native English speakers and the PNSM-J to 1320 native Japanese speakers. Results Factor analysis and target rotation revealed a nearly identical factor structure and factor loadings of the items of the PNSM and PNSM-J between the different cultural groups. High Cronbach's alpha coefficient supported the reliability of the test scores on both versions. Conclusion The equivalence between the two scales was supported. It is suggested that the PNSM and PNSM-J are suitable tools for comparative cross-cultural studies.

Leading the Future We Envision: Nurturing a Culture of Innovation Across the Continuum of Care.

Science.gov (United States)

DʼAlfonso, Jim; Zuniga, Anita; Weberg, Daniel; Orders, Ann E

2016-01-01

In the Fall of 2012, this large integrated health care system located in Northern California, comprising 21 hospitals and employing more than 25 000 nurses across all inpatient, outpatient, and continuum of care areas, embarked upon a comprehensive initiative to further engage the "hearts and minds" of its nursing workforce while establishing a foundation for innovation in an era of health care reform. This article will outline the strategy employed to ensure that professional nurses across the continuum of care were made aware of the impact of the Affordable Care Act. Major shifts to value-based care and improved performance expectations focus our attention on quality, service, and affordability, also known as the "Triple Aim." Transitioning from a volume-focused model to a value-based care model requires measurable and sustainable improvements over current performance, reinforcing the importance of increased levels of engagement, shared accountability, and purposeful collaboration. Over a span of 18 months, the organization conducted 55 interactive educational forums for point-of-care care teams and leadership. These dynamic learning events helped recalibrate the working foundation for how leaders would nurture the process for innovation among care teams and transform care across the continuum of care.

Preventive care delivered within Public Dental Service after caries risk assessment of young adults

DEFF Research Database (Denmark)

Hänsel Petersson, G; Ericson, E; Twetman, S

2016-01-01

OBJECTIVES: To study preventive care provided to young adults in relation to their estimated risk category over a 3-year period. METHODS: The amount and type of preventive treatment during 3 years was extracted from the digital dental records of 982 patients attending eight public dental clinics...... adults attending public dental service. Further research is needed how to reach those with the greatest need of primary and secondary prevention....

Services in the Community for Adults with Psychosis and Intellectual Disabilities: A Delphi Consultation of Professionals' Views

Science.gov (United States)

Hemmings, C. P.; Underwood, L. A.; Bouras, N.

2009-01-01

Background: There remains a severe lack of evidence on the effectiveness of community services for adults with psychosis and intellectual disabilities (ID). There has been little consensus even of what services should provide for this service user group. Method: A consultation of multidisciplinary professionals was carried out by using a…

Why nature prevails over nurture in the making of the elite athlete.

Science.gov (United States)

Georgiades, Evelina; Klissouras, Vassilis; Baulch, Jamie; Wang, Guan; Pitsiladis, Yannis

2017-11-14

While the influence of nature (genes) and nurture (environment) on elite sporting performance remains difficult to precisely determine, the dismissal of either as a contributing factor to performance is unwarranted. It is accepted that a complex interaction of a combination of innumerable factors may mold a talented athlete into a champion. The prevailing view today is that understanding elite human performance will require the deciphering of two major sources of individual differences, genes and the environment. It is widely accepted that superior performers are endowed with a high genetic potential actualised through hard and prodigious effort. Heritability studies using the twin model have provided the basis to disentangle genetic and environmental factors that contribute to complex human traits and have paved the way to the detection of specific genes for elite sport performance. Yet, the heritability for most phenotypes essential to elite human performance is above 50% but below 100%, meaning that the environment is also important. Furthermore, individual differences can potentially also be explained not only by the impact of DNA sequence variation on biology and behaviour, but also by the effects of epigenetic changes which affect phenotype by modifying gene expression. Despite this complexity, the overwhelming and accumulating evidence, amounted through experimental research spanning almost two centuries, tips the balance in favour of nature in the "nature" and "nurture" debate. In other words, truly elite-level athletes are built - but only from those born with innate ability.

Nurture thru Nature: Creating Natural Science Identities in Populations of Disadvantaged Children through Community Education Partnership

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Camasso, Michael J.; Jagannathan, Radha

2018-01-01

In this article we describe the development, implementation, and some of the early impacts of Nurture thru Nature (NtN), an American after-school and summer program designed to introduce elementary school students in disadvantaged, urban public schools to natural science and environmental education. The program, which began operations in 2010 as a…

Relationship between health service use and health information technology use among older adults: analysis of the US National Health Interview Survey.

Science.gov (United States)

Choi, Namkee

2011-04-20

Older adults are the most frequent and heaviest users of health services in the United States; however, previous research on older adults' use of health information technology (HIT) has not examined the possible association of HIT use among older adults with their use of health services. This study examined the relationship between US older adults' use of health services and their use of the Internet for health-related activities, controlling for socioeconomic characteristics and aging-related limitations in sensory and cognitive function. It also examined gender differences in the pattern of association between the types of health services used and HIT use. The data for this study were drawn from the 2009 US National Health Interview Survey (NHIS), which was the first nationally representative household survey to collect data on HIT (Internet) use. First, the rates of lifetime and 12-month HIT use among sample adults (n = 27,731) by age group (18-29 to 85 and over) were analyzed. Second, bivariate analysis of sociodemographic characteristics, health status, and health service use by HIT use status among those aged 65 or older (n = 5294) was conducted. Finally, multivariate binary logistic regression analysis was used to test the study hypotheses with 12-month HIT use as the dependent variable and 12-month health service uses among the age group 65 or older as possible correlates. The rates of HIT use were significantly lower among the age groups 65 or older compared with the younger age groups, although the age group 55 to 64 was not different from those younger. The rates of HIT use decreased from 32.2% in the age group 65 to 74 to 14.5% in the age group 75 to 84 and 4.9% in the 85 and older age group. For both genders, having seen or talked to a general practitioner increased the odds of HIT use. However, having seen or talked to a medical specialist, eye doctor, or physical therapist/occupational therapist (PT/OT) were significantly associated with HIT use only

Costs and Trends in Utilization of Low-value Services Among Older Adults With Commercial Insurance or Medicare Advantage.

Science.gov (United States)

Carter, Elizabeth A; Morin, Pamela E; Lind, Keith D

2017-11-01

Overutilization of low-value services (unnecessary or minimally beneficial tests or procedures) has been cited as a large contributor to the high costs of health care in the United States. To analyze trends in utilization of low-value services from 2009 to 2014 among commercial and Medicare Advantage (MA) enrollees 50 and older. A retrospective analysis of deidentified claims obtained from the OptumLab Data Warehouse. Adults 50 and older enrolled in commercial plans and adults 65 and older enrolled in MA plans between 2009 and 2014. Costs and utilization of 16 low-value services in the following categories: cancer screening, imaging, and invasive procedures. The most commonly performed low-value service was imaging of the head for syncope, at rates of 33%-39% in commercial enrollees and 45% in MA enrollees. The least common service was peripheral artery stenting (value service utilization. Greater consistency would facilitate monitoring use of low-value services and changing clinical practice patterns over time.

Using Mobile Phone Technology to Support Young Liver Transplant Recipients Moving to Adult Services.

Science.gov (United States)

Coad, Jane; Toft, Alex; Claridge, Lee; Ferguson, James; Hind, Jonathon; Jones, Rebecca; McClean, Patricia; McKiernan, Patrick; Samyn, Marianne; Taylor, Rachel

2017-06-01

The process and preparation of moving from child to adult services (transition) is a challenging period of time for young people and represents significant changes in care and support systems. The proliferation of mobile phone applications for health purposes suggests that it is an area for further investigation. The review explores the potential to use mobile phone technology to help support young liver transplant recipients moving to adult services. It represents the first review conducted in this specialism and considers a new model of support for young liver patients. A systematic rapid review of the published peer-reviewed literature. Two searches were conducted: Search 1: the use of technology to support transition to adult services (6 studies) and Search 2: how best to support liver transplant recipients during transition (6 studies). Research shows that to achieve positive transition young people need information about their condition and transition. The process needs to be guided by transition readiness, rather than the young persons' age. Although parents and support networks should be in place and are valued, transition should build upon self-management and independence. Results suggest that there appears to be scope to use mobile phone technology to support transition. This is the first time a review has explored the types of issues or concerns facing liver transplant patients and how these can be addressed through mobile phone technology.

Possibilities of ICT-supported services in the clinical management of older adults.

Science.gov (United States)

Vollenbroek-Hutten, Miriam; Jansen-Kosterink, Stephanie; Tabak, Monique; Feletti, Luca Carlo; Zia, Gianluca; N'dja, Aurèle; Hermens, Hermie

2017-02-01

Services making use of information and communication technology (ICT) are of potential interest to face the challenges of our aging society. Aim of this article is to describe the possible field of application for ICT-supported services in the management of older adults, in particular those with functional impairment. The current status of ICT-supported services is described and examples of how these services can be implemented in everyday practice are given. Upcoming technical solutions and future directions are also addressed. An ICT-supported service is not only the technological tool, but its combination with clinical purposes for which it is used and the way it is implemented in everyday care. Patient's satisfaction with ICT-supported services is moderate to good. Actual use of patients is higher than those of professionals but very variable. Frequency of use is positively related to clinical outcome. ICT offers a variety of opportunities for the treatment and prevention of frailty and functional decline. Future challenges are related to the intelligence of the systems and making the technologies even more unobtrusive and intuitive.

Pathways into homelessness: recently homeless adults - problems and service use before and after becoming homeless in Amsterdam

NARCIS (Netherlands)

van Laere, Igor R.; de Wit, Matty A. S.; Klazinga, Niek S.

2009-01-01

ABSTRACT: OBJECTIVE: To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. METHODS: Recently homeless adults (last housing lost up to two years ago and legally

Youth and young adults with spina bifida: their utilization of physician and hospital services.

Science.gov (United States)

Young, Nancy L; Anselmo, Lianne A; Burke, Tricia A; McCormick, Anna; Mukherjee, Shubhra

2014-03-01

To describe current patterns of health care utilization of youth and young adults who have spina bifida (SB) and provide evidence to guide the development of health care for this growing population. We conducted a secondary analysis of health services utilization data from the Canadian Institute for Health Information to determine the rates and patterns of health care utilization, because comprehensive health care has been recognized as critical to positive health outcomes. Participants were identified from 6 publicly funded children's treatment centers. Health records from youth (n=164; age range, 13.0-17.9y) and adults (n=120; age range, 23.0-32.9y) with SB contributed to this study. Not applicable. The rates of outpatient physician visits and hospital admissions for the youth and adult groups were calculated. The proportion with a "medical home" was also calculated. The annual rates of outpatient physician visits per 1000 persons were 8031 for youth and 8524 for adults with SB. These rates were approximately 2.9 and 2.2 times higher, respectively, than for their age-matched peers. On average, 12% of youth and 24% of adults with SB had a medical home. The annual rates of hospital admissions per 1000 persons were 329 for youth and 285 for adults with SB. Rates of admissions were 19.4 and 12.4 times higher, respectively, for these groups than for the general population. It appears that persons with SB are accessing health services more often than their age-matched peers, and few have a medical home. We recommend that seamless medical care be provided to all adults with SB, coordinated by a primary care provider, to facilitate comprehensive care. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Promoting Social Nurturance and Positive Social Environments to Reduce Obesity in High Risk Youth

Science.gov (United States)

Wilson, Dawn K.; Sweeney, Allison M.; Kitzman-Ulrich, Heather; Gause, Haylee; St. George, Sara M.

2017-01-01

Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth’s behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family and social-environmental level factors contribute to the development of nurturing environments. In this paper, we summarize evidence-based randomized controlled trials that integrate positive parenting, motivational, and behavioral skills strategies in different contexts, including primary care, home, community, and school-based settings. Taken together, these studies suggest that youth and parents are most likely to benefit when youth receive individual-level behavioral skills, family-level support and communication, and autonomous motivational support from the broader social environment. Future investigators and health care providers should consider integrating these evidence-based approaches that support the effects of positive social climate-based interventions on promoting healthy eating, physical activity, and weight management in youth. PMID:28229248

The Perennial Debate: Nature, Nurture, or Choice? Black and White Americans' Explanations for Individual Differences

Science.gov (United States)

Jayaratne, Toby Epstein; Gelman, Susan A.; Feldbaum, Merle; Sheldon, Jane P.; Petty, Elizabeth M.; Kardia, Sharon L.R.

2009-01-01

This paper examines three common explanations for human characteristics: genes, the environment, and choice. Based on data from a representative sample of White and Black Americans, respondents indicated how much they believed each factor influenced individual differences in athleticism, nurturance, drive, math ability, violence, intelligence, and sexual orientation. Results show that across traits: 1) Black respondents generally favor choice and reject genetic explanations, whereas White respondents indicate less causal consistency; 2) although a sizeable subset of respondents endorse just one factor, most report multiple factors as at least partly influential; and 3) among White respondents greater endorsement of genetic explanations is associated with less acceptance of choice and the environment, although among Black respondents a negative relationship holds only between genes and choice. The social relevance of these findings is discussed within the context of the attribution, essentialism and lay theory literature. The results underscore the need to consider more complex and nuanced issues than are implied by the simplistic, unidimensional character of the nature/nurture and determinism/free will debates — perennial controversies that have significance in the current genomic era. PMID:20072661

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

Science.gov (United States)

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

2014-11-01

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

Examining a conceptual model of parental nurturance, parenting practices and physical activity among 5–6 year olds

Science.gov (United States)

Sebire, Simon J.; Jago, Russell; Wood, Lesley; Thompson, Janice L.; Zahra, Jezmond; Lawlor, Deborah A.

2016-01-01

Rationale Parenting is an often-studied correlate of children's physical activity, however there is little research examining the associations between parenting styles, practices and the physical activity of younger children. Objective This study aimed to investigate whether physical activity-based parenting practices mediate the association between parenting styles and 5–6 year-old children's objectively-assessed physical activity. Methods 770 parents self-reported parenting style (nurturance and control) and physical activity-based parenting practices (logistic and modeling support). Their 5–6 year old child wore an accelerometer for five days to measure moderate-to-vigorous physical activity (MVPA). Linear regression was used to examine direct and indirect (mediation) associations. Data were collected in the United Kingdom in 2012/13 and analyzed in 2014. Results Parent nurturance was positively associated with provision of modeling (adjusted unstandardized coefficient, β = 0.11; 95% CI = 0.02, 0.21) and logistic support (β = 0.14; 0.07, 0.21). Modeling support was associated with greater child MVPA (β = 2.41; 0.23, 4.60) and a small indirect path from parent nurturance to child's MVPA was identified (β = 0.27; 0.04, 0.70). Conclusions Physical activity-based parenting practices are more strongly associated with 5–6 year old children's MVPA than parenting styles. Further research examining conceptual models of parenting is needed to understand in more depth the possible antecedents to adaptive parenting practices beyond parenting styles. PMID:26647364

Origin of the cosmic network in ΛCDM: Nature vs nurture

International Nuclear Information System (INIS)

Shandarin, Sergei; Habib, Salman; Heitmann, Katrin

2010-01-01

The large-scale structure of the Universe, as traced by the distribution of galaxies, is now being revealed by large-volume cosmological surveys. The structure is characterized by galaxies distributed along filaments, the filaments connecting in turn to form a percolating network. Our objective here is to quantitatively specify the underlying mechanisms that drive the formation of the cosmic network: By combining percolation-based analyses with N-body simulations of gravitational structure formation, we elucidate how the network has its origin in the properties of the initial density field (nature) and how its contrast is then amplified by the nonlinear mapping induced by the gravitational instability (nurture).

Origin of the cosmic network in ΛCDM: Nature vs nurture

Science.gov (United States)

Shandarin, Sergei; Habib, Salman; Heitmann, Katrin

2010-05-01

The large-scale structure of the Universe, as traced by the distribution of galaxies, is now being revealed by large-volume cosmological surveys. The structure is characterized by galaxies distributed along filaments, the filaments connecting in turn to form a percolating network. Our objective here is to quantitatively specify the underlying mechanisms that drive the formation of the cosmic network: By combining percolation-based analyses with N-body simulations of gravitational structure formation, we elucidate how the network has its origin in the properties of the initial density field (nature) and how its contrast is then amplified by the nonlinear mapping induced by the gravitational instability (nurture).

National Characteristics of Emergency Medical Services Responses for Older Adults in the United States.

Science.gov (United States)

Duong, Hieu V; Herrera, Lauren Nicholas; Moore, Justin Xavier; Donnelly, John; Jacobson, Karen E; Carlson, Jestin N; Mann, N Clay; Wang, Henry E

2018-01-01

Older adults, those aged 65 and older, frequently require emergency care. However, only limited national data describe the Emergency Medical Services (EMS) care provided to older adults. We sought to determine the characteristics of EMS care provided to older adults in the United States. We used data from the 2014 National Emergency Medical Services Information System (NEMSIS), encompassing EMS response data from 46 States and territories. We excluded EMS responses for children older adults as age ≥65 years. We compared patient demographics (age, sex, race, primary payer), response characteristics (dispatch time, location type, time intervals), and clinical course (clinical impression, injury, procedures, medications) between older and younger adult EMS emergency 9-1-1 responses. During the study period there were 20,212,245 EMS emergency responses. Among the 16,116,219 adult EMS responses, there were 6,569,064 (40.76%) older and 9,547,155 (59.24%) younger adults. Older EMS patients were more likely to be white and the EMS incident to be located in healthcare facilities (clinic, hospital, nursing home). Compared with younger patients, older EMS patients were more likely to present with syncope (5.68% vs. 3.40%; OR 1.71; CI: 1.71-1.72), cardiac arrest/rhythm disturbance (3.27% vs. 1.69%; OR 1.97; CI: 1.96-1.98), stroke (2.18% vs. 0.74%; OR 2.99; CI: 2.96-3.02) and shock (0.77% vs. 0.38%; OR 2.02; CI: 2.00-2.04). Common EMS interventions performed on older persons included intravenous access (32.02%), 12-lead ECG (14.37%), CPR (0.87%), and intubation (2.00%). The most common EMS drugs administered to older persons included epinephrine, atropine, furosemide, amiodarone, and albuterol or ipratropium. One of every three U.S. EMS emergency responses involves older adults. EMS personnel must be prepared to care for the older patient.

Performance of the measures of processes of care for adults and service providers in rehabilitation settings.

Science.gov (United States)

Bamm, Elena L; Rosenbaum, Peter; Wilkins, Seanne; Stratford, Paul

2015-01-01

In recent years, client-centered care has been embraced as a new philosophy of care by many organizations around the world. Clinicians and researchers have identified the need for valid and reliable outcome measures that are easy to use to evaluate success of implementation of new concepts. The current study was developed to complete adaptation and field testing of the companion patient-reported measures of processes of care for adults (MPOC-A) and the service provider self-reflection measure of processes of care for service providers working with adult clients (MPOC-SP(A)). A validation study. In-patient rehabilitation facilities. MPOC-A and measure of processes of care for service providers working with adult clients (MPOC-SP(A)). Three hundred and eighty-four health care providers, 61 patients, and 16 family members completed the questionnaires. Good to excellent internal consistency (0.71-0.88 for health care professionals, 0.82-0.90 for patients, and 0.87-0.94 for family members), as well as moderate to good correlations between domains (0.40-0.78 for health care professionals and 0.52-0.84 for clients) supported internal reliability of the tools. Exploratory factor analysis of the MPOC-SP(A) responses supported the multidimensionality of the questionnaire. MPOC-A and MPOC-SP(A) are valid and reliable tools to assess patient and service-provider accounts, respectively, of the extent to which they experience, or are able to provide, client-centered service. Research should now be undertaken to explore in more detail the relationships between client experience and provider reports of their own behavior.

Parents in transition: Experiences of parents of young people with a liver transplant transferring to adult services.

Science.gov (United States)

Wright, J; Elwell, L; McDonagh, J E; Kelly, D A; Wray, J

2017-02-01

Predictors of successful transition from pediatric to adult services include ability to self-manage and engage with healthcare services. Parents have a key role in healthcare management throughout childhood and adolescence including encouraging development of self-management skills in their children. Transition to adult services can be challenging for parents and young people, yet parents' views regarding transition remain largely unexplored. Nine parents of pediatric liver transplant recipients (15.2-25.1 yr) participated in semistructured interviews. Interviews were analyzed using IPA. Analysis revealed three key themes: "emotional impact of transplantation," "protection vs. independence," and "ending relationships and changing roles." Parents expressed the dichotomous nature of the desire to promote independence in their child while still maintaining control and protection, and discussed how changing roles and relationships were difficult to navigate. Parents are important facilitators of young people's development of self-management skills for successful transfer to adult services. Parents should be supported to move from a "managerial" to a "supervisory" role during transition to help young people engage independently with the healthcare team. Findings support the development of interventions for parents to emphasize their role in transition and guide the transfer of self-management skills from parent to young person. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Theory of Connectivity: Nature and Nurture of Cell Assemblies and Cognitive Computation.

Science.gov (United States)

Li, Meng; Liu, Jun; Tsien, Joe Z

2016-01-01

Richard Semon and Donald Hebb are among the firsts to put forth the notion of cell assembly-a group of coherently or sequentially-activated neurons-to represent percept, memory, or concept. Despite the rekindled interest in this century-old idea, the concept of cell assembly still remains ill-defined and its operational principle is poorly understood. What is the size of a cell assembly? How should a cell assembly be organized? What is the computational logic underlying Hebbian cell assemblies? How might Nature vs. Nurture interact at the level of a cell assembly? In contrast to the widely assumed randomness within the mature but naïve cell assembly, the Theory of Connectivity postulates that the brain consists of the developmentally pre-programmed cell assemblies known as the functional connectivity motif (FCM). Principal cells within such FCM is organized by the power-of-two-based mathematical principle that guides the construction of specific-to-general combinatorial connectivity patterns in neuronal circuits, giving rise to a full range of specific features, various relational patterns, and generalized knowledge. This pre-configured canonical computation is predicted to be evolutionarily conserved across many circuits, ranging from these encoding memory engrams and imagination to decision-making and motor control. Although the power-of-two-based wiring and computational logic places a mathematical boundary on an individual's cognitive capacity, the fullest intellectual potential can be brought about by optimized nature and nurture. This theory may also open up a new avenue to examining how genetic mutations and various drugs might impair or improve the computational logic of brain circuits.

Initiation of Addiction Treatment and Access to Services: Young Adults' Accounts of Their Help-Seeking Experiences.

Science.gov (United States)

Wagner, Vincent; Bertrand, Karine; Flores-Aranda, Jorge; Acier, Didier; Brunelle, Natacha; Landry, Michel; Brochu, Serge

2017-09-01

Substance addiction in young adults is particularly problematic. Yet, much remain at stake in understanding the specifics of this population's access to services. The objective of this study is to explore young adults' initiation of substance misuse treatment. Our study sample was composed of 35 individuals aged 18 to 30 with problematic psychoactive substance use who have been identified in criminal courts, hospital emergency departments, and Health and Social Services Centers in Québec (Canada). A thematic analysis was performed on the 62 semi-structured interviews conducted with participants. Three components emerged. First, personal elements-expectations, individual motivations, perceptions of use, and capacity to control it-influence initiation of substance misuse treatment. Second, family and peers have noticeable influences. Finally, system characteristics and prior care experiences also shape the process. Consideration should be given to tailor interventions that can reach young adults and encourage them to initiate appropriate care.

Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam.

Science.gov (United States)

van Laere, Igor R; de Wit, Matty A; Klazinga, Niek S

2009-01-07

To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. Recently homeless adults (last housing lost up to two years ago and legally staying in the Netherlands) were sampled in the streets, day centres and overnight shelters in Amsterdam. In April and May 2004, students conducted interviews and collected data on demographics, self reported pathways into homelessness, social and medical problems, and service use, before and after becoming homeless. among 120 recently homeless adults, (male 88%, Dutch 50%, average age 38 years, mean duration of homelessness 23 weeks), the main reported pathways into homelessness were evictions 38%, relationship problems 35%, prison 6% and other reasons 22%. Compared to the relationship group, the eviction group was slightly older (average age 39.6 versus 35.5 years; p = 0.08), belonged more often to a migrant group (p = 0.025), and reported more living single (p homelessness, in the total group, contacts with any social service were 38% and with any medical service 27%. Despite these contacts they did not keep their house. During homelessness only contacts with social work and benefit agencies increased, contacts with medical services remained low. the recently homeless fit the overall profile of the homeless population in Amsterdam: single (Dutch) men, around 40 years, with a mix of financial debts, addiction, mental and/or physical health problems. Contacts with services were fragmented and did not prevent homelessness. For homelessness prevention, systematic and outreach social medical care before and during homelessness should be provided.

Service Providers' Perceptions of Active Ageing among Older Adults with Lifelong Intellectual Disabilities

Science.gov (United States)

Buys, L.; Aird, R.; Miller, E.

2012-01-01

Background: Considerable attention is currently being directed towards both active ageing and the revising of standards for disability services within Australia and internationally. Yet, to date, no consideration appears to have been given to ways to promote active ageing among older adults with intellectual disabilities (IDs). Methods:…

Examining Self-Protection Measures Guarding Adult Protective Services Social Workers against Compassion Fatigue

Science.gov (United States)

Bourassa, Dara

2012-01-01

Little research has focused on the risk factors, effects, and experiences of compassion fatigue among gerontological social workers. This qualitative study explores the experiences and perspectives of nine Adult Protective Services (APS) social workers in relation to compassion fatigue. Results show that the APS social workers combined personal…

Unmet need for healthcare services in adolescents and young adults with cancer and their parent carers.

Science.gov (United States)

Sawyer, Susan M; McNeil, Robyn; McCarthy, Maria; Orme, Lisa; Thompson, Kate; Drew, Sarah; Dunt, David

2017-07-01

Cancer in adolescents in and young adults (AYA) has the potential to disrupt health, well-being and developmental trajectories. This study aimed to describe the healthcare support service needs of AYAs with cancer and parent carers and to explore the association of unmet need and emotional distress. As part of a national Australian survey of 15-25 year olds with cancer and a nominated parent carer, 196 AYAs reported total and unmet need for 10 clinical services and 204 parents reported on their child's and their own healthcare service needs. Proportions of total and unmet need for specific clinical services are reported. The association of unmet service needs and distress (measured using the Posttraumatic Stress Disorder Checklist) was also examined. AYAs and parent carers expressed high total need for clinical services during treatment. Leading AYA unmet needs were for an exercise therapist (37%), genetic counsellor (30%), dietitian (26%), peer support group (26%) and educational and vocational advisor (24%). After treatment, AYAs and parents had fewer total needs. However, 60% of AYA and 38% of parents had two or more unmet needs, similar to during treatment. Female gender and receiving treatment in an adult setting were significantly associated with unmet need for clinical services. After treatment, higher distress levels in AYAs and parents were associated with two or more unmet service needs. AYAs and parents had high levels of total and unmet service need, which were associated with greater emotional distress. These results highlight opportunities to re-orientate services to better meet AYA and parent needs.

How Are Service Dogs for Adults with Post Traumatic Stress Disorder Integrated with Rehabilitation in Denmark? A Case Study

OpenAIRE

Glintborg, Chalotte; Hansen, Tia G. B.

2017-01-01

Simple Summary The use of service dogs for adults with mental illnesses has become generally accepted. With reference to a single case study of a client with Post Traumatic Stress (PTSD), this study illustrates some of the potential advantages, but also note an important concern that appears to have gone unnoticed. The provision of service animals/therapy animals for adults with mental illnesses must be sufficiently informed by relevant knowledge and integrated with concurrent rehabilitation ...

Research on Clinical Preventive Services for Adolescents and Young Adults: Where Are We and Where Do We Need to Go?

Science.gov (United States)

Harris, Sion K; Aalsma, Matthew C; Weitzman, Elissa R; Garcia-Huidobro, Diego; Wong, Charlene; Hadland, Scott E; Santelli, John; Park, M Jane; Ozer, Elizabeth M

2017-03-01

We reviewed research regarding system- and visit-level strategies to enhance clinical preventive service delivery and quality for adolescents and young adults. Despite professional consensus on recommended services for adolescents, a strong evidence base for services for young adults, and improved financial access to services with the Affordable Care Act's provisions, receipt of preventive services remains suboptimal. Further research that builds off successful models of linking traditional and community clinics is needed to improve access to care for all youth. To optimize the clinical encounter, promising clinician-focused strategies to improve delivery of preventive services include screening and decision support tools, particularly when integrated into electronic medical record systems and supported by training and feedback. Although results have been mixed, interventions have moved beyond increasing service delivery to demonstrating behavior change. Research on emerging technology-such as gaming platforms, mobile phone applications, and wearable devices-suggests opportunities to expand clinicians' reach; however, existing research is based on limited clinical settings and populations. Improved monitoring systems and further research are needed to examine preventive services facilitators and ensure that interventions are effective across the range of clinical settings where youth receive preventive care, across multiple populations, including young adults, and for more vulnerable populations with less access to quality care. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Competing values in serving older and vulnerable adults: adult protective services, mandated reporting, and domestic violence programs.

Science.gov (United States)

Cramer, Elizabeth P; Brady, Shane R

2013-01-01

State mandatory reporting statutes may directly or indirectly list domestic violence programs as among those that are mandated reporters of cases of suspected abuse, neglect, or exploitation of older individuals and those with disabilities. Domestic violence programs, however, may not consider themselves to be mandated reporters, because the responsibility of reporting abuse may be contrary to their programmatic philosophy. In the Commonwealth of Virginia, the potential conflict between domestic violence programs and Adult Protective Services about the issue of mandated reporting has created tension between these organizations as each entity continues interpreting the issues and policies of mandated reporting through its own lens. The authors draw out some of the reasons for the conflict as well as make recommendations for improving relationships between the two organizations, which will ultimately benefit vulnerable adults who are experiencing abuse.

Investigating the perception of Romanian adults on ophthalmology services from an experiential marketing perspective.

Science.gov (United States)

Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin

2017-01-01

Nowadays, we live in a world in which we are daily bombed by hundreds of advertisements. Specialists have to discover other channels or embed attractive elements in the advertisements' messages to cut through the clutter and catch the consumers' attention. The evolution of the concept of service has changed from the commercial status to determining a lifestyle. Buying a service has led to a change in the consumer behavior. Consumers want to buy services that dazzle their senses, touch their hearts, and stimulate their minds, not as before, excellent or satisfying. Ophthalmology is the medical specialty that is the most oriented toward outpatient care, as hospitalization is required only in a small percentage of cases. The objective of this case study was to investigate the perception of Romanian adult consumers on ophthalmology services from an experiential marketing perspective, by using the Focus Group method. Ophthalmology requires a wide range of skills due to the diversity of consumers who demand specialized consultations. Experiential marketing is a valuable strategy that ophthalmologic organizations may use to target specific consumers. The purpose of this case study was to identify the perceptions of Romanian adults on experiential marketing campaigns and determine the degree to which these campaigns influenced their decisions of buying an ophthalmologic service. Using a snowball sampling technique we have sent a filter questionnaire to 40 people on the internet. The filter questionnaire consisted of questions about wearing eyeglasses, the period of wearing them, the last ophthalmologic consultation, the type of ophthalmologic clinic they were going to, age and education. The respondents revealed there is almost no visibility on promoting services even if there is an upsurge of organizations offering this type of health service in the Romanian ophthalmology sector.

Investigating the perception of Romanian adults on ophthalmology services from an experiential marketing perspective

Science.gov (United States)

Gheorghe, Consuela-Mădălina; Gheorghe, Iuliana-Raluca; Purcărea, Victor Lorin

2017-01-01

Nowadays, we live in a world in which we are daily bombed by hundreds of advertisements. Specialists have to discover other channels or embed attractive elements in the advertisements’ messages to cut through the clutter and catch the consumers’ attention. The evolution of the concept of service has changed from the commercial status to determining a lifestyle. Buying a service has led to a change in the consumer behavior. Consumers want to buy services that dazzle their senses, touch their hearts, and stimulate their minds, not as before, excellent or satisfying. Ophthalmology is the medical specialty that is the most oriented toward outpatient care, as hospitalization is required only in a small percentage of cases. The objective of this case study was to investigate the perception of Romanian adult consumers on ophthalmology services from an experiential marketing perspective, by using the Focus Group method. Ophthalmology requires a wide range of skills due to the diversity of consumers who demand specialized consultations. Experiential marketing is a valuable strategy that ophthalmologic organizations may use to target specific consumers. The purpose of this case study was to identify the perceptions of Romanian adults on experiential marketing campaigns and determine the degree to which these campaigns influenced their decisions of buying an ophthalmologic service. Using a snowball sampling technique we have sent a filter questionnaire to 40 people on the internet. The filter questionnaire consisted of questions about wearing eyeglasses, the period of wearing them, the last ophthalmologic consultation, the type of ophthalmologic clinic they were going to, age and education. The respondents revealed there is almost no visibility on promoting services even if there is an upsurge of organizations offering this type of health service in the Romanian ophthalmology sector. PMID:29450395

中医养生中庸思想探讨%Concept of the Golden Mean in life nurturing of Chinese medicine

Institute of Scientific and Technical Information of China (English)

邓月娥

2012-01-01

Through discussing the concept of the Golden Mean in the theory and methods of TCM life nurturing, the author indicated that the Golden Mean, harmony and balance are the core ideology in TCM life nurturing. During the process of life nurturing, we should conform to four seasons and yin and yang, keep regular daily life, appropriate work, rest, a better diet and temperance sex, maintain body and spirit, combine dynamic and static exercises, and uphold the Golden Mean. In this way we will correspond to nature externally, become an entity internally with balanced yin and yang, and have a health body and peaceful spirit.%通过探讨中医养生学理论和养生方法的中庸思想,指出中庸、和谐、平衡是中医养生的核心思想.在保养生命的过程中,顺应四时阴阳,起居有常,劳逸适度,饮食有节,房事适当,形神共养,动静适宜,时时秉持中庸思想,就能使人体外与大自然协调一致,内为一个阴阳和谐平衡的统一体,因而身体健康,精神安乐.

[Determinants of dental services utilization by adults: a population-based study in Florianópolis, Santa Catarina State, Brazil].

Science.gov (United States)

Miranda, Camila Dal-Bó Coradini; Peres, Marco Aurélio

2013-11-01

This study aimed to estimate the prevalence of dental services utilization by adults and to identify associated socioeconomic, demographic, behavioral, and self-awareness factors. A cross-sectional population-based study was conducted with adults living in the urban area of Florianópolis, Santa Catarina State, Brazil, in 2009. Associations were tested between use of dental services and predisposing, enabling, and needs-based variables. Multivariate analysis was conducted using Poisson regression with estimates of prevalence ratios and was stratified by place of last dental appointment. Prevalence of dental services utilization was 66% (95%CI: 62.9-70.7). Dental visits were 20% more frequent among women and 72% more frequent among individuals with more schooling (the latter in both public and private dental services). Individuals with private dental plans used dental services 13% more than those without. Schooling was the most important variable in predicting utilization. The study's results show the importance of monitoring associated factors in order to promote more equitable use of dental services.

Family Nurture Intervention in preterm infants alters frontal cortical functional connectivity assessed by EEG coherence.

Science.gov (United States)

Myers, M M; Grieve, P G; Stark, R I; Isler, J R; Hofer, M A; Yang, J; Ludwig, R J; Welch, M G

2015-07-01

To assess the impact of Family Nurture Intervention (FNI) on cortical function in preterm infants at term age. Family Nurture Intervention is a NICU-based intervention designed to establish emotional connection between mothers and preterm infants. Infants born at 26-34 weeks postmenstrual age (PMA) were divided into two groups, standard care (SC, N = 49) and FNI (FNI, N = 56). Infants had EEG recordings of ~one hour duration with 124 lead nets between 37 and 44 weeks PMA. Coherence was measured between all pairs of electrodes in ten frequency bands. Data were summarised both within and between 12 regions during two sleep states (active, quiet). Coherence levels were negatively correlated with PMA age in both groups. As compared to SC infants, FNI infants showed significantly lower levels of EEG coherence (1-18 Hz) largely within and between frontal regions. Coherence in FNI infants was decreased in regions where we previously found robust increases in EEG power. As coherence decreases with age, results suggest that FNI may accelerate brain maturation particularly in frontal brain regions, which have been shown in research by others to be involved in regulation of attention, cognition and emotion regulation; domains deficient in preterm infants. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Cognitive bias in clinical practice - nurturing healthy skepticism among medical students.

Science.gov (United States)

Bhatti, Alysha

2018-01-01

Errors in clinical reasoning, known as cognitive biases, are implicated in a significant proportion of diagnostic errors. Despite this knowledge, little emphasis is currently placed on teaching cognitive psychology in the undergraduate medical curriculum. Understanding the origin of these biases and their impact on clinical decision making helps stimulate reflective practice. This article outlines some of the common types of cognitive biases encountered in the clinical setting as well as cognitive debiasing strategies. Medical educators should nurture healthy skepticism among medical students by raising awareness of cognitive biases and equipping them with robust tools to circumvent such biases. This will enable tomorrow's doctors to improve the quality of care delivered, thus optimizing patient outcomes.

Organisational simplification and secondary complexity in health services for adults with learning disabilities.

Science.gov (United States)

Heyman, Bob; Swain, John; Gillman, Maureen

2004-01-01

This paper explores the role of complexity and simplification in the delivery of health care for adults with learning disabilities, drawing upon qualitative data obtained in a study carried out in NE England. It is argued that the requirement to manage complex health needs with limited resources causes service providers to simplify, standardise and routinise care. Simplified service models may work well enough for the majority of clients, but can impede recognition of the needs of those whose characteristics are not congruent with an adopted model. The data were analysed in relation to the core category, identified through thematic analysis, of secondary complexity arising from organisational simplification. Organisational simplification generates secondary complexity when operational routines designed to make health complexity manageable cannot accommodate the needs of non-standard service users. Associated themes, namely the social context of services, power and control, communication skills, expertise and service inclusiveness and evaluation are explored in relation to the core category. The concept of secondary complexity resulting from organisational simplification may partly explain seemingly irrational health service provider behaviour.

[Hope as psychological resource for nurturant professionals (medicine case study)].

Science.gov (United States)

Водопьянова, Наталия Е; Чикер, Вера А; Потявина, Валерия В

In the article, the issues concerning hope, which is one of the most important resources for specialists of many nurturant professions, are observed. The theoretical analysis of hope and its categorization from the perspective of subjective and resource-based view is given. The special scientific and practical interest to human subjective and personal resources is determined by their unique role not only in human life support, but also in overcoming hard situations and extreme obstacles, including crisis situations in professional activity, with the example of the profession of a doctor. The aim of the empirical research is studying the correlation between hope and such manifestations of subjective regulations medical practice as inner subjective control and failure avoidance motivation. 120 doctors (60 men and 60 women) working in St. Petersburg hospitals took part in the research. Several research methods were used, such as 'Resource map' application form, R. Snyder's hope scale adapted by K. Muzdybayev, 'Subjective control level' method by E. Bazhin, E. Golynkina and L. Etkind, 'Failure avoidance motivation' method by T. Ehlers. Doctors think that Hope and Optimism are among important components of their professional practice, together with willing features helping them to reach their goals (such as persistence, patience, eagerness, insistence and endurance) and such personal qualities as self-assuredness, motion control in different situations, ability to solve hard problems. According the data of correlation and regression analyses, the anticipation that hope is determined by high level of inner control locus and low failure avoidance motivation (responsibility for patients' lives) within medical practice. Most doctors have average or high level of hope, which lets determine this personal disposition quality as one of the important ones for this profession. Being the positive result of professional practice and not depending on the doctors' sex and

Organic materials in planetary and protoplanetary systems: nature or nurture?

Science.gov (United States)

Dalle Ore, C. M.; Fulchignoni, M.; Cruikshank, D. P.; Barucci, M. A.; Brunetto, R.; Campins, H.; de Bergh, C.; Debes, J. H.; Dotto, E.; Emery, J. P.; Grundy, W. M.; Jones, A. P.; Mennella, V.; Orthous-Daunay, F. R.; Owen, T.; Pascucci, I.; Pendleton, Y. J.; Pinilla-Alonso, N.; Quirico, E.; Strazzulla, G.

2011-09-01

Aims: The objective of this work is to summarize the discussion of a workshop aimed at investigating the properties, origins, and evolution of the materials that are responsible for the red coloration of the small objects in the outer parts of the solar system. Because of limitations or inconsistencies in the observations and, until recently, the limited availability of laboratory data, there are still many questions on the subject. Our goal is to approach two of the main questions in a systematic way: - Is coloring an original signature of materials that are presolar in origin ("nature") or stems from post-formational chemical alteration, or weathering ("nurture")? - What is the chemical signature of the material that causes spectra to be sloped towards the red in the visible? We examine evidence available both from the laboratory and from observations sampling different parts of the solar system and circumstellar regions (disks). Methods: We present a compilation of brief summaries gathered during the workshop and describe the evidence towards a primordial vs. evolutionary origin for the material that reddens the small objects in the outer parts of our, as well as in other, planetary systems. We proceed by first summarizing laboratory results followed by observational data collected at various distances from the Sun. Results: While laboratory experiments show clear evidence of irradiation effects, particularly from ion bombardment, the first obstacle often resides in the ability to unequivocally identify the organic material in the observations. The lack of extended spectral data of good quality and resolution is at the base of this problem. Furthermore, that both mechanisms, weathering and presolar, act on the icy materials in a spectroscopically indistinguishable way makes our goal of defining the impact of each mechanism challenging. Conclusions: Through a review of some of the workshop presentations and discussions, encompassing laboratory experiments as well

Sex education and family planning services for young adults: alternative urban strategies in Mexico.

Science.gov (United States)

Townsend, J W; Diaz de May, E; Sepúlveda, Y; Santos de Garza, Y; Rosenhouse, S

1987-01-01

In Mexico, youth face difficulties in obtaining reliable information on sex education and family planning through existing community programs. Two alternative strategies to provide these services are being tested in poor urban areas of Monterrey. In one experimental area, Integrated Youth Centers were established, which provide sex education and family planning services as well as counseling, academic tutoring, and recreational activities. In another area, trained young adults and community counselors work through informal networks to provide sex education and family planning information. Both utilization and the cost of these services are examined in the context of plans for expanding coverage in Mexico-U.S. border areas.

Working With LGBT Baby Boomers and Older Adults: Factors That Signal a Welcoming Service Environment.

Science.gov (United States)

Croghan, Catherine F; Moone, Rajean P; Olson, Andrea M

2015-01-01

Many providers recognize the importance of creating culturally competent services for lesbian, gay, bisexual, and transgender (LGBT) older adults. Although multiple resources list steps to make professional practices more LGBT-welcoming, these resources provide no empirical data to support their recommendations. LGBT older adults (N = 327) were asked to describe what signals that a provider is LGBT-welcoming. Six of the top 10 signals related to provider behavior and suggest the importance of staff training; the balance included display of signage and rainbow flags, use of inclusive language on forms and the presence of LGBT-identified staff. Results provide evidence-based recommendations for working with LGBT older adults.

Theory of Connectivity: Nature and Nurture of Cell Assemblies and Cognitive Computation

Directory of Open Access Journals (Sweden)

Meng eLi

2016-04-01

Full Text Available Richard Semon and Donald Hebb are among the firsts to put forth the notion of cell assembly – a group of coherently or sequentially-activated neurons– to represent percept, memory, or concept. Despite the rekindled interest in this age-old idea, the concept of cell assembly still remains ill-defined and its operational principle is poorly understood. What is the size of a cell assembly? How should a cell assembly be organized? What is the computational logic underlying Hebbian cell assemblies? How might Nature vs Nurture interact at the level of a cell assembly? In contrast to the widely assumed local randomness within the mature but naïve cell assembly, the recent Theory of Connectivity postulates that the brain consists of the developmentally pre-programmed cell assemblies known as the functional connectivity motif (FCM. Principal cells within such FCM is organized by the power-of-two-based mathematical principle that guides the construction of specific-to-general combinatorial connectivity patterns in neuronal circuits, giving rise to a full range of specific features, various relational patterns, and generalized knowledge. This pre-configured canonical computation is predicted to be evolutionarily conserved across many circuits, ranging from these encoding memory engrams and imagination to decision-making and motor control. Although the power-of-two-based wiring and computational logic places a mathematical boundary on an individual’s cognitive capacity, the fullest intellectual potential can be brought about by optimized nature and nurture. This theory may also open up a new avenue to examining how genetic mutations and various drugs might impair or enhance the computational logic of brain circuits.

Health Concerns and Health Service Utilization in a Population Cohort of Young Adults with Autism Spectrum Disorder

Science.gov (United States)

Weiss, Jonathan A.; Isaacs, Barry; Diepstra, Heidi; Wilton, Andrew S.; Brown, Hilary K.; McGarry, Caitlin; Lunsky, Yona

2018-01-01

Individuals with autism spectrum disorder (ASD) have many health needs that place demands on the health service sector. This study used administrative data to compare health profiles in young adults 18-24 years of age with ASD to peers with and without other developmental disability. Young adults with ASD were more likely to have almost all the…

Predicting Help-Seeking Attitudes Toward Mental Health Services Among American Indian Older Adults: Is Andersen's Behavioral Model a Good Fit?

Science.gov (United States)

Roh, Soonhee; Burnette, Catherine E; Lee, Kyoung Hag; Lee, Yeon-Shim; Martin, James I; Lawler, Michael J

2017-01-01

American Indian (AI) older adults are vulnerable to mental health disparities, yet very little is known about the factors associated with help-seeking for mental health services among them. The purpose of this study was to investigate the utility of Andersen's Behavioral Model in explaining AI older adults' help-seeking attitudes toward professional mental health services. Hierarchical regression analysis was used to examine predisposing, enabling, and need variables as predictors of help-seeking attitudes toward mental health services in a sample of 233 AI older adults from the Midwest. The model was found to have limited utility in the context of older AI help-seeking attitudes, as the proportion of explained variance was low. Gender, perceived stigma, social support, and physical health were significant predictors, whereas age, perceived mental health, and health insurance were not. © The Author(s) 2014.

Can Older Adults Accurately Report their Use of Physical Rehabilitation Services?

Science.gov (United States)

Freedman, Vicki A; Kasper, Judith D; Jette, Alan

2018-04-10

To explore accuracy of rehabilitation service use reports by older adults and variation in accuracy by demographic characteristics, time since use, duration, and setting (inpatient, outpatient, home). We calculate the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of survey-based measures from an observational panel study, the National Health and Aging Trends Study (NHATS), relative to measures developed from linked Medicare claims. Community-dwelling sample of Medicare fee-for-service beneficiaries in 2015 NHATS who were enrolled in Medicare Parts A and B for 12 months prior to their interview (N=4,228). Respondents were asked whether they received rehabilitation services in the last year and the duration and location of services. Healthcare Common Procedure Coding System codes and Revenue Center codes were used to identify Medicare-eligible rehabilitation service. Survey-based reports and Medicare claims yielded similar estimates of rehabilitation use over the last year. Self-reported measures had high sensitivity (77%) and PPV (80%) and even higher specificity and NPV (approaching 95%). However, in adjusted models sensitivity was lower for Black enrollees, the very old, and those with lower education levels. Survey-based measures of rehabilitation accurately captured use over the past year but differential reporting should be considered when characterizing rehabilitation use in certain subgroups of older Americans. Copyright © 2018. Published by Elsevier Inc.

Protocol for a cohort study of adolescent mental health service users with a nested cluster randomised controlled trial to assess the clinical and cost-effectiveness of managed transition in improving transitions from child to adult mental health services (the MILESTONE study)

NARCIS (Netherlands)

Singh, S.P. (Swaran P.); Tuomainen, H. (Helena); Girolamo, G.D. (Giovanni De); A. Maras (Athanasios); P. Santosh (Paramala); McNicholas, F. (Fiona); Schulze, U. (Ulrike); Purper-Ouakil, D. (Diane); Tremmery, S. (Sabine); Franić, T. (Tomislav); Madan, J. (Jason); Paul, M. (Moli); F.C. Verhulst (Frank); G.C. Dieleman (Gwen); Warwick, J. (Jane); Wolke, D. (Dieter); Street, C. (Cathy); Daffern, C. (Claire); Tah, P. (Priya); Griffin, J. (James); Canaway, A. (Alastair); Signorini, G. (Giulia); Gerritsen, S. (Suzanne); Adams, L. (Laura); O'Hara, L. (Lesley); Aslan, S. (Sonja); Russet, F. (Frédérick); Davidović, N. (Nikolina); Tuffrey, A. (Amanda); Wilson, A. (Anna); Gatherer, C. (Charlotte); Walker, L. (Leanne)

2017-01-01

textabstractIntroduction Disruption of care during transition from child and adolescent mental health services (CAMHS) to adult mental health services may adversely affect the health and well-being of service users. The MILESTONE (Managing the Link and Strengthening Transition from Child to Adult

How well are we doing? Families of adolescents or young adults with cerebral palsy share their perceptions of service delivery.

Science.gov (United States)

Darrah, J; Magil-Evans, J; Adkins, R

2002-07-10

The satisfaction of families of adolescents and young adults with a diagnosis of cerebral palsy with the service delivery they had experienced in the areas of health, education, recreation, employment, housing and transportation was examined. Common themes across the six service areas were identified. Forty-nine adolescents (13-15 years) and 39 young adults (19-23 years) and their families rated their satisfaction with services and then participated in semi-structured interviews to discuss their experiences. Using a constant comparative method of analysis, common themes were identified from the transcribed interviews. Four themes were identified and named: caring and supportive people; fighting and fatigue; communication/information; and disability awareness. Families continue to experience dissatisfaction and frustration with service delivery in the six areas examined. Both bureaucratic structure and attitudes of service providers contribute to their dissatisfaction.

Improving Indonesian Construction Consulting Services

Directory of Open Access Journals (Sweden)

Rizal Z. Tamin

2015-05-01

Full Text Available Indonesian construction consulting services are facing a complex problem in fulfilling the nation’s expectations regarding high quality infrastructure development and the construction industry’s competitiveness. A study of this problem and a formulation of solutions to improve the situation are presented in this paper. A survey was carried out in Jakarta, West Java, East Java, and North Sumatra provinces to collect data related to this problem. A focus group discussion and a workshop with all stakeholders were conducted to formulate improvement actions that need to be taken. It was revealed that the problems faced include, among others, the limited number of professional engineers compared to the number of national consultancy companies, the uneven distribution of engineers in Indonesian regions, an imperfect procurement system, and low-quality work output in general. Recommended actions include improvement of the government’s role in consulting services nurturing and facilitation, development of partnerships, and amelioration of the professional engineer and consultant certification system.

The state of Danish nursing ethnographic research: flowering, nurtured or malnurtured - a critical review.

Science.gov (United States)

Uhrenfeldt, Lisbeth; Martinsen, Bente; Jørgensen, Lene Bastrup; Sørensen, Erik Elgaard

2018-03-01

Nursing was established in Denmark as a scholarly tradition in the late nineteen eighties, and ethnography was a preferred method. No critical review has yet summarised accomplishments and gaps and pointing at directions for the future methodological development and research herein. This review critically examines the current state of the use of ethnographic methodology in the body of knowledge from Danish nursing scholars. We performed a systematic literature search in relevant databases from 2003 to 2016. The studies included were critically appraised by all authors for methodological robustness using the ten-item instrument QARI from Joanna Briggs Institute. Two hundred and eight studies met our inclusion criteria and 45 papers were included; the critical appraisal gave evidence of studies with certain robustness, except for the first question concerning the congruity between the papers philosophical perspective and methodology and the seventh question concerning reflections about the influence of the researcher on the study and vice versa. In most studies (n = 34), study aims and arguments for selecting ethnographic research are presented. Additionally, method sections in many studies illustrated that ethnographical methodology is nurtured by references such as Hammersley and Atkinson or Spradley. Evidence exists that Danish nursing scholars' body of knowledge nurtures the ethnographic methodology mainly by the same few authors; however, whether this is an expression of a deliberate strategy or malnutrition in the form of lack of knowledge of other methodological options appears yet unanswered. © 2017 Nordic College of Caring Science.

Relevance of the nature vs nurture debate to clinical nursing.

Science.gov (United States)

McVicar, A; Clancy, J

The philosophy of holistic care underpins nurse education, and the 'nature-nurture debate' is frequently used to facilitate discussion regarding the influence of interactions with the environment in 'shaping' the individual. A limitation to this approach is that much of the work cited in the literature relates primarily to psychosocial interactions. This conveys a narrow perspective on holism, and creates an impression that the debate cannot be applied to other aspects of health and wellbeing, yet models of nursing care emphasize the need for nurses to appreciate the interactional basis of health. This article uses examples from mental health, physical health and the influence of ageing, to argue that interactions must be viewed from a much wider perspective. Only in doing so can the principles and application of holistic care, and an understanding of the bases of health education practices, be appreciated.

[Mental health of children, adolescents and young adults--part 1: prevalence, illness persistence, adversities, service use, treatment delay and consequences].

Science.gov (United States)

Lambert, M; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Karow, A

2013-11-01

Numerous birth-control studies, epidemiological studies, and observational studies have investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use by children, adolescents and young adults is low, even lower than for adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for a poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the interface of child and adolescent and adult psychiatry. Emerging studies show that these health-care structures are effective and efficient. Part 1 of the present review summarises the current state of mental health in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, and treatment delay with consequences. © Georg Thieme Verlag KG Stuttgart · New York.

A collaborative approach to improve the assessment of physical health in adult consumers with schizophrenia in Queensland mental health services.

Science.gov (United States)

Plever, Sally; McCarthy, Irene; Anzolin, Melissa; Emmerson, Brett; Khatun, Mohsina

2016-02-01

The objective of this study was to apply a quality improvement collaborative to increase the number of physical health assessments conducted with consumers diagnosed with schizophrenia in adult community mental health services across Queensland. Sixteen adult mental health service organisations voluntarily took part in the statewide collaborative initiative to increase the number of physical health assessments completed on persons with a diagnosis of schizophrenia spectrum disorders managed through the community mental health service. Improvement in the physical health assessment clinical indicator was demonstrated across the state over a 3-year period with an increase in the number of physical health assessments recorded from 12% to 58%. Significant improvements were made over a 3-year period by all mental health services involved in the collaborative, supporting the application of a quality improvement methodology to drive change across mental health services. © The Royal Australian and New Zealand College of Psychiatrists 2015.

The transition of young adults with lifelong urological needs from pediatric to adult services: An international children's continence society position statement.

Science.gov (United States)

Bower, Wendy F; Christie, Deborah; DeGennaro, Mario; Latthe, Pallavi; Raes, Ann; Romao, Rodrigo L P; Taghizadeh, Arash; Wood, Dan; Woodhouse, Christopher R J; Bauer, Stuart B

2017-03-01

Children with urinary tract disorders managed by teams, or individual pediatricians, urologists, nephrologists, gastroenterologists, neurologists, psychologists, and nurses at some point move from child-centered to adult-centered health systems. The actual physical change is referred to as the transfer whilst the process preceding this move constitutes transition of care. Our aims are twofold: to identify management and health-service problems related to children with congenital or acquired urological conditions who advance into adulthood and the clinical implications this has for long-term health and specialist care; and, to understand the issues facing both pediatric and adult-care clinicians and to develop a systems-approach model that meets the needs of young adults, their families and the clinicians working within adult services. Information was gleaned from presentations at an International Children's Continence Society meeting with collaboration from the International Continence Society, that discussed problems of transfer and transitioning such children. Several specialists attending this conference finalized this document identifying issues and highlighting ways to ease this transition and transfer of care for both patients and practitioners. The consensus was, urological patients with congenital or other lifelong care needs, are now entering adulthood in larger numbers than previously, necessitating new planning processes for tailored transfer of management. Adult teams must become familiar with new clinical problems in multiple organ systems and anticipate issues provoked by adolescence and physical growth. During this period of transitional care the clinician or team assists young patients to build attitudes, skills and understanding of processes needed to maximize function of their urinary tract-thus taking responsibility for their own healthcare needs. Preparation must also address, negotiating adult health care systems, psychosocial, educational or

Service user engagement: A co-created interview schedule exploring mental health recovery in young adults.

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McCauley, Claire-Odile; McKenna, Hugh; Keeney, Sinead; McLaughlin, Derek

2017-10-01

The aim of this study was to co-create of an interview schedule exploring mental health recovery in collaboration with young adult service users. Service user involvement in research has been increasingly recognized as providing a vital authentic insight into mental health recovery. Engagement and collaboration with service users have facilitated the exploration of inaccessible or under-investigated aspects of the lived experience of mental health recovery, not only directing the trajectory of research, but making it relevant to their own contextual experience. A qualitative content analysis framework was employed in the co-creation of a semi-structured interview schedule through an engagement process with service users. Two separate engagement groups took place at the premises of the service user organizations, between January - February 2014. Miles and Huberman's analysis framework was chosen for this phase as it enabled the visual presentation of factors, concepts or variables and the established relationship between them. The lived experience of mental ill health in young adulthood and how this was understood by others was a particularly relevant theme for participants. Further themes were identified between the impact of painful experiences at this developmental life stage leading to a deeper understanding of others through finding meaning in their own mental health recovery journey. Our findings identified that suffering painful experiences is an integral aspect in the process of mental health recovery. This understanding has particular relevance to mental health nursing practice, ensuring the care delivered is cognizant of the suffering or painful experiences that young adults are encountering. © 2017 John Wiley & Sons Ltd.

76 FR 44573 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Science.gov (United States)

2011-07-26

... DEPARTMENT OF AGRICULTURE Food and Nutrition Service Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service Payment Rates, and Administrative Reimbursement Rates for Sponsoring Organizations of Day Care Homes for the Period July 1, 2011 Through June 30, 2012 Correction In notice document 2011-18257 appearin...

A survey of georgia adult protective service staff: implications for older adult injury prevention and policy.

Science.gov (United States)

Strasser, Sheryl M; Kerr, Judith; King, Patricia S; Payne, Brian; Beddington, Sarah; Pendrick, Danielle; Leyda, Elizabeth; McCarty, Frances

2011-07-01

The aging population is a rapidly growing demographic. Isolation and limited autonomy render many of the elderly vulnerable to abuse, neglect and exploitation. As the population grows, so does the need for Adult Protective Services (APS). This study was conducted to examine current knowledge of older adult protection laws in Georgia among APS staff and to identify training opportunities to better prepare the APS workforce in case detection and intervention. The Georgia State University Institute of Public Health faculty developed a primary survey in partnership with the Georgia Division of Aging Services' leadership to identify key training priority issues for APS caseworkers and investigators. A 47-item electronic questionnaire was delivered to all APS employees via work-issued email accounts. We conducted descriptive analyses, t-tests and chi-square analyses to determine APS employees' baseline knowledge of Georgia's elder abuse policies, laws and practices, as well as examine associations of age, ethnicity, and educational attainment with knowledge. We used a p-value of 0.05 and 95% confidence intervals to determine statistical significance of analyses performed. Ninety-two out of 175 APS staff responded to the survey (53% response rate). The majority of respondents were Caucasian (56%) women (92%). For over half the survey items, paired sample t-tests revealed significant differences between what APS staff reported as known and what APS staff members indicated they needed to know more about in terms of elder abuse and current policies. Chi-square tests revealed that non-Caucasians significantly preferred video conferencing as a training format (44% compared to 18%), [χ(2)(1) = 7.102, p < .008], whereas Caucasians preferred asynchronous online learning formats (55% compared to 28%) [χ(2)(1) =5.951, p < .015]. Results from this study provide the Georgia Division of Aging with insight into specific policy areas that are not well understood by APS staff

Correlates of mental health services utilization 18 months and almost 4 years postdisaster among adults with mental health problems

NARCIS (Netherlands)

van der Velden, Peter G.; Yzermans, C. Joris; Kleber, Rolf J.; Gersons, B. P. R.

2007-01-01

The authors assess the correlates of mental health services utilization (MHS) after a disaster among adults with mental health problems. Data of a three-wave longitudinal study among adult survivors of a fireworks disaster (T1: 2-3 weeks, T2: 18 months, T3: almost 4 years postdisaster) were linked

Influence of Students’ Feedback on the Quality of Adult Higher Distance Education Service Delivery

Directory of Open Access Journals (Sweden)

Akpovire ODUARAN

2017-10-01

Full Text Available The evaluation of a program’s compliance with service delivery and features necessary for the attainment of the programs educational objectives, student outcomes and continuous improvement is an important element in program accreditation and continuous improvement process. The study reported in this paper investigated the possible effects of students’ feedback on the improvement of adult higher education distance learning service quality in a South African rural-based university. The study interrogated the service provision factors that seemingly helped in improving the delivery of the program. Such information are vital for planning, good governance, policy formulation, monitoring and evaluation, and for decision-making. The study used a quantitative descriptive statistics analysis of data generated ranging from 2013-2014. It comprised of overall student satisfaction as the dependent variable and the explanatory variables were given by program management, facilitation, assessment, learner support, systems, resources, program outcomes and subject matter. Analytical results were obtained from the Mann Whitney Test. The population consisted of students enrolled in the Advanced Certificate in Education (ACE program by distance mode. The 313 respondents sampled were randomly selected from a total population of 916 students. Data were collected using a semi-structured questionnaire. The results revealed that service qualities linked to effective management, facilitation, academic support and subject matter delivery were the main qualities that the students recommended for the improvement of the program. It is therefore recommended that adult higher education programs must have a documented systematically utilized and effective process involving program service delivery constituencies like assessment, academic support and resources provided, for the periodic review of the program educational objectives to ensure that the program remains consistent

Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults

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There has been no consensus on best practices in food and nutrition services in assisted living facilities (ALFs) for older adults. We documented experts’ views on optimal food and nutrition services emphases in ALFs, and factors affecting their views. One hundred thirty-five national experts speci...

Culture Embrained: Going Beyond the Nature-Nurture Dichotomy.

Science.gov (United States)

Kitayama, Shinobu; Salvador, Cristina E

2017-09-01

Over the past three decades, the cultural psychology literature has established that there is systematic cultural variation in the nature of agency in the domains of cognition, emotion, and motivation. This literature adopted both self-report and performance-based (or behavioral) indicators of these processes, which set the stage for a more recent systematic exploration of cultural influences at the neural and biological level. Moreover, previous work has largely focused on East-West differences, thereby calling for a systematic exploration of other ethnic groups. To address these issues, this article reviews recent work in cultural neuroscience, while paying close attention to Latino Americans-the single most rapidly growing minority group in the United States. We focus on research that has employed neural measures and show that culture has systematic influences on the brain. We also point out that, unlike more traditional self-report or performance-based measures, neural indicators of culture are reliably linked to theoretically relevant individual difference variables such as self-construal and acculturation. Cultural neuroscience offers the framework to go beyond the dichotomy between nature and nurture and to explore how they may dynamically interact.

Work Engagement, Burnout and Personal Accomplishments Among Social Workers: A Comparison Between Those Working in Children and Adults' Services in England.

Science.gov (United States)

Hussein, Shereen

2018-04-26

Social workers (SWs) provide emotional and practical support to vulnerable service users who are likely to suffer from emotional trauma and mental health conditions. Stress and burnout levels are reported to be high among SWs, however, little is known about their relationships with different characteristics. The current article utilises unique and large dataset (n = 3786) on SWs working in adults and children's services to examine factors associated with burnout. Employing job-demand/resources model and structural equations modelling, we highlight the varying significant impact of work-engagement, administrative support and work experience as moderating factors to burnout across adult and children service specialism in this sample.

Nature versus nurture segues to choice versus circumstance in the new millennium: one consideration for an integrative biopsychosocial philosophy, art, and science of chiropractic.

Science.gov (United States)

Smith, Monica

2009-12-01

This commentary discusses the evolving sociocultural roles and sociocultural authority of chiropractic. The complex interconnectivity of the biological, psychological, and social aspects of our individual and collective well-being has occupied centuries of "nature versus nurture" philosophical debate, creative art, and scientific work. What has emerged is a better understanding of how our human development is affected by the circumstances of what we are born with (ie, nature) and how we are shaped by the circumstances that we are born into (ie, nurture). In the new millennium, a cumulative challenge to the emerging integrative biopsychosocial health care disciplines is one of reconciling "circumstance versus choice"; that is, advancing individually and collectively the fullest actualization of human potential through the philosophy, art, and science of autonomy and empowerment.

Pathways into homelessness: recently homeless adults problems and service use before and after becoming homeless in Amsterdam

Directory of Open Access Journals (Sweden)

de Wit Matty A

2009-01-01

Full Text Available Abstract Background To improve homelessness prevention practice, we met with recently homeless adults, to explore their pathways into homelessness, problems and service use, before and after becoming homeless. Methods Recently homeless adults (last housing lost up to two years ago and legally staying in the Netherlands were sampled in the streets, day centres and overnight shelters in Amsterdam. In April and May 2004, students conducted interviews and collected data on demographics, self reported pathways into homelessness, social and medical problems, and service use, before and after becoming homeless. Results among 120 recently homeless adults, (male 88%, Dutch 50%, average age 38 years, mean duration of homelessness 23 weeks, the main reported pathways into homelessness were evictions 38%, relationship problems 35%, prison 6% and other reasons 22%. Compared to the relationship group, the eviction group was slightly older (average age 39.6 versus 35.5 years; p = 0.08, belonged more often to a migrant group (p = 0.025, and reported more living single (p Conclusion the recently homeless fit the overall profile of the homeless population in Amsterdam: single (Dutch men, around 40 years, with a mix of financial debts, addiction, mental and/or physical health problems. Contacts with services were fragmented and did not prevent homelessness. For homelessness prevention, systematic and outreach social medical care before and during homelessness should be provided.

Commissioning specialist diabetes services for adults with diabetes: summary of a Diabetes UK Task and Finish group report.

Science.gov (United States)

Goenka, N; Turner, B; Vora, J

2011-12-01

The increasing prevalence of diabetes, the drive to develop community services for diabetes and the Quality and Outcomes Framework for diabetes have led to improvements in the management of diabetes in primary care settings, with services traditionally provided only in specialist care now provided for many patients with diabetes by non-specialists. Consequently, there is a need to redefine roles, responsibilities and components of a specialist diabetes service to provide for the needs of patients in the National Health Service (NHS) today. The delivery of diabetes care is complex and touches on almost every aspect of the health service. It is the responsibility of those working within commissioning and specialist provider roles to work together with people with diabetes to develop, organize and deliver a full range of integrated diabetes care services. The local delivery model agreed within the local diabetes network, comprising specialist teams, primary care teams, commissioners and people with diabetes, should determine how the diabetes specialist services are organizsed. It should identify the roles and responsibilities of provider organizations to ensure that the right person provides the right care, at the right time, and in the right place. We summarize a report entitled 'Commissioning Diabetes Specialist Services for Adults with Diabetes', which has been produced, as a 'Task and Finish' group activity within Diabetes UK, to assist managers, commissioners and healthcare professionals to provide advice on the structure, roles and components of specialist diabetes services for adults. © 2011 The Authors. Diabetic Medicine © 2011 Diabetes UK.

Screening for Elder Mistreatment among Older Adults Seeking Legal Assistance Services

Directory of Open Access Journals (Sweden)

Sheryl M Strasser

2013-08-01

Full Text Available Introduction: The aging population is a rapidly growing demographic in the United States. Isolation, limited autonomy, and declining physical and mental health render many older adults vulnerable to elder mistreatment (EM. The purpose of this study was to assess the prevalence and correlates of EM among a sample of older adults using legal assistance services in Atlanta, Georgia.Methods: Researchers administered surveys to consenting older adults (aged 60þ in 5 metro Atlanta community centers that hosted legal assistance information sessions as part of the Elderly Legal Assistance Program. The surveys screened for risk factors and prevalence of EM risk using valid and reliable measures and included additional questions regarding demographics characteristics and healthcare use behaviors.Results: Surveys were completed by 112 participants. Findings reveal that 32 (28.6% respondents met the criteria for elder abuse / neglect risk; 17 (15.2% respondents met criteria for depression; and 105 (93.7% had visited a healthcare provider during the past 6 months.Conclusion: The rates of EM risk in this sample were higher than those previously reported in research. Findings support continued examination of unique risks that may be present among older adults who may be possibly facing legal issues. Additionally, the reported frequency of healthcare visits among participants reveals a promising opportunity to examine development of a more widespread EM screening approach to be conducted in non-emergency settings. Interdisciplinary collaboration is required to inform screening approaches that account for complexities that EM cases present. [West J Emerg Med. 2013;14(4:309–315.

Mental healthcare need and service utilization in older adults living in public housing.

Science.gov (United States)

Simning, Adam; van Wijngaarden, Edwin; Fisher, Susan G; Richardson, Thomas M; Conwell, Yeates

2012-05-01

Anxiety and depression in socioeconomically disadvantaged older adults frequently go unrecognized and untreated. This study aims to characterize mental illness and its treatment in older adult public housing residents who have many risk factors for anxiety and depression. Cross-sectional study. Public housing high-rises in Rochester, New York. One hundred ninety residents aged 60 years and older. Anxiety and depression were assessed using the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, GAD-7, and Patient Health Questionnaire. We obtained information on mental healthcare from medication review and self-report. Participants had a median age of 66 years, 58% were women, 80% were black, and 92% lived alone. Many participants (31%) were in need of mental healthcare: 21% had syndromal and 11% had subsyndromal anxiety or depression. Mental healthcare need was associated with younger age; intact cognitive functioning; impairments in instrumental activities of daily living (IADL); more medical illness; decreased mobility; smaller social network size; more severe life events; and increased utilization of medical, human, and informal services. Of those with mental healthcare need, most were not receiving it. Compared with residents receiving mental healthcare, residents with untreated need were more likely to be men and have less IADL impairment, medical illness, severe life events, onsite social worker use, and human services utilization. Mental illness was common and largely untreated in public housing residents. Increasing collaboration between medical, mental, and human services is needed to improve identification, treatment, and ultimately prevention of late-life mental illness in this community setting.

Spending on Hospital Care and Pediatric Psychology Service Use Among Adolescents and Young Adults With Cancer.

Science.gov (United States)

McGrady, Meghan E; Peugh, James L; Brown, Gabriella A; Pai, Ahna L H

2017-10-01

To examine the relationship between need-based pediatric psychology service use and spending on hospital care among adolescents and young adults (AYAs) with cancer. Billing data were obtained from 48 AYAs with cancer receiving need-based pediatric psychology services and a comparison cohort of 48 AYAs with cancer not receiving services. A factorial analysis of covariance examined group differences in spending for hospital care. Pending significant findings, a multivariate analysis of covariance was planned to examine the relationship between need-based pediatric psychology service use and spending for inpatient admissions, emergency department (ED) visits, and outpatient visits. Spending for hospital care was higher among AYAs receiving need-based pediatric psychology services than in the comparison cohort (p psychology services. The behavioral and psychosocial difficulties warranting need-based pediatric psychology services may predict higher health care spending. © The Author 2017. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Youth experiences of transition from child mental health services to adult mental health services: a qualitative thematic synthesis.

Science.gov (United States)

Broad, Kathleen L; Sandhu, Vijay K; Sunderji, Nadiya; Charach, Alice

2017-11-28

Adolescence and young adulthood is a vulnerable time during which young people experience many development milestones, as well as an increased incidence of mental illness. During this time, youth also transition between Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). This transition puts many youth at risk of disengagement from service use; however, our understanding of this transition from the perspective of youth is limited. This systematic review aims to provide a more comprehensive understanding of youth experiences of transition from CAMHS to AMHS, through a qualitative thematic synthesis of the extant literature in this area. Published and unpublished literature was searched using keywords targeting three subject areas: Transition, Age and Mental Health. Studies were included if they qualitatively explored the perceptions and experiences of youth who received mental health services in both CAMHS and AMHS. There were no limitations on diagnosis or age of youth. Studies examining youth with chronic physical health conditions were excluded. Eighteen studies, representing 14 datasets and the experiences of 253 unique service-users were included. Youth experiences of moving from CAMHS and AMHS are influenced by concurrent life transitions and their individual preferences regarding autonomy and independence. Youth identified preparation, flexible transition timing, individualized transition plans, and informational continuity as positive factors during transition. Youth also valued joint working and relational continuity between CAMHS and AMHS. Youth experience a dramatic culture shift between CAMHS and AMHS, which can be mitigated by individualized and flexible approaches to transition. Youth have valuable perspectives to guide the intelligent design of mental health services and their perspectives should be used to inform tools to evaluate and incorporate youth perspectives into transitional service improvement

Dose optimization in adult patients exams in a computerized tomography service

International Nuclear Information System (INIS)

Pimentel, Juliana; Finatto, Jerusa D.; Silva, Ana Maria Marques da; Froner, Ana Paula P.

2013-01-01

This paper presents a study of dose optimization in computed tomography X-ray of skull, chest and abdomen of adult patients, performed in a diagnostic imaging service in a large hospital. Images of a simulated dose phantom were acquired and the kVp, mAs, pitch, thickness and CTDI vol were collected directly from the equipment. Using the PACS system, regions of interest were delineated, where the mean and standard deviation of CT numbers for each protocol were been calculated. The optimization took into account the maintenance of the CT number and noise from images acquired with clinical protocols. It was observed that the protocols used in the service, in general, exhibit a low dose, despite the great variability among the different professional shifts. In examinations of the chest, skull and abdomen, changes in the values of mAs and pitch were suggested, allowing dose reductions (60%, 17% and 19%, respectively), without compromising the image diagnostic quality. (author)

Screening for Obstructive Sleep Apnea in Adults: US Preventive Services Task Force Recommendation Statement.

Science.gov (United States)

Bibbins-Domingo, Kirsten; Grossman, David C; Curry, Susan J; Davidson, Karina W; Epling, John W; García, Francisco A R; Herzstein, Jessica; Kemper, Alex R; Krist, Alex H; Kurth, Ann E; Landefeld, C Seth; Mangione, Carol M; Phillips, William R; Phipps, Maureen G; Pignone, Michael P; Silverstein, Michael; Tseng, Chien-Wen

2017-01-24

Based on data from the 1990s, estimated prevalence of obstructive sleep apnea (OSA) in the United States is 10% for mild OSA and 3.8% to 6.5% for moderate to severe OSA; current prevalence may be higher, given the increasing prevalence of obesity. Severe OSA is associated with increased all-cause mortality, cardiovascular disease and cerebrovascular events, diabetes, cognitive impairment, decreased quality of life, and motor vehicle crashes. To issue a new US Preventive Services Task Force (USPSTF) recommendation on screening for OSA in asymptomatic adults. The USPSTF reviewed the evidence on the accuracy, benefits, and potential harms of screening for OSA in asymptomatic adults seen in primary care, including those with unrecognized symptoms. The USPSTF also evaluated the evidence on the benefits and harms of treatment of OSA on intermediate and final health outcomes. The USPSTF found insufficient evidence on screening for or treatment of OSA in asymptomatic adults or adults with unrecognized symptoms. Therefore, the USPSTF was unable to determine the magnitude of the benefits or harms of screening for OSA or whether there is a net benefit or harm to screening. The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for OSA in asymptomatic adults. (I statement).

Book Beat: A Young Adult Services Manual for Louisiana's Libraries. Face It: Read a Book: Be Somebody. [Updated Edition.

Science.gov (United States)

Fairbanks, Gretchen, Ed.; Jaques, Thomas F., Ed.

Libraries need to reach out to teens and enhance their skills in serving the teenage population. Through the Louisiana Young Adult Services program, it is hoped that all staff working with young adults will be reached to accomplish the following: (1) promote a better understanding of the psychology of this age group; (2) increase skills in…

Why older adults may decline offers of post-acute care services: A qualitative descriptive study.

Science.gov (United States)

Sefcik, Justine S; Ritter, Ashley Z; Flores, Emilia J; Nock, Rebecca H; Chase, Jo-Ana D; Bradway, Christine; Potashnik, Sheryl; Bowles, Kathryn H

The most common post-acute care (PAC) services available to patients after hospital discharge include home care, skilled nursing facilities, nursing homes, inpatient rehabilitation, and hospice. Patients who need PAC and receive services have better outcomes, however almost one-third of those offered services decline. Little research exists on PAC decision-making and why patients may decline services. This qualitative descriptive study explored the responses of thirty older adults to the question: "Can you, from the patient point of view, tell me why someone would not want post hospital care?" Three themes emerged. Participants may decline due to 1) previous negative experiences with PAC, or 2) a preference to be home. Some participants stated, "I'd be there" and would not decline services. Participants also discussed 3) why other patients might decline PAC which included patients' past experiences, lack of understanding/preconceived ideas, and preferences. Clinical implications include assessing patients' knowledge and experience before providing recommendations. Copyright © 2016 Elsevier Inc. All rights reserved.

Competitive Employment and Service Management for Adolescents and Young Adults with Emotional and Behavioral Disorders.

Science.gov (United States)

Bullis, Michael; Paris, Kathleen

1996-01-01

Given the variety and severity of problems associated with adolescents with emotional and behavioral disorders (EBD), it is imperative that a coordinated system of vocational training and social support be afforded adolescents and young adults with EBD for them to become successful members of the workforce. Describes such a service model.…

What is the perceived nature of parental care and support for young people with cystic fibrosis as they enter adult health services?

Science.gov (United States)

Iles, Nicola; Lowton, Karen

2010-01-01

The majority of those diagnosed with cystic fibrosis (CF) now live to adulthood. In response to increased survival age, transition services have been developed to ensure smooth transfer from paediatric to adult specialist healthcare, although the majority of treatment and care continues to be delivered in the home. However, little is known about how young adults and staff conceptualise the nature of the parental role after young people have left paediatric care. The aim of this study is to explore the nature of parental support that is perceived to be available at this time. As part of a larger study of transitional care, semi-structured interviews were conducted with 50 young people with CF aged 13-24 years (32 with experience of transition and/or adult CF services) and 23 specialist healthcare professionals (14 working in adult care) across two CF centres in Southeast England. Interviews took place in young people's homes or within CF services, using a topic guide and were recorded, transcribed and analysed thematically. Four domains of perceived parental support were identified by the young people interviewed, with varying degrees of continuity into adult care: (1) Providing non-clinical practical and emotional support; (2) Acting as 'troubleshooters' in times of health-related crisis; (3) Working in partnership with offspring in ongoing disease management in the home and clinic; (4) Acting as 'protectors' of their children. Young people and service staff expressed tensions in managing parental involvement in post-paediatric consultations and the degree to which parents should be aware of their offspring's deteriorating health and social concerns. Parental anxiety and over-involvement was perceived by many young people and staff as unsupportive. We suggest that although health and social care providers are mindful of the tensions that arise for those leaving paediatric services, the place of parental support in adult care is currently contentious for these 'new

Family Nurture Intervention in the Neonatal Intensive Care Unit improves social-relatedness, attention, and neurodevelopment of preterm infants at 18 months in a randomized controlled trial.

Science.gov (United States)

Welch, Martha G; Firestein, Morgan R; Austin, Judy; Hane, Amie A; Stark, Raymond I; Hofer, Myron A; Garland, Marianne; Glickstein, Sara B; Brunelli, Susan A; Ludwig, Robert J; Myers, Michael M

2015-11-01

Preterm infants are at high risk for adverse neurodevelopmental and behavioral outcomes. Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) is designed to counteract adverse effects of separation of mothers and their preterm infants. Here, we evaluate effects of FNI on neurobehavioral outcomes. Data were collected at 18 months corrected age from preterm infants. Infants were assigned at birth to FNI or standard care (SC). Bayley Scales of Infant Development III (Bayley-III) were assessed for 76 infants (SC, n = 31; FNI, n = 45); the Child Behavior Checklist (CBCL) for 57 infants (SC, n = 31; FNI, n = 26); and the Modified Checklist for Autism in Toddlers (M-CHAT) was obtained for 59 infants (SC, n = 33; FNI, n = 26). Family Nurture Intervention significantly improved Bayley-III cognitive (p = .039) and language (p = .008) scores for infants whose scores were greater than 85. FNI infants had fewer attention problems on the CBCL (p Nurture Intervention is the first NICU intervention to show significant improvements in preterm infants across multiple domains of neurodevelopment, social-relatedness, and attention problems. These gains suggest that an intervention that facilitates emotional interactions between mothers and infants in the NICU may be key to altering developmental trajectories of preterm infants. © 2015 Association for Child and Adolescent Mental Health.

Illness-related behaviour and utilization of oral health services among adult city-dwellers in Burkina Faso

DEFF Research Database (Denmark)

Varenne, Benoît; Petersen, Poul Erik; Fournet, Florence

2006-01-01

-economic and socio-cultural factors such as religious affiliation, material living conditions and participation in a social network were significantly associated with the use of oral health care services by adults who had experienced oral health problems during the previous year. CONCLUSION: The proportion of people...

Used and foregone health services among a cohort of 87,134 adult open university students residing throughout Thailand.

Science.gov (United States)

Yiengprugsawan, Vasoontara; Seubsman, Sam-Ang; Lim, Lynette L-Y; Sleigh, Adrian C

2009-11-01

There are limited data on the frequency of foregone health service use in defined populations. Here we describe Thai patterns of health service use, types of health insurance used and reports of foregone health services according to geo-demographic and socioeconomic characteristics. Data on those who considered they had needed but not received health care over the previous year were obtained from a national cohort of 87,134 students from the Sukhothai Thammathirat Open University (STOU). The cohort was enrolled in 2005 and was largely made up of young and middle-age adults living throughout Thailand. Among respondents, 21.0% reported use of health services during the past year. Provincial/governmental hospitals (33.4%) were the most attended health facilities in general, followed by private clinics (24.1%) and private hospitals (20.1%). Health centers and community hospitals were sought after in rural areas. The recently available government operated Universal Coverage Scheme (UCS) was popular among the lower income groups (13.6%), especially in rural areas. When asked, 42.1% reported having foregone health service use in the past year. Professionals and office workers frequently reported 'long waiting time' (17.1%) and 'could not get time off work' (13.7%) as reasons, whereas manual workers frequently noted it was 'difficult to travel' (11.6%). This information points to non-financial opportunity cost barriers common to a wide array of Thai adults who need to use health services. This issue is relevant for health and workplace policymakers and managers concerned about equitable access to health services.

Volunteers in Specialist Palliative Care: A Survey of Adult Services in the United Kingdom

Science.gov (United States)

Burbeck, Rachel; Low, Joe; Sampson, Elizabeth L.; Bravery, Ruth; Hill, Matthew; Morris, Sara; Ockenden, Nick; Payne, Sheila

2014-01-01

Abstract Background: Worldwide, the demand for specialist palliative care is increasing but funding is limited. The role of volunteers is underresearched, although their contribution reduces costs significantly. Understanding what volunteers do is vital to ensure services develop appropriately to meet the challenges faced by providers of palliative care. Objective: The study's objective is to describe current involvement of volunteers with direct patient/family contact in U.K. specialist palliative care. Design: An online survey was sent to 290 U.K. adult hospices and specialist palliative care services involving volunteers covering service characteristics, involvement and numbers of volunteers, settings in which they are involved, extent of involvement in care services, specific activities undertaken in each setting, and use of professional skills. Results: The survey had a 67% response rate. Volunteers were most commonly involved in day care and bereavement services. They entirely ran some complementary therapy, beauty therapy/hairdressing, and pastoral/faith-based care services, and were involved in a wide range of activities, including sitting with dying patients. Conclusions: This comprehensive survey of volunteer activity in U.K. specialist palliative care provides an up-to-date picture of volunteer involvement in direct contact with patients and their families, such as providing emotional care, and the extent of their involvement in day and bereavement services. Further research could focus on exploring their involvement in bereavement care. PMID:24475743

Predictors of homeless services re-entry within a sample of adults receiving Homelessness Prevention and Rapid Re-Housing Program (HPRP) assistance.

Science.gov (United States)

Brown, Molly; Vaclavik, Danielle; Watson, Dennis P; Wilka, Eric

2017-05-01

Local and national evaluations of the federal Homelessness Prevention and Rapid Re-Housing Program (HPRP) have demonstrated a high rate of placement of program participants in permanent housing. However, there is a paucity of research on the long-term outcomes of HPRP, and research on rehousing and prevention interventions for single adults experiencing homelessness is particularly limited. Using Homeless Management Information System data from 2009 to 2015, this study examined risk of return to homeless services among 370 permanently housed and 71 nonpermanently housed single adult HPRP participants in Indianapolis, Indiana. Kaplan-Meier survival curves were conducted to analyze time-to-service re-entry for the full sample, and the homelessness prevention and rapid rehousing participants separately. With an average follow-up of 4.5 years after HPRP exit, 9.5% of the permanently housed HPRP participants and 16.9% of those nonpermanently housed returned to homeless services. By assistance type, 5.4% of permanently housed and 15.8% of nonpermanently housed homelessness prevention recipients re-entered services, and 12.8% of permanently housed and 18.2% of nonpermanently housed rapid rehousing recipients re-entered during the follow-up period. Overall, veterans, individuals receiving rapid rehousing services, and those whose income did not increase during HPRP had significantly greater risk of returning to homeless services. Veterans were at significantly greater risk of re-entry when prevention and rehousing were examined separately. Findings suggest a need for future controlled studies of prevention and rehousing interventions for single adults, aiming to identify unique service needs among veterans and those currently experiencing homelessness in need of rehousing to inform program refinement. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Predictors of the Availability and Variety of Social Care Services for Older Adults: Comparison of Central European Countries

Czech Academy of Sciences Publication Activity Database

Lehmann, Štěpánka; Havlíková, Jana

2015-01-01

Roč. 41, č. 1 (2015), s. 113-132 ISSN 0148-8376 Institutional support: RVO:68378025 Keywords : Older adults * social care services * availability Subject RIV: AO - Sociology, Demography Impact factor: 0.510, year: 2015

Fast-food and full-service restaurant consumption and daily energy and nutrient intakes in US adults.

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An, R

2016-01-01

Calorie intake and diet quality are influenced by the source of food and the place of consumption. This study examines the impacts of fast-food and full-service restaurant consumption on daily energy and nutrient intakes in US adults. Nationally representative data of 18,098 adults 18 years of age and above from the National Health and Nutrition Examination Survey 2003-2010 waves were analyzed. Outcomes included daily intake of total calories and 24 nutrients of public health concern. The key predictors were any food/beverage consumption in a day from fast-food or full-service restaurant, differentiated by consumption at home versus away from home. First-difference estimator addressed confounding bias from time-invariant unobservables such as personal food/beverage preferences by using within-individual variations in diet and restaurant consumption status between two nonconsecutive 24-h dietary recalls. Fast-food and full-service restaurant consumption, respectively, were associated with a net increase in daily total energy intake of 190.29 and 186.74 kcal, total fat of 10.61 and 9.58 g, saturated fat of 3.49 and 2.46 g, cholesterol of 10.34 and 57.90 mg, and sodium of 297.47 and 411.92 mg. The impact of fast-food and full-service restaurant consumption on energy and nutrient intakes differed by sex, race/ethnicity, education, income and weight status. Increased total energy, total fat, saturated fat, cholesterol and sodium intake were substantially larger when full-service restaurant food was consumed away from home than at home. A holistic policy intervention is warranted to target the American's overall dining-out behavior rather than fast-food consumption alone.

Experiences of community-dwelling older adults with the use of telecare in home care services: a qualitative systematic review.

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Karlsen, Cecilie; Ludvigsen, Mette Spliid; Moe, Carl Erik; Haraldstad, Kristin; Thygesen, Elin

2017-12-01

The aging population will lead to a rise in the number of people with age-related diseases, and increasing demand for home care services. Telecare is seen as a solution to this challenge by promoting aging in place. Nevertheless, there is still a poor understanding of older adults' experiences with the actual use of telecare. The aim of this review was to identify and synthesize the best available qualitative evidence of community-dwelling older adults' experience with the use of telecare in home care services. This review considered studies that focused on qualitative data, examining older adults' experiences with the use of active and passive technology devices, such as personal alarms and sensor technology, in the context of home care services. This review systematically searched the databases Scopus, CINAHL, PsycINFO, and SveMed+ to find both published and unpublished studies in English, Norwegian, Swedish and Danish, from 2005 to 2017. Methodological quality of the included studies was assessed independently by two reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. Qualitative data were extracted from papers included in the review using the standardized Qualitative Assessment and Review Instrument from the Joanna Briggs Institute. Qualitative research findings were pooled using the Joanna Briggs Institute Qualitative Assessment and Review Instrument, and involved aggregation and synthesis of findings. A total of 118 findings from 11 studies were aggregated into 20 categories. The categories generated seven synthesized findings: 1) Aging in place is desired; however, it may also be related to feeling isolated and lonely. 2) Telecare contributes to safety, security, and aging in place. 3) Privacy is not seen as a problem by most older adults because the technology is intended to help them live safely in their own home. 4) Some telecare devices have side effects, especially new technology. Some devices do not work outside

Nurturing a service orientated paradigm of management within a traditionally manufacturing enterprise: A South African case study

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Richard Weeks

2011-12-01

Full Text Available Purpose: The purpose of this paper is to analyse and draw a correlation between service science theory and practice as it relates to the complexity of engendering a services orientated paradigm of management within a traditionally manufacturing enterprise. It is suggested that the traditional manufacturing paradigm is founded on scientific management principles whereas that of service science is far more multidisciplinary and complex in nature. It would seem that the service science paradigm is directed at co-creational value in contrast to a transactional paradigm of management that form the foundation of the manufacturing era. Problem investigated: With the emergence of an essentially services orientated global economy, manufacturing enterprises are increasing adding a range of services to the value offerings they make available to clients. The first part of this paper constitutes a literature study directed at gaining a theoretical understanding and insight into the underlying principles of management involved in moving from an essentially manufacturing management setting to one that incorporates services and in some instances where services assume the dominant paradigm of management. The second part of the paper attempts to correlate the theoretical insights gain from the literature study with relation to that of practice by means of a case study undertaken at a South African manufacturing enterprise that has implemented a servitization strategy. Methodology: A multidisciplinary literature review and analysis is undertaken to gain an insight of contemporary management theory and practice, as it relates to servitization or the transition from an essentially manufacturing to a services inclusive operational setting. With the insights gained from the literature research serving as a source of information and reference a case study was undertaken at a South African enterprise to determine if a correlation exists between theory as expressed in

Assessment of the responsiveness of a public health service from the perspective of older adults.

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Melo, Denise da Silva; Martins, René Duarte; Jesus, Renata Patrícia Freitas Soares de; Samico, Isabella Chagas; Santo, Antônio Carlos Gomes do Espírito

2017-06-26

To assess the quality of health care of older adults using as a parameter the assessment of the responsiveness of the service. This is a descriptive cross-sectional study conducted in a reference unit of the Brazilian Unified Health System at the outpatient level. The sample was probabilistic and had 385 older adults; data collection occurred in 2014. The domains assessed were: choice, autonomy, confidentiality, dignity, communication, physical facilities, and fast service. To this end, we used Pearson correlation test and Fisher's exact test. The domains of dignity, confidentiality, and communication reached the highest level of adequate responsiveness. On the other hand, freedom of choice and fast service received the worst assessments. Participation in decision-making regarding treatment was significantly lower among the older adults who had no education. In addition, the older adults that self-reported as black receive a lower quality of care regarding clear explanation and respected privacy in the appointment, when compared to users of any other race. Although most domains studied have receive a positive assessment, we have found a need for an equal care by the health professionals, regardless of race, education level, or any other adjective characteristic of older adults, users of public health services. Avaliar a qualidade da atenção à saúde da população idosa usando como parâmetro a avaliação da responsividade do serviço. Trata-se de um estudo descritivo, de corte transversal, realizado em uma unidade de referência do Sistema Único de Saúde em nível ambulatorial. A amostra foi probabilística composta por 385 idosos e a coleta de dados ocorreu em 2014. Foram avaliados os domínios: escolha, autonomia, confidencialidade, dignidade, comunicação, instalações físicas e atendimento rápido. Para tanto, foram utilizados o teste de correlação de Pearson e o teste de Fisher. Os domínios dignidade, confidencialidade e comunicação atingiram o

Spillover Effects of Adult Medicaid Expansions on Children's Use of Preventive Services.

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Venkataramani, Maya; Pollack, Craig Evan; Roberts, Eric T

2017-12-01

Since the passage of the Affordable Care Act, Medicaid enrollment has increased by ∼17 million adults, including many low-income parents. One potentially important, but little studied, consequence of expanding health insurance for parents is its effect on children's receipt of preventive services. By using state Medicaid eligibility thresholds linked to the 2001-2013 Medical Expenditure Panel Surveys, we assessed the relationship between changes in adult Medicaid eligibility and children's likelihood of receiving annual well-child visits (WCVs). In instrumental variable analyses, we used these changes in Medicaid eligibility to estimate the relationship between parental enrollment in Medicaid and children's receipt of WCVs. Our analytic sample consisted of 50 622 parent-child dyads in families with incomes Medicaid eligibility (measured relative to the federal poverty level) was associated with a 0.27 percentage point higher probability that a child received an annual WCV (95% confidence interval: 0.058 to 0.48 percentage points, P = .012). Instrumental variable analyses revealed that parental enrollment in Medicaid was associated with a 29 percentage point higher probability that their child received an annual WCV (95% confidence interval: 11 to 47 percentage points, P = .002). In our study, we demonstrate that Medicaid expansions targeted at low-income adults are associated with increased receipt of recommended pediatric preventive care for their children. This finding reveals an important spillover effect of parental insurance coverage that should be considered in future policy decisions surrounding adult Medicaid eligibility. Copyright © 2017 by the American Academy of Pediatrics.

The role of primary care in adult weight management: qualitative interviews with key stakeholders in weight management services

OpenAIRE

Blane, David N.; Macdonald, Sara; Morrison, David; O’Donnell, Catherine A.

2017-01-01

Background Primary care has a key role to play in the prevention and management of obesity, but there remain barriers to engagement in weight management by primary care practitioners. The aim of this study was to explore the views of key stakeholders in adult weight management services on the role of primary care in adult weight management. Methods Qualitative study involving semi-structured interviews with nine senior dietitians involved in NHS weight management from seven Scottish health bo...

Predictors of post-sentence mental health service use in a population cohort of first-time adult offenders in Western Australia.

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Sodhi-Berry, Nita; Knuiman, Matthew; Preen, David B; Alan, Janine; Morgan, Vera A

2015-12-01

Little is known about whether or how offenders use mental health services after sentence completion. This study aimed to determine the likelihood of such service use by adult (18-44 years) first-time offenders up to 5 years after sentence completion and possible predictor variables. Pre-sentence and post-sentence mental health service use was obtained from whole-population linked administrative data on 23,661 adult offenders. Cox proportional hazard models were used to determine which socio-demographic, offending and pre-sentence health service variables were associated with such post-sentence service use. The estimated 5-year probability of any post-sentence mental health service use was 12% for offenders who had not previously used such services, but still only 42% for those who had. For the latter, best predictors of post-sentence use were past psychiatric diagnosis and history of self-harm; history of self-harm also predicted post-sentence use among new mental health services users and so also did past physical illness. Indigenous offenders had a greater likelihood of service use for any mental disorder or for substance use disorders than non-Indigenous offenders, irrespective of pre-sentence use. Among those with pre-sentence service contact, imprisoned offenders were less likely to use mental health services after sentence than those under community penalties; in its absence, socio-economic disadvantage and geographic accessibility were associated with greater likelihood of post-sentence use. Our findings highlight the discontinuity of mental healthcare for most sentenced offenders, but especially prisoners, and suggest a need for better management strategies for these vulnerable groups with mental disorders. Copyright © 2014 John Wiley & Sons, Ltd.

Leadership behaviours that nurture organizational trust: Re-examining the fundamentals

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Canute S. Thompson

2018-04-01

Full Text Available This study examines the variable of trust in organizational relationships and found six leadership behaviors that foster trust. Using a confirmatory factor analysis, these leadership behaviors were examined to see the nature of the relationships among latent variables. The goal of the research was to establish whether there were some fundamental qualities that characterized trust-producing leadership behaviours. The study used data that were gathered from a survey among teachers in Jamaica. The participants work at various levels of the Jamaican education system and they were selected using a convenience sampling technique. The research is timely given the growing evidence of mistrust among leaders and followers in organizations and its findings are significant in that it offers a new and more nuanced perspective on the kinds of leadership behaviours that nurture organizational trust. The instrument used to collect the data was designed by the researcher and tested for reliability using Cronbach’s Alpha and produced a result of .938. e study proposes recommendations for improving organizational trust.

Cognitive bias in clinical practice – nurturing healthy skepticism among medical students

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Bhatti A

2018-04-01

Full Text Available Alysha Bhatti Faculty of Medicine, Imperial College London, London, UK Abstract: Errors in clinical reasoning, known as cognitive biases, are implicated in a significant proportion of diagnostic errors. Despite this knowledge, little emphasis is currently placed on teaching cognitive psychology in the undergraduate medical curriculum. Understanding the origin of these biases and their impact on clinical decision making helps stimulate reflective practice. This article outlines some of the common types of cognitive biases encountered in the clinical setting as well as cognitive debiasing strategies. Medical educators should nurture healthy skepticism among medical students by raising awareness of cognitive biases and equipping them with robust tools to circumvent such biases. This will enable tomorrow’s doctors to improve the quality of care delivered, thus optimizing patient outcomes. Keywords: cognitive bias, diagnostic error, clinical decision making

Alcohol and substance use history among ADHD adults: the relationship with persistent and remitting symptoms, personality, employment, and history of service use.

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Huntley, Zoe; Young, Susan

2014-01-01

To profile substance use, personality, service use, and employment in adults with ADHD. The sample consisted of 216 consecutive referrals to an adult ADHD service and classified with ADHD, partially or fully remitted ADHD, or no ADHD. Normal controls (n = 33) were recruited from a general practitioner's center. Participants completed measures of alcohol and illicit substance use, employment, service use, ADHD symptoms, and personality. High rates of substance use were found in participants with current ADHD diagnoses. ADHD participants showed increased rates of personality trait or disorder scores and unemployment. There was some indication that those with ADHD and substance-related impairment place higher demand on services. Individuals with partially remitted ADHD showed similar substance use to those with current ADHD, whereas those in full remission were comparable with normal controls. Although ADHD symptoms may remit with time, individuals retaining persisting or partial symptoms have substantial needs in adulthood.

Nature and Nurture in the Early-Life Origins of Metabolic Syndrome.

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Gonzalez-Bulnes, Antonio; Astiz, Susana; Ovilo, Cristina; Garcia-Contreras, Consolacion; Vazquez-Gomez, Marta

The combination of genetic background together with food excess and lack of exercise has become the cornerstone of metabolic disorders associated to lifestyle. The scenario is furthermore reinforced by their interaction with other environmental factors (stress, sleeping patterns, education, culture, rural versus urban locations, and xenobiotics, among others) inducing epigenetic changes in the exposed individuals. The immediate consequence is the development of further alterations like obesity and metabolic syndrome, and other adverse health conditions (type-2 diabetes, cardiovascular diseases, cancer, reproductive, immune and neurological disorders). Thus, having in mind the impact of the metabolic syndrome on the worldwide public health, the present review affords the relative roles and the interrelationships of nature (genetic predisposition to metabolic syndrome) and nurture (lifestyle and environmental effects causing epigenetic changes), on the establishment of the metabolic disorders in women; disorders that may evolve to metabolic syndrome prior or during pregnancy and may be transmitted to their descendants.

Transitions of Care from Child and Adolescent Mental Health Services to Adult Mental Health Services (TRACK Study: A study of protocols in Greater London

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Ford Tamsin

2008-06-01

Full Text Available Abstract Background Although young people's transition from Child and Adolescent Mental Health Services (CAMHS to Adult Mental Health Services (AMHS in England is a significant health issue for service users, commissioners and providers, there is little evidence available to guide service development. The TRACK study aims to identify factors which facilitate or impede effective transition from CAHMS to AMHS. This paper presents findings from a survey of transition protocols in Greater London. Methods A questionnaire survey (Jan-April 2005 of Greater London CAMHS to identify transition protocols and collect data on team size, structure, transition protocols, population served and referral rates to AMHS. Identified transition protocols were subjected to content analysis. Results Forty two of the 65 teams contacted (65% responded to the survey. Teams varied in type (generic/targeted/in-patient, catchment area (locality-based, wider or national and transition boundaries with AMHS. Estimated annual average number of cases considered suitable for transfer to AMHS, per CAMHS team (mean 12.3, range 0–70, SD 14.5, n = 37 was greater than the annual average number of cases actually accepted by AMHS (mean 8.3, range 0–50, SD 9.5, n = 33. In April 2005, there were 13 active and 2 draft protocols in Greater London. Protocols were largely similar in stated aims and policies, but differed in key procedural details, such as joint working between CAHMS and AMHS and whether protocols were shared at Trust or locality level. While the centrality of service users' involvement in the transition process was identified, no protocol specified how users should be prepared for transition. A major omission from protocols was procedures to ensure continuity of care for patients not accepted by AMHS. Conclusion At least 13 transition protocols were in operation in Greater London in April 2005. Not all protocols meet all requirements set by government policy. Variation in

Comparing adult users of public and private dental services in the state of Minas Gerais, Brazil.

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Pinto, Rafaela da Silveira; de Abreu, Mauro Henrique Nogueira Guimarães; Vargas, Andrea Maria Duarte

2014-08-06

Studying the factors associated with the use of dental services can provide the necessary knowledge to understand the reasons why individuals seek out public healthcare services and the formulation of more appropriate public policies for the present-day reality. This work was a cross-sectional epidemiological study consisting of a sample of adults found in a research databank concerning the conditions of the oral health of the population of the state of Minas Gerais, Brazil. This study examined both main oral health disorders and relevant socioeconomic aspects. The dependent variable was defined as the type of service used, categorized under public and private use. The independent variables were selected and grouped to be inserted in the analysis model according to an adaptation of the behavioral model described by Andersen and Davidson. A hierarchical model was used to analyze the data. The description of variables and bivariate analyses were performed in an attempt to verify possible associations. For each group of variables at each hierarchical level, the gross and adjusted odds ratios (OR) and the respective 95% confidence intervals (CI) were estimated by means of logistic regression. The Complex Samples model from the SPSS statistics program, version 19.0, was used to analyze the sample framework. In the final model, the factors associated with the use of public healthcare services by adults were directly related to the socioeconomic and demographic conditions of the individuals, including: being of a dark-skinned black race/color, belonging to families with more than four household residents and with a lower income level, residing in small towns, having more teeth that need treatment. According to the findings from this study, socioeconomic and demographic factors, as well as normative treatment needs, are associated with the use of public dental services.

Using the Consumer Experience with Pharmacy Services Survey as a quality metric for ambulatory care pharmacies: older adults' perspectives.

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Shiyanbola, Olayinka O; Mott, David A; Croes, Kenneth D

2016-05-26

To describe older adults' perceptions of evaluating and comparing pharmacies based on the Consumer Experience with Pharmacy Services Survey (CEPSS), describe older adults' perceived importance of the CEPSS and its specific domains, and explore older adults' perceptions of the influence of specific CEPSS domains in choosing/switching pharmacies. Focus group methodology was combined with the administration of a questionnaire. The focus groups explored participants' perceived importance of the CEPSS and their perception of using the CEPSS to choose and/or switch pharmacies. Then, using the questionnaire, participants rated their perceived importance of each CEPSS domain in evaluating a pharmacy, and the likelihood of using CEPSS to switch pharmacies if their current pharmacy had low ratings. Descriptive and thematic analyses were done. 6 semistructured focus groups were conducted in a private meeting room in a Mid-Western state in the USA. 60 English-speaking adults who were at least 65 years, and had filled a prescription at a retail pharmacy within 90 days. During the focus groups, the older adults perceived the CEPSS to have advantages and disadvantages in evaluating and comparing pharmacies. Older adults thought the CEPSS was important in choosing the best pharmacies and avoiding the worst pharmacies. The perceived influence of the CEPSS in switching pharmacies varied depending on the older adult's personal experience or trust of other consumers' experience. Questionnaire results showed that participants perceived health/medication-focused communication as very important or extremely important (n=47, 82.5%) in evaluating pharmacies and would be extremely likely (n=21, 36.8%) to switch pharmacies if their pharmacy had low ratings in this domain. The older adults in this study are interested in using patient experiences as a quality metric for avoiding the worst pharmacies. Pharmacists' communication about health and medicines is perceived important and likely

Nurturing the Growing Generation’s Values in the Process of Socio-Cultural Transformation of Society

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Asbi Khaleb

2012-01-01

Full Text Available The Arab minority in Israel is in the process of socio-cultural transformation, its force rising and splitting the society. Modernization, the Arab society undergoes, is influenced by the constant contacts with the Jew- ish nation representing in its majority the western culture, the other influenc- ing factors being technologies and mass media. Some changes affect the soci- ety in a positive way, whereas the global uncontrollable ones can bring about the system crisis and the full split of society. In order to retain the integrity it is necessary to control this process on the level of basic elements of cultural awareness by nurturing both cultural and moral values within the framework of educational system. One of the main functions of educational system is the man’s adapta- tion in society including its cultural aspect; and the upbringing process should be performed in the context of belonging to cultural and national val- ues. Well-balanced organic system of education combining cardinal, national and religious values can facilitate harmonious personal growth, and affect the society in a positive way. However, the Arab educational system in Israel faces some challenges in the course of implementing the value nurturing programs. They include the lack of political initiative and control over the educational system devel- opment performed by the Arabs; and the absence of the definite and steady value system that can be given to the growing generation by means of school education. To overcome the problem the author recommends developing and implementing a special training program focused on the value component de- velopment, as the students might have difficulty getting by in the real world without it. 

Long-term care services and support systems for older adults: The role of technology.

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Czaja, Sara J

2016-01-01

The aging of the population, especially the increase in the "oldest old," is a remarkable achievement that presents both opportunities and challenges for policymakers, researchers, and society. Although many older adults enjoy relatively good health into their later years, many have one or more chronic conditions or diseases and need help with disease management activities or activities important to independent living. Technology is playing an increasingly important role in the health care arena and is becoming ubiquitous in health management activities. There are a variety of technology applications that can be used to enhance the mobility and quality of life of people who have limitations and help to foster the ability of those with chronic conditions to remain at home. Technology applications can also provide a central role in providing support to family caregivers in terms of enhancing access to information and community resources and connections to formal and informal support services. Monitoring technologies may also allow caregivers to check on the status or activities of their loved one while they are at work or at a distant location. Furthermore, telemedicine applications can aid the ability of care providers to monitor patients and deliver health services. The objective of this article is to highlight the potential role that technology can play in the provision of long-term support for older adults and their families. Challenges and barriers that currently limit the full potential of technology to be realized for these populations will also be discussed. Finally the role of psychological science toward maximizing the potential of technology applications in enhancing long term care and support services will be highlighted. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

The impact of early life family structure on adult social attachment, alloparental behavior, and the neuropeptide systems regulating affiliative behaviors in the monogamous prairie vole (Microtus ochrogaster

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Todd H Ahern

2009-08-01

Full Text Available Early social attachments lie at the heart of emotional and social development in many mammals, including humans. In nature, monogamous prairie voles (Microtus ochrogaster experience considerable natural variation in early social attachment opportunities due to differences in family structure (e.g., single-mothers, solitary breeding pairs, and communal groups. We exploited some of this natural variation in family structure to examine the influence of early social environment on the development of adult social behavior. First, we characterized the parental care received by pups reared biparentally (BP or by a single-mother (SM in the laboratory. Second, we examined whether BP- and SM-reared offspring differed in adult nurturing, bonding, and emotional behaviors. Finally, we investigated the effects of rearing condition on neuropeptide systems that regulate adult social behavior (oxytocin, vasopressin, and corticotropin-releasing factor [CRF]. Observations revealed that SM-reared pups were exposed more frequently (P<0.01, licked and groomed less (P<0.01, and matured more slowly (P<0.01 than BP-reared pups. In adulthood, there were striking socio-behavioral differences: SM-reared females showed low spontaneous, pup-directed alloparental behavior (P<0.01 and both males and females from the SM-reared condition showed delayed partner preference formation. While rearing did not impact neuropeptide receptor densities in the ventral forebrain as we predicted, SM-reared animals, particularly females, had increased OT content (P<0.01 and greater dorsal raphe CRF2 densities (P<0.05 and both measures correlated with licking and grooming experienced during the first 10 days of life. These results suggest that naturalistic variation in social rearing conditions can introduce diversity into adult nurturing and attachment behaviors.

A Cross-Sectional Study to Examine Factors Associated with Primary Health Care Service Utilization among Older Adults in the Irbid Governorate of Jordan

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Abdullah Alkhawaldeh

2014-01-01

Full Text Available Background. Recently, the percentage of older adults in developing countries has increased significantly. Objective. This study examined patterns and factors associated with primary health care services utilization in the past 1, 6, and 12 months. Method. A cross-sectional study design was used to collect data from 190 older adults in the Irbid governorate of Jordan. Results. Primary health care services were used by less than half of the participants in the past 1 month, by 68.4% in the past 6 months, and by 73.8% in the past 12 months. Primary health care (PHC services use was associated with age, education level, tobacco use, chronic illnesses, perceived general health status today, a physical component summary score, employment, and perceived general health status in the past 6 and 12 months. The primary predictor of PHC services use at 1, 6, and 12 months was chronic illnesses (OR=13.32, (OR=19.63, and (OR=17.91, respectively. Conclusion. Although many factors were associated with PHC service utilization, the strongest predictor of PHC service utilization was chronic illnesses.

Unmet Support Service Needs and Health-Related Quality of Life among Adolescents and Young Adults with Cancer: The AYA HOPE Study

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Ashley Wilder Smith

2013-04-01

Full Text Available Introduction: Cancer for adolescents and young adults (AYA differs from younger and older patients; AYA face medical challenges while navigating social and developmental transitions. Research suggests that these patients are under- or inadequately served by current support services, which may affect health-related quality of life (HRQOL.Methods: We examined unmet service needs and HRQOL in the National Cancer Institute’s Adolescent and Young Adult Health Outcomes and Patient Experience (AYA HOPE study, a population-based cohort (n=484, age 15-39, diagnosed with cancer 6-14 months prior, in 2007-2009. Unmet service needs were psychosocial, physical, spiritual, and financial services where respondents endorsed that they needed, but did not receive, a listed service. Linear regression models tested associations between any or specific unmet service needs and HRQOL, adjusting for demographic, medical and health insurance variables.Results: Over one-third of respondents reported at least one unmet service need. The most common were financial (16%, mental health (15%, and support group (14% services. Adjusted models showed that having any unmet service need was associated with worse overall HRQOL, fatigue, physical, emotional, social, and school/work functioning, and mental health (p’s<0.0001. Specific unmet services were related to particular outcomes (e.g., needing pain management was associated with worse overall HRQOL, physical and social functioning (p’s<0.001. Needing mental health services had the strongest associations with worse HRQOL outcomes; needing physical/occupational therapy was most consistently associated with poorer functioning across domains.Discussion: Unmet service needs in AYAs recently diagnosed with cancer are associated with worse HRQOL. Research should examine developmentally appropriate, relevant practices to improve access to services demonstrated to adversely impact HRQOL, particularly physical therapy and mental

Using the critical incident survey to assess hospital service quality.

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Longo, B; Connor, G; Barnhart, T

1993-01-01

This survey was designed to determine "standards of excellence" in hospital services as defined by (a) former patients, (b) physicians, (c) hospital employees, and (d) corporate insurance subscribers. One hundred forty-seven (147) patients, 188 employees, and 20 corporate subscribers were interviewed by telephone, and 52 physicians were interviewed in their offices. The interview consisted of a single question: "Can you think of a time when, as a patient/employee/employer/physician, you had a particularly satisfying or dissatisfying experience with a local hospital?" Reported incidents were reviewed, and 239 "critical incidents" were identified. These incidents were classified into 12 descriptive categories relating to the underlying factors in the incident reports. Six focus groups were later held with participants segregated by the population pool they represented. These groups were asked to develop definitions of "excellence" in hospital service quality and standards for service which would "exceed expectations." The focus groups created 122 standards of excellence, which were classified into 43 categories. Overall, the largest percentages of corporate, physician, and employee critical incidents were classified as "Administrative Policy" issues. Patients most often reported "Nurturing" incidents as critical to their perceptions of hospital service quality.

Screening for Dyslipidemia in Younger Adults: A Systematic Review for the U.S. Preventive Services Task Force.

Science.gov (United States)

Chou, Roger; Dana, Tracy; Blazina, Ian; Daeges, Monica; Bougatsos, Christina; Jeanne, Thomas L

2016-10-18

Dyslipidemia may occur in younger adults (defined as persons aged 21 to 39 years) and is an important risk factor for cardiovascular disease. Screening might identify younger adults with asymptomatic dyslipidemia who may benefit from lipid-lowering therapies. To update the 2008 U.S. Preventive Services Task Force review on dyslipidemia screening in younger adults. The Cochrane Central Register of Controlled Trials, the Cochrane Database of Systematic Reviews, and MEDLINE through May 2016, and reference lists. Randomized, controlled trials; cohort studies; and case-control studies on screening for or treatment of asymptomatic dyslipidemia in adults aged 21 to 39 years. The plan was for 1 investigator to abstract data and a second to check their accuracy, and for 2 investigators to independently assess study quality; however, no studies met the inclusion criteria. No study evaluated the effects of lipid screening versus no screening, treatment versus no treatment, or delayed versus earlier treatment on clinical outcomes in younger adults. In addition, no study evaluated the diagnostic yield of alternative screening strategies (such as targeted screening of persons with a family history of hyperlipidemia vs. general screening) in younger adults. No direct relevant evidence. Direct evidence on the benefits and harms of screening for or treatment of dyslipidemia in younger adults remains unavailable. Estimating the potential effects of screening for dyslipidemia in this population requires extrapolation from studies performed in older adults. Agency for Healthcare Research and Quality.

"It Just Makes You Feel Invincible": A Foucauldian Analysis of Children's Experiences of Organised Team Sports

Science.gov (United States)

Walters, Simon R.; Payne, Deborah; Schluter, Philip J.; Thomson, Rex W.

2015-01-01

The childhood years are highlighted as a crucial time when ongoing participation in physical activity can be nurtured and maintained. The nurturing of a child's proclivity to participate in organised sport normally falls into the domain of adults. While both parents and coaches have been identified as key influences on children's enjoyment of…

Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

OpenAIRE

Lee, Sungmin; Lee, Chanam; Rodiek, Susan

2017-01-01

Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 201...

Techno-Bureaucratic Governance and Public Service Delivery: Indonesia and Nigeria in Perspectives

Directory of Open Access Journals (Sweden)

Jacob Olufemi Fatile

2015-09-01

Full Text Available Techno-bureaucratic governance is fundamental to contemporary public service. This is because the roles of the bureaucrats and technocrats become more relevant in policy formulation and implementation when the government had to (reinvent its institutions to move from routine administration to that of development planning and management. Utilizing a qualitative approach, the paper notes that techno-bureaucratic ideology values technical expertise itself and its technical experts, efficiency, economic development and effective public service delivery. Adopting comparative perspective, the paper examines techno-bureaucratic governance and public service delivery in Indonesia and Nigeria. The paper takes a cursory look at the similarities and differences between the two countries. The paper notes that the technocracy nurtured by the New Order in Indonesia was cohesive and effective because of its technical expertise and has helped Indonesia to turn oil income into productive investments,whereas in Nigeria the oil income was used for prestigious projects to the detriment of productive investments. The paper therefore recommend among others that developing societies need a new strategy in delivery services in their public service, and this can be achieved through skilled professionals, technocrats and knowledge based actors. It concludes that for public service to deliver effective services, an efficient bureaucracy and technocracy remain invaluable.

The oxytocin system promotes resilience to the effects of neonatal isolation on adult social attachment in female prairie voles

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Barrett, C E; Arambula, S E; Young, L J

2015-01-01

Genes and social experiences interact to create variation in social behavior and vulnerability to develop disorders of the social domain. Socially monogamous prairie voles display remarkable diversity in neuropeptide receptor systems and social behavior. Here, we examine the interaction of early-life adversity and brain oxytocin receptor (OTR) density on adult social attachment in female prairie voles. First, pups were isolated for 3 h per day, or unmanipulated, from postnatal day 1–14. Adult subjects were tested on the partner preference (PP) test to assess social attachment and OTR density in the brain was quantified. Neonatal social isolation impaired female PP formation, without affecting OTR density. Accumbal OTR density was, however, positively correlated with the percent of time spent huddling with the partner in neonatally isolated females. Females with high accumbal OTR binding were resilient to neonatal isolation. These results are consistent with the hypothesis that parental nurturing shapes neural systems underlying social relationships by enhancing striatal OTR signaling. Thus, we next determined whether early touch, mimicking parental licking and grooming, stimulates hypothalamic OT neuron activity. Tactile stimulation induced immediate-early gene activity in OT neurons in neonates. Finally, we investigated whether pharmacologically potentiating OT release using a melanocortin 3/4 agonist, melanotan-II (10 mg kg−1 subcutaneously), would mitigate the social isolation-induced impairments in attachment behavior. Neonatal melanotan-II administration buffered against the effects of early isolation on partner preference formation. Thus, variation in accumbal OTR density and early OT release induced by parental nurturing may moderate susceptibility to early adverse experiences, including neglect. PMID:26196439

The oxytocin system promotes resilience to the effects of neonatal isolation on adult social attachment in female prairie voles.

Science.gov (United States)

Barrett, C E; Arambula, S E; Young, L J

2015-07-21

Genes and social experiences interact to create variation in social behavior and vulnerability to develop disorders of the social domain. Socially monogamous prairie voles display remarkable diversity in neuropeptide receptor systems and social behavior. Here, we examine the interaction of early-life adversity and brain oxytocin receptor (OTR) density on adult social attachment in female prairie voles. First, pups were isolated for 3 h per day, or unmanipulated, from postnatal day 1-14. Adult subjects were tested on the partner preference (PP) test to assess social attachment and OTR density in the brain was quantified. Neonatal social isolation impaired female PP formation, without affecting OTR density. Accumbal OTR density was, however, positively correlated with the percent of time spent huddling with the partner in neonatally isolated females. Females with high accumbal OTR binding were resilient to neonatal isolation. These results are consistent with the hypothesis that parental nurturing shapes neural systems underlying social relationships by enhancing striatal OTR signaling. Thus, we next determined whether early touch, mimicking parental licking and grooming, stimulates hypothalamic OT neuron activity. Tactile stimulation induced immediate-early gene activity in OT neurons in neonates. Finally, we investigated whether pharmacologically potentiating OT release using a melanocortin 3/4 agonist, melanotan-II (10 mg kg(-1) subcutaneously), would mitigate the social isolation-induced impairments in attachment behavior. Neonatal melanotan-II administration buffered against the effects of early isolation on partner preference formation. Thus, variation in accumbal OTR density and early OT release induced by parental nurturing may moderate susceptibility to early adverse experiences, including neglect.

Childhood Maltreatment and Child Protective Services Involvement Among the Commercially Sexually Exploited: A Comparison of Women Who Enter as Juveniles or as Adults.

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Cimino, Andrea N; Madden, Elissa E; Hohn, Kris; Cronley, Courtney M; Davis, Jaya B; Magruder, Karen; Kennedy, M Alexis

2017-04-01

A risk for commercial sexual exploitation is childhood maltreatment. It's unknown whether juveniles in commercial sexual exploitation experience more childhood maltreatment than adults or how involved child protective services is in investigating maltreatment, a focus of this study. Women (N = 96) who sold sex commercially completed a cross-sectional questionnaire. Descriptive statistics, t tests, chi-squares, and odds ratios were used to examine differences in background, childhood maltreatment, and child protective services involvement by juvenile or adult entry. Although 93% of participants experienced child maltreatment, juveniles had increased odds of parent/caregiver sexual abuse, being left alone, being kicked out, and running away from a parent/caregiver. There were no differences in cumulative childhood maltreatment resulting in an investigation or removal, indicating that juveniles not investigated or removed by child protective services had as much childhood maltreatment as juveniles who were investigated or removed by child protective services. Results highlight the need for child welfare staff to recognize childhood maltreatment as risks for commercial sexual exploitation.

How Are Service Dogs for Adults with Post Traumatic Stress Disorder Integrated with Rehabilitation in Denmark? A Case Study.

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Glintborg, Chalotte; Hansen, Tia G B

2017-04-25

A severe mental illness like Post Traumatic Stress Disorder (PTSD) is known to have psychosocial consequences that can lead to a decreased quality of life. Research in Animal-Assisted Therapy (AAT) has revealed that the presence of a dog can have a positive effect on health, e.g., increase quality of life and lessen depression and anxiety. However, canine companionship is not a catch-all solution. Previous research has revealed methodological limitations that prohibit any clear conclusions, as well as a sparsity of critical reflection in anecdotal reports and case studies, which means that more research is needed to contextualize the findings. There has been an increasing interest in animal-assisted intervention in Denmark in recent years. Previously, authorities could only grant service dogs to adults with physical disabilities, but now this has been extended to adults with mental illnesses. Therefore, it has become important to explore how these service dogs are incorporated into rehabilitation practices in mental health, and how rehabilitation professionals react to the use of service dogs. This paper is a case study of a person who suffers from PTSD. This study examines how the person describes the significance of having a dog during her rehabilitation process, and how this is integrated with existing rehabilitation. The case study has been developed based on a semi-structured interview. A Thematic Content analysis was used to reveal dominant patterns and categories. This study revealed a lack of communication and collaboration between public administration (social service), service dog providers, health rehabilitation services, and providers of psychological treatment. It also revealed limited access for the dog to public services, limited success in incorporating the dog into goal-directed treatment and rehabilitation procedures, a strongly felt emotional support from the dog, and a perceived stigma by having the dog wearing a vest with he words "mentally ill

Pharmacy services at admission and discharge in adult, acute, public hospitals in Ireland.

LENUS (Irish Health Repository)

Grimes, Tamasine

2012-02-01

OBJECTIVES: to describe hospital pharmacy involvement in medication management in Ireland, both generally and at points of transfer of care, and to gain a broad perspective of the hospital pharmacy workforce. METHODS: a survey of all adult, acute, public hospitals with an accident and emergency (A&E) department (n = 36), using a semi-structured telephone interview. KEY FINDINGS: there was a 97% (n = 35) response rate. The majority (n = 25, 71.4%) of hospitals reported delivery of a clinical pharmacy service. On admission, pharmacists were involved in taking or verifying medication histories in a minority (n = 15, 42.9%) of hospitals, while few (n = 6,17.1%) deployed staff to the A&E\\/acute medical admissions unit. On discharge, the majority (n = 30,85.7%) did not supply any take-out medication, a minority (n =5,14.3%) checked the discharge prescription, 51.4% (n = 18) counselled patients, 42.9% (n = 15) provided medication compliance charts and one hospital (2.9%) communicated with the patient\\'s community pharmacy. The number of staff employed in the pharmacy department in each hospital was not proportionate to the number of inpatient beds, nor the volume of admissions from A&E. There were differences identified in service delivery between hospitals of different type: urban hospitals with a high volume of admissions from A&E were more likely to deliver clinical pharmacy. CONCLUSIONS: the frequency and consistency of delivering pharmacy services to facilitate medication reconciliation at admission and discharge could be improved. Workforce constraints may inhibit service expansion. Development of national standards of practice may help to eliminate variation between hospitals and support service development.

Improving preventive service delivery at adult complete health check-ups: the Preventive health Evidence-based Recommendation Form (PERFORM cluster randomized controlled trial

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Moineddin Rahim

2006-07-01

Full Text Available Abstract Background To determine the effectiveness of a single checklist reminder form to improve the delivery of preventive health services at adult health check-ups in a family practice setting. Methods A prospective cluster randomized controlled trial was conducted at four urban family practice clinics among 38 primary care physicians affiliated with the University of Toronto. Preventive Care Checklist Forms© were created to be used by family physicians at adult health check-ups over a five-month period. The sex-specific forms incorporate evidence-based recommendations on preventive health services and documentation space for routine procedures such as physical examination. The forms were used in two intervention clinics and two control clinics. Rates and relative risks (RR of the performance of 13 preventive health maneuvers at baseline and post-intervention and the percentage of up-to-date preventive health services delivered per patient were compared between the two groups. Results Randomly-selected charts were reviewed at baseline (n = 509 and post-intervention (n = 608. Baseline rates for provision of preventive health services ranged from 3% (fecal occult blood testing to 93% (blood pressure measurement, similar to other settings. The percentage of up-to-date preventive health services delivered per patient at the end of the intervention was 48.9% in the control group and 71.7% in the intervention group. This is an overall 22.8% absolute increase (p = 0.0001, and 46.6% relative increase in the delivery of preventive health services per patient in the intervention group compared to controls. Eight of thirteen preventive health services showed a statistically significant change (p Conclusion This simple, low cost, clinically relevant intervention improves the delivery of preventive health services by prompting physicians of evidence-based recommendations in a checklist format that incorporates existing practice patterns. Periodic updates

Experts stress both wellness and amenity aspects of food and nutrition services in assisted living facilities for older adults.

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Chao, Shirley Y; Dwyer, Johanna T; Houser, Robert F; Jacques, Paul; Tennstedt, Sharon

2008-10-01

There has been no consensus on best practices in food and nutrition services in assisted living facilities for older adults. We documented experts' views on optimal food and nutrition services emphases in assisted living facilities, and factors affecting their views. One hundred thirty-five national experts specializing in health, aging, nutrition and assisted living facilities completed a survey consisting four scenarios (ie, home-style, restaurant/hotel, and health/medical, and a combination of these three) in six food and nutrition services areas: dining room environment, meal services, meal quality, nutrition services, employees' qualifications, and therapeutic nutrition services. Sixty-three percent of experts favored the combination scenario. Dietetics education and experts' beliefs that assisted living facilities should be health promotion and maintenance facilities were significant predictors of emphases, including wellness considerations. Experts' personal views exerted a powerful influence. Experts chose food and nutrition service quality indicators that emphasized a focus on both wellness and amenities as their ideal scenarios for optimal food and nutrition services in assisted living facilities.

Health Services Utilization in Older Adults with Dementia Receiving Care Coordination: The MIND at Home Trial.

Science.gov (United States)

Amjad, Halima; Wong, Stephanie K; Roth, David L; Huang, Jin; Willink, Amber; Black, Betty S; Johnston, Deirdre; Rabins, Peter V; Gitlin, Laura N; Lyketsos, Constantine G; Samus, Quincy M

2018-02-01

To investigate effects of a novel dementia care coordination program on health services utilization. A total of 303 community-dwelling adults aged ≥70 with a cognitive disorder in Baltimore, Maryland (2008-2011). Single-blind RCT evaluating efficacy of an 18-month care coordination intervention delivered through community-based nonclinical care coordinators, supported by an interdisciplinary clinical team. Study partners reported acute care/inpatient, outpatient, and home- and community-based service utilization at baseline, 9, and 18 months. From baseline to 18 months, there were no significant group differences in acute care/inpatient or total outpatient services use, although intervention participants had significantly increased outpatient dementia/mental health visits from 9 to 18 months (p = .04) relative to controls. Home and community-based support service use significantly increased from baseline to 18 months in the intervention compared to control (p = .005). While this dementia care coordination program did not impact acute care/inpatient services utilization, it increased use of dementia-related outpatient medical care and nonmedical supportive community services, a combination that may have helped participants remain at home longer. Future care model modifications that emphasize delirium, falls prevention, and behavior management may be needed to influence inpatient service use. © Health Research and Educational Trust.

Family nurture intervention improves the quality of maternal caregiving in the neonatal intensive care unit: evidence from a randomized controlled trial.

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Hane, Amie A; Myers, Michael M; Hofer, Myron A; Ludwig, Robert J; Halperin, Meeka S; Austin, Judy; Glickstein, Sara B; Welch, Martha G

2015-04-01

This study assessed the impact of Family Nurture Intervention (FNI) on the quality of maternal caregiving behavior (MCB) while in the neonatal intensive care unit (NICU). FNI is a randomized controlled trial conducted in a high-acuity NICU to facilitate an emotional connection between mothers and their premature infants. FNI begins shortly after birth, continues until discharge, and involves mother/infant calming sessions that include scent cloth exchange, vocal soothing and emotion expression, eye contact, skin-to-skin and clothed holding, and family-based support sessions. Maternal caregiving behavior was coded during a single holding and feeding session (∼30 min) in the NICU before discharge at approximately 36 weeks gestational age (GA). Sixty-five mothers and their premature infants (34 male, 31 female; 26-34 wk GA) were included in these analyses (FNI, n = 35; standard care [SC], n = 30). Relative to mothers in the SC condition, those in the FNI group showed significantly higher quality MCB, which remained significant when controlling for birth order, twin status, maternal depression, and maternal anxiety. This is the first study to demonstrate that in-unit MCB can be enhanced by a hospital-based intervention. FNI provides a new rationale for integrating nurture-based interventions into standard NICU care.

Group Training of Applied Behavior Analysis (ABA) Knowledge Competencies to Community-Based Service Providers for Adults with Developmental Disabilities

Science.gov (United States)

Luiselli, James K.; St. Amand, CarrieAnne; MaGee, Christine; Sperry, James M.

2008-01-01

We describe a training program to teach applied behavior analysis (ABA) knowledge competencies to paraprofessional staff (N = 47) at a habilitation services agency for adults with developmental disabilities. Before and following training, staff completed assessment of knowledge tests for three content areas: basic learning principles,…

Properties of Galaxies and Groups: Nature versus Nurture

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Niemi, Sami-Matias

2011-09-01

Due to the inherently nonlinear nature of gravity cosmological N-body simulations have become an invaluable tool when the growth of structure is being studied and modelled closer to the present epoch. Large simulations with high dynamical range have made it possible to model the formation and growth of cosmic structure with unprecedented accuracy. Moreover, galaxies, the basic building blocks of the Universe, can also be modelled in cosmological context. However, despite all the simulations and successes in recent decades, there are still many unanswered questions in the field of galaxy formation and evolution. One of the longest standing issue being the significance of the formation place and thus initial conditions to a galaxy's evolution in respect to environment, often formulated simply as "nature versus nurture" like in human development and psychology. Unfortunately, our understanding of galaxy evolution in different environments is still limited, albeit, for example, the morphology-density relation has shown that the density of the galaxy's local environment can affect its properties. Consequently, the environment should play a role in galaxy evolution, however despite the efforts, the exact role of the galaxy's local environment to its evolution remains open. This thesis introduction discusses briefly the background cosmology, cosmological N-body simulations and semi-analytical models. The second part is reserved for groups of galaxies, whether they are gravitationally bound, and what this may imply for galaxy evolution. The third part of the thesis concentrates on describing results of a case study of isolated field elliptical galaxies. The final chapter discusses another case study of luminous infra-red galaxies.

Origin of clear cell carcinoma: nature or nurture?

Science.gov (United States)

Kolin, David L; Dinulescu, Daniela M; Crum, Christopher P

2018-02-01

A rare but serious complication of endometriosis is the development of carcinoma, and clear cell and endometrioid carcinomas of the ovary are the two most common malignancies which arise from endometriosis. They are distinct diseases, characterized by unique morphologies, immunohistochemical profiles, and responses to treatment. However, both arise in endometriosis and can share common mutations. The overlapping mutational profiles of clear cell and endometrioid carcinomas suggest that their varied histologies may be due to a different cell of origin which gives rise to each type of cancer. Cochrane and colleagues address this question in a recent article in this journal. They show that a marker of ovarian clear cell carcinoma, cystathionine gamma lyase, is expressed in ciliated cells. Similarly, they show that markers of secretory cells (estrogen receptor and methylenetetrahydrofolate dehydrogenase 1) are expressed in ovarian endometrioid carcinoma. Taken together, they suggest that endometrioid and clear cell carcinomas arise from cells related to secretory and ciliated cells, respectively. We discuss Cochrane et al's work in the context of other efforts to determine the cell of origin of gynecological malignancies, with an emphasis on recent developments and challenges unique to the area. These limitations complicate our interpretation of tumor differentiation; does it reflect nature imposed by a specific cell of origin or nurture, by either mutation(s) or environment? Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd. Copyright © 2017 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Nurturing girls: a key to promoting maternal health.

Science.gov (United States)

1991-01-01

Mothers should invest in women's health and in the health of the next generation by taking good care of their daughters beginning at birth. Indeed girls who develop healthily, confidently, and is strong are more apt to have a safe motherhood and nurture their own children so they can reach their full potential. Nevertheless many obstacles to this occurring exist. Even though both girls and boys live in poverty, girls encounter the additional obstacle of sexual discrimination. For example, female infants have an elevated natural immunity level to fight off diseases than do male infants, female infant mortality exceeds male infant mortality in Bangladesh, India, and Pakistan. In addition, excessive death rates among small girls occur in some countries of Africa, the Middle East, Asia and South America. Reduced breast feeding, amount of food, immunization coverage, health care, and school enrollment for females contribute to these excessive death rates among females. In fact, if these deprivations do not result in death, they do cause poor health throughout life and greater risk during pregnancy and childbirth. Motherhood drains the already stunted and anemic bodies. For example, malnourished pregnant women, as evidenced by stunting, often have too small or deformed pelvises making it difficult to delivery a child normally. Anemic mothers cannot easily endure hemorrhaging loss during childbirth and abortion. Finally, deprivation influences a girl's mental ability to manage motherhood. Moreover, it reduces self esteem which in turn renders them reluctant to demand improvements in maternal care which would reduce maternal mortality.

Parental conflict and self-esteem: the rest of the story.

Science.gov (United States)

Pawlak, J L; Klein, H A

1997-09-01

Previous research has supported the hypothesis that high levels of marital conflict are related to lower self-esteem in children. In this study, 122 young adults completed the Rosenberg Self-Esteem Questionnaire and the Student Interparental Conflict Scale, as well as the Parental Nurturance Scale and the Parental Authority Questionnaire. One parent of each young adult completed the Parent Interparental Conflict Scale, the O'Leary-Porter Overt Hostility Scale, and a modified Parental Authority Questionnaire. Perceived interparental conflict and parental style discrepancies in nurturance and in authoritarianism were significantly and negatively related to self-esteem, but the best predictors of self-esteem were the parental styles themselves. Warm, nurturant parents were more likely to have high self-esteem children and demonstrated less conflict in marital partnerships. Correlations between marital conflict and self-esteem may reflect parental characteristics.

Church of England Schools as Centres for Religious Abuse or Avenues for Religious Nurture? (The Rights of Children to Encounter Faith in the School Context)

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Worsley, Howard

2008-01-01

After an overview of the British context in 2005 and its ambivalent attitude to Church schools, this article explores the issues of potential religious abuse, alongside a preferred holistic Christian discipleship. The final section explains how Church schools can operate in a way that encourages Christian nurture and prevent religious abuse. The…

The Effects of Service-Delivery Model and Purchase Price on Hearing-Aid Outcomes in Older Adults: A Randomized Double-Blind Placebo-Controlled Clinical Trial.

Science.gov (United States)

Humes, Larry E; Rogers, Sara E; Quigley, Tera M; Main, Anna K; Kinney, Dana L; Herring, Christine

2017-03-01

The objectives of this study were to determine efficacy of hearing aids in older adults using audiology best practices, to evaluate the efficacy of an alternative over-the-counter (OTC) intervention, and to examine the influence of purchase price on outcomes for both service-delivery models. The design of this study was a single-site, prospective, double-blind placebo-controlled randomized trial with three parallel branches: (a) audiology best practices (AB), (b) consumer decides OTC model (CD), and (c) placebo devices (P). Outcome measures were obtained after a typical 6-week trial period with follow-up 4-week AB-based trial for those initially assigned to CD and P groups. Older adults from the general community were recruited via newspaper and community flyers to participate at a university research clinic. Participants were adults, ages 55-79 years, with mild-to-moderate hearing loss. There were 188 eligible participants: 163 enrolled as a volunteer sample, and 154 completed the intervention. All participants received the same high-end digital mini-behind-the-ear hearing aids fitted bilaterally. AB and P groups received best-practice services from audiologists; differing mainly in use of appropriate (AB) or placebo (P) hearing aid settings. CD participants self-selected their own pre-programmed hearing aids via an OTC model. Primary outcome measure was a 66-item self-report, Profile of Hearing Aid Benefit (Cox & Gilmore, 1990). Secondary outcome measure was the Connected Speech Test (Cox, Alexander, & Gilmore, 1987) benefit. Additional measures of hearing-aid benefit, satisfaction, and usage were also obtained. Per-protocol analyses were performed. AB service-delivery model was found to be efficacious for most of the outcome measures, with moderate or large effect sizes (Cohen's d). CD service-delivery model was efficacious, with similar effect sizes. However, CD group had a significantly (p purchase hearing aids after the trial. Hearing aids are efficacious in

Exploring the boundary of a specialist service for adults with intellectual disabilities using a Delphi study: a quantification of stakeholder participation.

Science.gov (United States)

Hempe, Eva-Maria; Morrison, Cecily; Holland, Anthony

2015-10-01

There are arguments that a specialist service for adults with intellectual disabilities is needed to address the health inequalities that this group experiences. The boundary of such a specialist service however is unclear, and definition is difficult, given the varying experiences of the multiple stakeholder groups. The study reported here quantitatively investigates divergence in stakeholders' views of what constitutes a good specialist service for people with intellectual disabilities. It is the first step of a larger project that aims to investigate the purpose, function and design of such a specialist service. The results are intended to support policy and service development. A Delphi study was carried out to elicit the requirements of this new specialist service from stakeholder groups. It consisted of three panels (carers, frontline health professionals, researchers and policymakers) and had three rounds. The quantification of stakeholder participation covers the number of unique ideas per panel, the value of these ideas as determined by the other panels and the level of agreement within and between panels. There is some overlap of ideas about of what should constitute this specialist service, but both carers and frontline health professionals contributed unique ideas. Many of these were valued by the researchers and policymakers. Interestingly, carers generated more ideas regarding how to deliver services than what services to deliver. Regarding whether ideas are considered appropriate, the variation both within and between groups is small. On the other hand, the feasibility of solutions is much more contested, with large variations among carers. This study provides a quantified representation of the diversity of ideas among stakeholder groups regarding where the boundary of a specialist service for adults with learning disabilities should sit. The results can be used as a starting point for the design process. The study also offers one way to measure the

Political economy of love: nurturance gap, disembedded economy and freedom constraints within neoliberal capitalism

Directory of Open Access Journals (Sweden)

O’Hara Phillip Anthony

2014-01-01

Full Text Available This article critically evaluates the forms of love capital being accumulated by people in capitalist economies, through the lens of some of the core general principles of heterodox political economy (HPE. We start by situating love historically in the neoliberal culture and then examine the six main love styles as well as the five critical factors through the process of circular and cumulative causation. We then scrutinise the contradictions of neoliberal capitalism involving the nurturance gap, disembedded economy and freedom constraint which inhibit the generation of holistic love capital. The path dependent nature of love is then linked to relational phases and instabilities, especially involving serial monogamy in the United States. Some of the core principles of HPE provide a vantage point for scrutinising the problems involved in stimulating holistic love capital in the contemporary environment.

Comparison of access, outcomes and experiences of older adults and working age adults in psychological therapy.

Science.gov (United States)

Chaplin, Robert; Farquharson, Lorna; Clapp, Melissa; Crawford, Mike

2015-02-01

This study aimed to evaluate the access, experiences and outcomes of older adults receiving psychological therapies in comparison with adults of working age Primary and secondary care providers of psychological therapy services participated in the National Audit of Psychological Therapies. The main standards of access, experience and outcomes were measured by retrospective case records audits of people who completed therapy and a service user questionnaire. Outcomes were measured pre-treatment and post-treatment on the PHQ-9 and GAD-7. A total of 220 services across 97 organisations took part, 137 (62%) in primary care. Service user questionnaires were received from 14 425 (20%) respondents. A total of 122 740 records were audited, of whom 7794 (6.4%) were older adults. They were under represented as 13% of the sample would have been expected to be over 65 years according to age adjusted psychiatric morbidity figures. People over 75 years had the third expected referral rate. Significantly, more older adults than working age adults completed therapy (59.6% vs 48.6%) and were assessed as having 'recovered' post-treatment (58.5% vs 45.5%). Older adults were more satisfied with waiting times and numbers of sessions, but there were no differences in self-reported experience of therapy. Although older adults are less likely to gain access to psychological therapies, they appear to have better outcomes than working age adults. Further work is needed to improve access for older people. Copyright © 2014 John Wiley & Sons, Ltd.

[Mental health of children, adolescents and young adults--part 2: burden of illness, deficits of the German health care system and efficacy and effectiveness of early intervention services].

Science.gov (United States)

Karow, A; Bock, T; Naber, D; Löwe, B; Schulte-Markwort, M; Schäfer, I; Gumz, A; Degkwitz, P; Schulte, B; König, H H; Konnopka, A; Bauer, M; Bechdolf, A; Correll, C; Juckel, G; Klosterkötter, J; Leopold, K; Pfennig, A; Lambert, M

2013-11-01

Numerous birth-control studies, epidemiological studies, and observational studies investigated mental health and health care in childhood, adolescence and early adulthood, including prevalence, age at onset, adversities, illness persistence, service use, treatment delay and course of illness. Moreover, the impact of the burden of illness, of deficits of present health care systems, and the efficacy and effectiveness of early intervention services on mental health were evaluated. According to these data, most mental disorders start during childhood, adolescence and early adulthood. Many children, adolescents and young adults are exposed to single or multiple adversities, which increase the risk for (early) manifestations of mental diseases as well as for their chronicity. Early-onset mental disorders often persist into adulthood. Service use of children, adolescents and young adults is low, even lower than in adult patients. Moreover, there is often a long delay between onset of illness and first adequate treatment with a variety of linked consequences for poorer psychosocial prognosis. This leads to a large burden of illness with respect to disability and costs. As a consequence several countries have implemented so-called "early intervention services" at the border of child and adolescent and adult psychiatry. Emerging studies show that these health care structures are effective and efficient. Part 2 of the present review focuses on illness burden including disability and costs, deficits of the present health care system in Germany, and efficacy and efficiency of early intervention services. © Georg Thieme Verlag KG Stuttgart · New York.

25 CFR 20.402 - When are protective services provided?

Science.gov (United States)

2010-04-01

... AND SOCIAL SERVICES PROGRAMS Services to Children, Elderly, and Families § 20.402 When are protective services provided? Protective services are provided when children or adults: (a) Are deprived temporarily or permanently of needed supervision by responsible adults; (b) Are neglected, abused or exploited...

Nature versus nurture: functional assessment of restoration effects on wetland services using Nuclear Magnetic Resonance Spectroscopy

Science.gov (United States)

Sundareshwar, P.V.; Richardson, C.J.; Gleason, R.A.; Pellechia, P.J.; Honomichl, S.

2009-01-01

Land-use change has altered the ability of wetlands to provide vital services such as nutrient retention. While compensatory practices attempt to restore degraded wetlands and their functions, it is difficult to evaluate the recovery of soil biogeochemical functions that are critical for restoration of ecosystem services. Using solution 31P Nuclear Magnetic Resonance Spectroscopy, we examined the chemical forms of phosphorus (P) in soils from wetlands located across a land-use gradient. We report that soil P diversity, a functional attribute, was lowest in farmland, and greatest in native wetlands. Soil P diversity increased with age of restoration, indicating restoration of biogeochemical function. The trend in soil P diversity was similar to documented trends in soil bacterial taxonomic composition but opposite that of soil bacterial diversity at our study sites. These findings provide insights into links between ecosystem structure and function and provide a tool for evaluating the success of ecosystem restoration efforts. Copyright 2009 by the American Geophysical Union.

A Survey of Georgia Adult Protective Service Staff: Implications for Older Adult Injury Prevention and Policy

Directory of Open Access Journals (Sweden)

Strasser, Sheryl

2011-07-01

Full Text Available Background: The aging population is a rapidly growing demographic. Isolation and limited autonomy render many of the elderly vulnerable to abuse, neglect and exploitation. As the population grows, so does the need for Adult Protective Services (APS. This study was conducted to examine current knowledge of older adult protection laws in Georgia among APS staff and to identify training opportunities to better prepare the APS workforce in case detection and intervention.Methods: The Georgia State University Institute of Public Health faculty developed a primary survey in partnership with the Georgia Division of Aging Services’ leadership to identify key training priority issues for APS caseworkers and investigators. A 47-item electronic questionnaire was delivered to all APS employees via work-issued email accounts. We conducted descriptive analyses, t-tests and chi-square analyses to determine APS employees’ baseline knowledge of Georgia’s elder abuse policies, laws and practices, as well as examine associations of age, ethnicity, and educational attainment with knowledge. We used a p-value of 0.05 and 95% confidence intervals to determine statistical significance of analyses performed.Result: Ninety-two out of 175 APS staff responded to the survey (53% response rate. The majority of respondents were Caucasian (56% women (92%. For over half the survey items, paired sample t-tests revealed significant differences between what APS staff reported as known and what APS staff members indicated they needed to know more about in terms of elder abuse and current policies. Chi-square tests revealed that non-Caucasians significantly preferred video conferencing as a training format (44% compared to 18%, [χ2(1 = 7.102, p < .008], whereas Caucasians preferred asynchronous online learning formats (55% compared to 28% [χ2(1 =5.951, p < .015].Conclusion: Results from this study provide the Georgia Division of Aging with insight into specific policy areas

From bouncing back, to nurturing emergence: reframing the concept of resilience in health systems strengthening.

Science.gov (United States)

Barasa, Edwine W; Cloete, Keith; Gilson, Lucy

2017-11-01

Recent health system shocks such as the Ebola disease outbreak have focused global health attention on the notion of resilient health systems. In this commentary, we reflect on the current framing of the concept of resilience in health systems discourse and propose a reframing. Specifically, we propose that: (1) in addition to sudden shocks, health systems face the ongoing strain of multiple factors. Health systems need the capacity to continue to deliver services of good quality and respond effectively to wider health challenges. We call this capacity everyday resilience; (2) health system resilience entails more than bouncing back from shock. In complex adaptive systems (CAS), resilience emerges from a combination of absorptive, adaptive and transformative strategies; (3) nurturing the resilience of health systems requires understanding health systems as comprising not only hardware elements (such as finances and infrastructure), but also software elements (such as leadership capacity, power relations, values and appropriate organizational culture). We also reflect on current criticisms of the concept of resilient health systems, such as that it assumes that systems are apolitical, ignoring actor agency, promoting inaction, and requiring that we accept and embrace vulnerability, rather than strive for stronger and more responsive systems. We observe that these criticisms are warranted to the extent that they refer to notions of resilience that are mismatched with the reality of health systems as CAS. We argue that the observed weaknesses of resilience thinking can be addressed by reframing and applying a resilience lens that is better suited to the attributes of health systems as CAS. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Nurturing Soft Skills Among High School Students Through Space Weather Competition

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Abdullah, Mardina; Abd Majid, Rosadah; Bais, Badariah; Syaidah Bahri, Nor

2016-07-01

Soft skills fulfill an important role in shaping an individual's personality. It is of high importance for every student to acquire adequate skills beyond academic or technical knowledge. The objective of this project was to foster students' enthusiasm in space science and develop their soft skills such as; interpersonal communication, critical thinking and problem-solving, team work, lifelong learning and information management, and leadership skills. This is a qualitative study and the data was collected via group interviews. Soft skills development among high school students were nurtured through space weather competition in solar flare detection. High school students (16 to 17 years old) were guided by mentors consisting of science teachers to carry out this project based on a module developed by UKM's researchers. Students had to acquire knowledge on antenna development and construct the antenna with recyclable materials. They had to capture graphs and identify peaks that indicate solar flare. Their findings were compared to satellite data for verification. They also presented their work and their findings to the panel of judges. After observation, it can be seen that students' soft skills and interest in learning space science had become more positive after being involved in this project.

[Effectiveness of integrated early childhood development intervention on nurturing care for children aged 0-35 months in rural China].

Science.gov (United States)

Shi, H F; Zhang, J X; Wang, X L; Xu, Y Y; Dong, S L; Zhao, C X; Huang, X N; Zhao, Q; Chen, X F; Zhou, Y; O'Sullivan, Margo; Pouwels, Ron; Scherpbier, Robert W

2018-02-02

Objective: To explore whether Integrated Early Childhood Development (IECD) program has effectively improved the nurturing care for children aged 0-35 months in rural China. Methods: IECD has been implemented by the government of China with support from the United Nations Children's Fund (UNICEF) in four poverty-stricken rural counties since 2014. The interventions targeting the five key components of nurturing care (i.e. child and caregiver health, child nutrition, early learning support, child protection and social security) were delivered through the IECD program to children aged 0 to 35 months and their caregivers. A population-based intervention trial was designed to evaluate intervention effectiveness with data collected in 2013 (baseline) and 2016 (mid-term). The changes of nurturing care in the intervention and control group were analyzed by using a difference-in-differences (DID) model. This approach provided adjustment for sociodemographic and other confounding factors. Results: The baseline and mid-term survey enrolled 1 468 and 1 384 children in the intervention group, and 1 485 and 1 361 in the control group. After two years of implementation, the prevalence of caregiver's depression in the intervention group showed a decrease of 9.1% (mid-term 34.8% (479/1 377) vs. baseline 43.9% (621/1 414)), whereas that in control group showed a decrease of 1.6% (mid-term 34.3% (464/1 353) vs. baseline 35.9% (509/1 419)). With the confounding adjusted in the difference-in-differences model, the decrease of the caregiver's depression prevalence in the intervention group was 7.0% greater than that in the control group ( P= 0.008). The qualified rate of minimum meal frequency in the intervention group showed an increase of 10.4% (mid-term 69.0% (532/771) vs. baseline 58.6% (481/821)), whereas the qualified rate in the intervention group showed an increase of 2.9% (mid-term 66.4% (469/706) vs. baseline 63.5% (508/800)). With the confounding adjusted in the difference

Suicide and death ideation in older adults obtaining aging services.

Science.gov (United States)

O'Riley, Alisa A; Van Orden, Kimberly A; He, Hua; Richardson, Thomas M; Podgorski, Carol; Conwell, Yeates

2014-06-01

To assess the frequency and correlates of death and suicide ideation in older adults accessing aging services. Cross-sectional. Data for this study were collected via in-home interviews. Aging Services Network (ASN) care management clients aged 60 years and older (N = 377) were recruited for this study. The PHQ-9 and the Paykel Suicide Scale were used to assess death and suicide ideation. Correlates of death and suicide ideation were also examined. Fourteen percent of subjects endorsed current death or suicide ideation, 27.9% of subjects endorsed death ideation in the past year, and 9.3% of subjects endorsed suicide ideation in the last year. Current death and suicide ideation were associated with greater depressive symptoms. As compared with individuals without ideation, individuals with death ideation demonstrated higher levels of depressive symptoms, more medical conditions, and lower social support. Individuals with suicide ideation demonstrated higher depressive and anxiety symptoms and less perceived social support. Finally, as compared with individuals with death ideation, individuals with suicide ideation demonstrated higher depressive and anxiety symptoms and more alcohol misuse. Death and suicide ideation are common among ASN clients. There were both differences and similarities between correlates of death and suicide ideation. ASN providers are uniquely situated to address many of the correlates of suicide ideation identified in this study; in order to effectively manage suicide ideation in an ASN setting, however, links to primary and mental health care providers are necessary. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Decoding Pedophilia: Increased Anterior Insula Response to Infant Animal Pictures.

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Ponseti, Jorge; Bruhn, Daniel; Nolting, Julia; Gerwinn, Hannah; Pohl, Alexander; Stirn, Aglaja; Granert, Oliver; Laufs, Helmut; Deuschl, Günther; Wolff, Stephan; Jansen, Olav; Siebner, Hartwig; Briken, Peer; Mohnke, Sebastian; Amelung, Till; Kneer, Jonas; Schiffer, Boris; Walter, Henrik; Kruger, Tillmann H C

2017-01-01

Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles) not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system) to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants), we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found - in addition to other brain areas - in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

WILLIAM MCDOUGALL, AMERICAN PSYCHOLOGIST: A RECONSIDERATION OF NATURE-NURTURE DEBATES IN THE INTERWAR UNITED STATES.

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Rose, Anne C

2016-09-01

The British-born psychologist William McDougall (1871-1938) spent more than half of his academic career in the United States, holding successive positions after 1920 at Harvard and Duke universities. Scholarly studies uniformly characterize McDougall's relationship with his New World colleagues as contentious: in the standard view, McDougall's theory of innate drives clashed with the Americans' experimentation into learned habits. This essay argues instead that rising American curiosity about inborn appetites-an interest rooted in earlier pragmatic philosophy and empirically investigated by interwar scientists-explains McDougall's migration to the United States and his growing success there. A review of McDougall's intellectual and professional ties, evolving outside public controversy, highlights persistent American attention to natural agency and complicates arguments voiced by contemporaries in favor of nurture. © 2016 Wiley Periodicals, Inc.

Second Language Aquisition and The Development through Nature-Nurture

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Syahfitri Purnama

2017-10-01

Full Text Available There are some factors regarding which aspect of second language acquisition is affected by individual learner factors, age, learning style. aptitude, motivation, and personality. This research is about English language acquisition of fourth-year child by nature and nurture. The child acquired her second language acquisition at home and also in one of the courses in Jakarta. She schooled by her parents in order to be able to speak English well as a target language for her future time. The purpose of this paper is to see and examine individual learner difference especially in using English as a second language. This study is a library research and retrieved data collected, recorded, transcribed, and analyzed descriptively. The results can be concluded: the child is able to communicate well and also able to construct simple sentences, complex sentences, sentence statement, phrase questions, and explain something when her teacher asks her at school. She is able to communicate by making a simple sentence or compound sentence in well-form (two clauses or three clauses, even though she still not focus to use the past tense form and sometimes she forgets to put bound morpheme -s in third person singular but she can use turn-taking in her utterances. It is a very long process since the child does the second language acquisition. The family and teacher should participate and assist the child, the proven child can learn the first and the second language at the same time.

Documentation of and satisfaction with the service delivery process of electric powered scooters among adult users in different national contexts

DEFF Research Database (Denmark)

Sund, Terje; Iwarsson, Susanne; Andersen, Mette C

2013-01-01

-up design based on a consecutive inclusion of 50 Danish and 86 Norwegian adults as they were about to be provided a scooter. A study-specific structured questionnaire for documentation of the SDP was administered. The Satisfaction with Assistive Technology Services was used for documenting user satisfaction...

Experiences of community-dwelling older adults with the use of telecare in home care services

DEFF Research Database (Denmark)

Karlsen, Cecilie; Ludvigsen, Mette Spliid; Moe, Carl Erik

2017-01-01

BACKGROUND: The aging population will lead to a rise in the number of people with age-related diseases, and increasing demand for home care services. Telecare is seen as a solution to this challenge by promoting aging in place. Nevertheless, there is still a poor understanding of older adults...... both published and unpublished studies in English, Norwegian, Swedish and Danish, from 2005 to 2017. METHODOLOGICAL QUALITY: Methodological quality of the included studies was assessed independently by two reviewers using the Joanna Briggs Institute Qualitative Assessment and Review Instrument. DATA...

Family Nurture Intervention in the Neonatal Intensive Care Unit Improves Social-Relatedness, Attention, and Neurodevelopment of Preterm Infants at 18 Months in a Randomized Controlled Trial

Science.gov (United States)

Welch, Martha G.; Firestein, Morgan R.; Austin, Judy; Hane, Amie A.; Stark, Raymond I.; Hofer, Myron A.; Garland, Marianne; Glickstein, Sara B.; Brunelli, Susan A.; Ludwig, Robert J.; Myers, Michael M.

2015-01-01

Background: Preterm infants are at high risk for adverse neurodevelopmental and behavioral outcomes. Family Nurture Intervention (FNI) in the Neonatal Intensive Care Unit (NICU) is designed to counteract adverse effects of separation of mothers and their preterm infants. Here, we evaluate effects of FNI on neurobehavioral outcomes. Methods: Data…

Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers

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Sungmin Lee

2017-02-01

Full Text Available Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS. Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA were analyzed at the census tract level (n = 264. Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.

Neighborhood Factors and Fall-Related Injuries among Older Adults Seen by Emergency Medical Service Providers.

Science.gov (United States)

Lee, Sungmin; Lee, Chanam; Rodiek, Susan

2017-02-08

Falls are serious health problems among older adults, and are the leading cause of fatal and nonfatal injuries treated by emergency medical services (EMS). Although considerable research has examined the risk factors of falls at the individual level, relatively few studies have addressed the risk factors at the neighborhood level. This study examines the characteristics of neighborhood environments associated with fall injuries reported to EMS providers. A total of 13,163 EMS records from 2011 to 2014 involving adults aged 65 and older in the city of San Antonio (TX, USA) were analyzed at the census tract level (n = 264). Negative binomial regression was used to identify significant census tract-based neighborhood environmental variables associated with the count of fall injuries in each census tract. Adjusting for exposure variable and the size of the census tract, neighborhoods with higher residential stability, captured as the percent of those who lived in the same house as the previous year were associated with decreased count of fall injuries. Neighborhoods with higher residential density and having a higher vacancy rate were associated with increased count of fall injuries. The study highlights the importance of stable and safe neighborhoods in reducing fall risks among older adults, which should be considered a prerequisite for promoting age-friendly environments.

An evaluation of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program.

Science.gov (United States)

Portwood, Sharon G; Lambert, Richard G; Abrams, Lyndon P; Nelson, Ellissa Brooks

2011-08-01

This study evaluated the effectiveness of the Adults and Children Together (ACT) Against Violence Parents Raising Safe Kids program, developed by the American Psychological Association in collaboration with the National Association for the Education of Young Children, as an economical primary prevention intervention for child maltreatment. Using an experimental design with random assignment to groups, program impact on participating parents' knowledge, behavior, and attitudes compared to those of a comparison group of parents receiving standard community-based support services was examined. As hypothesized, the ACT Parents Raising Safe Kids program achieved positive results in several areas related to effective parenting, including a reduction in the use of harsh verbal and physical discipline and an increase in nurturing behavior. Positive results were observable both at the conclusion of the ACT program and at three-month follow-up. Results further indicated a positive impact on parent expectations and social support for those parents with the greatest need in these areas. Qualitative data collected through focus groups demonstrated that parents themselves perceived numerous benefits to the ACT program, including assistance in controlling their anger, learning and implementing better parenting and discipline strategies, and recognizing when their child's behavior is developmentally appropriate. Overall, findings suggest that the ACT Parents Raising Safe Kids program is a promising primary prevention strategy that can be implemented across diverse community settings.

Ethnic differences in oral health and use of dental services: cross-sectional study using the 2009 Adult Dental Health Survey.

Science.gov (United States)

Arora, Garima; Mackay, Daniel F; Conway, David I; Pell, Jill P

2016-06-16

Oral health impacts on general health and quality of life, and oral diseases are the most common non-communicable diseases worldwide. Non-White ethnic groups account for an increasing proportion of the UK population. This study explores whether there are ethnic differences in oral health and whether these are explained by differences in sociodemographic or lifestyle factors, or use of dental services. We used the Adult Dental Health Survey 2009 to conduct a cross-sectional study of the adult general population in England, Wales and Northern Ireland. Ethnic groups were compared in terms of oral health, lifestyle and use of dental services. Logistic regression analyses were used to determine whether ethnic differences in fillings, extractions and missing teeth persisted after adjustment for potential sociodemographic confounders and whether they were explained by lifestyle or dental service mediators. The study comprised 10,435 (94.6 %) White, 272 (2.5 %) Indian, 165 (1.5 %) Pakistani/Bangladeshi and 187 (1.7 %) Black participants. After adjusting for confounders, South Asian participants were significantly less likely, than White, to have fillings (Indian adjusted OR 0.25, 95 % CI 0.17-0.37; Pakistani/Bangladeshi adjusted OR 0.43, 95 % CI 0.26-0.69), dental extractions (Indian adjusted OR 0.33, 95 % CI 0.23-0.47; Pakistani/Bangladeshi adjusted OR 0.41, 95 % CI 0.26-0.63), and dental services. The differences could be partially explained by reported differences in dietary sugar.

A Community-Based, Technology-Supported Health Service for Detecting and Preventing Frailty among Older Adults: A Participatory Design Development Process.

Science.gov (United States)

van Velsen, Lex; Illario, Maddalena; Jansen-Kosterink, Stephanie; Crola, Catherine; Di Somma, Carolina; Colao, Annamaria; Vollenbroek-Hutten, Miriam

2015-01-01

Frailty is a multifaceted condition that affects many older adults and marks decline on areas such as cognition, physical condition, and nutritional status. Frail individuals are at increased risk for the development of disability, dementia, and falls. There are hardly any health services that enable the identification of prefrail individuals and that focus on prevention of further functional decline. In this paper, we discuss the development of a community-based, technology-supported health service for detecting prefrailty and preventing frailty and further functional decline via participatory design with a wide range of stakeholders. The result is an innovative service model in which an online platform supports the integration of traditional services with novel, Information Communication Technology supported tools. This service is capable of supporting the different phases of screening and offers training services, by also integrating them with community-based services. The service model can be used as a basis for developing similar services within a wide range of healthcare systems. We present the service model, the general functioning of the technology platform, and the different ways in which screening for and prevention of frailty has been localized. Finally, we reflect on the added value of participatory design for creating such health services.

Nurturing Holistic Development of University Students in Hong Kong: Where Are We and Where Should We Go?

Directory of Open Access Journals (Sweden)

Daniel T. L. Shek

2010-01-01

Full Text Available With reference to the mental health and developmental problems among university students, there is a need to review the university's role in nurturing holistic development of students. This paper explores the question of how holistic development of university students in Hong Kong can be promoted. Based on the positive youth development approach, it is argued that promotion of intrapersonal competencies, interpersonal relationship skills, civic responsibilities, and citizenship among university students is an important strategy to facilitate holistic development of young people in Hong Kong. Two general education or freshman seminar courses that focus on the cultivation of intrapersonal competencies, interpersonal relationship skills, civic responsibilities, and sense of citizenship among university students in Hong Kong are proposed.

'Talking a different language': an exploration of the influence of organizational cultures and working practices on transition from child to adult mental health services.

Science.gov (United States)

McLaren, Susan; Belling, Ruth; Paul, Moli; Ford, Tamsin; Kramer, Tami; Weaver, Tim; Hovish, Kimberly; Islam, Zoebia; White, Sarah; Singh, Swaran P

2013-07-03

Organizational culture is manifest in patterns of behaviour underpinned by beliefs, values, attitudes and assumptions, which can influence working practices. Cultural factors and working practices have been suggested to influence the transition of young people moving from child to adult mental health services. Failure to manage and integrate transitional care effectively can lead to young people losing contact with health and social care systems, resulting in adverse effects on health, well-being and potential. The study aim was to identify the organisational factors which facilitate or impede transition of young people from child and adolescent mental health services (CAMHS) to adult mental health services (AMHS) from the perspective of health professionals and representatives of voluntary organisations. Specific objectives were (i) to explore organizational cultures, structures, processes and resources which influence transition from child to adult mental health services; (ii) identify factors which constitute barriers and facilitators to transition and continuity of care and (iii) make recommendations for service improvements. Within an exploratory, qualitative design thirty four semi-structured interviews were conducted with health and social care professionals working in CAMHS and AMHS in four NHS Mental Health Trusts and four voluntary organizations, in England. A cultural divide appears to exist between CAMHS and AMHS, characterized by different beliefs, attitudes, mutual misperceptions and a lack of understanding of different service structures. This is exacerbated by working practices relating to communication and information transfer which could impact negatively on transition, relational, informational and cross boundary continuity of care. There is also evidence of a cultural shift, with some positive approaches to collaborative working across services and agencies, involving joint posts, parallel working, shared clinics and joint meetings. Cultural

The impact of transitional care programs on health services utilization in community-dwelling older adults: a systematic review.

Science.gov (United States)

Weeks, Lori E; Macdonald, Marilyn; Martin-Misener, Ruth; Helwig, Melissa; Bishop, Andrea; Iduye, Damilola F; Moody, Elaine

2018-02-01

The objective was to identify and synthesize the best available evidence on the impact of transitional care programs on various forms of health services utilization in community-dwelling older adults. There is growing evidence that transitional care programs can help address important challenges facing health care systems and our increasing older adult population in many countries by reducing unnecessary health service utilization. There is a need for a systematic review of the research evaluating the impact of transitional care programs on hospital and other health service usage. The review included studies on community-dwelling adults age 60 and over with at least one medical diagnosis, and which evaluated the outcomes of transitional care programs on health system utilization of older adults. The outcomes for this review were hospital usage including admissions and readmissions, emergency department usage, primary care/physician usage, nursing home usage, and home health care usage. The review considered experimental and epidemiological study designs including randomized controlled trials, non-randomized controlled trials, quasi-experimental studies, before and after studies, prospective and retrospective cohort studies, and case-control studies. A three-step search was utilized to find published and unpublished studies conducted in any country but reported in English. Six electronic databases were searched from inception of the database to May, 2016. A search for unpublished studies was also conducted. Methodological quality was assessed independently by two reviewers using the Joanna Briggs Institute critical appraisal checklist for systematic reviews and research synthesis. Quantitative data were extracted from included studies independently by the two reviewers using the standardized Joanna Briggs Institute data extraction tools. Due to the methodological heterogeneity of the included studies, a comprehensive meta-analysis for all outcomes was not possible

Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers.

Science.gov (United States)

Alhamdan, Adel A; Alshammari, Sulaiman A; Al-Amoud, Maysoon M; Hameed, Tariq A; Al-Muammar, May N; Bindawas, Saad M; Al-Orf, Saada M; Mohamed, Ashry G; Al-Ghamdi, Essam A; Calder, Philip C

2015-09-01

To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.

Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers

Directory of Open Access Journals (Sweden)

Adel A. Alhamdan

2015-09-01

Full Text Available Objectives: To evaluate the health care services provided for older adults by primary health care centers (PHCCs in Riyadh, Kingdom of Saudi Arabia (KSA, and the ease of use of these centers by older adults. Methods: Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Results: Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Conclusions: Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.

78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

Science.gov (United States)

2013-07-26

...This notice announces the annual adjustments to the national average payment rates for meals and snacks served in child care centers, outside-school-hours care centers, at-risk afterschool care centers, and adult day care centers; the food service payment rates for meals and snacks served in day care homes; and the administrative reimbursement rates for sponsoring organizations of day care homes, to reflect changes in the Consumer Price Index. Further adjustments are made to these rates to reflect the higher costs of providing meals in the States of Alaska and Hawaii. The adjustments contained in this notice are made on an annual basis each July, as required by the laws and regulations governing the Child and Adult Care Food Program.

Do Emotional Appeals in Public Service Advertisements Influence Adolescents' Intention to Reduce Consumption of Sugar-Sweetened Beverages?

Science.gov (United States)

Bleakley, Amy; Jordan, Amy B; Hennessy, Michael; Glanz, Karen; Strasser, Andrew; Vaala, Sarah

2015-08-01

Mass media campaigns are a commonly used approach to reduce sugary drink consumption, which is linked to obesity in children and adolescents. The present study investigated the direct and mediated effects of emotional appeals in public service advertisements (PSAs) that aired between 2010 and 2012 on adolescents' intention to reduce their sugar-sweetened beverage (SSB) consumption. An online randomized experiment was conducted with a national sample of adolescent respondents ages 13 to 17 years old (N = 805). Participants were randomly assigned to 1 of 4 conditions. Three experimental conditions represented PSAs with different emotional appeals: humor, fear, and nurturance, plus a fourth control condition. The outcome was adolescents' intention to cut back on SSBs. The direct effect of fear appeals on intention was mediated through adolescents' perception of the PSAs' argument strength; perceived argument strength was also the key mediator for the indirect effects of humor and nurturance on intention. Several hypothesized mediators influenced by the appeals were not associated with intention. This is the first study to test the effect of persuasive emotional appeals used in SSB-related PSAs. The perceived strength of the PSAs' arguments is important to consider in the communication of messages designed to reduce SSB consumption.

Predictors of utilisation of dental care services in a nationally representative sample of adults.

Science.gov (United States)

Guiney, H; Woods, N; Whelton, H; Morgan, K

2011-12-01

The objective of this study was to identify the predictors of utilisation of dental care services in Ireland. The 2007 Irish Survey of Lifestyle, Attitudes and Nutrition is a cross-sectional study, conducted in 2006/2007 (n = 10,364), by interviews at home to a representative sample of adults aged 18 years or over. Multivariate logistic regression was used to investigate the influence of socioeconomic, predisposing and enabling factors on the odds of males and females having a dental visit in the past year. The significant predictors of visiting the dentist in the past year were for males: having 3rd level education, employment status, earning 50,000 euros or more, location of residence, use of a car, brushing frequently, and dentition status. For females, the predictors were being between 25-34 or 55-64 years-old, education level, earning 50,000 euros or more, location of residence, use of a car, brushing frequently and dentition status. Predictors of the use of dental services vary by gender. Predictors common to both genders were education level, higher income, location of residence, use of a car, brushing frequently and dentition status. Many of the predictors of dental visiting in the past year are also related to social inequalities in health. These predictors may be useful markers of impact for policies designed to address inequalities in access to oral health services.

Differences between Irish and Australian psychiatric nurses' family-focused practice in adult mental health services

LENUS (Irish Health Repository)

Grant, Anne

2016-04-01

Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

Interprofessional education through service-learning: lessons from a student-led free clinic.

Science.gov (United States)

Farlow, Janice L; Goodwin, Charles; Sevilla, Javier

2015-05-01

The academic community must replicate and strengthen existing models for interprofessional education (IPE) to meet widespread calls for team-based patient-centered care. One effective but under-explored possibility for IPE is through student-led clinics, which now exist in the majority of medical schools. This short report presents the Indiana University Student Outreach Clinic (IU-SOC), which involves seven different professional programs across three institutions, as a model for how IPE can be delivered formally through service learning. Lessons learned, such as nurturing an intentional interprofessional program, structured orientation and reflection, and resource and knowledge sharing between the clinic and academic institutions, can be applied to all student-led clinics, but also can inform other IPE initiatives in health professional curricula.

Nature versus nurture: identical twins and bariatric surgery.

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Hagedorn, Judith C; Morton, John M

2007-06-01

Genetics and environment both play a role in weight maintenance. Twin studies may help clarify the influence of nature vs nurture in weight loss. We present the largest U.S. experience with monozygotic (MZ) twins undergoing bariatric surgery. We retrospectively reviewed the charts of four sets of MZ twins who underwent Roux-en-Y gastric bypass (RYGBP) surgery and laparoscopic adjustable gastric band (LAGB) placement at three different institutions. BMI and co-morbidities were examined pre- and postoperatively, and laboratory values were recorded. All four sets of twins are female, live together, and have similar professions. Twin cohort 1 had near identical weight loss patterns after open RYGBP surgery in 1996 (preop 146/142 kg; 2 years 82/82; and 10 years 108/107). Twin cohort 1 also both underwent cholecystectomies within the first year postoperatively. Twin cohort 2 underwent laparoscopic RYGBP surgery and also required cholecystectomies in the first postoperative year. Cohort 2 also experienced nearly identical weight loss at 1 year (36.7% vs 37.0% BMI loss). Twin cohort 3 underwent LAGB placement with two different surgeons with differing amounts of weight loss at 6 months (6.5% vs 15.7% BMI loss). Finally, twin cohort 4 underwent laparoscopic RYGBP with 2-year BMI loss of 39% vs 34%. In twin cohort 4, the twin who lost less weight lived apart from her twin and extended family, and her weight loss was less than the twin living with her family. Two sets of MZ twins had identical responses to bariatric surgery. The other two sets of identical twins had differential weight loss results, possibly due to differences in surgical approach and social support. While genetics do exert a strong influence on weight loss and maintenance, this case series demonstrates the potential effect of social support and postoperative management upon postoperative weight loss in the presence of identical genetics.

Decoding Pedophilia: Increased Anterior Insula Response to Infant Animal Pictures

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Jorge Ponseti

2018-01-01

Full Text Available Previous research found increased brain responses of men with sexual interest in children (i.e., pedophiles not only to pictures of naked children but also to pictures of child faces. This opens the possibly that pedophilia is linked (in addition to or instead of an aberrant sexual system to an over-active nurturing system. To test this hypothesis we exposed pedophiles and healthy controls to pictures of infant and adult animals during functional magnetic resonance imaging of the brain. By using pictures of infant animals (instead of human infants, we aimed to elicit nurturing processing without triggering sexual processing. We hypothesized that elevated brain responses to nurturing stimuli will be found – in addition to other brain areas – in the anterior insula of pedophiles because this area was repeatedly found to be activated when adults see pictures of babies. Behavioral ratings confirmed that pictures of infant or adult animals were not perceived as sexually arousing neither by the pedophilic participants nor by the heathy controls. Statistical analysis was applied to the whole brain as well as to the anterior insula as region of interest. Only in pedophiles did infants relative to adult animals increase brain activity in the anterior insula, supplementary motor cortex, and dorsolateral prefrontal areas. Within-group analysis revealed an increased brain response to infant animals in the left anterior insular cortex of the pedophilic participants. Currently, pedophilia is considered the consequence of disturbed sexual or executive brain processing, but details are far from known. The present findings raise the question whether there is also an over-responsive nurturing system in pedophilia.

Comparison of family-planning service quality reported by adolescents and young adult women in Mexico.

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Darney, Blair G; Saavedra-Avendano, Biani; Sosa-Rubi, Sandra G; Lozano, Rafael; Rodriguez, Maria I

2016-07-01

Associations between age and patient-reported quality of family planning services were examined among young women in Mexico. A repeated cross-sectional analysis of survey data collected in 2006, 2009, and 2014 was performed. Data from women aged 15-29years who had not undergone sterilization and were currently using a modern contraceptive method were included. The primary outcome was high-quality care, defined as positive responses to all five quality items regarding contraceptive services included in the survey. Multivariable logistic regression and marginal probabilities were used to compare adolescents and women aged 20-29years. The responses of respondents using different contraceptive methods were compared. Data were included from 15 835 individuals. The multivariable analysis demonstrated lower odds of reporting high-quality care among women aged 15-19years (odds ratio 0.73; 95% confidence interval 0.60-0.88) and 20-24years (odds ratio 0.85; 95% confidence interval 0.75-0.96) compared with women aged 25-29years. Adolescents using hormonal and long-acting reversible contraception had significantly lower odds of reporting high-quality care compared with women aged 25-29. Adolescents in Mexico reported a lower quality of family planning services compared with young adult women. Continued research and policies are needed to improve the quality of contraceptive services. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

75 FR 6188 - Full-Service Community Schools

Science.gov (United States)

2010-02-08

... for children to be ready and able to learn, they need academic, social, and health supports. The.... Mental health counseling services; and 12. Adult education, including instruction of adults in English as...) how the academic, social and/or health services provided would align with and support the school...

The Competitive Advantage: Client Service.

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Leffel, Linda G.; DeBord, Karen B.

The adult education literature contains a considerable amount of research on and discussion of client service in the marketing process, management and staff roles in service- and product-oriented businesses, and the importance of client service and service quality to survival in the marketplace. By applying the principles of client-oriented…

Nurturing Opportunity Identification for Business Sophistication in a Cross-disciplinary Study Environment

Directory of Open Access Journals (Sweden)

Karine Oganisjana

2012-12-01

Full Text Available Opportunity identification is the key element of the entrepreneurial process; therefore the issue of developing this skill in students is a crucial task in contemporary European education which has recognized entrepreneurship as one of the lifelong learning key competences. The earlier opportunity identification becomes a habitual way of thinking and behavior across a broad range of contexts, the more likely that entrepreneurial disposition will steadily reside in students. In order to nurture opportunity identification in students for making them able to organize sophisticated businesses in the future, certain demands ought to be put forward as well to the teacher – the person who is to promote these qualities in their students. The paper reflects some findings of a research conducted within the frameworks of a workplace learning project for the teachers of one of Riga secondary schools (Latvia. The main goal of the project was to teach the teachers to identify hidden inner links between apparently unrelated things, phenomena and events within 10th grade study curriculum and connect them together and create new opportunities. The creation and solution of cross-disciplinary tasks were the means for achieving this goal.

Adult care providers' perspectives on the transition to adult care for emerging adults with Type 1 diabetes: a cross-sectional survey.

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Michaud, S; Dasgupta, K; Bell, L; Yale, J-F; Anjachak, N; Wafa, S; Nakhla, M

2018-03-25

To assess adult diabetes care providers' current transition practices, knowledge about transition care, and perceived barriers to implementation of best practices in transition care for emerging adults with Type 1 diabetes mellitus. We administered a 38-item web-based survey to adult diabetes care providers identified through the Québec Endocrinologist Medical Association and Diabetes Québec. Fifty-three physicians responded (35%). Fewer than half of all respondents (46%) were familiar with the American Diabetes Association's transition care position statement. Approximately one-third of respondents reported a gap of >6 months between paediatric and adult diabetes care. Most (83%) believed communication with the paediatric team was adequate; however, only 56% reported receiving a medical summary and 2% a psychosocial summary from the paediatric provider. Respondents believed that the paediatric team should improve emerging adults' preparation for transition care by developing their self-management skills and improve teaching about the differences between paediatric and adult-oriented care. Only 31% had a system for identifying emerging adults lost to follow-up in adult care. Perceived barriers included difficulty accessing psychosocial services, emerging adults' lack of motivation, and inadequate transition preparation. Most (87%) were interested in having additional resources, including a self-care management tool and a registry to track those lost to follow-up. Our findings highlight the need to better engage adult care providers into transition care practices. Despite adult physicians' interest in transition care, implementation of transition care recommendations and resources in clinical care remains limited. Enhanced efforts are needed to improve access to mental health services within the adult healthcare setting. © 2018 Diabetes UK.

Perceptions of diabetes, barriers to disease management, and service needs: a focus group study of working adults with diabetes in Hawaii.

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Fukunaga, Landry L; Uehara, Denise L; Tom, Tammy

2011-03-01

Research about the support needs for and barriers to successful disease management of working adults with diabetes is limited. Our objective was to gain an in-depth understanding of how working adults in Hawaii perceive diabetes, barriers to disease management, and the services needed to keep people healthy and working. From November 2008 through March 2009, we conducted focus group interviews with 74 employed adults with diabetes enrolled in the Hawaii Demonstration to Maintain Independence and Employment project. Responses to questions were analyzed within and across groups to identify recurring themes. A third layer of analysis examined themes across responses to all questions, specifically, how barriers related to identified service needs. Employed participants with diabetes experienced pervasive effects on their lives as a result of the disease, although they interpreted these effects positively or negatively. Barriers to disease management, such as additional health issues, social prejudice, and lack of social support, indicated a need to educate the general public about the disease. Participants identified needing social support from other people with diabetes, psychological support to address the emotional side of diabetes, and coordinated teams of specialists to address medication side effects and other health-related barriers to disease management. Many participants discussed the challenge of integrating diabetes management with work and family responsibilities and the need for monetary support. This study provides insight into how employed adults perceived their disease and what they perceived as challenges to successfully managing diabetes. The findings provide future directions for community and workplace diabetes initiatives.

Depression screening among older adults attending low-vision rehabilitation and eye-care services: Characteristics of those who screen positive and client acceptability of screening.

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Holloway, Edith E; Sturrock, Bonnie A; Lamoureux, Ecosse L; Keeffe, Jill E; Rees, Gwyneth

2015-12-01

To investigate characteristics associated with screening positive for depressive symptoms among older adults accessing low-vision rehabilitation and eye-care services and to determine client acceptability of depression screening using the Patient Health Questionnaire-2 (PHQ-2) in these settings. One-hundred and twenty-four older adults (mean = 77.02 years, SD = 9.12) attending low-vision rehabilitation and eye-care services across Australia were screened for depression and invited to complete a telephone-administered questionnaire to determine characteristics associated with depressive symptoms and client acceptability of screening in these settings. Thirty-seven per cent (n = 46/124) of participants screened positive for depressive symptoms, and the majority considered the new depression screening method to be a 'good idea' in vision services (85%). Severe vision loss (<6/60 in the better eye) was associated with an increased odds of screening positive for depressive symptoms (odds ratio 2.37; 95% confidence interval 1.08-6.70) even after adjusting for potential confounders. Participants who screened positive had a preference for 'talking' therapy or a combination of medication and 'talking therapy' delivered within their own home (73%) or via telephone (67%). The PHQ-2 appears to be an acceptable method for depression screening in eye-care settings among older adults. Targeted interventions that incorporate home-based or telephone delivered therapy sessions may improve outcomes for depression in this group. © 2014 ACOTA.

Health-Related Quality of Life: Expanding a Conceptual Framework to Include Older Adults Who Receive Long-Term Services and Supports

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Zubritsky, Cynthia; Abbott, Katherine M.; Hirschman, Karen B.; Bowles, Kathryn H.; Foust, Janice B.; Naylor, Mary D.

2013-01-01

For older adults receiving long-term services and supports (LTSS), health-related quality of life (HRQoL) has emerged as a critical construct to examine because of its focus on components of well-being, which are affected by progressive changes in health status, health care, and social support. HRQoL is a health-focused quality of life (QOL)…

Enhancing success in transition service coordinators: use of transformational leadership.

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Rearick, Ellen

2007-01-01

The lifespan of children with special healthcare needs has been extended because of improved technology and medical advances. Successful transition to the adult arena of healthcare, social services, and education by adolescents with special healthcare needs (ASHCN) is lacking. The transition service coordinator (TSC) is a multifaceted role of advanced practice nursing that provides highly specialized transition services to adolescents with special healthcare needs. The use of key concepts from the transformational leadership theory may improve healthcare outcomes. This article applies to pediatric and adult primary care and case management services that serve adolescents with special healthcare needs. Employing key concepts of transformational leadership theory will enhance the success of the TSC to improve both collaboration among stakeholders in the transitional team and young adults' transition to the world of adult services. Enhanced communication resulting in improved sharing of information, understanding of the stakeholder roles, and provision of formal linkages between pediatric and adult medical providers is a significant outcome affecting the ASHCN. Improved collaboration will produce a smooth transition for the ASHCN to the world of adult social services education, and employment. Incorporating the transformational leadership dimensions of idealized influence, inspirational motivation intellectual stimulation, and individualized consideration will enhance the ability of the TSC to improve collaboration among stakeholders in the transitional team and the quality of services for the ASHCN.

Knowledge, Attitudes and Behaviors of Older Adults and College Students Participating in Recycling Mentors, a Service-Learning, Environmental Health Education Program

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D'Abundo, Michelle Lee; Fugate-Whitlock, Elizabeth; Fiala, Kelly Ann; Covan, Eleanor Krassen

2013-01-01

Purpose: The purpose of this research was to assess the knowledge, attitudes and practices of both students and older adults that participated in a service-learning, environmental health education program called Recycling Mentors (RM). Methods: Surveys were conducted before and after participation in RM. Quantitative data were analyzed using SPSS.…

Employers' Perspective on Childcare Services for Hired Farm Workers.

Science.gov (United States)

Lee, Barbara C; Salzwedel, Marsha A; Chyou, Po-Huang; Liebman, Amy K

2017-01-01

The goal of this project was to protect children while parents work in agriculture by improving off-farm services for children of migrant and seasonal farm workers. Large agricultural enterprises have policies forbidding children in the worksite. At the same time, their employees, who are trying to generate income, seek as many work hours as possible but often lack viable options for childcare services. As employers strive to increase their labor pool, and workers seek off-farm childcare, there is mutual interest in improving access to childcare services in agricultural regions dependent on large numbers of full-time and seasonal workers. This report describes the employers' perspectives on childcare needs of hired farm workers' families and their barriers and motivators to facilitating off-farm childcare services. Using descriptive survey research methodology, data were collected from a convenience sample of 102 agribusiness owners and Human Resource directors attending an agricultural conference regarding labor laws or personnel management. Results revealed significant differences for those companies employing more than 25 workers compared to their counterparts. Primary motivators for offering childcare as an employment benefit were improved employee morale, enhanced company reputation, and a more stable workforce. A major barrier was that half of large-scale enterprises lack guidance on how to provide childcare options for their workers. Survey results are being used to facilitate collaboration among employers, farm workers, and childcare providers to offer a safe, nurturing environment for children while their parents work in agriculture.

Driving self-regulation and ride service utilization in a multicommunity, multistate sample of U.S. older adults.

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Bird, Donna C; Freund, Katherine; Fortinsky, Richard H; Staplin, Loren; West, Bethany A; Bergen, Gwen; Downs, Jonathan

2017-04-03

This study examined a multicommunity alternative transportation program available 24 hours a day, 7 days a week, for any purpose, offering door-through-door service in private automobiles to members who either do not drive or are transitioning away from driving. Specific aims were to describe the characteristics of members by driving status and ride service usage of these members. Data came from administrative records maintained by a nonprofit ride service program and include 2,661 individuals aged 65+ residing in 14 states who joined the program between April 1, 2010, and November 8, 2013. Latent class analysis was used to group current drivers into 3 classes of driving status of low, medium, and high self-regulation, based on their self-reported avoidance of certain driving situations and weekly driving frequency. Demographics and ride service use rate for rides taken through March 31, 2014, by type of ride (e.g., medical, social, etc.) were calculated for nondrivers and drivers in each driving status class. The majority of ride service users were female (77%) and aged 65-74 years (82%). The primary method of getting around when enrolling for the transportation service was by riding with a friend or family member (60%). Among the 67,883 rides given, nondrivers took the majority (69%) of rides. Medical rides were the most common, accounting for 40% of all rides. Reported ride usage suggests that older adults are willing to use such ride services for a variety of trips when these services are not limited to specific types (e.g., medical). Further research can help tailor strategies to encourage both nondrivers and drivers to make better use of alternative transportation that meets the special needs of older people.

Current Cigarette Smoking Among Adults Infographic

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U.S. Department of Health & Human Services — Explore the Current Cigarette Smoking Among Adults Infographic which outlines key facts related to current smoking among adults. For accessibility issues contact...

Service Use in the Month and Year Prior to Suicide Among Adults Enrolled in Ohio Medicaid.

Science.gov (United States)

Fontanella, Cynthia A; Warner, Lynn A; Hiance-Steelesmith, Danielle L; Sweeney, Helen Anne; Bridge, Jeffrey A; McKeon, Richard; Campo, John V

2017-07-01

The purpose of this study was to inform suicide prevention efforts by estimating the incidence of suicide among adult Medicaid enrollees and describing clinical profiles and service utilization patterns among decedents. Death certificate data for adults (N=1,338) ages 19 to 65 who died by suicide between January 1, 2008, and December 31, 2013, were linked with Ohio Medicaid data. The suicide rate was 18.9 deaths per 100,000 Ohio Medicaid enrollees. Most decedents (83%) made a general medical or mental health visit within one year of suicide, with 50% doing so within 30 days and 27% within one week before death. In the year before suicide, the median number of visits was 16, indicating a subgroup with intensive service utilization. Decedents whose visits were proximal to suicide (within 30 days) rather than distal (31-365 days) were more likely to have individual and co-occurring behavioral and general medical conditions and to be Medicaid eligible through disability. In the year before suicide, most visits (79%) were outpatient general medical visits. Also in the year before suicide, decedents with serious psychiatric disorders were more likely than those without such disorders to make only mental health visits, and those with chronic general medical conditions were more likely than those without such conditions to make only general medical visits. Medicaid enrollment designates a "virtual boundary" around a subpopulation of health care consumers relevant to national suicide prevention efforts. Findings highlight the potential of using Medicaid data to identify individuals at risk of suicide for screening, prevention, and intervention.

DO PARENTS THINK IT TAKES A VILLAGE? PARENTS' ATTITUDES TOWARDS NONPARENTAL ADULTS' INVOLVEMENT IN THE UPBRINGING AND NURTURE OF CHILDREN

NARCIS (Netherlands)

Kesselring, Marije; de Winter, Micha; Horjus, Bob; van de Schoot, Rens; van Yperen, Tom

2012-01-01

The current study explored parents attitudes towards nonparental adults involvement in childrearing practices. Parents attitudes were operationalized in their willingness to share parenting responsibility and interest to participate in parenting activities. Data were collected through a quantitative

DO PARENTS THINK IT TAKES A VILLAGE? PARENTS' ATTITUDES TOWARDS NONPARENTAL ADULTS' INVOLVEMENT IN THE UPBRINGING AND NURTURE OF CHILDREN

NARCIS (Netherlands)

Kesselring, Marije; de Winter, Micha; Horjus, Bob; van de Schoot, Rens; van Yperen, Tom

The current study explored parents attitudes towards nonparental adults involvement in childrearing practices. Parents attitudes were operationalized in their willingness to share parenting responsibility and interest to participate in parenting activities. Data were collected through a quantitative

Selected Films for Young Adults, 1984.

Science.gov (United States)

Top of the News, 1984

1984-01-01

This 22-item filmography of 16mm films recommended for use in programs planned for young adults was compiled by the Selected Films for Young Adults Committee, Young Adult Services Division, American Library Association. Producers, directors, distributors, length, price, and brief annotations are provided. Addresses for 12 distributors are…

Time-limited home-care reablement services for maintaining and improving the functional independence of older adults.

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Cochrane, Andy; Furlong, Mairead; McGilloway, Sinead; Molloy, David W; Stevenson, Michael; Donnelly, Michael

2016-10-11

Reablement, also known as restorative care, is one possible approach to home-care services for older adults at risk of functional decline. Unlike traditional home-care services, reablement is frequently time-limited (usually six to 12 weeks) and aims to maximise independence by offering an intensive multidisciplinary, person-centred and goal-directed intervention. To assess the effects of time-limited home-care reablement services (up to 12 weeks) for maintaining and improving the functional independence of older adults (aged 65 years or more) when compared to usual home-care or wait-list control group. We searched the following databases with no language restrictions during April to June 2015: the Cochrane Central Register of Controlled Trials (CENTRAL); MEDLINE (OvidSP); Embase (OvidSP); PsycINFO (OvidSP); ERIC; Sociological Abstracts; ProQuest Dissertations and Theses; CINAHL (EBSCOhost); SIGLE (OpenGrey); AgeLine and Social Care Online. We also searched the reference lists of relevant studies and reviews as well as contacting authors in the field. We included randomised controlled trials (RCTs), cluster randomised or quasi-randomised trials of time-limited reablement services for older adults (aged 65 years or more) delivered in their home; and incorporated a usual home-care or wait-list control group. Two authors independently assessed studies for inclusion, extracted data, assessed the risk of bias of individual studies and considered quality of the evidence using GRADE. We contacted study authors for additional information where needed. Two studies, comparing reablement with usual home-care services with 811 participants, met our eligibility criteria for inclusion; we also identified three potentially eligible studies, but findings were not yet available. One included study was conducted in Western Australia with 750 participants (mean age 82.29 years). The second study was conducted in Norway (61 participants; mean age 79 years).We are very uncertain as to

The interface between child/adolescent and adult mental health services: results from a European 28-country survey.

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Signorini, Giulia; Singh, Swaran P; Marsanic, Vlatka Boricevic; Dieleman, Gwen; Dodig-Ćurković, Katarina; Franic, Tomislav; Gerritsen, Suzanne E; Griffin, James; Maras, Athanasios; McNicholas, Fiona; O'Hara, Lesley; Purper-Ouakil, Diane; Paul, Moli; Russet, Frederick; Santosh, Paramala; Schulze, Ulrike; Street, Cathy; Tremmery, Sabine; Tuomainen, Helena; Verhulst, Frank; Warwick, Jane; de Girolamo, Giovanni

2018-04-01

Transition-related discontinuity of care is a major socioeconomic and societal challenge for the EU. The current service configuration, with distinct Child and Adolescent Mental Health (CAMHS) and Adult Mental Health Services (AMHS), is considered a weak link where the care pathway needs to be most robust. Our aim was to delineate transitional policies and care across Europe and to highlight current gaps in care provision at the service interface. An online mapping survey was conducted across all 28 European Countries using a bespoke instrument: The Standardized Assessment Tool for Mental Health Transition (SATMEHT). The survey was directed at expert(s) in each of the 28 EU countries. The response rate was 100%. Country experts commonly (12/28) reported that between 25 and 49% of CAMHS service users will need transitioning to AMHS. Estimates of the percentage of AMHS users aged under 30 years who had has previous contact with CAMHS were most commonly in the region 20-30% (33% on average).Written policies for managing the interface were available in only four countries and half (14/28) indicated that no transition support services were available. This is the first survey of CAMHS transitional policies and care carried out at a European level. Policymaking on transitional care clearly needs special attention and further elaboration. The Milestone Study on transition should provide much needed data on transition processes and outcomes that could form the basis for improving policy and practice in transitional care.

Evaluation of Outcomes in Adolescent Inflammatory Bowel Disease Patients Following Transfer From Pediatric to Adult Health Care Services: Case for Transition.

Science.gov (United States)

Cole, Rebecca; Ashok, Dhandapani; Razack, Abdul; Azaz, Amer; Sebastian, Shaji

2015-08-01

We aimed to evaluate the impact of a transition service on clinical and developmental outcomes in adolescent Inflammatory Bowel Disease (IBD) patients on transfer to adult health care services. We reviewed the records of IBD patients diagnosed in pediatric care following their transfer/attendance to the adult IBD service. The data on patients who attended the transition service were compared with those who did not pass through the transition service. Seventy-two patients were included in the study 41M and 31F. Forty-four patients went through the transition system (Group A), and 28 had no formalized transition arrangement before transfer (Group B). A significantly higher number of Group B patients needed surgery within 2 years of transfer when compared with patients in Group A (46% vs. 25%, p = .01). Sixty-one percent of patients in Group B needed at least one admission within 2 years of transfer when compared with 29% of Group A patients (p = .002). Nonattendance at clinics was higher in Group B patients with 78% having at least one nonattendance, whereas 29% of Group A failed to attend at least one appointment (p = .001). In addition, drug compliance rates were higher in the transition group when compared with Group B (89% and 46%, respectively; p = .002). A higher proportion of transitioned patients achieved their estimated maximum growth potential when completing adolescence. There was a trend toward higher dependence on opiates and smoking in Group B patients. In adolescent IBD patients, transition care is associated with better disease specific and developmental outcomes. Prospective studies of different models of transition care in IBD are needed. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Association Between Helicopter vs Ground Emergency Medical Services and Survival for Adults With Major Trauma

Science.gov (United States)

Galvagno, Samuel M.; Haut, Elliott R.; Zafar, S. Nabeel; Millin, Michael G.; Efron, David T.; Koenig, George J.; Baker, Susan P.; Bowman, Stephen M.; Pronovost, Peter J.; Haider, Adil H.

2012-01-01

Context Helicopter emergency medical services and their possible effect on outcomes for traumatically injured patients remain a subject of debate. Because helicopter services are a limited and expensive resource, a methodologically rigorous investigation of its effectiveness compared with ground emergency medical services is warranted. Objective To assess the association between the use of helicopter vs ground services and survival among adults with serious traumatic injuries. Design, Setting, and Participants Retrospective cohort study involving 223 475 patients older than 15 years, having an injury severity score higher than 15, and sustaining blunt or penetrating trauma that required transport to US level I or II trauma centers and whose data were recorded in the 2007–2009 versions of the American College of Surgeons National Trauma Data Bank. Interventions Transport by helicopter or ground emergency services to level I or level II trauma centers. Main Outcome Measures Survival to hospital discharge and discharge disposition. Results A total of 61 909 patients were transported by helicopter and 161 566 patients were transported by ground. Overall, 7813 patients (12.6%) transported by helicopter died compared with 17 775 patients (11%) transported by ground services. Before propensity score matching, patients transported by helicopter to level I and level II trauma centers had higher Injury Severity Scores. In the propensity score–matched multivariable regression model, for patients transported to level I trauma centers, helicopter transport was associated with an improved odds of survival compared with ground transport (odds ratio [OR], 1.16; 95% CI, 1.14–1.17; P<.001; absolute risk reduction [ARR], 1.5%). For patients transported to level II trauma centers, helicopter transport was associated with an improved odds of survival (OR, 1.15; 95% CI, 1.13–1.17; P < .001; ARR, 1.4%). A greater proportion (18.2%) of those transported to level I trauma centers

The Impact of Fear of Falling on Functional Independence Among Older Adults Receiving Home Health Services

Directory of Open Access Journals (Sweden)

Katherine A. Lawson OTR, LMSSW, PhD

2014-07-01

Full Text Available Background: Falls are the fifth leading cause of death for adults aged 65 years and older. Several intrinsic and extrinsic fall risk factors have been identified, butthere is less understanding of the impact of a fear of falling on falls. Seventy percent of recent fallers and 40% percent of non-fallers report a fear of falling. Therefore, the purpose of this study was to examine the correlation between a fear of falling and a history of falls, as well as the impact on the functional independence of community-dwelling older adults receiving home health services. Methods: The participants completed the Falls Efficacy Scale, the Modified Timed Up and Go Test, self- reported fear of falling, and the KATZ ADL-staircase. The participants were primarily Hispanic females. Results: There was not a significant correlation between a fear of falling and a history of falls. Only participants' age, gender, and the number of medical diagnoses were predictive of past falls. There was a moderate correlation between impaired functional mobility and dependence with activities of daily living (ADL. Additionally, a fear of falling was associated with dependence to perform ADLs as measured objectively. Conclusion: Future studies need to examine the effectiveness of interventions that include dual-task challenges during therapeutic interventions and ADL retraining to reduce fall risk among older adults.

Adult patients' experiences of NHS specialist services for chronic fatigue syndrome (CFS/ME): a qualitative study in England.

Science.gov (United States)

Broughton, Jessica; Harris, Sarah; Beasant, Lucy; Crawley, Esther; Collin, Simon M

2017-06-02

Few studies have explored patients' experiences of treatment for CFS/ME. This study aims to fill this gap by capturing the perspective of patients who have been treated by NHS specialist CFS/ME services in England. Semi-structured interviews were conducted during the period June-September 2014 with 16 adults who were completing treatment at one of three outpatient NHS specialist CFS/ME services. Interviews were analysed thematically using constant comparison techniques, with particular attention paid to contrasting views. Three themes were identified: 'Journey to specialist services'; 'Things that help or hinder treatment'; and 'Support systems'. Within these themes nine sub-themes were identified. A wide range of factors was evident in forming participants' experiences, including personal characteristics such as perseverance and optimism, and service factors such as flexibility and positive, supportive relationships with clinicians. Participants described how specialist services played a unique role, which was related to the contested nature of the condition. Many participants had experienced a lack of validation and medical and social support before attending a specialist service. Patients' experiences of life before referral, and the concerns that they expressed about being discharged, highlighted the hardship and obstacles which people living with CFS/ME continue to experience in our society. The experiences of CFS/ME patients in our study showed that NHS specialist CFS/ME services played a vital role in patients' journeys towards an improved quality of life. This improvement came about through a process which included validation of patients' experiences, acceptance of change, practical advice and support, and therapeutic outcomes.

Association between perceived social stigma against mental disorders and use of health services for psychological distress symptoms in the older adult population: validity of the STIG scale.

Science.gov (United States)

Préville, Michel; Mechakra Tahiri, Samia Djemaa; Vasiliadis, Helen-Maria; Quesnel, Louise; Gontijo-Guerra, Samantha; Lamoureux-Lamarche, Catherine; Berbiche, Djamal

2015-01-01

To document the reliability, construct and nomological validity of the perceived Social Stigmatisation (STIG) scale in the older adult population. Cross-sectional survey. Primary medical health services clinics. Probabilistic sample of older adults aged 65 years and over waiting for medical services in the general medical sector (n = 1765). Perceived social stigma against people with a mental health problem was measured using the STIG scale composed of seven indicators. A second-order measurement model of perceived social stigma fitted adequately the observed data. The reliability of the STIG scale was 0.83. According to our results, 39.6% of older adults had a significant level of perceived social stigma against people with a mental health problem. RESULTS showed that the perception of social stigma against mental health problems was not significantly associated with a respondent gender and age. RESULTS also showed that the perception of social stigma against the mental health problems was directly associated with the respondents' need for improved mental health (b = -0.10) and indirectly associated with their use of primary medical health services for psychological distress symptoms (b = -0.07). RESULTS lead us to conclude that social stigma against mental disorders perceived by older adults may limit help-seeking behaviours and warrants greater public health and public policy attention. Also, results lead us to conclude that physicians should pay greater attention to their patients' attitudes against mental disorders in order to identify possible hidden mental health problems.

Reported exposure to trauma among adult patients referred for psychological services at the Free State Psychiatric Complex, Bloemfontein

Directory of Open Access Journals (Sweden)

Laurisa van Zyl

2017-10-01

Objective: The study aimed to explore and describe the extent and nature of reported potentially traumatic events and associated variables in adult patients referred for psychological services at the Free State Psychiatric Complex (FSPC, Bloemfontein. Methods: In this cross-sectional study, demographic information, diagnostic morbidity and co-morbidity, and presence and type of reported trauma exposure reported by patients during the initial assessment were obtained from files of adult patients seen during a one-year period (2010 at the out-patient unit and the in-patient affective ward at the FSPC. Data were captured on data record forms by the researchers and analysed by means of descriptive statistics, univariate analysis and logistic regression (SAS version 9.1. Results: Of the 192 adults (71.9% White and 67.2% female referred for psychological services,75.5% were diagnosed with mood disorders, 17.2% with anxiety disorders, 22.4% with substance-related disorders and 20.9% with cluster B personality disorders or traits. A total of 145 (75.5% reported past trauma exposure. The most frequently reported types of trauma exposure were traumatic death/injury of a loved one (37.0%, physical assault (24.5%, witnessed/threatened violence (19.3%, and sexual assault (17.7%. Women were more likely to have been exposed to trauma than men (OR 4.02, 95% CI 1.87–8.62, in particular to traumatic death of a loved one (OR 3.13, physical assault (OR 4.08, or sexual assault (OR 5.43. Conclusions: The findings of this study contribute to current data regarding the prevalence of exposure to trauma and its possible association with mental illness. The importance of comprehensive trauma exposure screening in routine psychiatric interviewing practices is highlighted.

Adult Education in Liberia.

Science.gov (United States)

Smith, Robert M.

Adult education in Liberia is discussed as to the types of programs offered and the purposes and goals of each type. The programs are classified as Literacy Education, Continuing Education, Vocational Education, In-Service Education, and Fundamental Education. The needs of the adult Liberian in relation to the courses offered are discussed.…

Consumer-providers of care for adult clients of statutory mental health services.

Science.gov (United States)

Pitt, Veronica; Lowe, Dianne; Hill, Sophie; Prictor, Megan; Hetrick, Sarah E; Ryan, Rebecca; Berends, Lynda

2013-03-28

In mental health services, the past several decades has seen a slow but steady trend towards employment of past or present consumers of the service to work alongside mental health professionals in providing services. However the effects of this employment on clients (service recipients) and services has remained unclear.We conducted a systematic review of randomised trials assessing the effects of employing consumers of mental health services as providers of statutory mental health services to clients. In this review this role is called 'consumer-provider' and the term 'statutory mental health services' refers to public services, those required by statute or law, or public services involving statutory duties. The consumer-provider's role can encompass peer support, coaching, advocacy, case management or outreach, crisis worker or assertive community treatment worker, or providing social support programmes. To assess the effects of employing current or past adult consumers of mental health services as providers of statutory mental health services. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2012, Issue 3), MEDLINE (OvidSP) (1950 to March 2012), EMBASE (OvidSP) (1988 to March 2012), PsycINFO (OvidSP) (1806 to March 2012), CINAHL (EBSCOhost) (1981 to March 2009), Current Contents (OvidSP) (1993 to March 2012), and reference lists of relevant articles. Randomised controlled trials of current or past consumers of mental health services employed as providers ('consumer-providers') in statutory mental health services, comparing either: 1) consumers versus professionals employed to do the same role within a mental health service, or 2) mental health services with and without consumer-providers as an adjunct to the service. Two review authors independently selected studies and extracted data. We contacted trialists for additional information. We conducted analyses using a random-effects model, pooling studies that measured

Independent older adults perspectives on oral health.

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Khabra, K K; Compton, S M; Keenan, L P

2017-11-01

The purpose of this study was to explore oral health experiences from the perspective of older adults' living in community dwellings. The two objectives of this study were to identify facilitators and barriers to oral health care, and to determine how utilization of oral health services compares to utilization of other healthcare services. An interpretive descriptive methodology was employed with a purposive sample of 12 adults, aged 70 years or older. The inclusion criterion was English-speaking seniors residing in community dwellings. Community dwellings were defined as any housing outside of long-term care or other supportive living facilities. Semi-structured interviews were 30-80 min, audio-recorded and transcribed verbatim. Three researchers participated in the comparative analysis process to develop codes, generate categories, interpret patterns and construct themes. Three central themes surfacing from the data were as follows: life course influences on oral health, transparency in delivery of oral health services and interrelationships between oral health and overall health. Older adults in this study emphasized the value of establishing collaborative and trusting relationships between oral health practitioners and older adults. Oral health practitioners should be clear and transparent when communicating information about oral health costs and be cognizant of different circumstances from childhood to older adulthood that inhibit or promote routine utilization of oral health services. Including oral health services as part of interdisciplinary care teams could help promote understandings of the reciprocal relationship between oral health and general health and improve oral health status for older adults. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Medicaid provider reimbursement policy for adult immunizations.

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Stewart, Alexandra M; Lindley, Megan C; Cox, Marisa A

2015-10-26

State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Observational analysis using document review and a survey. Medicaid administrators in 50 states and the District of Columbia. Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. Copyright © 2015 Elsevier Ltd. All rights reserved.

Medicaid provider reimbursement policy for adult immunizations☆

Science.gov (United States)

Stewart, Alexandra M.; Lindley, Megan C.; Cox, Marisa A.

2015-01-01

Background State Medicaid programs establish provider reimbursement policy for adult immunizations based on: costs, private insurance payments, and percentage of Medicare payments for equivalent services. Each program determines provider eligibility, payment amount, and permissible settings for administration. Total reimbursement consists of different combinations of Current Procedural Terminology codes: vaccine, vaccine administration, and visit. Objective Determine how Medicaid programs in the 50 states and the District of Columbia approach provider reimbursement for adult immunizations. Design Observational analysis using document review and a survey. Setting and participants Medicaid administrators in 50 states and the District of Columbia. Measurements Whether fee-for-service programs reimburse providers for: vaccines; their administration; and/or office visits when provided to adult enrollees. We assessed whether adult vaccination services are reimbursed when administered by a wide range of providers in a wide range of settings. Results Medicaid programs use one of 4 payment methods for adults: (1) a vaccine and an administration code; (2) a vaccine and visit code; (3) a vaccine code; and (4) a vaccine, visit, and administration code. Limitations Study results do not reflect any changes related to implementation of national health reform. Nine of fifty one programs did not respond to the survey or declined to participate, limiting the information available to researchers. Conclusions Medicaid reimbursement policy for adult vaccines impacts provider participation and enrollee access and uptake. While programs have generally increased reimbursement levels since 2003, each program could assess whether current policies reflect the most effective approach to encourage providers to increase vaccination services. PMID:26403369

Disparities in Insurance Coverage, Health Services Use, and Access Following Implementation of the Affordable Care Act: A Comparison of Disabled and Nondisabled Working-Age Adults

OpenAIRE

Kennedy, Jae; Wood, Elizabeth Geneva; Frieden, Lex

2017-01-01

The objective of this study was to assess trends in health insurance coverage, health service utilization, and health care access among working-age adults with and without disabilities before and after full implementation of the Affordable Care Act (ACA), and to identify current disability-based disparities following full implementation of the ACA. The ACA was expected to have a disproportionate impact on working-age adults with disabilities, because of their high health care usage as well as...

Parents' and young adults' perspectives on transition outcomes for young adults with autism.

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Sosnowy, Collette; Silverman, Chloe; Shattuck, Paul

2018-01-01

Existing research shows that young adults with autism spectrum disorder have poorer outcomes than their peers with other developmental disabilities in the key areas of independent living, postsecondary education, and employment. However, we understand little about how young adults with autism and their families understand and value outcomes and whether these indicators match their goals and aspirations. We interviewed parents (n = 21) and young adults with autism spectrum disorder (n = 20) about their experiences with the transition to adulthood to understand what they consider to be desirable outcomes and how they seek to achieve them. Understanding these perspectives will help identify areas of need as well as disconnections between service objectives and the goals of young adults and their families. Participants described outcomes as more complex and nuanced than current conceptions and measures account for. They defined and evaluated outcomes in relation to their or their child's individual abilities, needs, and desires. These findings provide important insight into challenges to and facilitators of desired outcomes, which has implications for programming, service delivery, and policy.

The feasibility of introducing an adult safeguarding measure for inclusion in the Adult Social Care Outcomes Framework (ASCOF): findings from a pilot study.

Science.gov (United States)

Norrie, Caroline; Manthorpe, Jill; Cartwright, Cher; Rayat, Pritpal

2016-06-30

There are currently no national measures in England reporting the experiences of people who have been involved with adult safeguarding services following concerns that they may be at risk of abuse or neglect. The Health and Social Care Information Centre (HSCIC) aimed to develop a new adult safeguarding outcome measure (survey) for local authorities (LAs) that could be added to the Adult Social Care Outcomes Framework (ASCOF). The ASCOF is a national collection of social care outcomes performance indicators collected from the perspective of people receiving partial or total funding from a LA for care services. An outcome measure (a face-to-face interview based survey consisting of 7 questions) was piloted in 40 LAs with 382 adults at risk (or their representative) who had been the subject of a safeguarding investigation. The aim was to investigate the feasibility of the survey in three domains: i) if a statistically representative sample of adults at risk (or their family, friend, carer or advocate) could be recruited; ii) analysis of survey responses and its acceptability to participants iii) feedback from LAs about the survey's administration. Overall the survey results met statistical confidence; however the individual results for adults at risk did not, due to the high proportion of representatives who responded because adults at risk were unable. Responses to the survey were generally positive; 72 % of participants felt that the help received during the safeguarding investigation had made them or the adult at risk (if reporting as a proxy) feel 'quite a bit' or 'a lot safer'. These results are the most robust data collected in England on the perspectives of adults at risk and their representatives on safeguarding services. Participants reported they appreciated being asked for feedback. LAs suggested survey administration improvements. This survey is one way LAs can meet their new legal requirement under the Care Act 2014 to 'seek feedback' from adults at

Access to oral health care services among adults with learning disabilities: a scoping review.

Science.gov (United States)

Naseem, Mustafa; Shah, Altaf H; Khiyani, Muhammad Faheem; Khurshid, Zohaib; Zafar, Muhammad Sohail; Gulzar, Shabnam; AlJameel, AlBandary H; Khalil, Hesham S

2016-01-01

The prevalence of oral diseases including dental caries and periodontal conditions is remarkably higher in people with disabilities. The provision of accessible oral health services for people with learning disabilities may be challenging. The objectives of the review were to identify barriers in accessing oral health care that persists within society, enabling or disabling people with learning disabilities. Using the Arksey O'Malley framework, a scoping review was conducted on PubMed/Medline, OVIDSP, and EMBASE. Studies were evaluated and short-listed based on the inclusion criteria, which consisted of: (1) study participants or population with learning disabilities, (2) aged 16 years or over, (3) reporting on access to oral health services, (4) published in the English language. Those that justified the inclusion criteria were carefully chosen after a blind peer-reviewed process when relevance and quality were debated. Nine studies were eventually included from searches. Tabulation of data was done under the heading of study type, outcomes, the year of publication and patient selection. The majority of studies provided a biomedical overview of access for adults with learning disabilities. The concept of access for people with disability is still ill-defined and obscure. Access to oral health care and needs of people with learning disabilities are complex and multi-facet.

Preferences of Young Adults With First-Episode Psychosis for Receiving Specialized Mental Health Services Using Technology: A Survey Study.

Science.gov (United States)

Lal, Shalini; Dell'Elce, Jennifer; Tucci, Natasha; Fuhrer, Rebecca; Tamblyn, Robyn; Malla, Ashok

2015-01-01

Despite the potential and interest of using technology for delivering specialized psychiatric services to young adults, surprisingly limited attention has been paid to systematically assess their perspectives in this regard. For example, limited knowledge exists on the extent to which young people receiving specialized services for a first-episode psychosis (FEP) are receptive to using new technologies as part of mental health care, and to which types of technology-enabled mental health interventions they are amenable to. The purpose of this study is to assess the interest of young adults with FEP in using technology to receive mental health information, services, and supports. This study uses a cross-sectional, descriptive survey design. A convenience sample of 67 participants between the ages of 18 and 35 were recruited from two specialized early intervention programs for psychosis. Interviewer-administered surveys were conducted between December 2013 and October 2014. Descriptive statistics are reported. Among the 67 respondents who completed the survey, the majority (85%, 57/67) agreed or strongly agreed with YouTube as a platform for mental health-related services and supports. The top five technology-enabled services that participants were amenable to were (1) information on medication (96%, 64/67); (2) information on education, career, and employment (93%, 62/67); (3) decision-making tools pertaining to treatment and recovery (93%, 62/67); (4) reminders for appointments via text messaging (93%, 62/67); and (5) information about mental health, psychosis, and recovery in general (91%, 61/67). The top self-reported barriers to seeking mental health information online were lack of knowledge on how to perform an Internet search (31%, 21/67) and the way information is presented online (27%, 18/67). Two thirds (67%; 45/67) reported being comfortable in online settings, and almost half (48%; 32/67) reported a preference for mixed formats when viewing mental health

Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

Science.gov (United States)

Gomes, Barbara; Calanzani, Natalia; Curiale, Vito; McCrone, Paul; Higginson, Irene J

2013-01-01

Background Extensive evidence shows that well over 50% of people prefer to be cared for and to die at home provided circumstances allow choice. Despite best efforts and policies, one-third or less of all deaths take place at home in many countries of the world. Objectives 1. To quantify the effect of home palliative care services for adult patients with advanced illness and their family caregivers on patients' odds of dying at home; 2. to examine the clinical effectiveness of home palliative care services on other outcomes for patients and their caregivers such as symptom control, quality of life, caregiver distress and satisfaction with care; 3. to compare the resource use and costs associated with these services; 4. to critically appraise and summarise the current evidence on cost-effectiveness. Search methods We searched 12 electronic databases up to November 2012. We checked the reference lists of all included studies, 49 relevant systematic reviews, four key textbooks and recent conference abstracts. We contacted 17 experts and researchers for unpublished data. Selection criteria We included randomised controlled trials (RCTs), controlled clinical trials (CCTs), controlled before and after studies (CBAs) and interrupted time series (ITSs) evaluating the impact of home palliative care services on outcomes for adults with advanced illness or their family caregivers, or both. Data collection and analysis One review author assessed the identified titles and abstracts. Two independent reviewers performed assessment of all potentially relevant studies, data extraction and assessment of methodological quality. We carried out meta-analysis where appropriate and calculated numbers needed to treat to benefit (NNTBs) for the primary outcome (death at home). Main results We identified 23 studies (16 RCTs, 6 of high quality), including 37,561 participants and 4042 family caregivers, largely with advanced cancer but also congestive heart failure (CHF), chronic obstructive

38 CFR 21.142 - Adult basic education.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Adult basic education. 21...) VOCATIONAL REHABILITATION AND EDUCATION Vocational Rehabilitation and Employment Under 38 U.S.C. Chapter 31 Special Rehabilitation Services § 21.142 Adult basic education. (a) Definition. The term adult basic...

Organisation of services for managing ADHD.

Science.gov (United States)

Coghill, D R

2017-10-01

There is considerable variation in practice, both between and with different countries in the management of attention deficit hyperactivity disorder (ADHD). Whilst there is no one optimal model of service organisation there are general principles of care that can be introduced to reduce this variability. There are frequent debates and discussions about which professional group is best placed to manage ADHD at different points in the life cycle. Who delivers care is however less important than ensuring that training schemes provide adequate exposure, training and experience to both the core and non-core skills required to provide a comprehensive package of care. Most evidence-based guidelines recommend a multi-modal, multi-professional and multi-agency approach. Many also promote the use of both stepped care and shared care approaches for the management of ADHD. As most of those with ADHD continue to have ADHD-related problems into adulthood, it is important to consider how best to transition care into adulthood and think about who should deliver care to adults with ADHD. Young people with ADHD should generally be transferred to adult mental health services if they continue to have significant symptoms of ADHD or other coexisting conditions that require treatment. Unfortunately services for adults with ADHD remain relatively scarce across much of the world and some adult psychiatrists remain unsure of the diagnosis and uncertain about the appropriate use of ADHD medications in adults, but there is a strong case for increased services for adults. ADHD is on the one hand easy to treat; it is much more difficult to treat well. Although optimised care for ADHD requires routine measurement of outcomes, this often does not happen in routine clinical practice. Focusing on optimising symptoms and minimising adverse effects can significantly improve both short- and long-term outcomes.

Creating a vision for the future: key competencies and strategies for culturally competent practice with lesbian, gay, bisexual, and transgender (LGBT) older adults in the health and human services.

Science.gov (United States)

Fredriksen-Goldsen, Karen I; Hoy-Ellis, Charles P; Goldsen, Jayn; Emlet, Charles A; Hooyman, Nancy R

2014-01-01

Sexual orientation and gender identity are not commonly addressed in health and human service delivery, or in educational degree programs. Based on findings from Caring and Aging with Pride: The National Health, Aging and Sexuality Study (CAP), the first national federally-funded research project on LGBT health and aging, this article outlines 10 core competencies and aligns them with specific strategies to improve professional practice and service development to promote the well-being of LGBT older adults and their families. The articulation of key competencies is needed to provide a blueprint for action for addressing the growing needs of LGBT older adults, their families, and their communities.

Creating a Vision for the Future: Key Competencies and Strategies for Culturally Competent Practice With Lesbian, Gay, Bisexual, and Transgender (LGBT) Older Adults in the Health and Human Services

Science.gov (United States)

FREDRIKSEN-GOLDSEN, KAREN I.; HOY-ELLIS, CHARLES P.; GOLDSEN, JAYN; EMLET, CHARLES A.; HOOYMAN, NANCY R.

2014-01-01

Sexual orientation and gender identity are not commonly addressed in health and human service delivery, or in educational degree programs. Based on findings from Caring and Aging with Pride: The National Health, Aging and Sexuality Study (CAP), the first national federally-funded research project on LGBT health and aging, this article outlines 10 core competencies and aligns them with specific strategies to improve professional practice and service development to promote the well-being of LGBT older adults and their families. The articulation of key competencies is needed to provide a blueprint for action for addressing the growing needs of LGBT older adults, their families, and their communities. PMID:24571387

Adult mortality in sub-saharan Africa, Zambia: Where do adults die?

Directory of Open Access Journals (Sweden)

Vesper H. Chisumpa

2017-12-01

Full Text Available Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of death among Zambian adults aged 15–59 years using the 2010–2012 sample vital registration with verbal autopsy survey (SAVVY data, descriptive statistics and multivariate logistic regression analysis. Results show that more than half of the adult deaths occurred in a health facility and two-fifths died at home. Higher educational attainment, urban versus rural residence, and being of female gender were significant predictors of the place of death. Improvement in educational attainment and investment in rural health facilities and the health care system as a whole may improve access and utilization of health services among adults.

Adult mortality in sub-saharan Africa, Zambia: Where do adults die?

Science.gov (United States)

Chisumpa, Vesper H; Odimegwu, Clifford O; De Wet, Nicole

2017-12-01

Place of death remains an issue of growing interest and debate among scholars as an indicator of quality of end-of-life care in developed countries. In sub-Saharan Africa, however, variations in place of death may suggest inequalities in access to and the utilization of health care services that should be addressed by public health interventions. Limited research exists on factors associated with place of death in sub-Saharan Africa. The study examines factors associated with the place of death among Zambian adults aged 15-59 years using the 2010-2012 sample vital registration with verbal autopsy survey (SAVVY) data, descriptive statistics and multivariate logistic regression analysis. Results show that more than half of the adult deaths occurred in a health facility and two-fifths died at home. Higher educational attainment, urban versus rural residence, and being of female gender were significant predictors of the place of death. Improvement in educational attainment and investment in rural health facilities and the health care system as a whole may improve access and utilization of health services among adults.

Benchmarks for effective primary care-based nursing services for adults with depression: a Delphi study.

Science.gov (United States)

McIlrath, Carole; Keeney, Sinead; McKenna, Hugh; McLaughlin, Derek

2010-02-01

This paper is a report of a study conducted to identify and gain consensus on appropriate benchmarks for effective primary care-based nursing services for adults with depression. Worldwide evidence suggests that between 5% and 16% of the population have a diagnosis of depression. Most of their care and treatment takes place in primary care. In recent years, primary care nurses, including community mental health nurses, have become more involved in the identification and management of patients with depression; however, there are no appropriate benchmarks to guide, develop and support their practice. In 2006, a three-round electronic Delphi survey was completed by a United Kingdom multi-professional expert panel (n = 67). Round 1 generated 1216 statements relating to structures (such as training and protocols), processes (such as access and screening) and outcomes (such as patient satisfaction and treatments). Content analysis was used to collapse statements into 140 benchmarks. Seventy-three benchmarks achieved consensus during subsequent rounds. Of these, 45 (61%) were related to structures, 18 (25%) to processes and 10 (14%) to outcomes. Multi-professional primary care staff have similar views about the appropriate benchmarks for care of adults with depression. These benchmarks could serve as a foundation for depression improvement initiatives in primary care and ongoing research into depression management by nurses.

Comparison of health care needs of child family members of adults with alcohol or drug dependence versus adults with asthma or diabetes.

Science.gov (United States)

Ray, G Thomas; Mertens, Jennifer R; Weisner, Constance

2014-05-01

To compare the health problems, preventive care utilization, and medical costs of child family members (CFMs) of adults diagnosed with alcohol or drug dependence (AODD) to CFMs of adults diagnosed with diabetes or asthma. Child family members of adults diagnosed with AODD between 2002 and 2005 and CFMs of matched adults diagnosed with diabetes or asthma were followed up to 7 years after diagnosis of the index adult. Logistic regression was used to determine whether the CFMs of AODD adults were more likely to be diagnosed with medical conditions, or get preventive care, than the CFMs of adults with asthma or diabetes. Children's health services use was compared using multivariate models. In Year 5 after index date, CFMs of adults with AODD were more likely to be diagnosed with depression and AODD than CFMs of adults with asthma or diabetes and were less likely to be diagnosed with asthma, otitis media, and pneumonia than CFMs of adults with asthma. CFMs of AODD adults were less likely than CFMs of adult asthmatic patients to have annual well-child visits. CFMs of AODD adults had similar mean annual total health care costs to CFMs of adults with asthma but higher total costs ($159/yr higher, confidence interval, $56-$253) than CFMs of adult diabetic patients. CFMs of adults with AODD had higher emergency department, higher outpatient alcohol and drug program, higher outpatient psychiatry, and lower primary care costs than CFMs of either adult asthmatic patients or diabetic patients. Children in families with an alcohol- or drug-dependent adult have unique patterns of health conditions, and differences in the types of health services used, compared to children in families with an adult asthmatic or diabetic family member. However, overall cost and utilization for health care services is similar or only somewhat higher. This is the first study of its kind, and the results have implications for the reduction of parental alcohol or drug dependence stigma by health care

Preferences for support services among adolescents and young adults with cancer or a blood disorder: a discrete choice experiment.

Science.gov (United States)

Goodall, Stephen; King, Madeleine; Ewing, Jane; Smith, Narelle; Kenny, Patricia

2012-10-01

Life-threatening illnesses in young people are traumatic for patients and their families. Support services can help patients and families deal with various non-medical impacts of diagnosis, disease and treatment. The aim of this study was to determine which types of support are most valued by adolescents and young adults (AYA) with cancer or blood disorders and their families. A discrete choice experiment (DCE). Separate experiments were conducted with AYA and their carers. Completed surveys were returned by 83 patients and 78 carers. AYA preferred emotional support for themselves (either by counsellors and/or peers), emotional support for their family, financial support and assistance returning to school/work over services relating to cultural and spiritual needs. Covariate analysis indicated female AYA were more likely than males to prefer emotional support, while males were more likely to prefer assistance returning to work/school. Carers preferred emotional support for their AYA and assistance returning to school/work. Like AYA, they were indifferent about services relating to cultural and spiritual needs. Providing the types of support services that people prefer should maximise effectiveness. This study suggests that AYA patients require support services that included financial aid, assistance returning to work/study, emotional support for themselves and for their family. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Development of a Course of Training Programs for Young Engineers at Work to Nurture the “Basic Competencies of Employees”

Science.gov (United States)

Itoh, Michiko; Jomura, Makoto; Hongo, Tetsuyuki; Chohji, Tetsuji

According to our feasibility study in 2005, many of small and medium-sized companies in and around Toyama city asked their young engineers for originality and strong will to try and solve problems positively in their workplaces. These skills have a lot in common with “Basic Competencies of Employees” advocated by the Ministry of Economy, Trade and Industry, Japan. Since Toyama National College of Technology has an accumulated educational know-how to nurture “Basic Competencies of Employees” , we have applied this to develop a course of training programs for young engineers. Through four year‧s practice and improvement, we have established and evaluated this training course. We show the details of our course in this report.

NOHSS Adult Indicators

Data.gov (United States)

U.S. Department of Health & Human Services — 2012-2014 (even years). Data from BRFSS for indicators of adult oral health for even years from 2012 through 2014. National estimates are represented by the median...

Older Adults and Emerging Digital Service Delivery: A Mixed Methods Study on Information and Communications Technology Use, Skills, and Attitudes.

Science.gov (United States)

Siren, Anu; Knudsen, Sine Grønborg

2017-01-01

Based on data from a survey (n = 3291) and 14 qualitative interviews among Danish older adults, this study investigated the use of, and attitudes toward, information communications technology (ICT) and the digital delivery of public services. While age, gender, and socioeconomic status were associated with use of ICT, these determinants lost their explanatory power when we controlled for attitudes and experiences. We identified three segments that differed in their use of ICT and attitudes toward digital service delivery. As nonuse of ICT often results from the lack of willingness to use it rather than from material or cognitive deficiencies, policy measures for bridging the digital divide should focus on skills and confidence rather than on access or ability.

Characteristics of HIV-infected adults in the Deep South and their utilization of mental health services: A rural vs. urban comparison.

Science.gov (United States)

Reif, Susan; Whetten, Kathryn; Ostermann, Jan; Raper, James L

2006-01-01

Insufficient utilization of mental health services has been described among HIV-infected individuals in urban areas; however, little is known about utilization of mental health services among rural-living HIV-infected individuals. This article examines use of mental health services by HIV-infected adults in the Southern U.S., where approximately two-thirds of rural HIV cases reside, and compares mental health services use between those in rural and urban areas. Data were obtained from surveys of HIV-infected individuals receiving care at tertiary Infectious Diseases clinics in the Southern U.S. (n = 474). Study findings indicated that participants living in areas with a higher proportion of rural-living individuals were less likely to report seeing a mental health provider (p mental health visits in the previous month (p = .025). Furthermore, rural living was significantly associated with being African-American, heterosexual, less educated, and having minor children in the home. Due to differences in characteristics and mental health services use by degree of rurality, efforts are needed to assess and address the specific mental health and other needs of HIV-infected individuals in rural areas.

Teaching Young Adults with Disabilities through Service Learning

Science.gov (United States)

Woodruff, Elizabeth A.; Sinelnikov, Oleg A.

2015-01-01

While many scholars agree that service learning is beneficial to both the student and the community, the research on service learning in the physical education setting is limited. However, there are courses that can be aligned with the professional preparation needs of students and the broader needs of the community. Drawing on theory which has…

Genes and life-style factors in BELFAST nonagenarians: Nature, Nurture and Narrative.

Science.gov (United States)

Rea, Jennifer Nicola M; Carvalho, Ashley; McNerlan, Susan E; Alexander, H Denis; Rea, Irene Maeve

2015-10-01

Understanding how to 'Age Longer and Age Well' is a priority for people personally, for populations globally and for government policy. Nonagenarians are the oldest members of our societies and survivors of their generation. Approximately 10 % of nonagenarians reach 90 years and beyond in good condition and seem to have a combination of both age-span and health-span. But what are the factors which help people reach their ninetieth birthday and beyond in good condition? Are they genetics, as in 'nature', or do they depend on 'nurture' and are related to environment, or are both factors inextricably intertwined within the concept of behavioural genetics? Nonagenarians have rich life experiences that can teach us much about ageing well; they are reservoirs of genetic, life-style and behavioural information which can help dissect out how to live not only longer but better. Personal family history and narrative are powerful tools that help to determine familial traits, beliefs and social behaviours and when used in parallel with new biotechnology methods inform and elaborate causality. Here we present themes and insights from personal narrative enquiry from nonagenarian participants from the Belfast Elderly Longitudinal Free-living Ageing STudy (BELFAST) about factors they consider important for good quality ageing and relate these insights to the emerging genetics and life-style evidence associated with healthy longevity.

User satisfaction with public and private dental services for different age groups in Brazil

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Aline Macarevich

2018-02-01

Full Text Available Abstract: This article aimed to describe the levels of user satisfaction in different age groups and to study the association between user satisfaction and different types of dental services in a representative sample of Brazilians. This study is based on the Brazilian Oral Health Survey, which evaluated the dental health of adolescents, adults and older adults in 177 Brazilian cities. The outcome variable was user satisfaction, related to the last dental visit, evaluated in a five-level Likert-type scale. The main exposure variable was the type of dental service (public service, private service, health plan or insurance. The independent variables were DMFT (decay, missing and filled teeth; pain intensity in the past six months; reason for the last dental visit; perceived need for treatment; frequency of use of dental services; sex; equivalent income; and educational level. An ordered logistic regression analysis was performed separately for each age group. Few participants evaluated the services as bad or very bad (4.3% of adolescents, 6.1% of adults and 4.1% of older adults. In the crude model, the use of public services was associated with lower satisfaction than the use of private services and health plans between all groups. However, after adjusting by covariates, this association remained only in adolescents, who showed lower satisfaction with the public service compared to the private service and health plans. In general, Brazilians are satisfied with dental services, but, among adolescents, the use of public services was associated with lower satisfaction. Public services may be focused on issues related to children, adults and older adults, and not to the adolescent audience, which has specific demands.

Fast-food and full-service restaurant consumption in relation to daily energy and nutrient intakes among US adult cancer survivors, 2003-2012.

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An, Ruopeng; Liu, Junyi

2013-01-01

Healthy diet is an essential component in cancer survivorship care planning. Cancer survivors should be particularly prudent regarding their daily food choices, with an aim of ensuring safe consumption, reducing risk of recurrence or other comorbidity, and improving quality of life. We aimed to examine the impacts of fast-food and full-service restaurant consumption on daily energy and nutrient intakes among US adult cancer survivors. Nationally representative data of 1308 adult cancer survivors came from the National Health and Nutrition Examination Survey 2003-2012 waves. First-difference estimator was adopted to address confounding bias from time-invariant unobservables like personal food/beverage preferences by using within-individual variations in diet and restaurant consumption status between two non-consecutive 24-hour dietary recalls. Fast-food and full-service restaurant consumption, respectively, was associated with an increase in daily total energy intake by 125.97 and 152.26 kcal and sodium intake by 312.47 and 373.75 mg. Fast-food consumption was significantly associated with a decrease in daily vitamin A intake by 119.88 µg and vitamin K intake by 30.48 µg, whereas full-service restaurant consumption was associated with an increase in daily fat intake by 8.99 g and omega-6 fatty acid intake by 3.85 g, and a decrease in vitamin D intake by 0.93 µg. Compared with fast-food and full-service restaurant consumption at home, consumption away from home led to further reduced diet quality. Individualized nutrition counseling and food assistance programs should address cancer survivors' overall dining-out behavior rather than fast-food consumption alone. © The Author(s) 2015.

Applicability of SWOT analysis for measuring quality of public oral health services as perceived by adult patients in Finland. Strengths, weaknesses, opportunities and threats.

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Toivanen, T; Lahti, S; Leino-Kilpi, H

1999-10-01

To determine the applicability of SWOT analysis for measuring the quality of public oral health services from the adult client's perspective. Data were collected using a structured questionnaire developed in an earlier study. The study group consisted of all adult (over 18 years of age) clients (n = 256) using public municipal oral health services in Kirkkonummi, Finland, during 2 weeks in 1995. Before treatment, patients filled out a questionnaire that measured the importance of their expectations in different aspects of oral care. After the appointment, they filled out a similar questionnaire that measured the enactment of these expectations in the treatment situation. The response rate was 51%. The difference between subjective importance and enactment of expectations was tested by Wilcoxon's signed rank test. Results were interpreted using both a conventional analysis of "expectation enacted or not" and SWOT analysis, which is used in strategic planning to identify areas of strengths (S), weaknesses (W), opportunities (O) and threats (T) in an organisation. In 28 statements out of 35, the two analyses revealed similar interpretations. In most areas the patient-perceived quality of the services was good. Weaknesses were found in the following areas: communicating to patients the causes and risk of developing oral diseases, informing them about different treatment possibilities, and including patients in decision-making when choosing restorative materials. SWOT analysis provided more structured interpretation of the results, and can be more easily transferred to development of services.

Marketing and Retention Strategies for Adult Degree Programs

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Brown, Joann A.

2004-01-01

Four marketing strategies are critical to the success of adult degree programs: integrating marketing, knowing your students (research), shaping programs and services for adults, and staying the course (retention).

Socioeconomic determinants of access to health services among older adults: a systematic review.

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Almeida, Ana Paula Santana Coelho; Nunes, Bruno Pereira; Duro, Suele Manjourany Silva; Facchini, Luiz Augusto

2017-05-15

The objective of this study was to analyze the association between the socioeconomic characteristics and the access to or use of health services among older adults. This is a systematic review of the literature. The search has been carried out in the databases PubMed, LILACS and Web of Science, without restriction of dates and languages; however we have included only articles published in Portuguese, English, and Spanish. The inclusion criteria were: observational design, socioeconomic factors as variables of interest in the analysis of the access to or use of health services among older adults, representative sample of the target population, adjustment for confounding factors, and no selection bias. We have found 5,096 articles after deleting duplicates and 36 of them have been selected for review after the process of reading and evaluating the inclusion criteria. Higher income and education have been associated with the use and access to medical appointments in developing countries and some developed countries. The same association has been observed in dental appointments in all countries. Most studies have shown no association between socioeconomic characteristics and the use of inpatient and emergency services. We have identified greater use of home visits in lower-income individuals, with the exception of the United States. We have observed an unequal access to or use of health services in most countries, varying according to the type of service used. The expansion of the health care coverage is necessary to reduce this unequal access generated by social inequities. Analisar a associação entre características socioeconômicas e acesso ou utilização de serviços de saúde entre idosos. Revisão sistemática da literatura. A busca foi realizada nas bases de dados PubMed, Lilacs e Web of Science, sem restrição de datas e idiomas, entretanto foram incluídos somente os artigos publicados em português, inglês e espanhol. Foram critérios de inclusão: ter

Nature, nurture and evolution of intra-species variation in mosquito arbovirus transmission competence.

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Tabachnick, Walter J

2013-01-11

Mosquitoes vary in their competence or ability to transmit arthropod-borne viruses (arboviruses). Many arboviruses cause disease in humans and animals. Identifying the environmental and genetic causes of variation in mosquito competence for arboviruses is one of the great challenges in public health. Progress identifying genetic (nature) and environmental (nurture) factors influencing mosquito competence for arboviruses is reviewed. There is great complexity in the various traits that comprise mosquito competence. The complex interactions between environmental and genetic factors controlling these traits and the factors shaping variation in Nature are largely unknown. The norms of reaction of specific genes influencing competence, their distributions in natural populations and the effects of genetic polymorphism on phenotypic variation need to be determined. Mechanisms influencing competence are not likely due to natural selection because of the direct effects of the arbovirus on mosquito fitness. More likely the traits for mosquito competence for arboviruses are the effects of adaptations for other functions of these competence mechanisms. Determining these other functions is essential to understand the evolution and distributions of competence for arboviruses. This information is needed to assess risk from mosquito-borne disease, predict new mosquito-arbovirus systems, and provide novel strategies to mitigate mosquito-borne arbovirus transmission.

Nature, Nurture and Evolution of Intra-Species Variation in Mosquito Arbovirus Transmission Competence

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Walter J. Tabachnick

2013-01-01

Full Text Available Mosquitoes vary in their competence or ability to transmit arthropod-borne viruses (arboviruses. Many arboviruses cause disease in humans and animals. Identifying the environmental and genetic causes of variation in mosquito competence for arboviruses is one of the great challenges in public health. Progress identifying genetic (nature and environmental (nurture factors influencing mosquito competence for arboviruses is reviewed. There is great complexity in the various traits that comprise mosquito competence. The complex interactions between environmental and genetic factors controlling these traits and the factors shaping variation in Nature are largely unknown. The norms of reaction of specific genes influencing competence, their distributions in natural populations and the effects of genetic polymorphism on phenotypic variation need to be determined. Mechanisms influencing competence are not likely due to natural selection because of the direct effects of the arbovirus on mosquito fitness. More likely the traits for mosquito competence for arboviruses are the effects of adaptations for other functions of these competence mechanisms. Determining these other functions is essential to understand the evolution and distributions of competence for arboviruses. This information is needed to assess risk from mosquito-borne disease, predict new mosquito-arbovirus systems, and provide novel strategies to mitigate mosquito-borne arbovirus transmission.

Nature, Nurture and Evolution of Intra-Species Variation in Mosquito Arbovirus Transmission Competence

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Tabachnick, Walter J.

2013-01-01

Mosquitoes vary in their competence or ability to transmit arthropod-borne viruses (arboviruses). Many arboviruses cause disease in humans and animals. Identifying the environmental and genetic causes of variation in mosquito competence for arboviruses is one of the great challenges in public health. Progress identifying genetic (nature) and environmental (nurture) factors influencing mosquito competence for arboviruses is reviewed. There is great complexity in the various traits that comprise mosquito competence. The complex interactions between environmental and genetic factors controlling these traits and the factors shaping variation in Nature are largely unknown. The norms of reaction of specific genes influencing competence, their distributions in natural populations and the effects of genetic polymorphism on phenotypic variation need to be determined. Mechanisms influencing competence are not likely due to natural selection because of the direct effects of the arbovirus on mosquito fitness. More likely the traits for mosquito competence for arboviruses are the effects of adaptations for other functions of these competence mechanisms. Determining these other functions is essential to understand the evolution and distributions of competence for arboviruses. This information is needed to assess risk from mosquito-borne disease, predict new mosquito-arbovirus systems, and provide novel strategies to mitigate mosquito-borne arbovirus transmission. PMID:23343982

Spiritual formation and the nurturing of creative spirituality: A case study in Proverbs

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Anneke Viljoen

2016-03-01

Full Text Available The article is positioned in the interface between Old Testament scholarship and the discipline of spiritual direction of which spiritual formation is a component. The contribution that a Ricoeurian hermeneutic may make in unlocking the potential which an imaginal engagement with the book of Proverbs may hold for the discipline of spiritual formation was explored. Specifically three aspects of the text of Proverbs illustrated the creative process at work in the text, and how it converges with the concept of spiritual formation and the nurturing of creative spirituality. These aspects were, the development in Lady Wisdom�s discourses, the functional definition of the fear of Yahweh (illustrated from Proverbs 10:1�15:33, and the paradigmatic character of the book of Proverbs.Intradisciplinary and/or interdisciplinary implications: The research is positioned in the interface between Old Testament studies and Practical Theology. The research results in the enhancement of the interdisciplinary dialogue and interchange of resources between the named disciplines with regard to the interest in formation of persons that the biblical book of Proverbs and the discipline of spiritual formation shares.Keywords: Spiritual formation; fear of Yahweh; Proverbs; Wisdom; Hermeneutics; Paul Ricoeur; Symbolic world; Textual reference

Creating Nurturing Environments: A Science-Based Framework for Promoting Child Health and Development within High-Poverty Neighborhoods

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Komro, Kelli A.; Flay, Brian R.; Biglan, Anthony

2013-01-01

Living in poverty and living in areas of concentrated poverty pose multiple risks for child development and for overall health and wellbeing. Poverty is a major risk factor for several mental, emotional, and behavioral disorders, as well as for other developmental challenges and physical health problems. In this paper, the Promise Neighborhoods Research Consortium describes a science-based framework for the promotion of child health and development within distressed high-poverty neighborhoods. We lay out a model of child and adolescent developmental outcomes, and integrate knowledge of potent and malleable influences to define a comprehensive intervention framework to bring about a significant increase in the proportion of young people in high-poverty neighborhoods who will develop successfully. Based on a synthesis of research from diverse fields, we designed the Creating Nurturing Environments framework to guide community-wide efforts to improve child outcomes and reduce health and educational inequalities. PMID:21468644

[Nurturing clinician investigators is the best way to promote innovative drug development from academia].

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Fukuhara, Shunichi; Sakushima, Ken; Nishimura, Masaharu

2012-03-01

Clinical research in Japan is still lacking in quality and quantity, and that situation is worsening. One important cause of those problems is the dearth of clinician-investigators. A recent change in the system for post-graduate clinical training affected the career paths of medical residents and reduced the number of young doctors who enter graduate school. Even those who are interested in clinical research now have incentives to avoid graduate school. In Japan, 19th-century biological absolutism is still the dominant paradigm in the medical-research community. Science for public health in the 21st century will benefit from a probabilistic paradigm, which can help to restore an appropriate balance between basic sciences and clinical research. Research done by clinician-investigators should be based on clinical questions that arise in medical practice. That research includes investigation of disease and practice, exploration of associations between causes and outcomes, evaluation of diagnostic tests, and studies of the efficacy of treatments and prevention strategies. We emphasize the importance of nurturing clinician-investigators for the development of clinical research in Japan. This may not be the fastest way to promote innovative drug development from academia, but it is certainly the best.

Fall Risk and Its Associated Factors among Older Adults without Home-Help Services in a Swedish Municipality.

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Hammarlund, Catharina Sjödahl; Hagell, Peter; Westergren, Albert

2016-01-01

During preventive home visits, the purpose of this study was to identify the prevalence of fall risk and any associated factors. Participants (n = 1471) were cognitively sound community-dwelling older adults (≥ 70 years) without home-help service, living in a Swedish municipality. The Downton Fall Risk Index and nine single items were used. Tiredness/fatigue, age ≥ 80, inability to walk 1 hr, inability to climb stairs and worrying were significantly associated with fall risk. Preventive home visits incorporating fall-risk screening proved valuable, providing information for interventions aimed at preventing falls, maintaining independence, and facilitating health among community dwelling participants.

Working with young adults with Type 1 diabetes: views of a multidisciplinary care team and implications for service delivery.

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Brierley, S; Eiser, C; Johnson, B; Young, V; Heller, S

2012-05-01

Young adults with Type 1 diabetes experience difficulties achieving glucose targets. Clinic attendance can be poor, although health and self-care tend to be better among those who attend regularly. Our aims were to describe staff views about challenges working with this age-group (16-21 years). Semistructured interviews were conducted with 14 staff from Sheffield Teaching Hospitals diabetes care team. Interviews were audio-recorded, transcribed and analysed using thematic analysis. Three main themes emerged. Unique challenges working with young adults included staff emotional burden, the low priority given to self-care by young adults and the complexity of the diabetes regimen. Working in a multidisciplinary team was complicated by differences in consultation styles, poor team cohesion and communication. An ideal service should include psychological support for the professional team, identification of key workers, and development of individualized care plans. Staff differed in their views about how to achieve optimal management for young adults, but emphasized the need for greater patient-centred care and a range of interventions appropriate for individual levels of need. They also wanted to increase their own skills and confidence working with this age-group. While these results reflect the views of staff working in only one diabetes centre, they are likely to reflect the views of professionals delivering care to individuals of this age; replication is needed to determine their generalizability. © 2012 The Authors. Diabetic Medicine © 2012 Diabetes UK.

Family nurture intervention (FNI: methods and treatment protocol of a randomized controlled trial in the NICU

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Welch Martha G

2012-02-01

Full Text Available Abstract Background The stress that results from preterm birth, requisite acute care and prolonged physical separation in the Neonatal Intensive Care Unit (NICU can have adverse physiological/psychological effects on both the infant and the mother. In particular, the experience compromises the establishment and maintenance of optimal mother-infant relationship, the subsequent development of the infant, and the mother's emotional well-being. These findings highlight the importance of investigating early interventions that are designed to overcome or reduce the effects of these environmental insults and challenges. Methods This study is a randomized controlled trial (RCT with blinded assessment comparing Standard Care (SC with a novel Family Nurture Intervention (FNI. FNI targets preterm infants born 26-34 weeks postmenstrual age (PMA and their mothers in the NICU. The intervention incorporates elements of mother-infant interventions with known efficacy and organizes them under a new theoretical context referred to collectively as calming activities. This intervention is facilitated by specially trained Nurture Specialists in three ways: 1 In the isolette through calming interactions between mother and infant via odor exchange, firm sustained touch and vocal soothing, and eye contact; 2 Outside the isolette during holding and feeding via the Calming Cycle; and 3 through family sessions designed to engage help and support the mother. In concert with infant neurobehavioral and physiological assessments from birth through 24 months corrected age (CA, maternal assessments are made using standard tools including anxiety, depression, attachment, support systems, temperament as well as physiological stress parameters. Quality of mother-infant interaction is also assessed. Our projected enrolment is 260 families (130 per group. Discussion The FNI is designed to increase biologically important activities and behaviors that enhance maternally

Family nurture intervention (FNI): methods and treatment protocol of a randomized controlled trial in the NICU.

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Welch, Martha G; Hofer, Myron A; Brunelli, Susan A; Stark, Raymond I; Andrews, Howard F; Austin, Judy; Myers, Michael M

2012-02-07

The stress that results from preterm birth, requisite acute care and prolonged physical separation in the Neonatal Intensive Care Unit (NICU) can have adverse physiological/psychological effects on both the infant and the mother. In particular, the experience compromises the establishment and maintenance of optimal mother-infant relationship, the subsequent development of the infant, and the mother's emotional well-being. These findings highlight the importance of investigating early interventions that are designed to overcome or reduce the effects of these environmental insults and challenges. This study is a randomized controlled trial (RCT) with blinded assessment comparing Standard Care (SC) with a novel Family Nurture Intervention (FNI). FNI targets preterm infants born 26-34 weeks postmenstrual age (PMA) and their mothers in the NICU. The intervention incorporates elements of mother-infant interventions with known efficacy and organizes them under a new theoretical context referred to collectively as calming activities. This intervention is facilitated by specially trained Nurture Specialists in three ways: 1) In the isolette through calming interactions between mother and infant via odor exchange, firm sustained touch and vocal soothing, and eye contact; 2) Outside the isolette during holding and feeding via the Calming Cycle; and 3) through family sessions designed to engage help and support the mother. In concert with infant neurobehavioral and physiological assessments from birth through 24 months corrected age (CA), maternal assessments are made using standard tools including anxiety, depression, attachment, support systems, temperament as well as physiological stress parameters. Quality of mother-infant interaction is also assessed. Our projected enrolment is 260 families (130 per group). The FNI is designed to increase biologically important activities and behaviors that enhance maternally-mediated sensory experiences of preterm infants, as well as

Psychological distress among homeless adults.

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Gelberg, L; Linn, L S

1989-05-01

Recent studies have reported a high prevalence of mental illness among the homeless. As part of a community-based survey of 529 homeless adults, we developed and tested a model to increase our understanding of the factors related to their psychological distress. Using a previously validated and reliable scale of perceived psychological distress, we found that homeless adults were more likely to report psychological distress than the general population (80% vs. 49%). Distress levels were not associated with most demographic or homeless characteristics or general appearance. However, distress was related to unemployment, greater cigarette and alcohol use, worse physical health, fewer social supports, and perceived barriers to obtaining needed medical care. Since mental, physical, and social health are strongly related among homeless adults, alleviating distress among them may be most effectively done by implementing a broad-based health services package coupled with employment programs provided in an accessible service delivery setting.

Attitudes Toward Mental Health Services Among American Indians by Two Age Groups.

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Roh, Soonhee; Brown-Rice, Kathleen A; Lee, Kyoung Hag; Lee, Yeon-Shim; Yee-Melichar, Darlene; Talbot, Elizabeth P

2015-11-01

This study examined determinants of attitudes toward mental health services with a sample of American Indian younger-old-adults (aged 50-64, n = 158) and American Indian older-old adults (aged 65 and older, n = 69). Adapting Andersen's behavioral model of healthcare utilization, predisposing factors, mental health needs, and enabling factors were considered as potential predictors. Female and those with higher levels of social support tend to report more positive attitudes toward mental health services. Culture-influenced personal belief was associated with negative attitudes toward mental health services among American Indian younger-old -adults. Age and higher chronic medical conditions were significantly related to negative attitudes toward mental health services. Health insurance was positively associated with positive attitudes toward mental health services in the American Indian older-old adults. Findings indicate that practitioners should engage how culture, social support, and chronic conditions influence the response to mental health needs when working with older American Indians.

Health Trajectories of Family Caregivers: Associations With Care Transitions and Adult Day Service Use

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Liu, Yin; Kim, Kyungmin; Zarit, Steven H.

2017-01-01

Objective The study examines family caregivers’ health changes over 1 year on four health dimensions and explores the association of differential health trajectories with adult day service (ADS) use and caregiving transitions. Method The participants were 153 primary caregivers of individuals with dementia (IWDs) who provided information on care situations and their own health at baseline, 6-month, and 12-month interviews. Results Caregivers showed increasing functional limitations and decreasing bodily pain over time, whereas role limitation and general health perception remained stable. Furthermore, caregivers’ trajectories of functional limitation were associated with their extent of ADS use at baseline and their relatives’ placement. Discussion Health is multidimensional; all dimensions of caregiver health do not change in a uniform manner. The findings underscore the importance of the association of caregiving transitions and caregiver health and the potential health benefits of ADS use for family caregivers. PMID:25348275

Experience-based co-design in an adult psychological therapies service.

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Cooper, Kate; Gillmore, Chris; Hogg, Lorna

2016-01-01

Experience-based co-design (EBCD) is a methodology for service improvement and development, which puts service-user voices at the heart of improving health services. The aim of this paper was to implement the EBCD methodology in a mental health setting, and to investigate the challenges which arise during this process. In order to achieve this, a modified version of the EBCD methodology was undertaken, which involved listening to the experiences of the people who work in and use the mental health setting and sharing these experiences with the people who could effect change within the service, through collaborative work between service-users, staff and managers. EBCD was implemented within the mental health setting and was well received by service-users, staff and stakeholders. A number of modifications were necessary in this setting, for example high levels of support available to participants. It was concluded that EBCD is a suitable methodology for service improvement in mental health settings.

Why do adults entitled to free or highly subsidized dental services select fully out-of-pocket-paid care?

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Bayat, Fariborz; Vehkalahti, Miira M; Murtomaa, Heikki; Tala, Heikki

2010-02-01

To investigate patients' reasons for selecting a dental clinic given their choice of free or highly-subsidized dental services. The study was based on cross-sectional data obtained through phone interviews with adults in Tehran, Iran. The present study included those entitled to free or highly-subsidized dental services (n = 726). The data covered the patients' awareness of subsidized dental services and type of dental clinic for their most recent visit and their reasons for selecting that clinic. Awareness of subsidized dental services was dichotomized as being either aware or unaware of such subsidy. The type of clinic was dichotomized as providing either free or highly-subsidized (FHS) or fully out-of-pocket paid (FOP) services. Free format answers about the subjects' reasons for selecting a particular clinic were later sub-grouped as: convenient access, good technical aspects, good interpersonal aspects, low or reasonable fees, recommendation by a friend, and no reason. Socio-demographic status was based on background. Data analysis included the chi-square test and logistic regression model. Of the subjects (n = 726), 60% were women and 58% were under 35 years of age. The subjects' mean age was 33.5 years with no difference by gender (P = 0.24) and the majority had public insurance (91%). Of all the subjects, 60% selected FOP. Good interpersonal aspects were the strongest reason for selecting FOP (OR = 4.6), follow by good technical aspects (OR = 2.3). Those subjects who were unaware of their benefit had 4.6 times the odds of selecting FOP. Despite the opportunity to use highly-subsidized dental services, good interpersonal and good technical aspects lead patients to select private dentists and to pay fully out of pocket.

Identifying Student Traits and Motives to Service-Learn: Public Service Orientation among New College Freshmen

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Christensen, Robert K.; Stritch, Justin M.; Kellough, J. Edward; Brewer, Gene A.

2015-01-01

Among college students, public service motives influence choice of major or job. Although the link between public service motives and prosocial behavior has been established among working adults, researchers have not adequately examined how these motives affect the reported behavior of precareer students. In this article, the authors explored how…

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

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Margaret K Danilovich

2015-11-01

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

Investing in the foundation of sustainable development: pathways to scale up for early childhood development

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Richter, Linda M; Daelmans, Bernadette; Lombardi, Joan; Heymann, Jody; Boo, Florencia Lopez; Behrman, Jere R; Lu, Chunling; Lucas, Jane E; Perez-Escamilla, Rafael; Dua, Tarun; Bhutta, Zulfiqar A; Stenberg, Karin; Gertler, Paul; Darmstadt, Gary L

2018-01-01

Building on long-term benefits of early intervention (Paper 2 of this Series) and increasing commitment to early childhood development (Paper 1 of this Series), scaled up support for the youngest children is essential to improving health, human capital, and wellbeing across the life course. In this third paper, new analyses show that the burden of poor development is higher than estimated, taking into account additional risk factors. National programmes are needed. Greater political prioritisation is core to scale-up, as are policies that afford families time and financial resources to provide nurturing care for young children. Effective and feasible programmes to support early child development are now available. All sectors, particularly education, and social and child protection, must play a role to meet the holistic needs of young children. However, health provides a critical starting point for scaling up, given its reach to pregnant women, families, and young children. Starting at conception, interventions to promote nurturing care can feasibly build on existing health and nutrition services at limited additional cost. Failure to scale up has severe personal and social consequences. Children at elevated risk for compromised development due to stunting and poverty are likely to forgo about a quarter of average adult income per year, and the cost of inaction to gross domestic product can be double what some countries currently spend on health. Services and interventions to support early childhood development are essential to realising the vision of the Sustainable Development Goals. PMID:27717610

Animal-Assisted Therapy and Application to Older Adults in Long Term Care

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Kimberly Ann Mercer

2015-05-01

Full Text Available In the past thirty years animal-assisted therapy (AAT has moved beyond anecdotal status to a scientific evidence-based intervention. AAT comes in many shapes and sizes. There are a variety of animals which can be used such as dogs, cats, rabbits, horses, guinea pigs, goats, dolphins, and even fish aquariums. Loneliness is a common theme among older adults in long term care (LTC. Many older adults living in LTC facilities feel isolated. Some have little contact with family members or friends. Many describe feelings of loneliness and withdraw from social activities and interaction with others. Some feel as if they have nothing to look forward to and find no useful purpose in life.  The absence of having another to care for or nurture can also be distressing. The purpose of this project was to explore the use of AAT as an intervention to decrease loneliness in residents living in a LTC setting by introducing visits from a Sphynx cat registered by the Delta Society as a therapy animal. The project sample consisted of seven participants all over the age of 60 years who resided in a LTC facility in Texas. Pre-intervention and post-intervention checklists and open-ended questions were employed to collect data from participants. Analysis of the project findings revealed a notable decrease in loneliness.

Mathematical Competence of a Child - Life Success of an Adult

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Tina Bregant

2017-10-01

Full Text Available Aims: To provide a brief overview of literature studying the relationship between mathematical competences in childhood and adult life success measured in academic achievements, socioeconomic status, and health measures. Results: Mathematical competences are determined by the ability to process mathematical symbols and quantity determination which is partially inborn. We can stimulate mathematical abilities by preschool stimulation, which leads to a less difficult behavioural pattern. Better mathematical competences correlate with positive socio-emotional control and positive attitudes towards learning and school which contribute to a more engaged academic life-style. Higher mathematical achievements correlate with better paid positions and also increased gross domestic product (GDP on the national level. The Study of Mathematically Precocious Youth showed that their adult careers, accomplishments, and psychological well-being far exceeded base-rate expectations. On the other hand, children who are born preterm or near term experience mathematical learning difficulties which, despite the absence of overt health problems, present an obstacle into leading an otherwise fulfilling life. Conclusions: We can conclude from the findings, that mathematical precocity early in life predicts later creative contributions and leadership in critical occupational roles. Mathematical abilities are partially inborn. However, mathematical literacy can be further nurtured in preschool and school programmes. Since it is connected to a higher prosperity on individual as well as on national level, mathematical intervention should be offered especially to those who are underprivileged. When stimulating mathematical competences, a greater prosperity for all can be anticipated.

Business Incubators: A Review. Digest Number 97-4.

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Schuyler, Gwyer

A business incubator is an organization of services designed to nurture new businesses. Services that can be offered include management assistance, access to financing, business or technical support services, and shared office services. In 1997, 550 incubators served more than 13,000 clients, affiliates, and graduates. More than 80 percent of the…

Community factors to promote parents' quality of child-nurturing life.

Science.gov (United States)

Aoyama, Megumi; Wei, Chang Nian; Chang-nian, Wei; Harada, Koichi; Ueda, Kimiyo; Takano, Miyuki; Ueda, Atsushi

2013-01-01

The purpose of this study was to clarify the role of community factors in parents' quality of child-nurturing life (QCNL). We developed a questionnaire to evaluate the degree of QCNL and determine the structural factors related to QCNL as community factors related to parents' QCNL derived from focus group interviews and the Delphi technique. The questionnaire also included the battery of the self-rating depression scale and Tsumori-Inage Infant's Developmental Test. Using the questionnaire, we then conducted a quantitative survey of parents whose children attended nursery schools in Kumamoto Prefecture. Factor analysis, calculation of the mean score and/or ratio to each item, Pearson's correlation coefficient, t test, multiple regression analysis, and covariance structure analysis were performed. The questionnaire we developed consisted of seven items with 75 elements, involving ten elements as community factors. Subjects included 699 parents (mean age 33.6 ± 5.4 years) and 965 children (age range 0-6 years). Factor analysis revealed that community factors consisted of five factors, such as "lifestyle rooted in the ground," "balance of housekeeping and work," "community network," "amenity," and "regeneration of life". These factors may be dominant in a rural area. Finally, we developed a structural model with "community factors," QCNL, QOL, and "child growth" by covariance structural analysis. The analysis revealed that community factors had a positive relation to parents' QCNL (r = 0.81, p < 0.001) and that parental SDS score had a negative relation to parents' QCNL (r = -0.59, p < 0.001). The analysis did show that community factors were positively related to the sound growth of children. The covariance structure analysis revealed that community factors were associated with parents' QCNL, SDS, and "child growth."

Family Violence Among Older Adult Patients Consulting in Primary Care Clinics: Results From the ESA (Enquête sur la santé des aînés) Services Study on Mental Health and Aging

Science.gov (United States)

Préville, Michel; Mechakra-Tahiri, Samia Djemaa; Vasiliadis, Helen-Maria; Mathieu, Véronique; Quesnel, Louise; Gontijo-Guerra, Samantha; Lamoureux-Lamarche, Catherine; Berbiche, Djamal

2014-01-01

Objective To document the reliability and construct validity of the Family Violence Scale (FVS) in the older adult population aged 65 years and older. Method: Data came from a cross-sectional survey, the Enquête sur la santé des aînés et l’utilisation des services de santé (ESA Services Study), conducted in 2011–2013 using a probabilistic sample of older adults waiting for medical services in primary care clinics (n = 1765). Family violence was defined as a latent variable, coming from a spouse and from children. Results: A model with 2 indicators of violence; that is, psychological and financial violence, and physical violence, adequately fitted the observed data. The reliability of the FVS was 0.95. According to our results, 16% of older adults reported experiencing some form of family violence in the past 12 months of their interview, and 3% reported a high level of family violence (FVS > 0.36). Our results showed that the victim’s sex was not associated with the degree of violence (β = 0.02). However, the victim’s age was associated with family violence (β = −0.12). Older adults, aged 75 years and older, reported less violence than those aged between 65 and 74 years. Conclusion: Our results lead us to conclude that family violence against older adults is common and warrants greater public health and political attention. General practitioners could play an active role in the detection of violence among older adults. PMID:25161067

Suicidality among adults with intellectual disability.

Science.gov (United States)

Lunsky, Yona; Raina, Poonam; Burge, Philip

2012-11-01

The objective of the current study is to arrive at a better understanding of individuals with intellectual disability (ID) who threaten or attempt suicide. From a sample of 751 adults with ID who experienced a crisis, demographic and clinical profiles of 39 adults who threatened to commit suicide were compared to 28 adults who attempted suicide. These individuals were then compared to 337 adults who behaved aggressively toward others. Individuals who attempted suicide appeared similar to those who voiced suicide with the exception that suicide attempters were younger and more likely to visit the emergency department. Females, higher functioning individuals, and persons with a history of self-harm had higher odds of attempting or threatening suicide Research findings based on informant reported data, so diagnoses and delivery of services in hospital cannot be validated. Suicidality does occur in adults with ID, and can result in emergency department visits and hospitalizations. Recognition of variables associated with suicidality among those with ID by clinicians may allow for enhanced assessment, treatment services and ultimately more positive mental health outcomes for this group. Crown Copyright © 2012. Published by Elsevier B.V. All rights reserved.

Consequences of the presence of the mother or unfamiliar adult female on cortisol, ACTH, testosterone and behavioral responses of periadolescent guinea pigs during exposure to novelty.

Science.gov (United States)

Hennessy, M B; Maken, D S; Graves, F C

2000-08-01

Periadolescent guinea pigs were exposed to a novel environment for 10, 30, 60, or 90 min while either alone or with either their biological mother or an unfamiliar adult female. Both classes of females reduced plasma cortisol, ACTH and vocalization responses to the novel environment, and did so to an equivalent degree. However, behavioral interactions with the mother and unfamiliar female differed considerably. The offspring exhibited more defensive behavior and were the targets of more agonistic acts when with the unfamiliar female, though one agonistic behavior, kicking, was observed more often in tests with the mother. Males displayed more social/courtship behavior and tumescence with the unfamiliar female. Further, males exhibited higher plasma testosterone levels when with the unfamiliar female than when either with the mother or alone. These data in conjunction with earlier findings suggest that the ability of unfamiliar adult females to moderate hypothalamic-pituitary-adrenal activity fully emerges during the periadolescent period, is not dependent on nurturant behavior by the adult female, and may facilitate the redirection of social behavior from the mother to unrelated adults. Further, mothers appear to inhibit maternally directed sexual behavior and plasma testosterone elevations in their periadolescent sons, effects which likely serve to inhibit inbreeding.

The impact of staff and service user gender on staff responses towards adults with intellectual disabilities who display aggressive behaviour.

Science.gov (United States)

Kleinberg, I; Scior, K

2014-02-01

The impact of staff and service user gender on responses of staff in intellectual disability (ID) services is poorly understood. The present study set out to assess the role of gender in influencing staff emotions, attributions and behavioural intentions in response to aggression displayed by adults with ID. A new scale measuring staff behavioural intentions was developed. A two × two (staff gender × service user gender) between subjects design was used to compare the responses of day and residential support staff to physical aggression by a hypothetical service user. In response to a vignette depicting a service user with ID assaulting a member of staff, 160 respondents completed measures of affective responses, causal attributions and behavioural intentions while imagining themselves as the target of the service user's assault. Female participants reported feeling more fear/anxiety, more depression/anger and less confident/relaxed than male participants. The longer staff had worked with people with ID, the more likely they were to favour safety-focused behaviours. More confident female participants were less likely to favour safety-focused behaviours, but confidence had no effect on male participants' endorsement of these behaviours. Increased confidence in both was associated with lower agreement of safety-focused behaviours in relation to the female vignette, regardless of participant gender. The more control women believed the service user had over their behaviour, the more likely they were to choose safety-focused behaviours. Punitive behaviours were favoured more in response to the male rather than the female service user. Punitive behaviours were also favoured more by more junior staff and by participants who expected feeling more depressed/angry in response to the vignettes. Both staff and service user gender influenced staff responses to aggression, yet the latter played a smaller role than expected. The role of gender in staff-service user

Supporting Wellness in Adult Online Education

Science.gov (United States)

Thompson, Jacklyn J.; Porto, Stella C. S.

2014-01-01

Online education cannot continue to grow at the current pace while ignoring a crucial component of campus support, wellness for adult online learners. This paper brings awareness to the concept of wellness as an important student support service in adult online education. It includes a summarized review of relevant literature and identifies…

Mental health service use for adult patients with co-occurring depression and physical chronic health care needs, 2007-2010.

Science.gov (United States)

Jolles, Mónica Pérez; Haynes-Maslow, Lindsey; Roberts, Megan C; Dusetzina, Stacie B

2015-08-01

Individuals with mental illness experience poor health and may die prematurely from chronic illness. Understanding whether the presence of co-occurring chronic physical health conditions complicates mental health treatment is important, particularly among patients seeking treatment in primary care settings. Examine (1) whether the presence of chronic physical conditions is associated with mental health service use for individuals with depression who visit a primary care physician, and (2) whether race modifies this relationship. Secondary analysis of the National Ambulatory Medical Care Survey, a survey of patient-visits collected annually from a random sample of 3000 physicians in office-based settings. Office visits from 2007 to 2010 were pooled for adults aged 35-85 with a depression diagnosis at the time of visit (N=3659 visits). Mental health services were measured using a dichotomous variable indicating whether mental health services were provided during the office visit or a referral made for: (1) counseling, including psychotherapy and other mental health counseling and/or (2) prescribing of psychotropic medications. Most patient office visits (70%) where a depression diagnosis was recorded also had co-occurring chronic physical conditions recorded. The presence of at least 1 physical chronic condition was associated with a 6% decrease in the probability of receiving any mental health services (Phealth conditions, particularly as the health care system moves toward an integrated care model.

Randomized controlled trial of Family Nurture Intervention in the NICU: assessments of length of stay, feasibility and safety.

Science.gov (United States)

Welch, Martha G; Hofer, Myron A; Stark, Raymond I; Andrews, Howard F; Austin, Judy; Glickstein, Sara B; Ludwig, Robert J; Myers, Michael M

2013-09-24

While survival rates for preterm infants have increased, the risk for adverse long-term neurodevelopmental and behavioral outcomes remains very high. In response to the need for novel, evidence-based interventions that prevent such outcomes, we have assessed Family Nurture Intervention (FNI), a novel dual mother-infant intervention implemented while the infant is in the Neonatal Intensive Care Unit (NICU). Here, we report the first trial results, including the primary outcome measure, length of stay in the NICU and, the feasibility and safety of its implementation in a high acuity level IV NICU. The FNI trial is a single center, parallel-group, randomized controlled trial at Morgan Stanley Children's Hospital for mothers and their singleton or twin infants of 26-34 weeks gestation. Families were randomized to standard care (SC) or (FNI). FNI was implemented by nurture specialists trained to facilitate affective communication between mother and infant during specified calming interactions. These interactions included scent cloth exchange, sustained touch, vocal soothing and eye contact, wrapped or skin-to-skin holding, plus family-based support interactions. A total of 826 infants born between 26 and 34 weeks during the 3.5 year study period were admitted to the NICU. After infant and mother screening plus exclusion due to circumstances that prevented the family from participating, 373 infants were eligible for the study. Of these, we were unable to schedule a consent meeting with 56, and consent was withheld by 165. Consent was obtained for 150 infants from 115 families. The infants were block randomized to groups of N = 78, FNI and N = 72, SC. Sixteen (9.6%) of the randomized infants did not complete the study to home discharge, 7% of those randomized to SC and 12% of FNI infants. Mothers in the intervention group engaged in 3 to 4 facilitated one- to two-hour sessions/week. Intent to treat analyses revealed no significant difference between groups in

38 CFR 52.130 - Nursing services.

Science.gov (United States)

2010-07-01

... on duty each day of operation of the adult day health care program. This nurse must be currently... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.130 Nursing services. The program... to meet the total nursing care needs, as determined by participant assessment and individualized...

The influence of parenting on maladaptive cognitive schema: a cross-sectional research on a group of adults.

Science.gov (United States)

Pellerone, Monica; Iacolino, Calogero; Mannino, Giuseppe; Formica, Ivan; Zabbara, Simona Maria

2017-01-01

The literature emphasizes the role of early interpersonal experiences in the development of cognitive vulnerability; in particular, interruptions in early family relationships, parental unavailability and dysfunctional parenting are potential evolutionary precursors to negative cognitive style and emotional disorders. This study measured the relationship of retrospective ratings on parental bonding with cognitive patterns in a group of Italian adults. The objectives of this study were as follows: to analyze the influence of age and education level on cognitive domains; to verify whether being parents and living at home with parents affect both parenting style and cognitive domains; to investigate how the type of the maternal and paternal parenting independently affects cognitive styles; to measure the predictive variables for the use of cognitive dysfunctional patterns and to investigate age as a moderating variable of the relation between parenting styles and cognitive domains in a group of adult men and women. The research involved 209 adults (118 males and 91 females) living in Sicily (Italy) aged between 20 and 60 years ( M = 37.52; SD = 11.42). The research lasted for 1 year. The instruments used were the Parental Bonding Instrument to measure the perception of parenting during childhood and the Young Schema Questionnaire-3 to investigate cognitive patterns. Data show that being a younger adult male with mother's parenting style characterized by a lower level of nurturance is predictive of the disconnection and rejection domain, whereas, being a younger adult woman, with a higher level of maternal control is predictive of the impaired limits domain. This study underlines that because mothers and fathers establish different bonds with their children, care and control by both parents might impact different domains of development.

Advance Care Planning Discussions with Adolescent and Young Adult Cancer Patients Admitted to a Community Palliative Care Service: A Retrospective Case-Note Audit.

Science.gov (United States)

Fletcher, Sophie; Hughes, Rachel; Pickstock, Sarah; Auret, Kirsten

2018-02-01

Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015. Information was collected regarding end-of-life care discussions, documentation of agreed plan of care, and care received. Twenty-seven AYA and 37 adult medical records were reviewed. Eighteen (66.7%) AYA patients died at home, compared with 19 (51.4%) adults (p = 0.028). Desire to pursue all available oncological therapies, including clinical trials, was documented for 14 (51.9%) AYA patients compared with 9 (24.3%) of the adult group (p = 0.02). Eleven AYA patients (40.7%) received chemotherapy during the last month of life compared with two (5.4%) adults (p = 0.001). The results indicate that end-of-life care preferences for this unique cohort may differ from those of the adult population and need to be captured and understood. An ACP document incorporating a discussion regarding goals of care, preferred location of care, preference for place of death, and consent to future intervention, including cardiopulmonary resuscitation and prompts for review, could assist in pursuing this objective.

A review of the nurtured heart approach to parenting: evaluation of its theoretical and empirical foundations.

Science.gov (United States)

Hektner, Joel M; Brennan, Alison L; Brotherson, Sean E

2013-09-01

The Nurtured Heart Approach to parenting (NHA; Glasser & Easley, 2008) is summarized and evaluated in terms of its alignment with current theoretical perspectives and empirical evidence in family studies and developmental science. Originally conceived and promoted as a behavior management approach for parents of difficult children (i.e., with behavior disorders), NHA is increasingly offered as a valuable strategy for parents of any children, despite a lack of published empirical support. Parents using NHA are trained to minimize attention to undesired behaviors, provide positive attention and praise for compliance with rules, help children be successful by scaffolding and shaping desired behavior, and establish a set of clear rules and consequences. Many elements of the approach have strong support in the theoretical and empirical literature; however, some of the assumptions are more questionable, such as that negative child behavior can always be attributed to unintentional positive reinforcement by parents responding with negative attention. On balance, NHA appears to promote effective and validated parenting practices, but its effectiveness now needs to be tested empirically. © FPI, Inc.

Vulnerability within families headed by teen and young adult mothers investigated by child welfare services in Canada.

Science.gov (United States)

Hovdestad, W; Shields, M; Williams, G; Tonmyr, L

2015-01-01

Young mothers' families are at increased risk of child maltreatment and other poor health and social outcomes. Chi-square analyses of pooled child welfare services data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003; CIS-2008) were used to compare 284 teen mothers (18 years or younger) and 800 young mothers (19-21 years) and their families with 5752 families where the mother was 22 years or older. Twenty-six percent of young mothers were 18 years or younger. Most (68% of teen-mother families and 57% of families with a young adult mother) received social assistance as their main source of income compared with 36% of families with a mother aged 22 years or older. Teen and young adult mothers were more likely than those aged 22 or older to have childhood histories of out-of-home care (31% and 23% vs. 10%) and were more likely to have risk factors such as alcohol abuse (25% and 23% vs. 18%) and few social supports (46% and 41% vs. 37%). Secondary caregivers in families with young mothers also had more risk factors. Teen and young adult mother families were more likely to have their child placed out-of-home during the investigation (29% and 27% vs. 17%). All were equally likely to be victims of domestic violence and to have mental health issues. Within this sample of high-risk families, young mothers' families were more at risk than comparison families. Mothers' youth may be a useful criterion to identify families for targeted interventions.

Advances in Psychotherapy for Depressed Older Adults.

Science.gov (United States)

Raue, Patrick J; McGovern, Amanda R; Kiosses, Dimitris N; Sirey, Jo Anne

2017-09-01

We review recent advances in psychotherapies for depressed older adults, in particular those developed for special populations characterized by chronic medical illness, acute medical illness, cognitive impairment, and suicide risk factors. We review adaptations for psychotherapy to overcome barriers to its accessibility in non-specialty settings such as primary care, homebound or hard-to-reach older adults, and social service settings. Recent evidence supports the effectiveness of psychotherapies that target late-life depression in the context of specific comorbid conditions including COPD, heart failure, Parkinson's disease, stroke and other acute conditions, cognitive impairment, and suicide risk. Growing evidence supports the feasibility, acceptability, and effectiveness of psychotherapy modified for a variety of health care and social service settings. Research supports the benefits of selecting the type of psychotherapy based on a comprehensive assessment of the older adult's psychiatric, medical, functional, and cognitive status, and tailoring psychotherapy to the settings in which older depressed adults are most likely to present.

Getting young adults back to church: A marketing approach

Directory of Open Access Journals (Sweden)

Michelle C. van der Merwe

2013-04-01

Full Text Available Worldwide, church membership is decreasing. A decline in the number of young adults that attend church services is also evident. The purpose of the research was to determine whether the application of a well-established body of knowledge of marketing theories and principles could be used by churches to encourage young adults to return to the church. The application of services marketing to the church as a non-profit organisation is discussed by focussing on non-physical and physical atmospheric cues in the church’s servicescape that could enhance church attendance. A quantitative approach was used by testing the opinions of 200 church service attendees of different denominations. The findings indicated that certain elements in the servicescape of a church may be useful in attracting young adults. It was found that music is a strong determinant of whether young adults attend church services, followed by layout and design of the church and then by the signs and symbols used in the church. Females reported significantly higher levels of positive perceptions concerning the layout and design. Although the research showed that some marketing elements, such as a positive servicescape, could improve church attendance, other personal elements such as forming personal relationships with fellow Christians and God need to be further explored.

A community participatory model of mobile dental service-survey among stakeholders

Directory of Open Access Journals (Sweden)

Biney Anne Thomas

2015-01-01

Full Text Available Background: The mobile dental service (MDS at Ludhiana is a unique model of oral health care delivery which enables rural communities to develop their own creative system through partnerships, for ensuring consistent oral health care delivery in the underserved areas. Objectives: The objective of this study was to assess the satisfaction among the stakeholders participating in the MDS program of a premier Dental College in Ludhiana. Methodology: A cross-sectional survey was conducted in 12 villages of Ludhiana district in Punjab where the MDSs were being provided. Four hundred and fifty patients, 50 organizers and 40 service providers were interviewed separately with pretested questionnaires. Results: About 98.4% of the patients were completely satisfied with the overall care provided. 71.1% of the patients felt there was increased times in services and 76.7% felt that there was inadequate referral network. Most patients were satisfied with the communication skills of the doctors. 57.5% of the organizers felt that the overall care provided in the MDSs was consistently good and high quality in spite of challenging infrastructure. 100% of the health care providers felt that working in the MDS was a good learning experience in spite of the heavy workload and infrastructure challenges. Conclusion: The study reveals that the MDS is a satisfactory mode of dental care delivery for all the stakeholders involved. Despite the challenges, this partnership program can be nurtured as a successful model of oral health care delivery in underserved areas.

New graduates’ perceptions of preparedness to provide speech-language therapy services in general and dysphagia services in particular

Science.gov (United States)

Booth, Alannah; Choto, Fadziso; Gotlieb, Jessica; Robertson, Rebecca; Morris, Gabriella; Stockley, Nicola; Mauff, Katya

2015-01-01

Background Upon graduation, newly qualified speech-language therapists are expected to provide services independently. This study describes new graduates’ perceptions of their preparedness to provide services across the scope of the profession and explores associations between perceptions of dysphagia theory and clinical learning curricula with preparedness for adult and paediatric dysphagia service delivery. Methods New graduates of six South African universities were recruited to participate in a survey by completing an electronic questionnaire exploring their perceptions of the dysphagia curricula and their preparedness to practise across the scope of the profession of speech-language therapy. Results Eighty graduates participated in the study yielding a response rate of 63.49%. Participants perceived themselves to be well prepared in some areas (e.g. child language: 100%; articulation and phonology: 97.26%), but less prepared in other areas (e.g. adult dysphagia: 50.70%; paediatric dysarthria: 46.58%; paediatric dysphagia: 38.36%) and most unprepared to provide services requiring sign language (23.61%) and African languages (20.55%). There was a significant relationship between perceptions of adequate theory and clinical learning opportunities with assessment and management of dysphagia and perceptions of preparedness to provide dysphagia services. Conclusion There is a need for review of existing curricula and consideration of developing a standard speech-language therapy curriculum across universities, particularly in service provision to a multilingual population, and in both the theory and clinical learning of the assessment and management of adult and paediatric dysphagia, to better equip graduates for practice. PMID:26304217

Young Adults Deserve the Best: YALSA's Competencies in Action

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Flowers, Sarah

2010-01-01

As high school enrollment continues to rise, the need for effective librarianship serving young adults is greater than ever before. "Young Adults Deserve the Best: Competencies for Librarians Serving Youth," developed by Young Adult Library Services Association (YALSA), is a document outlining areas of focus for providing quality library service…

Adult Tobacco Consumption In The U.S., 2000-Present

Data.gov (United States)

U.S. Department of Health & Human Services — 2000 to Present. Adult Tobacco Consumption in the U.S. This dataset highlights critical trends in adult total and per capita consumption of both combustible...

Report on the surveys in fiscal 1999 on foundations for establishing industrial technology strategies. Technological strategies by fields (Field of nurturing human resources in chemical technologies); 1999 nendo sangyo gijutsu senryaku sakutei kiban chosa hokokusho. Bun'yabetsu senryaku (kagaku gijutsusha jinzai ikusei bun'ya)

Energy Technology Data Exchange (ETDEWEB)

NONE

2000-03-01

This paper describes nurturing of human resources in chemical technologies, as part of the surveys in fiscal 1999 on foundations for establishing industrial technology strategies. In association with the progress in scientific technologies, convenience of living has been enhanced exceptionally. On the other hand, however, problems lie in a heap, such as in global environment, energy, resources and population. Safety of chemical substances is questioned. Industrial world is greeted with the times of bubble collapse, information orientation, internationalization, and great competition. Chemical industries are aiming at differentiation and power strengthening, but demanded of conversion into making more independent developments. A large number of problems difficult of solving must be overcome by progress of scientific technologies. The core of the progress is in innovation and creation of new chemical technologies. Since what shoulders the requirements is people, nurturing chemical engineers is the urgent and important issue. Chemical engineers are demanded of having knowledge and experience in environment and safety, and ethics to accomplish social responsibilities, not to speak of their specialty technologies. Human resource nurturing must be carried out effectively under collaboration and cooperation of universities and corporations, rather than they do it independently. This paper describes problems and solution ideas, such as institutions and programs, to achieve the goal. (NEDO)

Parents in adult psychiatric care and their children: a call for more interagency collaboration with social services and child and adolescent psychiatry.

Science.gov (United States)

Afzelius, Maria; Östman, Margareta; Råstam, Maria; Priebe, Gisela

2018-01-01

A parental mental illness affects all family members and should warrant a need for support. To investigate the extent to which psychiatric patients with underage children are the recipients of child-focused interventions and involved in interagency collaboration. Data were retrieved from a psychiatric services medical record database consisting of data regarding 29,972 individuals in southern Sweden and indicating the patients' main diagnoses, comorbidity, children below the age of 18, and child-focused interventions. Among the patients surveyed, 12.9% had registered underage children. One-fourth of the patients received child-focused interventions from adult psychiatry, and out of these 30.7% were involved in interagency collaboration as compared to 7.7% without child-focused interventions. Overall, collaboration with child and adolescent psychiatric services was low for all main diagnoses. If a patient received child-focused interventions from psychiatric services, the likelihood of being involved in interagency collaboration was five times greater as compared to patients receiving no child-focused intervention when controlled for gender, main diagnosis, and inpatient care. Psychiatric services play a significant role in identifying the need for and initiating child-focused interventions in families with a parental mental illness, and need to develop and support strategies to enhance interagency collaboration with other welfare services.

Casino gambling among older adults in North Dakota: a policy analysis.

Science.gov (United States)

Bjelde, Kristine; Chromy, Barbara; Pankow, Debra

2008-12-01

This article examined social issues surrounding casino gambling among older adults both nationally and in the state of North Dakota. An exploratory review of gambling trends among older adults and an examination of policies to protect older gamblers revealed that older adults are targeted by the gaming industry as a lucrative market (Singh et al. J Retail Leisure Property 2007, 6(1):61-68). The authors used the national literature to frame their qualitative study, which explored gambling issues among older adults in North Dakota from the perspective of six counselors trained in gambling addiction who provide treatment services in the state. Findings indicated that relatively few policies existed at the state and national levels to protect older, more vulnerable adults who gamble. Further, the six casinos in North Dakota were viewed as very effective in marketing their casino gaming opportunities to older citizens by the gambling treatment providers interviewed. Additionally, barriers to gambling addiction treatment involved lack of available services and distance to receive services in this rural state. Based on the findings of this study, social policy changes which could lead to increased protection for older adult gamblers in the state were included.

Philosophy of adult education and the implication for agricultural ...

African Journals Online (AJOL)

Philosophy of adult education and the implication for agricultural extension service. ... The paper highlights the relationhip between adult education and extension using the philosophy as a fulcrum between both. The paper further reiterated ...

Adult Education in Museums and Public Libraries.

Science.gov (United States)

Miller, Harry G.

Both museums and public libraries are available sources of education for adults. Besides their traditional functions of collecting and preserving items from human artistic or scientific history, museums have taken on a more active role in educating the public, particularly adults. Some educational services provided by museums are dioramas, period…

The Role of Support Services in Promoting Social Inclusion for the Disadvantaged Urban-dwelling Elderly.

Science.gov (United States)

Nguyen, Vicky P K H; Sarkari, Feroz; Macneil, Kate; Cowan, Laura; Rankin, Joyce

2013-01-01

Disadvantaged older adults living in non-family situations in Toronto are more likely than older adults living in family situations to have less economic security, less social support, and less choice in housing. Older adults who live in poverty and are precariously housed are more likely to be chronically ill, to live with multiple illnesses, to have poor nutrition, high stress and loneliness, all of which are strongly associated with the determinant of health social exclusion. The aim of this study is to: 1) evaluate the level of social disadvantage and exclusion experienced by low-income older adults 65 years of age and older living alone or in non-family situations; 2) assess the level of dependency on government and community services (support services) to maintain a reasonable standard of living (minimize effects of social exclusion); and 3) identify consequences of social exclusion not addressed by current available services. Fifteen male older adult members of the Good Neighbours' Club in downtown Toronto were interviewed. Semi-structured questionnaires assessed barriers to, utility of, and perceived impact of support services available to disadvantaged older adults living in the central core of southeast Toronto. Support services for income, housing, food security, social support, and health care do mitigate the effects of social exclusion in the study participants. Data gathered from interviews identified factors that counter the efforts by support services to increase social inclusion in this population. Support services reduce social isolation experienced by these older adults. Evidence of the detrimental impact of low financial literacy suggests a need to design and implement training programs to build the older adults' capacity to manage their own finances effectively, and resist falling victim to financial fraud.

2009 YALSA Fabulous Films & Amazing Audiobooks for Young Adults

Science.gov (United States)

School Library Journal, 2009

2009-01-01

The Young Adult Library Services Association (YALSA), a division of the American Library Association (ALA), announced its 2009 annual lists of Fabulous Films for Young Adults and Amazing Audiobooks for Young Adults ages 12 to 18. This article presents the titles that were released in January 2009 during the ALA Midwinter Meeting in Denver,…

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

Science.gov (United States)

Weaver, Raven H; Roberto, Karen A

2017-06-01

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

Infants & Toddlers: How Babies Use Gestures to Communicate

Science.gov (United States)

Honig, Alice Sterling

2004-01-01

Evolution has provided babies with wonderful ways to get the loving attention and care that they need from adults. When a baby is distressed, his cry is the most primitive and powerful tool for bringing help. By the time a baby is 2 or 3 months old, his dazzling smile and crooked grin evokes tenderness, smiles, and nurturance from adults who are…

A survey of imaging services for children in England, Wales and Scotland

International Nuclear Information System (INIS)

Mathers, Sandra A.; Anderson, Helen; McDonald, Sheila

2011-01-01

Purpose: Children are major users of imaging services but little is known about the provision made for them. The objectives of this survey were to: determine the extent to which children are imaged in primarily adult departments and the nature of procedures performed; establish the availability of child friendly environments and investigate the extent to which children are involved in service development. Methods: An 18 item questionnaire was sent to all hospitals with imaging facilities in the UK. Two versions were produced, one for adult departments and another for children's hospitals. Quantitative data were entered into SPSS-PC. Results: Three hundred and fifty two questionnaires were returned including 17 from the 20 children's hospitals, representing a 70% response rate. Children were imaged in 84% of adult hospitals from which responses were obtained and estimates provided by respondents indicated that more children were imaged in adult than children's hospitals. In 89% of adult hospitals responses indicated that infants were imaged and in two thirds of English hospitals advanced procedures, such as MRI, were available for children. In 47%, 32% and 30% of adult hospitals in England, Wales and Scotland children's requirements were said to be considered when purchasing equipment. In 34%, 11% and 8% of English, Welsh and Scottish adult hospitals some separate provision for children (for example waiting rooms or toilets) was indicated. Overall 32% of adult hospitals (92 of the 95 were in England) reported having a lead radiographer, who specialised in a paediatric imaging. Responses indicated that in 60% of adult hospitals staff attended paediatric training courses. Children's views on hospital services were seldom sought in either the adult or children's hospitals. Conclusions: The survey indicates that the recommendations of the Children's National Service Framework and the Health Care Commission have not been implemented fully in many imaging departments.

Vulnerability within families headed by teen and young adult mothers investigated by child welfare services in Canada

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W. Hovdestad

2015-01-01

Full Text Available Introduction: Young mothers' families are at increased risk of child maltreatment and other poor health and social outcomes. Methods: Chi-square analyses of pooled child welfare services data from the Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003; CIS-2008 were used to compare 284 teen mothers (18 years or younger and 800 young mothers (19-21 years and their families with 5752 families where the mother was 22 years or older. Results: Twenty-six percent of young mothers were 18 years or younger. Most (68% of teen-mother families and 57% of families with a young adult mother received social assistance as their main source of income compared with 36% of families with a mother aged 22 years or older. Teen and young adult mothers were more likely than those aged 22 or older to have childhood histories of out-of-home care (31% and 23% vs. 10% and were more likely to have risk factors such as alcohol abuse (25% and 23% vs. 18% and few social supports (46% and 41% vs. 37%. Secondary caregivers in families with young mothers also had more risk factors. Teen and young adult mother families were more likely to have their child placed out-of-home during the investigation (29% and 27% vs. 17%. All were equally likely to be victims of domestic violence and to have mental health issues. Conclusion: Within this sample of high-risk families, young mothers' families were more at risk than comparison families. Mothers' youth may be a useful criterion to identify families for targeted interventions.

[Health services' utilization patterns in Catalonia, Spain].

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Medina, Carmen; Salvador, Xavier; Faixedas, M Teresa; Gallo, Pedro

2011-12-01

The purpose of this article is disclose services utilization patterns among the Catalan population with particular emphasis on primary care, specialised care, hospital care and emergency care. A number of logistic regression models were used to explain the utilization of the various types of services. Variables in the analysis included self-perceived need, lifestyles, and sociodemographic variables. Separate analyses were performed for male, female, adults, and children as well as for the general population. Women use all types of services more often than men. Children and people over 64 are more frequent users of primary care. Primary care is also associated to lower socioeconomic conditions. Young adults and the migrant population in general are found to be under users of services, except of emergency care services. The use of specialised care is associated to the better-off, to those with university level education attainment, individual private insurance, and those living in the city of Barcelona. Hospital care is largely associated to need variables. The use of health services is explained by self-perceived need as well as by demographic, socioeconomic and geographical factors. Copyright © 2011 Elsevier España S.L. All rights reserved.

77 FR 57096 - Part C Early Intervention Services Grant Under the Ryan White HIV/AIDS Program

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2012-09-17

... Intervention Services Grant Under the Ryan White HIV/AIDS Program AGENCY: Health Resources and Services... primary care services for persons living with HIV/AIDS, including primary adult HIV medical care, adult... Medical Center managed the Ryan White HIV/AIDS Program through a contractual agreement with the...

Promoting Healthy Child Development via a Two-Generation Translational Neuroscience Framework: The Filming Interactions to Nurture Development Video Coaching Program.

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Fisher, Philip A; Frenkel, Tahl I; Noll, Laura K; Berry, Melanie; Yockelson, Melissa

2016-12-01

In this article, we focus on applying methods of translational neuroscience to two-generation, family-based interventions. In recent years, a small but growing body of evidence has documented the reversibility of some of the neurobiological effects of early adversity in the context of environmental early interventions. Some of these interventions are now being implemented at scale, which may help reduce disparities in the face of early life stress. Further progress may occur by extending these efforts to two-generation models that target caregivers' capabilities to improve children's outcomes. In this article, we describe the content and processes of the Filming Interactions to Nurture Development (FIND) video coaching intervention. We also discuss the two-generation, translational neuroscience framework on which FIND is based, and how similar approaches can be developed and scaled to mitigate the effects of adversity.

Audiological management of adults with hearing impairment in Malaysia.

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Ali, Akmaliza; Hickson, Louise; Meyer, Carly

2017-06-01

This study explored the nature of audiological services for adults with hearing impairment in Malaysia, with an emphasis on whether current services address clients' overall functioning as described by the World Health Organisation's International Classification of Functioning, Disability, and Health (ICF) framework. An online survey exploring current practice, skills and confidence of audiologists, and the infrastructure and facilities available in their workplaces, was distributed to audiologists in Malaysia via professional associations and social media. A total of 111 audiologists, 84.7% female and 15.3% male (range = 23-44 years), participated in the study. Although audiologists in Malaysia reported addressing all of the ICF domains, less than 26% of them assessed the patients' speech perception, carried out real-ear measurements, or used outcome measures routinely. The majority of the audiologists reported feeling confident in managing adult patients. However, 83% of the audiologists indicated they wanted to improve their skills related to management of adult patients, particularly in the areas of counselling and auditory training. Inadequate infrastructure, resources and facilities in the workplace may have contributed to the gaps in service provision and influenced the current practice of audiological management for adult patients in Malaysia.

Nature Versus Nurture: Have Performance Gaps Between Men and Women Reached an Asymptote?

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Millard-Stafford, Mindy; Swanson, Ann E; Wittbrodt, Matthew T

2018-05-14

Men outperform women in sports requiring muscular strength and/or endurance, but the relative influence of "nurture" versus "nature" remains difficult to quantify. Performance gaps between elite men and women are well documented using world records in second, centimeter, or kilogram sports. However, this approach is biased by global disparity in reward structures and opportunities for women. Despite policies enhancing female participation (Title IX legislation), US women only closed performance gaps by 2% and 5% in Olympic Trial swimming and running, respectively, from 1972 to 1980 (with no change thereafter through 2016). Performance gaps of 13% in elite middistance running and 8% in swimming (∼4-min duration) remain, the 5% differential between sports indicative of load carriage disadvantages of higher female body fatness in running. Conversely, sprint swimming exhibits a greater sex difference than sprint running, suggesting anthropometric/power advantages unique to swim-block starts. The ∼40-y plateau in the performance gap suggests a persistent dominance of biological influences (eg, longer limb levers, greater muscle mass, greater aerobic capacity, and lower fat mass) on performance. Current evidence suggests that women will not swim or run as fast as men in Olympic events, which speaks against eliminating sex segregation in these individual sports. Whether hormone reassignment sufficiently levels the playing field in Olympic sports for transgender females (born and socialized male) remains an issue to be tackled by sport-governing bodies.

National Adult Tobacco Survey (NATS)

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U.S. Department of Health & Human Services — 2013-2014. The National Adult Tobacco Survey (NATS) was created to assess the prevalence of tobacco use, as well as the factors promoting and impeding tobacco use...

Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

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Barbara Gomes

Full Text Available BACKGROUND: Extensive evidence shows that well over 50% of people prefer to be cared for and to die at home provided circumstances allow choice. Despite best efforts and policies, one-third or less of all deaths take place at home in many countries of the world. OBJECTIVES: 1. to quantify the effect of home palliative care services for adult patients with advanced illness and their family caregivers on patients' odds of dying at home; 2. to examine the clinical effectiveness of home palliative care services on other outcomes for patients and their caregivers such as symptom control, quality of life, caregiver distress and satisfaction with care; 3. to compare the resource use and costs associated with these services; 4. to critically appraise and summarize the current evidence on cost-effectiveness. METHODS: Search methods: We searched 12 electronic databases up to November 2012. We checked the reference lists of all included studies, 49 relevant systematic reviews, four key textbooks and recent conference abstracts. We contacted 17 experts and researchers for unpublished data. Selection criteria: We included randomised controlled trials (RCTs, controlled clinical trials (CCTs, controlled before and after studies (CBAs and interrupted time series (ITSs evaluating the impact of home palliative care services on outcomes for adults with advanced illness or their family caregivers, or both. Data collection and analysis: One review author assessed the identified titles and abstracts. Two independent reviewers performed assessment of all potentially relevant studies, data extraction and assessment of methodological quality. We carried out meta-analysis where appropriate and calculated numbers needed to treat to benefit (NNTBs for the primary outcome (death at home. MAIN RESULTS: We identified 23 studies (16 RCTs, 6 of high quality, including 37,561 participants and 4042 family caregivers, largely with advanced cancer but also congestive heart failure