Car drivers’ knowledge and preferences regarding additional services at parking facilities

NARCIS (Netherlands)

van der Waerden, P.J.H.J.; de Bruin - Verhoeven, M.; Rodrigues da Silva, A.N.

2017-01-01

The paper presents a study on car drivers’ knowledge and preferences regarding additional services at parking facilities. The following eight services are investigated the presence of public toilets, parking spaces for challenged people, lockers, refreshment machines, elevators, charging points for

Parks and recreation employment status: implications from a civil service perspective

Science.gov (United States)

Joel Frater; Arthur Graham

2002-01-01

Current research on the credentialing process in parks, recreation and leisure services has focused primarily on accreditation and certification and has largely ignored the civil service exam as a credentialing toll or condition of employment in many state and municipal parks and recreation departments.

Assessing the risk of foliar injury from ozone on vegetation in parks in the U.S. National Park Service's Vital Signs Network

International Nuclear Information System (INIS)

Kohut, Robert

2007-01-01

The risk of ozone injury to plants was assessed in support of the National Park Service's Vital Signs Monitoring Network program. The assessment examined bioindicator species, evaluated levels of ozone exposure, and investigated soil moisture conditions during periods of exposure for a 5-year period in each park. The assessment assigned each park a risk rating of high, moderate, or low. For the 244 parks for which assessments were conducted, the risk of foliar injury was high in 65 parks, moderate in 46 parks, and low in 131 parks. Among the well-known parks with a high risk of ozone injury are Gettysburg, Valley Forge, Delaware Water Gap, Cape Cod, Fire Island, Antietam, Harpers Ferry, Manassas, Wolf Trap Farm Park, Mammoth Cave, Shiloh, Sleeping Bear Dunes, Great Smoky Mountains, Joshua Tree, Sequoia and Kings Canyon, and Yosemite. - An assessment of the risk of foliar ozone injury on plants was conducted for 269 parks in support of the U.S. National Park Service's Vital Signs Monitoring Network Program

42 CFR 441.15 - Home health services.

Science.gov (United States)

2010-10-01

... Provisions § 441.15 Home health services. With respect to the services defined in § 440.70 of this subchapter, a State plan must provide that— (a) Home health services include, as a minimum— (1) Nursing services... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 441.15 Section 441.15 Public...

Changes in lion (Panthera leo) home range size in Waza National Park, Cameroon

NARCIS (Netherlands)

Tumenta, P.N.; Van't Zelfde, M.; Croes, B.M.; Buij, R.; Funston, P.J.; Haes, de H.A.U.; longh, De H.H.

2013-01-01

The spatial ecology of Africa lions (Panthera leo) was studied from 2007 to 2009 in Waza National Park, Cameroon, by equipping individual lions with GPS/VHF radio-collars. Mean home range estimates using 100% minimum convex polygons (MCP) and 95% kernel-density estimation (KDE) were respectively

Services for People Innovation Park – Planning Methodologies

OpenAIRE

Maria Angela Campelo de Melo; Lygia Magalhães Magacho

2013-01-01

This article aims to identify appropriate methodologies for the planning of a Services for People Innovation Park-SPIP, designed according to the model proposed by the Ibero-American Network launched by La Salle University of Madrid. Projected to form a network, these parks were conceived to provoke social change in their region, improving quality of life and social welfare, through knowledge, technology and innovation transfer and creation of companies focused on developing product and servi...

Adoption of Lean Thinking and Service Improvement for Care Home Service

OpenAIRE

Chuang-Chun Chiou

2014-01-01

Ageing population is a global trend; therefore the need of care service has been increasing dramatically. There are three basic forms of service delivered to the elderly: institution, community, and home. Particularly, the institutional service can be seen as an extension of medical service. The nursing home or so-called care home which is equipped with professional staff and facilities can provide a variety of service including rehabilitation service, short-term care, and long term care. Sim...

Home Health Care: Services and Cost

Science.gov (United States)

Widmer, Geraldine; And Others

1978-01-01

Findings from a study of home care services in one New York district document the value and relatively modest costs of home health care for the chronically ill and dependent elderly. Professional nurses coordinated the care, but most of the direct services were provided by home health aides and housekeepers. (MF)

42 CFR 440.70 - Home health services.

Science.gov (United States)

2010-10-01

... an acute illness to avoid the recipient's transfer to a nursing facility. (d) “Home health agency... 42 Public Health 4 2010-10-01 2010-10-01 false Home health services. 440.70 Section 440.70 Public...) MEDICAL ASSISTANCE PROGRAMS SERVICES: GENERAL PROVISIONS Definitions § 440.70 Home health services. (a...

Home Care Services: Questions to Ask

Science.gov (United States)

Healthy Lifestyle Healthy aging Home care services range from medical care to help with daily household chores. If ... 12, 2017 Original article: http://www.mayoclinic.org/healthy-lifestyle/healthy-aging/in-depth/home-care-services/art- ...

UNMET NEED IN TURKEY: HOME CARE SERVICE

Directory of Open Access Journals (Sweden)

Nuket SUBASI

2006-02-01

Full Text Available Home care services can be provided as an alternative to institutional care to people, in case of their demand, who need care because of aging and chronic diseases. Structured home care service in health system does not exist in Turkey. Relatives try to provide care at home to those people. In this cross-sectional study, household was selected as a sampling unit, determining prevalence of home care at the households and gathering some information about home care in Cankaya district of Ankara was intended. It was found that in one-month period before this study was carried out, home care services were provided at 8.7% of the households in Cankaya district. 62.5% of people who received home care service were women, 15.3% of them were belonging to 65-74 age group; 31.7% of those were illiterate and 12.5% had no social and health insurance. Among people, 15.4% were receiving home care after surgical operation, 15.4% were receiving care because of stroke and cerebrovascular diseases and 9.6% were cancer patients. 81.7% of adults who were taken care at home were found to be dependent at different levels while performing daily living activities, the most common treatment method was detected as oral medication (81.4%. These people were in need of preventive, curative and rehabilitative and supportive services. A home care service model, which takes into consideration the social characteristics of the country, should be developed at this district where there is a large elderly population. [TAF Prev Med Bull 2006; 5(1.000: 19-31

Assessing the risk of foliar injury from ozone on vegetation in parks in the U.S. National Park Service's Vital Signs Network

Energy Technology Data Exchange (ETDEWEB)

Kohut, Robert [Boyce Thompson Institute for Plant Research, Cornell University, Ithaca, NY 14853 (United States)], E-mail: rjk9@cornell.edu

2007-10-15

The risk of ozone injury to plants was assessed in support of the National Park Service's Vital Signs Monitoring Network program. The assessment examined bioindicator species, evaluated levels of ozone exposure, and investigated soil moisture conditions during periods of exposure for a 5-year period in each park. The assessment assigned each park a risk rating of high, moderate, or low. For the 244 parks for which assessments were conducted, the risk of foliar injury was high in 65 parks, moderate in 46 parks, and low in 131 parks. Among the well-known parks with a high risk of ozone injury are Gettysburg, Valley Forge, Delaware Water Gap, Cape Cod, Fire Island, Antietam, Harpers Ferry, Manassas, Wolf Trap Farm Park, Mammoth Cave, Shiloh, Sleeping Bear Dunes, Great Smoky Mountains, Joshua Tree, Sequoia and Kings Canyon, and Yosemite. - An assessment of the risk of foliar ozone injury on plants was conducted for 269 parks in support of the U.S. National Park Service's Vital Signs Monitoring Network Program.

Social science in the national park service: an evolving mission and program

Science.gov (United States)

Richard H. Briceland

1992-01-01

In 1988 the director of the National Park Service requested that a social science program be established. Since that time a number of new research initiatives have been developed to address this need. This paper describes seven major steps taken thus far to meet social science needs of park superintendents, program managers, and park planners. Specific examples are...

78 FR 72703 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service...

Science.gov (United States)

2013-12-03

... of an inventory of human remains and associated funerary objects under the control of Canyonlands....R50000] Notice of Inventory Completion: U.S. Department of the Interior, National Park Service.... Department of the Interior, National Park Service, Canyonlands National Park, has completed an inventory of...

Home Care Services and the Rural Elderly.

Science.gov (United States)

Hayslip, Bert, Jr.; And Others

1980-01-01

Independent studies examined a needs v an agency perspective on home health care service needs within a rural county. Interviews with 299 elderly, aged 60-93, revealed there were substantial needs for home health care services and the desire for services varied with residence within the county. (Author)

Vocational Home Economics Curriculum Guide for Occupational Home and Institutional Services.

Science.gov (United States)

Dewald, Margaret R.

The training program outlined in this guide focuses upon the development of students for gainful employment through a two-year course of study in home and institutional services. Instructional topics are provided in nine areas: orientation to home and institutional services, cleaning supplies and equipment, cleaning surfaces, cleaning clothes and…

Volume of Home and Community Based Services and...

Data.gov (United States)

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

Prescribing quality for older people in Norwegian nursing homes and home nursing services using multidose dispensed drugs.

Science.gov (United States)

Halvorsen, Kjell H; Granas, Anne Gerd; Engeland, Anders; Ruths, Sabine

2012-09-01

To examine and compare the quality of drug prescribing for older patients in nursing homes and home nursing services. Cross-sectional study comprising 11,254 patients aged ≥ 65 years in nursing homes (n = 2986) and home nursing services (n = 8268). Potentially inappropriate medications were identified by using the Norwegian General Practice criteria and drug-drug interactions through a Norwegian Web-based tool. The impact of care setting on exposure to selected drug groups, potentially inappropriate medications, and drug interactions was calculated, adjusting for patients' age, gender, and number of drugs used. Patients in nursing homes and home nursing services used on average 5.7 (SD = 2.6) multidose dispensed regular drugs. Twenty-six percent used at least one potentially inappropriate medication, 31% in nursing homes and 25% in home nursing services, p nursing homes (18%) and home nursing services (9%), p nursing homes, more patients in home nursing services used cardiovascular drugs and fewer patients used psychotropic drugs. Altogether, 8615 drug-drug interactions were identified in 55% of patients, 48% in nursing homes and 57% in home nursing services, p quality of drug prescribing in nursing homes compared with home nursing services. Explanations as to why these differences exist need to be further explored. Copyright © 2011 John Wiley & Sons, Ltd.

Structural diversity: a multi-dimensional approach to assess recreational services in urban parks.

Science.gov (United States)

Voigt, Annette; Kabisch, Nadja; Wurster, Daniel; Haase, Dagmar; Breuste, Jürgen

2014-05-01

Urban green spaces provide important recreational services for urban residents. In general, when park visitors enjoy "the green," they are in actuality appreciating a mix of biotic, abiotic, and man-made park infrastructure elements and qualities. We argue that these three dimensions of structural diversity have an influence on how people use and value urban parks. We present a straightforward approach for assessing urban parks that combines multi-dimensional landscape mapping and questionnaire surveys. We discuss the method as well the results from its application to differently sized parks in Berlin and Salzburg.

Memory Management of Multimedia Services in Smart Homes

Science.gov (United States)

Kamel, Ibrahim; Muhaureq, Sanaa A.

Nowadays there is a wide spectrum of applications that run in smart home environments. Consequently, home gateway, which is a central component in the smart home, must manage many applications despite limited memory resources. OSGi is a middleware standard for home gateways. OSGi models services as dependent components. Moreover, these applications might differ in their importance. Services collaborate and complement each other to achieve the required results. This paper addresses the following problem: given a home gateway that hosts several applications with different priorities and arbitrary dependencies among them. When the gateway runs out of memory, which application or service will be stopped or kicked out of memory to start a new service. Note that stopping a given service means that all the services that depend on it will be stopped too. Because of the service dependencies, traditional memory management techniques, in the operating system literatures might not be efficient. Our goal is to stop the least important and the least number of services. The paper presents a novel algorithm for home gateway memory management. The proposed algorithm takes into consideration the priority of the application and dependencies between different services, in addition to the amount of memory occupied by each service. We implement the proposed algorithm and performed many experiments to evaluate its performance and execution time. The proposed algorithm is implemented as a part of the OSGi framework (Open Service Gateway initiative). We used best fit and worst fit as yardstick to show the effectiveness of the proposed algorithm.

Elephant (Loxodonta africana home ranges in Sabi Sand Reserve and Kruger National Park: a five-year satellite tracking study.

Directory of Open Access Journals (Sweden)

Bindi Thomas

Full Text Available During a five-year GPS satellite tracking study in Sabi Sand Reserve (SSR and Kruger National Park (KNP we monitored the daily movements of an elephant cow (Loxodonta africana from September 2003 to August 2008. The study animal was confirmed to be part of a group of seven elephants therefore her position is representative of the matriarchal group. We found that the study animal did not use habitat randomly and confirmed strong seasonal fidelity to its summer and winter five-year home ranges. The cow's summer home range was in KNP in an area more than four times that of her SSR winter home range. She exhibited clear park habitation with up to three visits per year travelling via a well-defined northern or southern corridor. There was a positive correlation between the daily distance the elephant walked and minimum daily temperature and the elephant was significantly closer to rivers and artificial waterholes than would be expected if it were moving randomly in KNP and SSR. Transect lines established through the home ranges were surveyed to further understand the fine scale of the landscape and vegetation representative of the home ranges.

Elephant (Loxodonta africana) home ranges in Sabi Sand Reserve and Kruger National Park: a five-year satellite tracking study.

Science.gov (United States)

Thomas, Bindi; Holland, John D; Minot, Edward O

2008-01-01

During a five-year GPS satellite tracking study in Sabi Sand Reserve (SSR) and Kruger National Park (KNP) we monitored the daily movements of an elephant cow (Loxodonta africana) from September 2003 to August 2008. The study animal was confirmed to be part of a group of seven elephants therefore her position is representative of the matriarchal group. We found that the study animal did not use habitat randomly and confirmed strong seasonal fidelity to its summer and winter five-year home ranges. The cow's summer home range was in KNP in an area more than four times that of her SSR winter home range. She exhibited clear park habitation with up to three visits per year travelling via a well-defined northern or southern corridor. There was a positive correlation between the daily distance the elephant walked and minimum daily temperature and the elephant was significantly closer to rivers and artificial waterholes than would be expected if it were moving randomly in KNP and SSR. Transect lines established through the home ranges were surveyed to further understand the fine scale of the landscape and vegetation representative of the home ranges.

Adaptation to Sea Level Rise in Coastal Units of the National Park Service (Invited)

Science.gov (United States)

Beavers, R. L.

2010-12-01

83 National Park Service (NPS) units contain nearly 12,000 miles of coastal, estuarine and Great Lakes shoreline and their associated resources. Iconic natural features exist along active shorelines in NPS units, including, e.g., Cape Cod, Padre Island, Hawaii Volcanoes, and the Everglades. Iconic cultural resources managed by NPS include the Cape Hatteras Lighthouse, Fort Sumter, the Golden Gate, and heiaus and fish traps along the coast of Hawaii. Impacts anticipated from sea level rise include inundation and flooding of beaches and low lying marshes, shoreline erosion of coastal areas, and saltwater intrusion into the water table. These impacts and other coastal hazards will threaten park beaches, marshes, and other resources and values; alter the viability of coastal roads; and require the NPS to re-evaluate the financial, safety, and environmental implications of maintaining current projects and implementing future projects in ocean and coastal parks in the context of sea level rise. Coastal erosion will increase as sea levels rise. Barrier islands along the coast of Louisiana and North Carolina may have already passed the threshold for maintaining island integrity in any scenario of sea level rise (U.S. Climate Change Science Program Synthesis and Assessment Program Report 4.1). Consequently, sea level rise is expected to hasten the disappearance of historic coastal villages, coastal wetlands, forests, and beaches, and threaten coastal roads, homes, and businesses. While sea level is rising in most coastal parks, some parks are experiencing lower water levels due to isostatic rebound and lower lake levels. NPS funded a Coastal Vulnerability Project to evaluate the physical and geologic factors affecting 25 coastal parks. The USGS Open File Reports for each park are available at http://woodshole.er.usgs.gov/project-pages/. These reports were designed to inform park planning efforts. NPS conducted a Storm Vulnerability Project to provide ocean and coastal

Paramedic-Initiated Home Care Referrals and Use of Home Care and Emergency Medical Services.

Science.gov (United States)

Verma, Amol A; Klich, John; Thurston, Adam; Scantlebury, Jordan; Kiss, Alex; Seddon, Gayle; Sinha, Samir K

2018-01-01

We examined the association between paramedic-initiated home care referrals and utilization of home care, 9-1-1, and Emergency Department (ED) services. This was a retrospective cohort study of individuals who received a paramedic-initiated home care referral after a 9-1-1 call between January 1, 2011 and December 31, 2012 in Toronto, Ontario, Canada. Home care, 9-1-1, and ED utilization were compared in the 6 months before and after home care referral. Nonparametric longitudinal regression was performed to assess changes in hours of home care service use and zero-inflated Poisson regression was performed to assess changes in the number of 9-1-1 calls and ambulance transports to ED. During the 24-month study period, 2,382 individuals received a paramedic-initiated home care referral. After excluding individuals who died, were hospitalized, or were admitted to a nursing home, the final study cohort was 1,851. The proportion of the study population receiving home care services increased from 18.2% to 42.5% after referral, representing 450 additional people receiving services. In longitudinal regression analysis, there was an increase of 17.4 hours in total services per person in the six months after referral (95% CI: 1.7-33.1, p = 0.03). The mean number of 9-1-1 calls per person was 1.44 (SD 9.58) before home care referral and 1.20 (SD 7.04) after home care referral in the overall study cohort. This represented a 10% reduction in 9-1-1 calls (95% CI: 7-13%, p home care referral and 0.79 (SD 6.27) after home care referral, representing a 7% reduction (95% CI: 3-11%, p home care records were included in the analysis, the reductions in 9-1-1 calls and ambulance transports to ED were attenuated but remained statistically significant. Paramedic-initiated home care referrals in Toronto were associated with improved access to and use of home care services and may have been associated with reduced 9-1-1 calls and ambulance transports to ED.

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

Science.gov (United States)

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

2015-10-01

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

Research and implementation of geographic information service mode in digital home

Science.gov (United States)

Lei, B.; Liu, K.; Gan, Y.; Zhong, M.

2014-04-01

Accompanying infrastructure improvements and networking technology innovation, the development of digital home service industry has gotten more and more attention. However, the digital home service levels have not sufficiently met rising demand from users. Therefore, it is urgent to propose and develop new service modes for the digital home. Geographic information services can provide various spatial information services such as map search, spatial information query. It has become an inevitable trend to implement geographic information services in the digital home. This paper proposes three new geographic information services modes for the digital home after sufficient requirement analysis: pushed information service mode, interactive information service mode, personalized information service mode. The key technologies to implement geographic information services on digital televisions are studied, involving digital television middleware technology, network transmission technology and visualization technology. According to the service modes' characteristics mentioned above, a service system in the digital home is established to implement geographic information services on the basis of digital television. The implementation of geographic information services in the digital home not only enriches the digital home services content, but also promotes geographic information from specialization to public popularity.

Development of Fuzzy Logic Forecast Models for Location-Based Parking Finding Services

Directory of Open Access Journals (Sweden)

Zhirong Chen

2013-01-01

Full Text Available Park-and-ride (PnR facilities provided by Australian transport authorities have been an effective way to encourage car drivers to use public transport such as trains and buses. However, as populations grow and vehicle running costs increase, the demand for more parking spaces has escalated. Often, PnR facilities are filled to capacity by early morning and commuters resort to parking illegally in streets surrounding stations. This paper reports on the development of a location-based parking finding service for PnR users. Based on their current location, the system can inform users which is the best station to park their cars during peak period. Two criteria—parking availability and the shortest travel time—were used to evaluate the best station. Fuzzy logic forecast models were used to estimate the uncertainty of parking availability during the peak parking demand period. A prototype using these methods has been developed based on a case study of the Oats Street and Carlisle PnR facilities in Perth, Western Australia. The system has proved to be efficacious and has the potential to be applied to other parking systems.

A Novel Web Service Based Home Energy Management System

DEFF Research Database (Denmark)

Rossello Busquet, Ana; Soler, José

2011-01-01

and optimize the energy consumption in home environments. The main element of HEMS is the home gateway. In this paper, a home gateway suitable for HEMS is presented. The home gateway proposed uses rules to implement the home energy management system. The rules can be downloaded though web services from a rule...... server. Furthermore, web services are used to provide modularity to the home gateway by enabling the deployment of the different logical components into different devices, if necessary....

Keeping it wild in the National Park Service: A user guide to integrating wilderness character into park planning, management, and monitoring

Science.gov (United States)

Peter Landres; Suzy Stutzman; Wade Vagias; Carol Cook; Christina Mills; Tim Devine; Sandee Dingman; Adrienne Lindholm; Miki Stuebe; Melissa Memory; Ruth Scott; Michael Bilecki; Ray O' Neil; Chris Holbeck; Frank Turina; Michael Haynie; Sarah Craighead; Chip Jenkins; Jeremy Curtis; Karen Trevino

2014-01-01

This User Guide was developed to help National Park Service (NPS) staff effectively and efficiently fulfill the mandate from the 1964 Wilderness Act and NPS policy to "preserve wilderness character" now and into the future. This mandate applies to all congressionally designated wilderness and other park lands that are, by policy, managed as wilderness,...

National Parks

Data.gov (United States)

Department of Transportation — National Park Service unit boundaries (NTAD). These park boundaries signify legislative boundary definitions and local park names have been consolidated according to...

Secure Service Discovery in Home Networks

NARCIS (Netherlands)

Scholten, Johan; van Dijk, H.W.; De Cock, Danny; Preneel, Bart; Kung, Antonio; d'Hooge, Michel

2006-01-01

This paper presents an architecture for secure service discovery for use in home networks. We give an overview and rationale of a cluster-based home network architecture that bridges different, often vendor specific, network technologies. We show how it integrates security, communication, and

Descriptive study of services offered to users of parks bio healthy of Galicia

Directory of Open Access Journals (Sweden)

Víctor Arufe Giráldez

2013-07-01

Full Text Available The worry of the citizens for the health grows year after year, up to the point that numerous town halls have invested an important budget item in the creation of parks of physical activity for major, parks bio healthy or geriatric parks since some authors name. These parks can be defined as green spaces that numerous equipments integrates for the development of the physical condition inside an urban area or extraurban. His design is focused towards the offer of sports practice for adult population. Across this work one tries to analyze of descriptive form some of the services with those who count these parks. The sample was formed by 30 parks bio healthy of Galicia, constructed between the year 2010 and 2012. The withdrawal of information was realized across a created ad hoc questionnaire. The variables that surrendered to study for this work are the availability of a source with drinkable water, availability of a public bathroom, presence of a professional of the sport, been of the machines and information for the user on the use of the machines. The results state that many of the town halls promoters of parks bio healthy do not bear in mind the presentation of a few minimal services that are necessary for the practice of the physical exercise (fiscal year in major persons, in order to guarantee an ideal care of his health.

Home Environment Service Knowledge Management System

DEFF Research Database (Denmark)

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

2011-01-01

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

[eLearning service for home palliative care].

Science.gov (United States)

Sakuyama, Toshikazu; Komatsu, Kazuhiro; Inoue, Daisuke; Fukushima, Osamu

2008-12-01

In order to support the home palliative care learning, we made the eLearning service for home palliative care (beta version) and tried to teach the palliative care to the medical staffs in the community. The various learners (such as nurses, pharmacists and the like) accessed to the online learning and used this eLearning service. After the learners finished eLearning for home palliative care, some questionnaires were distributed to the learners and analyzed by us. The analysis of questionnaires revealed that almost all were satisfied with our eLearning services. Especially the learners were not only interested in using the skills of opioids and the management of pain control, but they had a good cognition for the usage of opioids.

Interoperation, Composition and Simulation of Services at Home

NARCIS (Netherlands)

Kaldeli, Eirini; Warriach, Ehsan Ullah; Bresser, Jaap; Lazovik, Alexander; Aiello, Marco; Maglio, PP; Weske, M; Yang, J; Fantinato, M

2010-01-01

Pervasive computing environments such as our future homes are the prototypical example of a dynamic, complex system where Service-Oriented Computing techniques will play an important role. A home equipped with heterogeneous devices, whose services and location constantly change, needs to behave as a

Engaging and Empowering the National Park Service to apply Earth Observations to Management Decisions

Science.gov (United States)

Clayton, A.; Ross, K. W.; Crepps, G.; Childs-Gleason, L. M.; Ruiz, M. L.; Rogers, L.; Allsbrook, K. N.

2017-12-01

Since 2015, the NASA DEVELOP National Program has partnered with the National Park Service (NPS) engaging more than 120 program participants, working on over 22 projects across approximately 27 unique park units. These projects examined a variety of cultural and environmental concerns facing the NPS including landscape disturbance, invasive species mapping, archaeological site preservation, and water resources monitoring. DEVELOP, part of NASA's Applied Sciences' Capacity Building program, conducts 10-week feasibility projects which demonstrate the utility of NASA's Earth observations as an additional tool for decision-making processes. This presentation will highlight several of these projects and discuss the progress of capacity building working with individual, regional, and institutional elements within the National Park Service.

Home health services in primary care: What can we do?

Directory of Open Access Journals (Sweden)

Yasemin Çayır

2013-01-01

Full Text Available Home health services is to give examination, diagnosis,treatment, and rehabilitation services to the patients whobedridden, have difficulties to access health facility due toa variety of chronic or malignant disease by professionalhealth care team. Family physicians that providing healthcare in primary care is responsible for to determine whowill need home health care services, and to make homevisit on a regular basis among registered patients in theirpopulations. It is seems that the biggest shortcoming thecontent and scope of this service is not yet a standard. Inthis article, how home health services should be given willbe discussed.Key words: Primary health care, home health care, bedriddenpatient

Influence of home care services on caregivers' burden and satisfaction.

Science.gov (United States)

Kim, Eun-Young; Yeom, Hyun-E

2016-06-01

To examine the factors affecting the burden and satisfaction of family caregivers, focusing on the beneficial impacts of home care service use. Long-term care for older patients is a multifaceted process that brings both burden and satisfaction to family caregivers. It is expected that home care services offered by the Korean long-term care insurance may contribute to decreasing the burden of family caregivers and enhancing their satisfaction by assisting with practical caregiving tasks. A cross-sectional study. A convenience sample of 157 family caregivers was recruited from five home care service agencies in South Korea. Information about the caregivers, caregiving history, older care recipients and use of home care services was assessed. The effects of home care service use on caregiving burden and satisfaction were tested using hierarchical multiple regression analyses after adjusting for the characteristics of the caregivers, caregiving history and older care recipients. There was no significant influence of home care service use on reducing caregiving burden or on increasing caregivers' satisfaction. Although several factors were associated with caregiving burden and satisfaction, family functioning was the most unique factor to significantly affect both caregiving burden and satisfaction. Home care services might not automatically have a positive impact on caregivers' burden and satisfaction, but maintaining healthy family functioning is an important issue for family caregivers. The findings highlight the important need to reconsider ways to provide home care services and to develop nursing interventions to reinforce supportive family functioning. Practical strategies for providing home care services should be developed through a concrete assessment of the family dynamics and the needs of family caregivers. Health professionals should play a pivotal role in performing the assessment and in developing interventions to strengthen supportive family functioning

Allocation of home care services by municipalities in Norway: a document analysis.

Science.gov (United States)

Holm, Solrun G; Mathisen, Terje A; Sæterstrand, Torill M; Brinchmann, Berit S

2017-09-22

In Norway, elder care is primarily a municipal responsibility. Municipal health services strive to offer the 'lowest level of effective care,' and home healthcare services are defined as the lowest level of care in Norway. Municipalities determine the type(s) of service and the amount of care applicants require. The services granted are outlined in an individual decision letter, which serves as a contract between the municipality and the home healthcare recipient. The purpose of this study was to gain insight into the scope and duration of home healthcare services allocated by municipalities and to determine where home care recipients live in relation to home healthcare service offices. A document analysis was performed on data derived from 833 letters to individuals allocated home care services in two municipalities in Northern Norway (Municipality A = 500 recipients, Municipality B = 333 recipients). In Municipality A, 74% of service hours were allotted to home health nursing, 12% to practical assistance, and 14% to support contact; in Municipality B, the distribution was 73%, 19%, and 8%, respectively. Both municipalities allocated home health services with no service end date (41% and 85% of the total services, respectively). Among recipients of "expired" services, 25% in Municipality A and 7% in Municipality B continued to receive assistance. Our findings reveal that the municipalities adhered to the goal for home care recipients to remain at home as long as possible before moving into a nursing home. The findings also indicate that the system for allocating home healthcare services may not be fair, as the municipalities lacked procedures for revising individual decisions. Our findings indicate that local authorities should closely examine how they design individual decisions and increase their awareness of how long a service should be provided.

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

Energy Technology Data Exchange (ETDEWEB)

none,

2014-09-01

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

The influence of a mental health home visit service partnership intervention on the caregivers' home visit service satisfaction and care burden.

Science.gov (United States)

Cheng, Jui-Fen; Huang, Xuan-Yi; Lin, Mei-Jue; Wang, Ya-Hui; Yeh, Tzu-Pei

2018-02-01

To investigate a community-based and hospital-based home visit partnership intervention in improving caregivers' satisfaction with home service and reducing caregiver burden. The community-oriented mental healthcare model prevails internationally. After patients return to the community, family caregivers are the patients' main support system and they also take the most of the burden of caring for patients. It is important to assist these caregivers by building good community healthcare models. A longitudinal quasi-experimental quantitative design. The experimental group (n = 109) involved "partnership" intervention, and the control group (n = 101) maintained routine home visits. The results were measured before the intervention, 6 and 12 months after the partnership intervention. Six months after the partnership intervention, the satisfaction of the experimental group was higher than the control group for several aspects of care. Although the care burden was reduced in the experimental group, there was no significant difference between the two groups. This study confirms that the partnership intervention can significantly improve caregiver satisfaction with home services, without reducing the care burden. The community-based and hospital-based mental health home visit service partnership programme could improve the main caregiver's satisfaction with the mental health home visit services, while the reduction in care burden may need government policies for the provision of more individual and comprehensive assistance. © 2017 John Wiley & Sons Ltd.

Home healthcare services in Taiwan: a nationwide study among the older population

Directory of Open Access Journals (Sweden)

Lai Hsiu-Yun

2010-09-01

Full Text Available Abstract Background Home healthcare services are important in aging societies worldwide. The present nationwide study of health insurance data examined the utilization and delivery patterns, including diagnostic indications, for home healthcare services used by seniors in Taiwan. Methods Patients ≥65 years of age who received home healthcare services during 2004 under the Taiwanese National Health Insurance Program were identified and reimbursement claims were analyzed. Age, gender, disease diagnoses, distribution of facilities providing home healthcare services, and patterns of professional visits, including physician and skilled nursing visits, were also explored. Results Among 2,104,978 beneficiaries ≥65 years of age, 19,483 (0.9% patients received 127,753 home healthcare visits during 2004 with a mean number of 6.0 ± 4.8 visits per person. The highest prevalence of home healthcare services was in the 75-84 year age group in both sexes. Females received more home healthcare services than males in all age groups. Cerebrovascular disease was the most frequent diagnosis in these patients (50.7%. More than half of home healthcare visits and around half of the professional home visits were provided by community home nursing care institutions. The majority of the home skilled nursing services were tube replacements, including nasogastric tubes, Foley catheter, tracheostomy, nephrostomy or cystostomy tubes (95%. Conclusions Nine out of 1,000 older patients in Taiwan received home healthcare services during 2004, which was much lower than the rate of disabled older people in Taiwan. Females used home healthcare services more frequently than males and the majority of skilled nursing services were tube replacements. The rate of tube replacement of home healthcare patients in Taiwan deserves to be paid more attention.

A multidimensional approach to case mix for home health services

Science.gov (United States)

Manton, Kenneth G.; Hausner, Tony

1987-01-01

Developing a case-mix methodology for home health services is more difficult than developing one for hospitalization and acute health services, because the determinants of need for home health care are more complex and because of the difficulty in defining episodes of care. To evaluate home health service case mix, a multivariate grouping methodology was applied to records from the 1982 National Long-Term Care Survey linked to Medicare records on home health reimbursements. Using this method, six distinct health and functional status dimensions were identified. These dimensions, combined with factors describing informal care resources and local market conditions, were used to explain significant proportions of the variance (r2 = .45) of individual differences in Medicare home health reimbursements and numbers of visits. Though the data were not collected for that purpose, the high level of prediction strongly suggests the feasibility of developing case-mix strategies for home health services. PMID:10312187

A comparison of the home-care and healthcare service use and costs of older Australians randomised to receive a restorative or a conventional home-care service.

Science.gov (United States)

Lewin, Gill; Allan, Janine; Patterson, Candice; Knuiman, Matthew; Boldy, Duncan; Hendrie, Delia

2014-05-01

Restorative home-care services, or re-ablement home-care services as they are now known in the UK, aim to assist older individuals who are experiencing difficulties in everyday living to optimise their functioning and reduce their need for ongoing home care. Until recently, the effectiveness of restorative home-care services had only been investigated in terms of singular outcomes such as length of home-care episode, admission to hospital and quality of life. This paper reports on a more complex and perhaps more significant measure--the use and cost of the home-care and healthcare services received over the 2-year period following service commencement. Seven hundred and fifty older individuals referred for government-funded home care were randomly assigned to a restorative or standard service between June 2005 and August 2007. Health and aged care service data were sourced and linked via the Western Australian Data Linkage System. Restorative clients used fewer home-care hours (mean [SD], 117.3 [129.4] vs. 191.2 [230.4]), had lower total home-care costs (AU$5570 vs. AU$8541) and were less likely to be approved for a higher level of aged care (N [%], 171 [55.2] vs. 249 [63.0]) during follow-up. They were also less likely to have presented at an emergency department (OR = 0.69, 95% CI = 0.50-0.94) or have had an unplanned hospital admission [OR (95% CI), 0.69 (0.50-0.95)]. Additionally, the aggregated health and home-care costs of the restorative clients were lower by a factor of 0.83 (95% CI 0.72-0.96) over the 2-year follow-up (AU$19,090 vs. AU$23,428). These results indicate that at a time when Australia is facing the challenges of population ageing and an expected increase in demand for health and aged care services, the provision of a restorative service when an older person is referred for home care is potentially a more cost-effective option than providing conventional home care. © 2014 The Authors. Health and Social Care in the Community published by John

Optical broadband in-home networks for converged service delivery

NARCIS (Netherlands)

Shi, Y.

2013-01-01

Broadband access networks, and in particular fibre-to-the-home (FTTH) networks, are offering abundantly available bandwidth in the local loop with high quality of services. Under such broadband connectivity conditions, in-home networks should not represent the bottleneck for high capacity service

Decision Makers' Allocation of Home-Care Therapy Services: A Process Map

Science.gov (United States)

Poss, Jeff; Egan, Mary; Rappolt, Susan; Berg, Katherine

2013-01-01

ABSTRACT Purpose: To explore decision-making processes currently used in allocating occupational and physical therapy services in home care for complex long-stay clients in Ontario. Method: An exploratory study using key-informant interviews and client vignettes was conducted with home-care decision makers (case managers and directors) from four home-care regions in Ontario. The interview data were analyzed using the framework analysis method. Results: The decision-making process for allocating therapy services has four stages: intake, assessment, referral to service provider, and reassessment. There are variations in the management processes deployed at each stage. The major variation is in the process of determining the volume of therapy services across home-care regions, primarily as a result of financial constraints affecting the home-care programme. Government funding methods and methods of information sharing also significantly affect home-care therapy allocation. Conclusion: Financial constraints in home care are the primary contextual factor affecting allocation of therapy services across home-care regions. Given the inflation of health care costs, new models of funding and service delivery need to be developed to ensure that the right person receives the right care before deteriorating and requiring more costly long-term care. PMID:24403672

75 FR 57978 - Notice of Intent; Request for Comments on Adoption of the National Park Service's Wetland and...

Science.gov (United States)

2010-09-23

... Code: 7B] Notice of Intent; Request for Comments on Adoption of the National Park Service's Wetland and... adopt the National Park Service's (NPS) existing final environmental impact statement/environmental... (CSCC) to assist with implementing restoration activities that have been identified and reviewed under...

Data reliability in home healthcare services

NARCIS (Netherlands)

Vavilis, S.; Zannone, N.; Petkovic, M.

2013-01-01

Home healthcare services are emerging as a new frontier in healthcare practices. Data reliability, however, is crucial for the acceptance of these new services. This work presents a semi-automated system to evaluate the quality of medical measurements taken by patients. The system relies on data

Mobile home automation-merging mobile value added services and home automation technologies

OpenAIRE

Rosendahl, Andreas; Hampe, Felix J.; Botterweck, Goetz

2007-01-01

non-peer-reviewed In this paper we study mobile home automation, a field that emerges from an integration of mobile application platforms and home automation technologies. In a conceptual introduction we first illustrate the need for such applications by introducing a two-dimensional conceptual model of mobility. Subsequently we suggest an architecture and discuss different options of how a user might access a mobile home automation service and the controlled devices. As another contrib...

Description of the Implementation of Home Care Servicer at RS Murni Teguh, Medan

OpenAIRE

Manalu, Ayu P Sary

2014-01-01

Home care service constitutes providing service and nurses’ equipment for patients and their families at home in order to keep their health, education, prevention from diseases, palliative therapy, and rehabilitation. Home care service at RS Murni Teguh, Medan, has its specification in management, compared with home care service in other places. The objective of the research was to find out the description of the implementation of home care service at RS Murni Teguh, Medan. The research used ...

Prescribing quality for older people in Norwegian nursing homes and home nursing services using multidose dispensed drugs

OpenAIRE

Halvorsen, Kjell H.; Granås, Anne Gerd; Engeland, Anders; Ruths, Sabine

2012-01-01

Tverrsnittstudie, undersøker og sammenligner forskrivningskvaliteten hos eldre som bor i sykehjem og hjemme. Purpose: to examine and compare the quality of drug prescribing for older patients in nursing homes and home nursing services. Methods: Cross-sectional study comprising 11 254 patients aged ≥65 years in nursing homes (n = 2986) and home nursing services (n = 8268). Potentially inappropriate medications were identified by using the Norwegian General Practice criteria and drug–drug in...

75 FR 13808 - Missouri & Valley Park Railroad Corporation-Discontinuance of Service Exemption-in St Louis...

Science.gov (United States)

2010-03-23

... DEPARTMENT OF TRANSPORTATION Surface Transportation Board [STB Docket No. AB-1057X] Missouri & Valley Park Railroad Corporation--Discontinuance of Service Exemption--in St Louis County, MO On March 3... Subdivision between milepost 18.36 and milepost 20.50, near West Valley Park, St. Louis County, MO.\\2\\ The...

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.

Webcasting in home and hospice care services: virtual communication in home care.

Science.gov (United States)

Smith-Stoner, Marilyn

2011-06-01

The access to free live webcasting over home computers was much more available in 2007, when three military leaders from West Point, with the purpose of helping military personnel stay connected with their families when deployed, developed Ustream.tv. There are many types of Web-based video streaming applications. This article describes Ustream, a free and effective communication tool to virtually connect staff. There are many features in Ustream, but the most useful for home care and hospice service providers is its ability to broadcast sound and video to anyone with a broadband Internet connection, a chat room for users to interact during a presentation, and the ability to have a "co-host" or second person also broadcast simultaneously. Agencies that provide community-based services in the home will benefit from integration of Web-based video streaming into their communication strategy.

Location, Location, Location: Characteristics and Services of Long-Stay Home Care Recipients in Retirement Homes Compared to Others in Private Homes and Long-Term Care Homes.

Science.gov (United States)

Poss, Jeffrey W; Sinn, Chi-Ling Joanna; Grinchenko, Galina; Blums, Jane; Peirce, Tom; Hirdes, John

2017-02-01

We examine recipients of publicly funded ongoing care in a single Ontario jurisdiction who reside in three different settings: long-stay home care patients in private homes and apartments, other patients in retirement homes and residents of long-term care homes, using interRAI assessment instruments. Among home care patients, those in retirement homes have higher proportions of dementia and moderate cognitive impairment, less supportive informal care systems as well as more personal care and nursing services above those provided by the public home care system, more frequent but shorter home support visits and lower than expected public home care expenditures. These lower expenditures may be because of efficiency of care delivery or by retirement homes providing some services otherwise provided by the public home care system. Although persons in each setting are mostly older adults with high degrees of frailty and medical complexity, long-term care home residents show distinctly higher needs. We estimate that 40% of retirement home residents are long-stay home care patients, and they comprise about one in six of this Community Care Access Centre's long-stay patients. Copyright © 2017 Longwoods Publishing.

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.

Home health nursing care services in Greece during an economic crisis.

Science.gov (United States)

Adamakidou, T; Kalokerinou-Anagnostopoulou, A

2017-03-01

The purpose of this review was to describe public home healthcare nursing services in Greece. The effectiveness and the efficiency of home healthcare nursing are well documented in the international literature. In Greece, during the current financial crisis, the development of home healthcare nursing services is the focus and interest of policymakers and academics because of its contribution to the viability of the healthcare system. A review was conducted of the existing legislation, the printed and electronic bibliography related to the legal framework, the structures that provide home health care, the funding of the services, the human resources and the services provided. The review of the literature revealed the strengths and weaknesses of the existing system of home health care and its opportunities and threats, which are summarized in a SWOT analysis. There is no Greek nursing literature on this topic. The development of home health nursing care requires multidimensional concurrent and combined changes and adjustments that would support and strengthen healthcare professionals in their practices. Academic and nursing professionals should provide guidelines and regulations and develop special competencies for the best nursing practice in home health care. At present, in Greece, which is in an economic crisis and undergoing reforms in public administration, there is an undeniable effort being made to give primary health care the position it deserves within the health system. There is an urgent need at central and academic levels to develop home healthcare services to improve the quality and efficiency of the services provided. © 2016 International Council of Nurses.

Coordinating the Web of Services for a Smart Home

NARCIS (Netherlands)

Kaldeli, Eirini; Warriach, Ehsan Ullah; Lazovik, Alexander; Aiello, Marco

Domotics, concerned with the realization of intelligent home environments, is a novel field which can highly benefit from solutions inspired by service-oriented principles to enhance the convenience and security of modern home residents. In this work, we present an architecture for a smart home,

Energy Consumption Information Services for Smart Home Inhabitants

Science.gov (United States)

Schwanzer, Michael; Fensel, Anna

We investigate services giving users an adequate insight on his or her energy consumption habits in order to optimize it in the long run. The explored energy awareness services are addressed to inhabitants of smart homes, equipped with smart meters, advanced communication facilities, sensors and actuators. To analyze the potential of such services, a game at a social network Facebook has been designed and implemented, and the information about players' responses and interactions within the game environment has been collected and analyzed. The players have had their virtual home energy usage visualized in different ways, and had to optimize the energy consumption basing on their own perceptions of the consumption information. Evaluations reveal, in particular, that users are specifically responsive to information shown as a real-time graph and as costs in Euro, and are able to produce and share with each other policies for managing their smart home environments.

Accuracy of Caregiver Proxy Reports of Home Care Service Use.

Science.gov (United States)

Chappell, Neena L; Kadlec, Helena

2016-12-01

Although much of the research on service use by older adults with dementia relies on proxy reports by informal caregivers, little research assesses the accuracy of these reports, and that which does exist, does not focus on home care services. This brief report compares proxy reports by family caregivers to those with dementia with provincial Ministry of Health records collected for payment and monitoring. The four home care services examined include home nursing care, adult day care, home support, and respite care. Data come from a province-wide study of caregivers in British Columbia, Canada. Caregiver reports are largely consistent with Ministry records, ranging from 81.0% agreement for home support to 96.6% for respite care. Spouses living with the care recipient (the vast majority of the sample) are the most accurate. Others, whether living with the care recipient or not, have only a 50-50 chance of being correct.

The homes of tomorrow: service composition and advanced user interfaces

Directory of Open Access Journals (Sweden)

Claudio Di Ciccio

2011-12-01

Full Text Available Home automation represents a growing market in the industrialized world. Today’s systems are mainly based on ad hoc and proprietary solutions, with little to no interoperability and smart integration. However, in a not so distant future, our homes will be equipped with many sensors, actuators and devices, which will collectively expose services, able to smartly interact and integrate, in order to offer complex services providing even richer functionalities. In this paper we present the approach and results of SM4ALL- Smart hoMes for All, a project investigating automatic service composition and advanced user interfaces applied to domotics.

Network and Service Monitoring in Heterogeneous Home Networks

NARCIS (Netherlands)

Delphinanto, A.

2012-01-01

Home networks are becoming dynamic and technologically heterogeneous. They consist of an increasing number of devices which offer several functionalities and can be used for many different services. In the home, these devices are interconnected using a mixture of networking technologies (for

Needs of home care services for the bedridden patient’s problems living in their home

Directory of Open Access Journals (Sweden)

Nuran Akdemir

2011-03-01

Full Text Available The study was carry out as an semi-experimental study to identify the difficulties confronted by bedridden patients with stroke to give them necessary counseling services and to improve models of home care service.Method: The research sample is composed of 38 patients discarged from Hacettepe University İbni Sina Hospital and Health Ministry Ankara Numune Hospital Neurology services following cerebro-vascular accident. The data derived from the research is evaluated through percentage usage. Patients included in the study were visited average 5 times during the research.Result: During the home visiting, it is found out that most of the patients were in need of information concerning insufficient hygienic care, other illnesses, use of medication, discharge system problems like constipation and diarhea and dietary/nutritional; it is also observed that they are experiencing psycho-social diffuculties. The study results put forward suggestions in realizing progression and to form model of systematic home care services.

Human-assisted sound event recognition for home service robots.

Science.gov (United States)

Do, Ha Manh; Sheng, Weihua; Liu, Meiqin

This paper proposes and implements an open framework of active auditory learning for a home service robot to serve the elderly living alone at home. The framework was developed to realize the various auditory perception capabilities while enabling a remote human operator to involve in the sound event recognition process for elderly care. The home service robot is able to estimate the sound source position and collaborate with the human operator in sound event recognition while protecting the privacy of the elderly. Our experimental results validated the proposed framework and evaluated auditory perception capabilities and human-robot collaboration in sound event recognition.

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

Science.gov (United States)

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

2010-01-01

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

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

Science.gov (United States)

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

2018-06-18

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

Supporting home care for the dying: an evaluation of healthcare professionals' perspectives of an individually tailored hospice at home service.

Science.gov (United States)

Jack, Barbara A; Baldry, Catherine R; Groves, Karen E; Whelan, Alison; Sephton, Janice; Gaunt, Kathryn

2013-10-01

To explore health care professionals' perspective of hospice at home service that has different components, individually tailored to meet the needs of patients. Over 50% of adults diagnosed with a terminal illness and the majority of people who have cancer, prefer to be cared for and to die in their own home. Despite this, most deaths occur in hospital. Increasing the options available for patients, including their place of care and death is central to current UK policy initiatives. Hospice at home services aim to support patients to remain at home, yet there are wide variations in the design of services and delivery. A hospice at home service was developed to provide various components (accompanied transfer home, crisis intervention and hospice aides) that could be tailored to meet the individual needs of patients. An evaluation study. Data were collected from 75 health care professionals. District nurses participated in one focus group (13) and 31 completed an electronic survey. Palliative care specialist nurses participated in a focus group (9). One hospital discharge co-ordinator and two general practitioners participated in semi-structured interviews and a further 19 general practitioners completed the electronic survey. Health care professionals reported the impact and value of each of the components of the service, as helping to support patients to remain at home, by individually tailoring care. They also positively reported that support for family carers appeared to enable them to continue coping, rapid access to the service was suggested to contribute to faster hospital discharges and the crisis intervention service was identified as helping patients remain in their own home, where they wanted to be. Health care professionals perceived that the additional individualised support provided by this service contributed to enabling patients to continue be cared for and to die at home in their place of choice. This service offers various components of a hospice

A Home-Based Palliative Care Consult Service for Veterans.

Science.gov (United States)

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

2016-11-01

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

75 FR 17763 - National Park Service Benefits-Sharing Final Environmental Impact Statement Record of Decision

Science.gov (United States)

2010-04-07

... management in connection with the allocation of benefits from valuable discoveries, inventions, and other... share the benefits with the National Park Service. Another alternative prohibits scientific research... Service and researchers who study material associated with a Scientific Research and Collecting Permit to...

Parking regulations on the CERN sites

CERN Multimedia

General Infrastructure Services Department

2010-01-01

The site surveillance service is also responsible for supervising compliance with the parking regulations on the CERN site. In that context, it ensures that the following rules are complied with on the CERN car park: Vehicles may not be left on a CERN car park for longer than 5 consecutive working days. However, CERN users are entitled to leave their vehicles parked at CERN for a longer period in the car park near Building 588 , subject to completing the application form "Demande d'autorisation pour un stationnement de longue durée" (application for a long-term parking permit) and sending it to the Reception and Access Control Service (access.surveillance@cern.ch) prior to departure.   Parking spaces, which are in short supply in many crowded areas of the CERN site, must not be occupied by abandoned vehicles/wrecks. The service organizes the disposal of such vehicles. Any CERN users wishing to get rid of a private vehicle parked on one of the CERN car pa...

Socioeconomic disparities in home health care service access and utilization: a scoping review.

Science.gov (United States)

Goodridge, Donna; Hawranik, Pamela; Duncan, Vicky; Turner, Hollie

2012-10-01

Home health care services are expanding at a rapid pace in order to meet the needs of the growing population of older adults and those with chronic illnesses. Because of current restrictions on home health care as an insured service in some countries, individuals may be required to pay for some or all of their home care services out of pocket. These payments may potentially limit access to needed home care services for persons in the lowest socioeconomic strata. Previous research demonstrates a clear socioeconomic gradient in access to acute and primary care services, where those most in need of services are the most disadvantaged and under-serviced. There has been little attention paid thus far, however, to the way in which socioeconomic status may affect the receipt of home health care services. To determine what is known from existing literature about socioeconomic disparities in home health care access and utilization. A scoping review was used to map the extent and nature of the literature in this area. A search of the databases CINAHL, Medline, SocIndex and Sociological Abstracts as well as Dissertations International. A total of 206 potentially relevant articles were published between 2000 and April 2011. Two reviewers independently reviewed the articles, leaving 15 research articles to be included in the scoping review. The majority of articles reported secondary analyses of administrative datasets related to utilization of home health care. Several studies examined access and utilization using qualitative approaches. The distinction between professional and supportive home care services was not always clear in the articles. Individual and composite measures of socioeconomic status were reported, with the most frequently used indicator being income. Several studies used more complex composite ecological indicators of socieconomic status. There was general agreement that utilization of home health services favored persons with greater economic disadvantage

The Association between Freedom of Choice and Effectiveness of Home Care Services.

Science.gov (United States)

Steffansson, Marina; Pulliainen, Marjo; Kettunen, Aija; Linnosmaa, Ismo; Halonen, Miikka

2016-03-31

The aim of this paper is to study home care clients' freedom to choose their services, as well the association between the effectiveness of home care services and freedom of choice, among other factors. A structured postal survey was conducted among regular home care clients (n = 2096) aged 65 or older in three towns in Finland. Freedom of choice was studied based on clients' subjective experiences. The effectiveness of the services was evaluated by means of changes in the social-care-related quality of life. Regression analyses were used to test associations. As much as 62% of home care recipients reported having some choice regarding their services. Choosing meals and visiting times for the care worker were associated with better effectiveness. The basic model, which included needs and other factors expected to have an impact on quality of life, explained 15.4% of the changes in quality of life, while the extended model, which included the freedom-of-choice variables, explained 17.4%. The inclusion of freedom-of-choice variables increased the adjusted coefficient of determination by 2%. There was a significant positive association between freedom of choice and the effectiveness of public home care services. Freedom of choice does not exist for all clients of home care who desire it. By changing social welfare activities and structures, it is possible to show respect for clients' opinions and to thereby improve the effectiveness of home care services.

Research on the cultivation path of smart home-based care service mode in Internet+ vision

Directory of Open Access Journals (Sweden)

Peng Qingchao

2016-01-01

Full Text Available Home-based care for the aged is an effective method to solve the problem of caring the aged in China. This thesis analyzes some problems existing in the development of current home-based care service for the aged in our country and the positive effects brought by Internet+ in home-based care service. It proposes a new service mode of care for the aged--Internet+ home-based care service, and explains the establishment of this system and the responsibilities of the participants. Also, it explores the path to realize the establishment of Internet+ home-based care service mode so as to promote the healthy development of home-based care service in China.

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

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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.

Variation in Hospice Services by Location of Care: Nursing Home Versus Assisted Living Facility Versus Home.

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Unroe, Kathleen T; Bernard, Brittany; Stump, Timothy E; Tu, Wanzhu; Callahan, Christopher M

2017-07-01

To describe differences in hospice services for patients living at home, in nursing homes or in assisted living facilities, including the overall number and duration of visits by different hospice care providers across varying lengths of stay. Retrospective cohort study using hospice patient electronic medical record data. Large, national hospice provider. Data from 32,605 hospice patients who received routine hospice care from 2009 to 2014 were analyzed. Descriptive statistics were calculated for utilization measures for each type of provider and by location of care. Frequency and duration of service contacts were standardized to a 1 week period and pairwise comparisons were used to detect differences in care provided between the three settings. Minimal differences were found in overall intensity of service contacts across settings, however, the mix of services were different for patients living at home versus nursing home versus assisted living facility. Overall, more nurse care was provided at the beginning and end of the hospice episode; intensity of aide care services was higher in the middle portion of the hospice episode. Nearly 43% of the sample had hospice stays less than 2 weeks and up to 20% had stays greater than 6 months. There are significant differences between characteristics of hospice patients in different settings, as well as the mix of services they receive. Medicare hospice payment methodology was revised starting in 2016. While the new payment structure is in greater alignment with the U shape distribution of services, it will be important to evaluate the impact of the new payment methodology on length of stay and mix of services by different providers across settings of care. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

Experiences of the home-dwelling elderly in the use of telecare in home care services: a qualitative systematic review protocol.

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Karlsen, Cecilie; Ludvigsen, Mette S; Moe, Carl E; Haraldstad, Kristin; Thygesen, Elin

2017-05-01

The objective of this systematic review is to identify and synthesize the best evidence on the home-dwelling elderly's experiences with the use of telecare in home care services. Furthermore, the study will identify experiences with telecare devices and examine what beliefs the home-dwelling elderly hold regarding the impact of telecare on the ability to age in place.Review question 1: How do the home-dwelling elderly experience the use of telecare in the context of home care services?Review question 2: How do the home-dwelling elderly experience telecare devices?Review question 3: What beliefs do the home-dwelling elderly hold regarding the impact of telecare on the ability to age in place?

[The admission to Nursing Homes and Home care services of elderly patients: analysis of the trend from 2008 to 2011 in a North Italian district].

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Caporale, Loretta; Czaplejewicz, Monika; Odasmini, Bruna

2014-01-01

The effects of the economic crisis impact on several aspects, included the use of health and social services. To analyze the effects of the economic recession on the request of in-home and long run social-health services. Retrospective research. The databases of a In-home Nursing Service, the Social Services and the Welfare area of a Social-Health Local Service in North of Italy have been consulted, with reference to the period between 31st December 2008 to 31st December 2011. From 2008 to 2011 the users supported by the In-Home Nursing Service increased by 30.3% while a decrease in the waiting lists for public and private nursing homes was observed. The users of In-Home Assistance Service decreased by 11%, as well as recipients of In-Home Meal Service (33%). Since 2008, the number of regional economic allowance beneficiaries dramatically increased; these allowances are dispensed as a support to In-Home Nursing Service and to social frailty. Profound changes of the offer and use of long term care services is evident. The endurance of this trend could impair the In-Home Nursing Services ability to answer to health needs of citizens. Health care professionals should strengthen the educational interventions to improve the level of patients'self care.

Supporting family carers providing end-of-life home care: a qualitative study on the impact of a hospice at home service.

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Jack, Barbara A; O'Brien, Mary R; Scrutton, Joyce; Baldry, Catherine R; Groves, Karen E

2015-01-01

To explore bereaved family carers' perceptions and experiences of a hospice at home service. The increasing demand for the development of home-based end-of-life services is not confined to the western world; such services are also emerging in resource-poor countries where palliative care services are developing with limited inpatient facilities. Despite this growing trend, studies show a variety of interrelated factors, with an emphasis on the availability of informal carers and their ability to cope, which can influence whether terminally ill patients actually remain at home. A hospice at home service was developed to meet patients' and families' needs by providing individually tailored resources. A qualitative study. Data were collected by semi-structured, digitally recorded interviews from 20 family carers who had experienced the service. Interviews were transcribed verbatim and a thematic approach adopted for analysis. All participants reported a personal positive impact of the service. Family carers commented the service provided a valued presence, they felt in good hands and importantly it helped in supporting normal life. The impact of an individualised, targeted, hospice at home service using dedicated, palliative care trained, staff, is perceived positively by family carers and importantly, supportive of those with additional caring or employment commitments. The emergence of hospice at home services has resulted in more options for patients and their families, when the increased amount of care a family member has to provide in these circumstances needs to be adequately supported, with the provision of a flexible service tailored to individual needs and delivered by appropriately trained staff. © 2014 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

Primary Caregivers Satisfaction and its Related Factors in Home Health Care Services

Directory of Open Access Journals (Sweden)

Shu-Ping Wei

2011-06-01

Conclusion: This study showed that the overall perceived performance is higher than expectation for home health care service provided. The primary caregiver who was older than 30 years, who had lower education level, and other than siblings showed higher satisfaction. The four items that need improving included “home health care nurses will provide detailed description of services,” “home health care nurses will provide knowledge of illness,” “home health care nurses can complete the promised tasks,” and “home health care nurses will actively inquire patient’s conditions and needs.”

[Development of an evaluation instrument for service quality in nursing homes].

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Lee, Jia; Ji, Eun Sun

2011-08-01

The purposes of this study were to identify the factors influencing service quality in nursing homes, and to develop an evaluation instrument for service quality. A three-phase process was employed for the study. 1) The important factors to evaluate the service quality in nursing homes were identified through a literature review, panel discussion and focus group interview, 2) the evaluation instrument was developed, and 3) validity and reliability of the study instrument were tested by factor analysis, Pearson correlation coefficient, Cronbach's α and Cohen's Kappa. Factor analysis showed that the factors influencing service quality in nursing homes were healthcare, diet/assistance, therapy, environment and staff. To improve objectivity of the instrument, quantitative as well as qualitative evaluation approaches were adopted. The study instrument was developed with 30 items and showed acceptable construct validity. The criterion-related validity was a Pearson correlation coefficient of .85 in 151 care facilities. The internal consistency was Cronbach's α=.95. The instrument has acceptable validity and a high degree of reliability. Staff in nursing homes can continuously improve and manage their services using the results of the evaluation instrument.

Home care services for sick children: Healthcare professionals' conceptions of challenges and facilitators.

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Castor, Charlotte; Hallström, Inger; Hansson, Helena; Landgren, Kajsa

2017-09-01

To explore healthcare professionals' conceptions of caring for sick children in home care services. Families often prefer home care to hospital care, and the number of home care services for children is increasing. Caring for children at home has been recognised as challenging for healthcare professionals in home care services used to providing care predominately for adults. An inductive qualitative design. Seven focus group interviews were performed with 36 healthcare professionals from multidisciplinary home care services. Data were analysed stepwise using a phenomenographic analysis. Three description categories emerged: "A challenging opportunity", "A child perspective", and "Re-organise in accordance with new prerequisites." Providing home care services for children was conceived to evoke both professional and personal challenges such as feelings of inadequacy and fear and professional growth such as increased competence and satisfaction. Conceptions of whether the home or the hospital was the best place for care differed. Adapting to the child's care was conceived as important. Cooperation with paediatric departments and a well-functioning team work were important organisational aspects. Providing home care for children was a challenging but rewarding task for healthcare professionals used to care for adults. To provide care with a child perspective was experienced as important even though there were conflicting conceptions of how this should be done. Close cooperation with paediatric departments and teamwork were prerequisites that make up for the low number of paediatric patients and facilitate confidence and competence. A sufficient number of referred children and enabling healthcare professionals to be part of the re-organising and implementation processes might facilitate the home care services for sick children. Enough time and good teamwork must be emphasised. Early referrals, continuous cooperation with paediatric clinics complemented with

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

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Walus, Ashley N; Woloschuk, Donna M M

2017-01-01

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

Park availability and physical activity, TV time, and overweight and obesity among women: Findings from Australia and the United States.

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Veitch, Jenny; Abbott, Gavin; Kaczynski, Andrew T; Wilhelm Stanis, Sonja A; Besenyi, Gina M; Lamb, Karen E

2016-03-01

This study examined relationships between three measures of park availability and self-reported physical activity (PA), television viewing (TV) time, and overweight/obesity among women from Australia and the United States. Having more parks near home was the only measure of park availability associated with an outcome. Australian women (n=1848) with more parks near home had higher odds of meeting PA recommendations and lower odds of being overweight/obese. In the US sample (n=489), women with more parks near home had lower odds of watching >4h TV per day. A greater number of parks near home was associated with lower BMI among both Australian and US women. Evidence across diverse contexts provides support to improve park availability to promote PA and other health behaviors. Copyright © 2016 Elsevier Ltd. All rights reserved.

Agency ownership, patient payment source, and length of service in home care, 1992 2000.

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Han, Beth; McAuley, William J; Remsburg, Robin E

2007-08-01

Little is known about whether an association exists between agency ownership and length of service among home care patients with different payment sources. This study investigated how for-profit and not-for-profit agencies responded to policy changes in the 1990s with respect to length of service. We examined length of service among 37,364 home care patients using the 1992, 1994, 1996, 1998, and 2000 National Home and Hospice Care Surveys. We used Kaplan-Meier methods and Cox regression models. After we adjusted for patient and agency characteristics, our results revealed that agency ownership was not associated with length of service for patients with private insurance, Medicare, Medicaid, Medicare plus Medicaid, or Medicare plus private insurance. This finding was consistent from 1992 through 2000. Length of service among patients with Medicare decreased significantly from 1998 through 2000, but length of service among patients with Medicaid did not change significantly from 1992 through 2000. Agency ownership is not associated with patient length of service in home care. Regardless of the policy changes in the home care arena in the 1990s, for-profit and not-for-profit home health agencies behaved similarly with regard to length of service among patients within differently structured payment systems.

Relationship between home care service use and changes in the care needs level of Japanese elderly.

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Kato, Gohei; Tamiya, Nanako; Kashiwagi, Masayo; Sato, Mikiya; Takahashi, Hideto

2009-12-21

With the introduction of long-term care insurance (LTCI) in Japan, more home care services are available for the community-dwelling elderly. To deliver effective home care services, it is important to know the effects of service use. In this study, as the first step to determine this, we sought to describe different home service use in the sustained/improved group and deteriorated group in their care needs levels, and to report the relationship between the use of home care services and changes in care needs levels. The participants included 624 of a total of 1,474 users of LTCI services in one city in Japan. Home care service users were stratified into a 'lower care needs level subgroup' and a 'higher care needs level subgroup' based on the baseline care needs level. Simple statistical comparison and multiple logistic regression analyses in which the change in care needs level was set as a dependent variable were performed. Gender, age, and baseline care needs level were designated as control variables. Home based services were treated as independent variables. In this study, home care services consisted of home help, home bathing services, a visiting nurse, home rehabilitation, nursing home daycare, health daycare, loan of medical devices, respite stay in a nursing home, respite stay in a health care facility, respite stay in a sanatorium-type medical care facility, and medical management by a physician. In the lower care needs level subgroup, age (OR = 1.04, CI, 1.01-1.08), use of respite stay in a nursing home (OR = 2.55; CI, 1.43-4.56), and the number of types of long-term care services (OR = 1.33; CI, 1.02-1.74) used during an 11 month period were significantly related to a deterioration of the user's care needs level. In the higher care needs level subgroup, use of medical management by a physician (OR = 6.99; CI, 1.42-41.25) was significantly related to a deterioration of the user's care needs level. There were no home based services significantly related to

Provision of NHS generalist and specialist services to care homes in England: review of surveys.

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Iliffe, Steve; Davies, Susan L; Gordon, Adam L; Schneider, Justine; Dening, Tom; Bowman, Clive; Gage, Heather; Martin, Finbarr C; Gladman, John R F; Victor, Christina; Meyer, Julienne; Goodman, Claire

2016-03-01

The number of beds in care homes (with and without nurses) in the United Kingdom is three times greater than the number of beds in National Health Service (NHS) hospitals. Care homes are predominantly owned by a range of commercial, not-for-profit or charitable providers and their residents have high levels of disability, frailty and co-morbidity. NHS support for care home residents is very variable, and it is unclear what models of clinical support work and are cost-effective. To critically evaluate how the NHS works with care homes. A review of surveys of NHS services provided to care homes that had been completed since 2008. It included published national surveys, local surveys commissioned by Primary Care organisations, studies from charities and academic centres, grey literature identified across the nine government regions, and information from care home, primary care and other research networks. Data extraction captured forms of NHS service provision for care homes in England in terms of frequency, location, focus and purpose. Five surveys focused primarily on general practitioner services, and 10 on specialist services to care home. Working relationships between the NHS and care homes lack structure and purpose and have generally evolved locally. There are wide variations in provision of both generalist and specialist healthcare services to care homes. Larger care home chains may take a systematic approach to both organising access to NHS generalist and specialist services, and to supplementing gaps with in-house provision. Access to dental care for care home residents appears to be particularly deficient. Historical differences in innovation and provision of NHS services, the complexities of collaborating across different sectors (private and public, health and social care, general and mental health), and variable levels of organisation of care homes, all lead to persistent and embedded inequity in the distribution of NHS resources to this population

Transformation by stealth: the retargeting of home care services in Finland.

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Kröger, Teppo; Leinonen, Anu

2012-05-01

This paper analyses the trends and changes that home care services for older people have undergone during the last two decades in Finland. The data used come from national social care statistics, covering the time period from 1990-2010. The results show that, in contrast to many other European nations that have expanded their home care provisions, the coverage levels in Finland have dropped dramatically during this period. Those with the highest needs do receive increased amounts of support, but others have become excluded from publicly funded home care provisions and often need to rely on family members. In most localities, public service provision is focused on personal care, and no longer covers household tasks. This major change of the character of the service is connected to three other recent trends that structure current provisions: the amalgamation of home-based social and healthcare services, the marketisation and emerging privatisation of care and the integration of informal family care into the formal care system. Overall, the changes represent weakening defamilisation, that is, decreasing public responsibility for the needs of many older people and, correspondingly, an increasing reliance on family carers. This full-scale transformation of home care has taken place without any real policy debate or major modification of legislation. No actual decision was ever made to thoroughly alter the character of home care in Finland: the transformation happened by stealth. © 2011 Blackwell Publishing Ltd.

A model for ageing-home-care service process improvement

OpenAIRE

Yu, Shu-Yan; Shie, An-Jin

2017-01-01

The purpose of this study was to develop an integrated model to improve service processes in ageing-home-care. According to the literature, existing service processes have potential service failures that affect service quality and efficacy. However, most previous studies have only focused on conceptual model development using New Service Development (NSD) and fail to provide a systematic model to analyse potential service failures and facilitate managers developing solutions to improve the se...

Can home care services achieve cost savings in long-term care for older people?

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Greene, V L; Ondrich, J; Laditka, S

1998-07-01

To determine whether efficient allocation of home care services can produce net long-term care cost savings. Hazard function analysis and nonlinear mathematical programming. Optimal allocation of home care services resulted in a 10% net reduction in overall long-term care costs for the frail older population served by the National Long-Term Care (Channeling) Demonstration, in contrast to the 12% net cost increase produced by the demonstration intervention itself. Our findings suggest that the long-sought goal of overall cost-neutrality or even cost-savings through reducing nursing home use sufficiently to more than offset home care costs is technically feasible, but requires tighter targeting of services and a more medically oriented service mix than major home care demonstrations have implemented to date.

Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy.

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Chen, Chia-Ching; Yamada, Tetsuji; Nakashima, Taeko; Chiu, I-Ming

2017-01-01

The purposes of this study are: (1) to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC) service use; (2) to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3) to investigate health outcome disparity based on substitutability. The methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR), which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly. There exists a complement relationship between the informal home care (IHC) and community-based FHC services, and the elasticity's ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH) services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services. Policy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

Substitution of Formal and Informal Home Care Service Use and Nursing Home Service Use: Health Outcomes, Decision-Making Preferences, and Implications for a Public Health Policy

Directory of Open Access Journals (Sweden)

Chia-Ching Chen

2017-11-01

Full Text Available ObjectivesThe purposes of this study are: (1 to empirically identify decision-making preferences of long-term health-care use, especially informal and formal home care (FHC service use; (2 to evaluate outcomes vs. costs based on substitutability of informal and FHC service use; and (3 to investigate health outcome disparity based on substitutability.Methodology and dataThe methods of ordinary least squares, a logit model, and a bivariate probit model are used by controlling for socioeconomic, demographic, and physical/mental health factors to investigate outcomes and costs based substitutability of informal and formal health-care use. The data come from the 2013 Japanese Study of Aging and Retirement (JSTAR, which is designed by Keizai-Sangyo Kenkyu-jo, Hitotsubashi University, and the University of Tokyo. The JSTAR is a globally comparable data survey of the elderly.ResultsThere exists a complement relationship between the informal home care (IHC and community-based FHC services, and the elasticity’s ranges from 0.18 to 0.22. These are reasonable results, which show that unobservable factors are positively related to IHC and community-based FHC, but negatively related to nursing home (NH services based on our bivariate probit model. Regarding health-care outcome efficiency issue, the IHC is the best one among three types of elderly care: IHC, community-based FHC, and NH services. Health improvement/outcome of elderly with the IHC is heavier concentrated on IHC services than the elderly care services by community-based FHC and NH care services.ConclusionPolicy makers need to address a diversity of health outcomes and efficiency of services based on providing services to elderly through resource allocation to the different types of long-term care. A provision of partial or full compensation for elderly care at home is recommendable and a viable option to improve their quality of lives.

Rehabilitation services after the implementation of the nursing home prospective payment system: differences related to patient and nursing home characteristics.

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Murray, Patrick K; Love, Thomas E; Dawson, Neal V; Thomas, Charles L; Cebul, Randall D

2005-11-01

The prospective payment system (PPS) for nursing homes was designed to curtail the rapid expansion of Medicare costs for skilled nursing care. This study examines the changes that occurred in nursing home patients and rehabilitation services following the PPS. Free-standing Medicare and/or Medicaid certified nursing homes in Ohio. The percent of new admissions receiving therapy and the amount of rehabilitation therapy provided. A total of 7006 first admissions in 1994-6 (pre-PPS) and 61,569 first admissions in 2000-1 (post-PPS). A logistic model predicting likelihood of rehabilitation was developed and validated in pre-PPS admissions and applied to the post-PPS patients. Rehabilitation services were compared in the pre-PPS and post-PPS cohorts overall, stratified by quintile of predicted score, diagnosis group, and by nursing home profit status. Post-PPS patients had less cognitive impairment, more depression, and more family support. The amount of rehabilitation services declined the most in the higher quintiles of predicted likelihood of rehabilitation and among patients with stroke. The percent of patients receiving rehabilitation services increased the most in the lowest quintile and among patients with medical conditions. These changes were greater in for-profit nursing homes. The implementation of the PPS in nursing homes has been associated with a decrease in the amount of rehabilitation services, targeted at those predicted to receive higher amounts and an increased frequency of providing services targeted at those predicted to be less likely to receive them. The outcomes of the changes deserve further study.

Prevalence of Different Combinations of Antiepileptic Drugs and CNS Drugs in Elderly Home Care Service and Nursing Home Patients in Norway.

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Halvorsen, Kjell H; Johannessen Landmark, Cecilie; Granas, Anne Gerd

2016-01-01

Introduction. Antiepileptic drugs (AEDs) are used to treat different conditions in elderly patients and are among the drug classes most susceptible to be involved in drug-drug interactions (DDI). The aim of the study was to describe and compare use of AEDs between home care service and nursing home patients, as these patients are not included in nationwide databases of drug utilization. In the combined population, we investigate DDI of AEDs with other central nervous system- (CNS-) active drugs and DDIs involving AEDs in general. Materials and Methods. Point-prevalence study of Norwegian patients in home care services and nursing homes in 2009. At the patient level, we screened for different DDIs involving AEDs. Results. In total, 882 patients (7.8%) of 11,254 patients used AEDs and number of users did not differ between home care services and nursing homes (8.2% versus 7.7%). In the combined population, we identified 436 potential DDIs in 45% of the patients. Conclusions. In a large population of elderly, home care service and nursing home patients do not differ with respect to exposure of AEDs but use more AEDs as compared to the general population of similar age. The risk of DDIs with AEDs and other CNS-active drugs should be taken into consideration and individual clinical evaluations are assessed in this population.

76 FR 71920 - Payment for Home Health Services and Hospice Care by Non-VA Providers

Science.gov (United States)

2011-11-21

... concerning the billing methodology for non-VA providers of home health services and hospice care. The proposed rulemaking would include home health services and hospice care under the VA regulation governing... to ``RIN 2900-AN98--Payment for home health and services and hospice care by non-VA providers...

Research on the cultivation path of smart home-based care service mode in Internet+ vision

OpenAIRE

Peng Qingchao

2016-01-01

Home-based care for the aged is an effective method to solve the problem of caring the aged in China. This thesis analyzes some problems existing in the development of current home-based care service for the aged in our country and the positive effects brought by Internet+ in home-based care service. It proposes a new service mode of care for the aged--Internet+ home-based care service, and explains the establishment of this system and the responsibilities of the participants. Also, it explor...

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

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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.

76 FR 7232 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Dinosaur...

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2011-02-09

.... Department of the Interior, National Park Service, Dinosaur National Monument, Dinosaur, CO AGENCY: National... Service, Dinosaur National Monument, Dinosaur, CO, has completed an inventory of human remains and... Indian tribe that believes itself to be culturally affiliated with the human remains may contact Dinosaur...

The relationship between older Americans act in-home services and low-care residents in nursing homes.

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Thomas, Kali S

2014-03-01

The aim of the study was to investigate the relationship between supportive services provided under Title III-B of the Older Americans Act (OAA) and the prevalence of low-care residents in nursing homes (NHs). State Program Reports (state-level expenditure and utilization data for each OAA service) and NH facility-level data were analyzed using a two-way fixed effects model. Results suggest that every additional 1% of the population age 65+ that receives personal care services is associated with a 0.8% decrease in the proportion of low-care residents in NHs. Despite efforts to rebalance long-term care, there are still many NH residents who have the functional capacity to live in a less restrictive environment. This is among the first studies to suggest that states that have invested in their in-home supportive services, particularly personal care services provided through the OAA, have proportionally fewer of these people.

Literature Review of the Evidence Base for a Hospice at Home Service

OpenAIRE

Stosz, Laura

2008-01-01

This literature review aimed to identify the evidence base for a hospice at home service at the end of life for facilitating death at home to narrow the gap between preference and reality. This study defines ‘hospice at home’ as hospice style care provided in the home environment; this means specialist palliative care, equipment and medication is available 24/7. However, services operating under this term are not uniform across the literature. Terms encountered in the literature that are used...

Physical activity levels of older adults receiving a home care service.

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Burton, Elissa; Lewin, Gill; Boldy, Duncan

2013-04-01

The 3 study objectives were to compare the activity levels of older people who had received a restorative home care service with those of people who had received "usual" home care, explore the predictors of physical activity in these 2 groups, and determine whether either group met the minimum recommended activity levels for their age group. A questionnaire was posted to 1,490 clients who had been referred for a home care service between 2006 and 2009. Older people who had received a restorative care service were more active than those who had received usual care (p = .049), but service group did not predict activity levels when other variables were adjusted for in a multiple regression. Younger individuals who were in better physical condition, with good mobility and no diagnosis of depression, were more likely to be active. Investigation of alternatives to the current exercise component of the restorative program is needed.

The Water-Quality Partnership for National Parks—U.S. Geological Survey and National Park Service, 1998–2016

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Nilles, Mark A.; Penoyer, Pete E; Ludtke, Amy S.; Ellsworth, Alan C.

2016-07-13

The U.S. Geological Survey (USGS) and the National Park Service (NPS) work together through the USGS–NPS Water-Quality Partnership to support a broad range of policy and management needs related to high-priority water-quality issues in national parks. The program was initiated in 1998 as part of the Clean Water Action Plan, a Presidential initiative to commemorate the 25th anniversary of the Clean Water Act. Partnership projects are developed jointly by the USGS and the NPS. Studies are conducted by the USGS and findings are used by the NPS to guide policy and management actions aimed at protecting and improving water quality.The National Park Service manages many of our Nation’s most highly valued aquatic systems across the country, including portions of the Great Lakes, ocean and coastal zones, historic canals, reservoirs, large rivers, high-elevation lakes and streams, geysers, springs, and wetlands. So far, the Water-Quality Partnership has undertaken 217 projects in 119 national parks. In each project, USGS studies and assessments (http://water.usgs.gov/nps_partnership/pubs.php) have supported science-based management by the NPS to protect and improve water quality in parks. Some of the current projects are highlighted in the NPS Call to Action Centennial initiative, Crystal Clear, which celebrates national park water-resource efforts to ensure clean water for the next century of park management (http://www.nature.nps.gov/water/crystalclear/).New projects are proposed each year by USGS scientists working in collaboration with NPS staff in specific parks. Project selection is highly competitive, with an average of only eight new projects funded each year out of approximately 75 proposals that are submitted. Since the beginning of the Partnership in 1998, 189 publications detailing project findings have been completed. The 217 studies have been conducted in 119 NPS-administered lands, extending from Denali National Park and Preserve in Alaska to Everglades

42 CFR 440.180 - Home or community-based services.

Science.gov (United States)

2010-10-01

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

Home care clients in the last year of life: is material deprivation associated with service characteristics?

Science.gov (United States)

Goodridge, Donna; Buckley, Alan; Marko, Josh; Steeves, Megan; Turner, Hollie; Whitehead, Steve

2011-09-01

To compare demographic, social, medical, and health care characteristics of home care clients in the last year of life by quintile of deprivation and examine associations between material deprivation and service characteristics. This retrospective study used administrative data for 700 clients who died while receiving home care services. Outcome measures were the receipt of supportive or palliative home care. Associations were assessed using multiple logistic regression. Material deprivation was not associated with either the hours of home care received or the receipt of supportive home care services. Clients with dementia or stroke, those were older than 80 years and those who were single were less likely to receive palliative care services than other groups. Inequalities in allocation of home care services based on age, diagnosis, and marital status, but not material deprivation, suggest the need to carefully match service with need at the end of life.

Enhancing Visitor Experiences Using Thematic Interpretation in Park Guiding Service in Sarawak National Parks

Directory of Open Access Journals (Sweden)

Amin Victor Luna

2014-01-01

Full Text Available Enhancing visitor experiences is arguably the primary and most important goal for interpretation by many protected area managers and tourism business. However, little research has been conducted in Sarawak, Malaysia to directly quantify the effects of thematic interpretation has on tourist experiences. Drawing on the TORE-model of interpretation and through the inception of Park Guiding Training and Licensing System in Sarawak since 2007, this quantitative study examines the effectiveness of thematic interpretive guided tours delivered by park guides at Bako National Park, Sarawak, with the assumption that it will further enhance visitor experiences. A descriptive analysis and Pearson's product-moment correlation analysis of sub-indicators of the global evaluation of interpretation of site, and sub-indicators of elaboration surveyed from visitors of purposively sampled park guides revealed a strong measurement and correlation coefficients of visitors’ overall quality of thematic intepretive guided tours effecting visitor satisfaction and experiences. These findings provide empirical evidence that good thematic interpretive guided tour makes a positive impacts on visitor experiences, thus making training of tourism businesses' employees as park guides as a good investment. The suggestions for further research in influencing visitor attitude and shaping visitor behaviour are offered.

Service First: Embracing the Scholarship on Teaching and Learning through Active Engagement in Parks, Recreation, and Tourism Education

Science.gov (United States)

Schwab, Keri; Greenwood, Brian; Dustin, Daniel

2014-01-01

In this article, we turn the tripartite responsibility of teaching, scholarship, and service inside out. Rather than considering service to be a poor stepchild to scholarship and teaching, we reason that service as engaged scholarship should be the centerpiece of academic life, especially in an applied discipline like parks, recreation, and…

Evaluating sociodemographic and medical conditions of patients under home care service

Directory of Open Access Journals (Sweden)

Tolga Önder

2015-09-01

Full Text Available Objective: In our study, we aimed to reveal medical conditions and the sociodemographic conditions of patients under home care service. Methods: Our study is planned on 52 patients who are under home care service at Sarıkamış State Hospital between June 2013 and May 2014. Patients' sex, education, social security status, comorbid diseases and general health status were recorded. Results: Fifty-two patients enrolled. 21 of them (40.4% were men, 31 of them (59.6 % were women. It is revealed that In 36 patients (69.2% did not receive formal education throughout their lives, while16 (30.8% of them had only primary education. All female patients were housewives. The most frequent diseases in home care patients were cerebrovascular disease in 18 (34.6% subjects, Alzheimer's disease in 9 (17.3%, and chronic obstructive pulmonary disease in 4 (7.7% d. 38 patients (73.1% needed routine follow-up. Most of the patients (61.5% had green card health insurance. Only 6 patients (11.5% were in need of narcotic analgesics. Thirteen patients had pressure ulcers due to immobilization. Evaluating the exercise capacity of the patients; 43 (82.7% could not dressed themselves, 38 (73.1% could not use phone. Thirty-two patients had urinary incontinence and 31 had fecal incontinence. Conclusion: Today, population of patients who need home care service is increasing due to ease access to home care service and increase in survival. For a better care of patients, home care providers should be well educated and differences on features of patients and medical conditions it should be taken into consideration.

Social Support and the Receipt of Home Care Services.

Science.gov (United States)

Chappell, Neena L.

1985-01-01

Compares differences between elderly who use formal home care services and those who do not. Data revealed users as less healthy and less active and as receiving more assistance from both formal and informal sources. Suggests that formal and informal services complement rather than substitute for one another. (NRB)

Arsenic Removal from Drinking Water by Adsorptive Media - U.S. EPA Demonstration Project at Hot Springs Mobile Home Park in Willard, Utah - Final Performance Evaluation Report

Science.gov (United States)

This report documents activities performed for and results obtained from the arsenic removal treatment technology demonstration project at the Hot Springs Mobile Home Park (HSMHP) in Willard, UT. The objectives of the project were to evaluate the effectiveness of Adsorbsia™ GTO™...

A systematic review of integrated working between care homes and health care services

Science.gov (United States)

2011-01-01

Background In the UK there are almost three times as many beds in care homes as in National Health Service (NHS) hospitals. Care homes rely on primary health care for access to medical care and specialist services. Repeated policy documents and government reviews register concern about how health care works with independent providers, and the need to increase the equity, continuity and quality of medical care for care homes. Despite multiple initiatives, it is not known if some approaches to service delivery are more effective in promoting integrated working between the NHS and care homes. This study aims to evaluate the different integrated approaches to health care services supporting older people in care homes, and identify barriers and facilitators to integrated working. Methods A systematic review was conducted using Medline (PubMed), CINAHL, BNI, EMBASE, PsycInfo, DH Data, Kings Fund, Web of Science (WoS incl. SCI, SSCI, HCI) and the Cochrane Library incl. DARE. Studies were included if they evaluated the effectiveness of integrated working between primary health care professionals and care homes, or identified barriers and facilitators to integrated working. Studies were quality assessed; data was extracted on health, service use, cost and process related outcomes. A modified narrative synthesis approach was used to compare and contrast integration using the principles of framework analysis. Results Seventeen studies were included; 10 quantitative studies, two process evaluations, one mixed methods study and four qualitative. The majority were carried out in nursing homes. They were characterised by heterogeneity of topic, interventions, methodology and outcomes. Most quantitative studies reported limited effects of the intervention; there was insufficient information to evaluate cost. Facilitators to integrated working included care home managers' support and protected time for staff training. Studies with the potential for integrated working were longer in

42 CFR 403.764 - Basis and purpose of religious nonmedical health care institutions providing home service.

Science.gov (United States)

2010-10-01

... care institutions providing home service. 403.764 Section 403.764 Public Health CENTERS FOR MEDICARE... Basis and purpose of religious nonmedical health care institutions providing home service. (a) Basis... and 1878 of the Act regarding Medicare payment for items and services provided in the home setting...

Why Hospitals and Payers are Recommending Home Care Upon Discharge Instead of SNF or Traditional Home Health Services--Alternative Payment Model Hospital Incentives Aligning with Patient Choice.

Science.gov (United States)

Luke, Josh

2016-01-01

Seniors and other hospital patients in the United States have traditionally had the option of being discharged to a skilled nursing facility (convalescent home) for post-acute services, or home with nursing and therapy services provided in the home setting. Traditionally, these home based services have been referred to as "home health." As more Americans have retired, home health services have expanded and are readily accessible. This growth put tremendous stress on the Medicare fund which pays for senior care services. However, "Home Care," which traditionally has been viewed as non-medical home based services, has also become a booming industry for the cost conscious in recent years as more Americans reach retirement age. With the passing of the Affordable Care Act in 2010, providers and payers are now finding themselves responsible for post-acute care and continuous patient health, so cost efficient solutions for post-acute care are thriving. For the first time in history, American hospitals and Insurers are recognizing Home Care as an effective model that achieves the Triple Aim of Health Care reform. Home Care, which is no longer completely non-medical services, has proven to be an integral part of the care continuum for seniors in recent years and is now becoming a viable solution for keeping patients well, while still honoring their desire to age and heal at home. This paper analyzes the benefits and risks of home care and provides a clear understanding as to why American hospitals are emphasizing SNF Avoidance and skipping home health, opting instead to refer patients directly to home care as the preferred discharge solution in a value based model.

Developing and utilising a new funding model for home-care services in New Zealand.

Science.gov (United States)

Parsons, Matthew; Rouse, Paul; Sajtos, Laszlo; Harrison, Julie; Parsons, John; Gestro, Lisa

2018-05-01

Worldwide increases in the numbers of older people alongside an accompanying international policy incentive to support ageing-in-place have focussed the importance of home-care services as an alternative to institutionalisation. Despite this, funding models that facilitate a responsive, flexible approach are lacking. Casemix provides one solution, but the transition from the well-established hospital system to community has been problematic. This research seeks to develop a Casemix funding solution for home-care services through meaningful client profile groups and supporting pathways. Unique assessments from 3,135 older people were collected from two health board regions in 2012. Of these, 1,009 arose from older people with non-complex needs using the interRAI-Contact Assessment (CA) and 2,126 from the interRAI-Home-Care (HC) from older people with complex needs. Home-care service hours were collected for 3 months following each assessment and the mean weekly hours were calculated. Data were analysed using a decision tree analysis, whereby mean hours of weekly home-care was the dependent variable with responses from the assessment tools, the independent variables. A total of three main groups were developed from the interRAI-CA, each one further classified into "stable" or "flexible." The classification explained 16% of formal home-care service hour variability. Analysis of the interRAI-HC generated 33 clusters, organised through eight disability "sub" groups and five "lead" groups. The groupings explained 24% of formal home-care services hour variance. Adopting a Casemix system within home-care services can facilitate a more appropriate response to the changing needs of older people. © 2017 John Wiley & Sons Ltd.

Technology support to a telehealth in the home service: Qualitative observations.

Science.gov (United States)

Taylor, Alan; Wade, Victoria; Morris, Greg; Pech, Joanne; Rechter, Stuart; Kidd, Michael; Carati, Colin

2016-07-01

The Flinders University Telehealth in the Home (FTH) trial was an action research initiative that introduced and evaluated the impact of telehealth services on palliative care patients living in the community, home-based rehabilitation services for the elderly, and services to the elderly in residential aged care. The aim of this study was to understand the issues encountered during the provision of technology services that supported this trial. A mixed methods approach was undertaken to analyse the roles of information and communication technology (ICT) and clinical staff in design, technology management and training. The data sources were staff observations and documents including job logs, meetings, emails and technology descriptions. Use of consumer technology for telehealth required customisation of applications and services. Clinicians played a key role in definition of applications and the embedding of workflow into applications. Usability of applications was key to their subsequent use. Management of design creep and technology services, coupled with support and training for clinicians were important to maintenance of a telehealth service. In the setting described, an iterative approach to the development of telehealth services to the home using consumer technologies was needed. The efficient management of consumer devices in multiple settings will become critical as telehealth services grow in scale. Effective collaboration between clinical and technical stakeholders and further workforce education in telehealth can be key enablers for the transition of face-to-face care to a telehealth mode of delivery. © The Author(s) 2015.

The Bromhead Care Home Service: the impact of a service for care home residents with dementia on hospital admission and dying in preferred place of care.

Science.gov (United States)

Garden, Gill; Green, Suzanne; Pieniak, Susan; Gladman, John

2016-04-01

People with dementia have worse outcomes associated with hospital admission, are more likely to have interventions and are less likely to be offered palliative care than people without dementia. Advance care planning for care home residents has been shown to reduce hospital admissions without increasing mortality. Studies have shown that staff confidence in managing delirium, a common reason for admission, improves with training. A service combining education for care home staff and advance care planning for care home residents with dementia was introduced to care homes in Boston, UK. There were improvements in staff confidence in recognition, prevention, management and knowledge of factors associated with delirium and dysphagia. 92% of carers rated the service >9/10. Admissions fell by 37% from baseline in the first year and 55% in the second and third years. All but one resident died in the preferred place of care. © 2016 Royal College of Physicians.

36 CFR 7.25 - Hawaii Volcanoes National Park.

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false Hawaii Volcanoes National Park. 7.25 Section 7.25 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR SPECIAL REGULATIONS, AREAS OF THE NATIONAL PARK SYSTEM § 7.25 Hawaii Volcanoes National Park. (a...

A Survey of Intelligent Car Parking System

OpenAIRE

Faheem; S.A. Mahmud; G.M. Khan; M. Rahman; H. Zafar

2013-01-01

The industrialization of the world, increase in population, slow paced city development and mismanagement of the available parking space has resulted in parking related problems. There is a dire need for a secure, intelligent, efficient and reliable system which can be used for searching the unoccupied parking facility, guidance towards the parking facility, negotiation of the parking fee, along with the proper management of the parking facility. Intelligent Parking Service is a part of Intel...

Home care: from adequate funding to integration of services.

Science.gov (United States)

Hébert, Réjean

2009-01-01

With the aging of the population, the healthcare system needs to shift from the actual hospital-centred system developed in the past century for dealing with acute diseases and a young population toward a home-centred system, more appropriate for serving older people with chronic diseases. Funding of home care should not only be significantly increased but also be managed differently. We propose the introduction of an autonomy support benefit (ASB) to cover costs related to disabilities, irrespective of living environment, and to set up a public universal autonomy insurance program that will cover the ASB. This insurance should be at least partly capitalized to provide for the aging of the population and to ensure intergenerational equity. Also, since the home is a much more complicated service-delivery environment than the hospital, these services must be coordinated and integrated. The Program of Research to Integrate the Services for the Maintenance of Autonomy (PRISMA) is a coordination-type model of integration that was implemented and evaluated in three areas (one urban and two rural) in and around Sherbrooke, Quebec. A four-year longitudinal quasi-experimental study with over 1,500 participants demonstrated its efficiency in improving system effectiveness at no extra cost.

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

Science.gov (United States)

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

2018-01-01

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

Guiding people with early dementia home with the talkmehome service

NARCIS (Netherlands)

Christian Hesselman; Martine de Jong; Marcel Roest; Marike Hettinga; Matti Groot; Lammie van den Bosch; Jeffrey Brangert; Jan M. Nauta

2012-01-01

People suffering from mild dementia may get lost during a walk, which can be dangerous for them and adds to the anxiety felt by their informal caregivers. TalkMeHome is a new service that allows these people to get home safely in such situations using their mobile phone. They can call a remote care

ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA U.S. EPA DEMONSTRATION PROJECT AT SPRING BROOK MOBILE HOME PARK IN WALES, ME SIX-MONTH EVALUATION REPORT

Science.gov (United States)

This report documents the activities performed during and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Spring Brook Mobile Home Park in Wales, ME. The objectives of the project are to evaluate the effectiv...

ARSENIC REMOVAL FROM DRINKING WATER BY ADSORPTIVE MEDIA U.S. EPA DEMONSTRATION PROJECT AT CHATEAU ESTATES MOBILE HOME PARK IN SPRINGFIELD, OH. SIX-MONTH EVALUATION REPORT

Science.gov (United States)

This report documents the activities performed for and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Chateau Estates Mobile Home Park at Springfield, OH. The objectives of the project are to evaluate the ef...

ARSENIC REMOVAL FROM DRINKING WATER BY IRON REMOVAL USEPA DEMONSTRATION PROJECT AT BIG SAUK LAKE MOBILE HOME PARK IN SAUK CENTRE, MN. SIX MONTH EVALUATION REPORT

Science.gov (United States)

This report documents the activities performed and the results obtained from the first six months of the arsenic removal treatment technology demonstration project at the Big Sauk Lake Mobile Home Park (BSLMHP) in Sauk Centre, MN. The objectives of the project are to evaluate the...

On Managed Services Lanes and their Use in Home Networks

NARCIS (Netherlands)

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

2013-01-01

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

Valuation of tropical forest services and mechanisms to finance their conservation and sustainable use: A case study of Tapantí National Park, Costa Rica

NARCIS (Netherlands)

Bernard, F.; Groot, de R.S.; Campos, J.J.

2009-01-01

The Tapanti National Park in Costa Rica comprises a precious but vulnerable tropical rain forest area. The monetary values of ecosystem services that are provided by this park are estimated in order to assess the mechanisms to finance the park's conservation and sustainable use. The main ecosystem

The Influence Of Business Partnership And Competitive Strategy On Business Performance Of Recreation Park Services Industry In West Java Indonesia

Directory of Open Access Journals (Sweden)

Kurniawan

2015-08-01

Full Text Available Recreational parks services industry in West Java have problems due to low business performance caused by the difficulty of companies to compete whereas tourism services right now are yet offered unique characteristics products due to the product is relatively similar with competitors. Based on that background the research aims to obtain a study on the influence of business partnerships and competitive strategy on business performance in recreation park service industries in West Java. Research conducted using an explanatory survey. In this study the target population is a company incorporated in the tourism service industry in West Java. Time horizon is a cross-sectional which research is done in one time simultaneously. The data analyzed through verification. Hypothesis is tested using partial least square PLS. The research findings reveal that there is a simultaneous and partial influence of business partnerships and competitive strategy on business performance. The influence of competitive strategy is more dominant than business partnership in improving business performance the rest influenced by other factors not examined in this study. Based on that it would need to the management of recreation park services companies in West Java to increase the competitive strategy as the first priority in efforts to improve business performance.

Parking guidance - modelling, simulation and impact assessment

NARCIS (Netherlands)

Jonkers, E.; Noort, M. van; Veen, J.L. van der

2011-01-01

Intelligent parking services that help drivers with reservation of a parking spot, navigation and automated payment have reached the deployment phase. These services may provide significant benefits to drivers and municipalities. Drivers may experience an increase in comfort and lower and more

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

Science.gov (United States)

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

2013-08-01

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

Counselling and Psychological Services for Clients at the Shelter Home

Directory of Open Access Journals (Sweden)

Ľudmila Fonferová

2014-07-01

Full Text Available Problem: The paper is dealing with a psychological approach to the work with families and their children at a shelter home. It describes the circumstances and conditions for the work in the specific socio-therapeutic environment of the Horni Pocernice Shelter Home. The main research question - 'What are the options of psychological intervention and psychotherapeutic work with clients in the scope of services offered by the shelter home in Horni Pocernice'- works with the hypopaper that psychology and psychotherapy have their place within and next to social services. For clients who use services of this shelter home is this work essential and contributes to better understanding of their life situation and their social relations. Effectivity of psychological work in the environment of a shelter home is in a great deal connected to its acceptance, inner belief and understanding of its real possibilities by every single social worker. Lack of understanding, distorted expectations both on the side of social workers and psychologists complicate or even prevent psychotherapeutic work with clients for whom the requirements and demands of social workers are determining during their stay. Methods: This paper is based on the design of ethnographic field research. Empirical design of this research is defined by the premises of the shelter home and the time period from 2007 to 2012. Therapeutic possibilities of clients are examined from the position of psychologist and psychotherapist of this centre who offers his/her services once a week for about 5 to 7 hours. The research sample was being created during the collection of data in the examined period and its analysis when it was early established with respect to the research question that all available cases typical for full collection will be included (there were 646 clients in the examined period. Results: The answer to the main research question concerns two variables which are related to each other. The

'That would have been beneficial': LGBTQ education for home-care service providers.

Science.gov (United States)

Daley, Andrea; MacDonnell, Judith A

2015-05-01

This paper reports qualitative findings from a pilot study that explored the lesbian, gay, bisexual, transgender and queer (LGBTQ) education needs of home-care service providers working in one large, urban Canadian city. The pilot study builds upon research that has documented barriers to health services for diversely situated LGBTQ people, which function to limit access to good-quality healthcare. LGBTQ activists, organisations and allies have underscored the need for health provider education related to the unique health and service experiences of sexual and gender minority communities. However, the home-care sector is generally overlooked in this important body of research literature. We used purposeful convenience sampling to conduct four focus groups and two individual interviews with a total of 15 professionally diverse home-care service providers. Data collection was carried out from January 2011 to July 2012 and data were analysed using grounded theory methods towards the identification of the overarching theme, 'provider education' and it had two sub-themes: (i) experiences of LGBTQ education; and (ii) recommendations for LGBTQ education. The study findings raise important questions about limited and uneven access to adequate LGBTQ education for home-care service providers, suggest important policy implications for the education and health sectors, and point to the need for anti-oppression principles in the development of education initiatives. © 2014 John Wiley & Sons Ltd.

77 FR 58868 - Teleconference for the National Park Service Alaska Region's Subsistence Resource Commission Program

Science.gov (United States)

2012-09-24

... Wildlife Updates 8. NPS Staff Reports 9. New Business 10. Public and other Agency Comments 11. Select Time... Subsistence Collections Environmental Assessment Update b. SRC Letters 10. New Business a. Susitna-Watana...: National Park Service, Interior. ACTION: Notice of open public meetings. SUMMARY: The Lake Clark National...

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

Intelligent Parking Assistant - A Showcase of the MOBiNET Platform Functionalities

DEFF Research Database (Denmark)

Mikkelsen, Lars Møller; Toledo, Raphael; Agerholm, Niels

availability, location and pricing schemes. The intelligence of the IPA system consists of automatically fetching parking lot information from the relevant service, automatically registering when the vehicle is stopped, evaluating whether the vehicle is stopped inside a payed parking lot, and automatically......The Intelligent Parking Assistant (IPA) system is developed based on work done in the Danish ITS Platform project. The IPA system includes an Android app that helps the user chose, find and pay for parkings. The app uses information about parking lots fetched from a web service, including live...... initiating the payment for the parking. The IPA app and the back end services, are published via the MOBiNET platform which is a European-wide platform supporting ITS services, and offering functionalities enabling easy migration of services. The migration is enabled by defining a common methodology...

Models of home care services for persons with dementia: a narrative review.

Science.gov (United States)

Low, Lee-Fay; Fletcher, Jennifer

2015-10-01

Worldwide trends of increasing dementia prevalence, have put economic and workforce pressures to shifting care for persons with dementia from residential care to home care. We reviewed the effects of the four dominant models of home care delivery on outcomes for community-dwelling persons with dementia. These models are: case management, integrated care, consumer directed care, and restorative care. This narrative review describes benefits and possible drawbacks for persons with dementia outcomes and elements that comprise successful programs. Case management for persons with dementia may increase use of community-based services and delay nursing home admission. Integrated care is associated with greater client satisfaction, increased use of community based services, and reduced hospital days however the clinical impacts on persons with dementia and their carers are not known. Consumer directed care increases satisfaction with care and service usage, but had little effect on clinical outcomes. Restorative models of home care have been shown to improve function and quality of life however these trials have excluded persons with dementia, with the exception of a pilot study. There has been a little research into models of home care for people with dementia, and no head-to-head comparison of the different models. Research to inform evidence-based policy and service delivery for people with dementia needs to evaluate both the impact of different models on outcomes, and investigate how to best deliver these models to maximize outcomes.

Home delivery of medication - the role of a patient information leaflet on maximising service uptake.

Science.gov (United States)

Watson, L; Ahmed, N; Mccall, H; Minton, J; Benn, P; Edwards, S; Waters, L

2014-12-01

There are currently over 30,000 HIV-positive individuals in London and over 25,000 on anti-retroviral therapy. In 2009/2010, this equated to £170m spent by London's NHS on anti-retroviral drugs. Ways employed to reduce this cost include standardising the drugs patients are on and delivering medication to patients at home. Home delivery (HD) medication is exempt from value-added tax. The savings made from 10 patients using the home delivery service would free up resources to provide anti-retroviral therapy to one further patient. Studies have shown that concerns surrounding potential breaches of confidentiality are a potential barrier to some people using the home delivery service. In order to challenge these concerns, a leaflet was devised highlighting the major benefits to both the patient and the NHS of home delivery and addressing concerns over confidentiality. The leaflet was handed out to patients at the Mortimer Market Centre who were currently on anti-retroviral medication but not on home delivery. They were asked to complete a survey on their views of the service before and after reading the leaflet, whether they had been previously aware of the service and whether their concerns had been addressed. Some 79% felt that the patient information leaflet addressed all of their concerns, and it helped 11% decide whether to consider using home delivery. However, as more patients were opposed to the service after reading the patient information leaflet than those considering it, more work needs to be done to explore patients' concerns and other factors influencing home delivery service uptake. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Transforming Data into Practical Information: Using Consumer Input to Improve Home-Care Services

Science.gov (United States)

Applebaum, Robert; Kunkel, Suzanne; Wilson, Ken

2007-01-01

Purpose: As funds have increased for the provision of in-home care, so too have concerns about the quality of services. In response, care management agencies and home-care providers have developed an array of monitoring activities designed to ensure the quality of services. In this article, we show how an area agency on aging both collected and…

42 CFR 415.204 - Services of residents in skilled nursing facilities and home health agencies.

Science.gov (United States)

2010-10-01

... Services of Residents § 415.204 Services of residents in skilled nursing facilities and home health... 42 Public Health 3 2010-10-01 2010-10-01 false Services of residents in skilled nursing facilities and home health agencies. 415.204 Section 415.204 Public Health CENTERS FOR MEDICARE & MEDICAID...

A cost-constrained model of strategic service quality emphasis in nursing homes.

Science.gov (United States)

Davis, M A; Provan, K G

1996-02-01

This study employed structural equation modeling to test the relationship between three aspects of the environmental context of nursing homes; Medicaid dependence, ownership status, and market demand, and two basic strategic orientations: low cost and differentiation based on service quality emphasis. Hypotheses were proposed and tested against data collected from a sample of nursing homes operating in a single state. Because of the overwhelming importance of cost control in the nursing home industry, a cost constrained strategy perspective was supported. Specifically, while the three contextual variables had no direct effect on service quality emphasis, the entire model was supported when cost control orientation was introduced as a mediating variable.

Medicare Home Health Services: A Difficult Program to Control

Science.gov (United States)

1981-09-25

represent about one-third of all visits provided under the program. Family and friends altio provide similar services to the elderly and consequently...example, that the individual is to be confined to his or her home but that this does not necessarily mean that the patient is bedridden . At the same...34feebleness" and "insecurity" cannot be considered home- bound. We believe that in many cases (particularly for the elderly ) it would be extremely

Service oriented network architecture for control and management of home appliances

Science.gov (United States)

Hayakawa, Hiroshi; Koita, Takahiro; Sato, Kenya

2005-12-01

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

A critique of wildlife radio-tracking and its use in National Parks: a report to the National Park Service

Science.gov (United States)

Mech, L. David; Barber, Shannon M.

2002-01-01

Because of the naturalness of National Parks and because of the public’s strong interest in the parks, the National Park Service (NPS) must gather as much information as needed to help understand and preserve the natural functioning of its ecosystems, and especially of its wildlife. The most useful technique for studying wildlife is radio-tracking, or wildlife telemetry. Radio-tracking is the technique of determining information about an animal through the use of radio signals from or to a device carried by the animal.The basic components of a traditional radio-tracking system are (1) a transmitting subsystem consisting of a radio transmitter, a power source and a propagating antenna, and (2) a receiving subsystem including a “pick-up” antenna, a signal receiver with reception indicator (speaker and/or display) and a power source. Most radio tracking systems involve transmitters tuned to different frequencies (analogous to different AM/FM radio stations) that allow individual identification.Three distinct types of radio-tracking are in use today: (1)conventional, very-high-frequency (VHF) radio tracking, (2) satellite tracking, and (3) Global Positioning System (GPS) tracking. VHF radio-tracking is the standard technique that has been in use since 1963.However, radio-tracking can be considered intrusive in that it requires live-capturing animals and attaching a collar or other device to them. A person must then monitor signals from the device, thus usually requiring people in the field in vehicles, aircraft, and on foot. Nevertheless, most national parks have recognized the benefits of radio-tracking and have hosted radio-tracking studies for many years; in some parks, hundreds of animals have been, or are being, so studied.As a result, some NPS staff are concerned about actual or potential intrusiveness of radio-tracking. Ideally, wildlife studies would still be done but with no intrusion on animals or conflict with park visitors.Thus the NPS has decided to

Socioeconomic Differences in and Predictors of Home-Based Palliative Care Health Service Use in Ontario, Canada.

Science.gov (United States)

Cai, Jiaoli; Guerriere, Denise N; Zhao, Hongzhong; Coyte, Peter C

2017-07-18

The use of health services may vary across people with different socioeconomic statuses, and may be determined by many factors. The purposes of this study were (i) to examine the socioeconomic differences in the propensity and intensity of use for three main home-based health services, that is, home-based palliative care physician visits, nurse visits and personal support worker (PSW) hours; and (ii) to explore the determinants of the use of home-based palliative care services. A prospective cohort study was employed. A total of 181 caregivers were interviewed biweekly over the course of the palliative care trajectory, yielding a total of 994 interviews. The propensity and intensity of health service use were examined using logistic regression and negative binomial regression, respectively. The results demonstrated that both the propensity and intensity of home-based nurse and PSW visits fell with socioeconomic status. The use of home-based palliative care services was not concentrated in high socioeconomic status groups. The common predictors of health service use in the three service categories were patient age, the Palliative Performance Scale (PPS) score and place of death. These findings may assist health service planners in the appropriate allocation of resources and service packages to meet the complex needs of palliative care populations.

Barriers in access to home care services among ethnic minority and Dutch elderly--a qualitative study.

Science.gov (United States)

Suurmond, Jeanine; Rosenmöller, Doenja L; El Mesbahi, Hakima; Lamkaddem, Majda; Essink-Bot, Marie-Louise

2016-02-01

Ethnic minority elderly have a high prevalence of functional limitations and chronic conditions compared to Dutch elderly. However, their use of home care services is low compared to Dutch elderly. Explore the barriers to access to home care services for Turkish, Moroccan Surinamese and ethnic Dutch elderly. Qualitative semi-structured group interviews and individual interviews. The Netherlands. Seven group interviews (n=50) followed by individual interviews (n=5) were conducted, in the preferred language of the participants. Results were ordered and reported according to a framework of access to health care services. This framework describes five dimensions of accessibility to generate access to health care services, from the perspective of the users: ability to perceive health needs, ability to seek health care, ability to reach, ability to pay and ability to engage. This study shows that while barriers are common among all groups, several specific barriers in access to home care services exist for ethnic minority elderly. Language and communication barriers as well as limited networks and a preference for informal care seem to mutually enforce each other, resulting in many barriers during the navigation process to home care. In order to provide equal access to home care for all who need it, the language and communication barriers should be tackled by home care services and home care nurses. Copyright © 2015 Elsevier Ltd. All rights reserved.

Exploration of the administrative aspects of the delivery of home health care services: a qualitative study.

Science.gov (United States)

Shahsavari, Hooman; Nasrabadi, Alireza Nikbakht; Almasian, Mohammad; Heydari, Heshmatolah; Hazini, Abdolrahim

2018-01-01

Because of the variety of services and resources offered in the delivery of home health care, its management is a challenging and difficult task. The purpose of this study was to explore the administrative aspects of the delivery of home health care services. This qualitative study was conducted based on the traditional content analysis approach in 2015 in Iran. The participants were selected using the purposeful sampling method and data were collected through in-depth semi-structured personal interviews and from discussions in a focus group. The collected data were analyzed using the Lundman and Graneheim method. 23 individuals participated in individual interviews, and the collected data were categorized into the two main themes of policymaking and infrastructures, each of which consisted of some subcategories. Health policymakers could utilize the results of this study as baseline information in making decisions about the delivery of home health care services, taking into account the contextual dimensions of home care services, leading to improvements in home health care services.

Integrating Social Services and Home-Based Primary Care for High-Risk Patients.

Science.gov (United States)

Feinglass, Joe; Norman, Greg; Golden, Robyn L; Muramatsu, Naoko; Gelder, Michael; Cornwell, Thomas

2018-04-01

There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centered care and integration of health care with social services are the cornerstones of a more humane and efficient system. The article describes the strengths and weaknesses of research evaluating the effects of social services in addressing social determinants of health, and how social support is critical to successful acute care transition programs. It reviews the history of incorporating social services into care management, and the prospects that recent payment reforms and regulatory initiatives can succeed in stimulating the financial integration of social services into new care coordination initiatives. The article reviews the literature on home-based primary care for the chronically ill and disabled, and suggests that it is the emergence of this care modality that holds the greatest promise for delivery system reform. In the hope of stimulating further discussion and debate, the authors summarize existing viewpoints on how a home-centered system, which integrates social and medical services, might emerge in the next few years.

Care and Service at Home for Persons With Dementia in Europe.

Science.gov (United States)

Bökberg, Christina; Ahlström, Gerd; Leino-Kilpi, Helena; Soto-Martin, Maria E; Cabrera, Esther; Verbeek, Hilde; Saks, Kai; Stephan, Astrid; Sutcliffe, Caroline; Karlsson, Staffan

2015-09-01

To describe available and utilized formal care and service at home for persons with dementia, from diagnosis to end-of-life stage, in eight European countries. A descriptive cross-country design concerning eight European countries as a part of the European research project RightTimePlaceCare. The research team in each country used a mapping system to collect country-specific information concerning dementia care and service system. The mapping system consists of 50 types of care and service activities. Sixteen of the 50 predefined activities concerning care and service at home were selected for this study and subdivided into three categories, following the stages of dementia. Availability was reported to be higher than utilization, and the findings indicated more similarities than differences among the eight countries involved. Even though there were several available activities of "basic care and services" and "healthcare interventions," they were utilized by few in most countries. Furthermore, "specialized dementia care and services" were sparsely available and even more sparsely utilized in the participating countries. The findings indicated that persons with dementia in Europe received formal care and service on a general, basic level but seldom adjusted to their specific needs. This study describes the gap between service provision and utilization enabling nurses to develop individually adjusted care plans for persons with dementia during the progress of the disease. The findings do not include matters of quality of care or how to best organize effective care and services. However, the activities of care and services presented here should shed light on what room there is for improvement when it comes to enabling persons with dementia to go on living at home. © 2015 Sigma Theta Tau International.

Home Care Pharmacy Practice in Canada: A Cross-Sectional Survey of Services Provided, Remuneration, Barriers, and Facilitators.

Science.gov (United States)

Houle, Sherilyn; MacKeigan, Linda

2017-01-01

As the population ages, and individuals desire to remain in their homes as long as possible, the need for in-home care is expected to increase. However, pharmacists have rarely been included in studies of in-home care, and little is known about the prevalence or effectiveness of pharmacists' home-based services in Canada. To identify pharmacy practices in Canada that regularly provide in-home patient care and to identify specific services provided, remuneration obtained, and barriers and facilitators influencing the provision of home-based care. A link to a web-based survey was posted in e-newsletters of provincial, territorial, and national pharmacy associations in Canada. In addition, pharmacists known to the researchers as providing in-home clinical services were contacted directly. The survey was open from October to December 2015. Practices or organizations that performed at least one home visit per week for clinical purposes, with documentation of the services provided, were eligible to participate. One response per practice or organization was allowed. Seventeen practices meeting the inclusion criteria were identified, representing community, hospital, and clinic settings. Home visits were most commonly performed for individuals with complex medication regimens or nonadherence to medication therapy. The most common services were conducting medication reconciliation and reviews and counselling patients about medication adherence. No practices or organizations billed patients for these services, yet lack of remuneration was an important barrier identified by many respondents. Although 12 (71%) of the respondents collected data for evaluative purposes, collection of clinical or health system outcome data was rare. Few Canadian pharmacy practices that provide in-home patient care at least once a week could be identified. Data collection suitable to establish an evidence base for this service was infrequently performed by practices and organizations providing

Association of Cost Sharing With Use of Home Health Services Among Medicare Advantage Enrollees.

Science.gov (United States)

Li, Qijuan; Keohane, Laura M; Thomas, Kali; Lee, Yoojin; Trivedi, Amal N

2017-07-01

Several policy proposals advocate introducing copayments for home health care in the Medicare program. To our knowledge, no prior studies have assessed this cost-containment strategy. To determine the association of home health copayments with use of home health services. A difference-in-differences case-control study of 18 Medicare Advantage (MA) plans that introduced copayments for home health care between 2007 and 2011 and 18 concurrent control MA plans. The study included 135 302 enrollees in plans that introduced copayment and 155 892 enrollees in matched control plans. Introduction of copayments for home health care between 2007 and 2011. Proportion of enrollees receiving home health care, annual numbers of home health episodes, and days receiving home health care. Copayments for home health visits ranged from $5 to $20 per visit, which were estimated to be associated with $165 (interquartile range [IQR], $45-$180) to $660 (IQR, $180-$720) in out-of-pocket spending for the average user of home health care. The increased copayment for home health care was not associated with the proportion of enrollees receiving home health care (adjusted difference-in-differences, -0.15 percentage points; 95% CI, -0.38 to 0.09), the number of home health episodes per user (adjusted difference-in-differences, 0.01; 95% CI, -0.01 to 0.03), and home health days per user (adjusted difference-in-differences, -0.19; 95% CI, -3.02 to 2.64). In both intervention and control plans and across all levels of copayments, we observed higher disenrollment rates among enrollees with greater baseline use of home health care. We found no evidence that imposing copayments reduced the use of home health services among older adults. More intensive use of home health services was associated with increased rates of disenrollment in MA plans. The findings raise questions about the potential effectiveness of this cost-containment strategy.

Parking management : strategies, evaluation and planning

International Nuclear Information System (INIS)

Litman, T.A.

2006-01-01

Parking facilities are a major cost to society. Current planning practices are based on the assumption that parking should be abundant and provided free, with costs borne indirectly. This report examined parking management strategies related to integrated parking plans. Problems with current parking planning practices were reviewed. The costs of parking facilities were examined, as well as the savings that can accrue from improved management techniques. Strategies included shared parking; remote parking and shuttle services; walking and cycling improvements; improved enforcement and control; and increasing the capacity of existing parking facilities. Parking pricing methods, financial incentives and parking tax reforms were reviewed. Issues concerning user information and marketing were examined. Overflow parking plans were evaluated. Three illustrative examples of parking management programs were outlined, along with details of implementation, planning and evaluation procedures. It was concluded that cost-effective parking management programs can often reduce parking requirements by 20 to 40 per cent compared with conventional planning requirements, in addition to providing economic, social and environmental benefits. 32 refs., 7 tabs., 3 figs

Predictors of suicidal ideation in older individuals receiving home-care services.

Science.gov (United States)

Park, Jong-Il; Han, Myeong-Il; Kim, Myung Sig; Yoon, Myeong-Sook; Ko, Sung-Hee; Cho, Hye-Chung; Chung, Young-Chul

2014-04-01

Despite the importance of tending to older individuals who are vulnerable to suicide, little is known about suicidal ideation in the portion of this population receiving home-care services in Asian countries. The objective of this cross-sectional study was to examine predictors of suicidal ideation in older individuals using home-care service. Participants were randomly selected from the individuals 50 years old and over using home-care services across Jeollabuk-do Province, Korea. A total of 697 subjects participated in this study. Each participant completed the short version of the Geriatric Depression Scale, the Scale for Suicidal Ideation, the Multidimensional Scale of Perceived Social Support, and the World Health Organization Disability Assessment Schedule II. Hierarchical regression analyses revealed that depression, perceived social support, and disability were significant predictors of suicidal ideation, whereas the roles of subjective health status and fish consumption remained ambiguous in this regard. In terms of social support, we also found that less perceived social support from family members was related to higher levels of suicidal ideation. The associations between various categories of disability and suicidal ideation disappeared after controlling for depression. Our investigation of the mediating effect of depression on the relationship between disability and suicidal ideation revealed that depression was either a complete (disability related to cognition, self-care, getting along with others, and life activities) or partial (disability related to participation) mediator. Preventive strategies focusing on depression, social support, and disability should be emphasized during encounters with older people receiving home-care services. Copyright © 2013 John Wiley & Sons, Ltd.

Arsenic Removal from Drinking Water by Iron Removal - U.S. EPA Demonstration Project at Big Sauk Lake Mobile Home Park in Sauk Centre, MN Final Performance Evaluation Report

Science.gov (United States)

This report documents the activities performed and the results obtained from the one-year arsenic removal treatment technology demonstration project at the Big Sauk Lake Mobile Home Park (BSLMHP) in Sauk Centre, MN. The objectives of the project are to evaluate (1) the effective...

RoboCup@Home Scientific Competition and Benchmarking for Domestic Service Robots

NARCIS (Netherlands)

Wisspeintner, Thomas; van der Zant, Tijn; Iocchi, Luca; Schiffer, Stefan

2009-01-01

Being part of the RoboCup initiative, the ROBOCUP@HOME league targets the development and deployment of autonomous service and assistive robot technology being essential for future personal domestic applications. The domain of domestic service and assistive robotics implicates a wide range of

Factors associated with emergency services use in Taiwanese advanced cancer patients receiving palliative home care services during out-of-hours periods: a retrospective medical record study.

Science.gov (United States)

Kao, Yee-Hsin; Liu, Yao-Ting; Koo, Malcolm; Chiang, Jui-Kun

2018-03-12

For patients receiving palliative home care, the need to visit the emergency department is considered to be an indicator of poor quality care. The situation can be particularly distressing when it occurs outside of normal hours of palliative home care service. The aim of this study was to investigate the factors for emergency department use during out-of-hours periods of palliative home care service among advanced cancer patients in Taiwan. This case-control study was based on a retrospective medical chart review (January 2010 to December 2012) of advanced cancer patients who were receiving palliative home care in a community hospital in south Taiwan. The use of emergency medical services by these patients was dichotomized into either normal hours (8 a.m. to midnight, Monday to Friday, excluding public holidays) of palliative home care or outside normal hours. Logistic regression analyses were performed to evaluate factors associated with emergency services use during out-of-hours period of palliative home care. Of the 94 patients receiving palliative home care, 65 had used emergency services at least once during the 3-year study period. Of these 65 patients, 40% used emergency services during out-of-hours of palliative home care. Patients with distressing conditions (defined as the occurrence of any two conditions of dyspnea, change of consciousness, or gastrointestinal bleeding) were significantly more likely to use emergency services during out-of-hours of palliative home care. Patients at risk of developing dyspnea, change of consciousness, or gastrointestinal bleeding should be provided with relevant information regarding these symptoms and signs.

Ecosystem Services Valuation of Lakeside Wetland Park beside Chaohu Lake in China

Directory of Open Access Journals (Sweden)

Tan Li

2016-07-01

Full Text Available Wetland ecosystems are one of the three great ecosystems on Earth. With a deepening of research on wetland ecosystems, researchers have paid more and more attention to wetland ecosystem services such as flood mitigation, climate control, pollution prevention, soil-erosion prevention, biodiversity maintenance, and bio-productivity protection. This study focuses on a lakeside wetland ecosystem in Hefei, a city in central China, and estimates the value of ecosystem services such as material production, air purification, water conservation, biodiversity, recreation, species conservation, education and scientific research. We adopted the market value method, carbon tax method, afforestation cost method, shadow engineering method and contingent value method (CVM using questionnaire survey data during the study period. The results show that the total value of the ecosystem services of Lakeside Wetland Park was 144 million CNY in 2015. Among these services, the value of society service is the maximum at 91.73 million CNY, followed by ecological service and material production service (42.23 million CNY and 10.43 billion CNY in 2015 respectively. When considering wetland ecosystems for economic development, other services must be considered in addition to material production to obtain a longer-term economic value. This research reveals that there is scope for more comprehensive and integrated model development, including multiple wetland ecosystem services and appropriate handling of wetland ecosystem management impacts.

Elgon/Kibale National Parks carbon sequestration projects

OpenAIRE

Face Foundation

2007-01-01

Metadata only record In Uganda we are collaborating with the Uganda Wildlife Authority (UWA), one of whose tasks is to manage the country's national parks. We are jointly implementing forest restoration projects in Mount Elgon National Park and Kibale National Park. PES-1 (Payments for Environmental Services Associate Award)

36 CFR 910.33 - Off-street parking.

Science.gov (United States)

2010-07-01

... for parking spaces is as follows: (1) Hotel: One parking space for each four sleeping rooms or suites; (2) Places of public assemblage other than hotels: (i.e., arena, armory, theater, auditorium...; (3) Retail, trade, and service establishments: one parking space for each 750 square feet of gross...

Differences in home-based palliative care service utilisation of people with cancer and non-cancer conditions.

Science.gov (United States)

Kralik, Debbie; Anderson, Barbara

2008-11-01

To identify home-based palliative care service utilisation by people with cancer and non-cancer conditions. Palliative care knowledge and skill have been derived from working with people with cancer. People with chronic conditions are now referred for home-based palliative care; however, there has been few studies published that have explored the impact of service utilisation by people with end-stage chronic conditions. The Australia-modified Karnofsky Performance Status (AKPS) scale was calculated for each person upon referral for home-based palliative care services to determine the functional capacity of the individual at the point of referral. Clients were divided into those with cancer diagnosis and those with non-cancer diagnosis. Service utilisation of the individual client was determined until separation from the palliative care service. The study was undertaken in 2007. The majority of people with cancer (63%) and non-cancer (71%) were assessed as having an AKPS score between 50-60. Thirty-one cancer clients (18·7%) and three non-cancer clients (7·1%) had an AKPS score between 70-90. This suggests that people with cancer are referred to palliative care services earlier than people with non-cancer conditions. People with non-cancer conditions were substantially higher users of home-based palliative care services over a longer period of time. Home-based palliative care service utilisation was higher for people with non-cancer conditions. Cost analysis research is recommended to delineate the actual costs of home-based palliative care service provision between people with cancer and non-cancer conditions. There is growing awareness of the need for palliative care services for people with non-cancer conditions. However, these services are provided for longer periods of time for this client group. Implications for practice are that the palliative care needs of people with non-cancer conditions may not be met within current palliative care service provision

Bluetooth Low Power Modes Applied to the Data Transportation Network in Home Automation Systems

Directory of Open Access Journals (Sweden)

Josu Etxaniz

2017-04-01

Full Text Available Even though home automation is a well-known research and development area, recent technological improvements in different areas such as context recognition, sensing, wireless communications or embedded systems have boosted wireless smart homes. This paper focuses on some of those areas related to home automation. The paper draws attention to wireless communications issues on embedded systems. Specifically, the paper discusses the multi-hop networking together with Bluetooth technology and latency, as a quality of service (QoS metric. Bluetooth is a worldwide standard that provides low power multi-hop networking. It is a radio license free technology and establishes point-to-point and point-to-multipoint links, known as piconets, or multi-hop networks, known as scatternets. This way, many Bluetooth nodes can be interconnected to deploy ambient intelligent networks. This paper introduces the research on multi-hop latency done with park and sniff low power modes of Bluetooth over the test platform developed. Besides, an empirical model is obtained to calculate the latency of Bluetooth multi-hop communications over asynchronous links when links in scatternets are always in sniff or the park mode. Smart home devices and networks designers would take advantage of the models and the estimation of the delay they provide in communications along Bluetooth multi-hop networks.

Bluetooth Low Power Modes Applied to the Data Transportation Network in Home Automation Systems

Science.gov (United States)

Etxaniz, Josu; Aranguren, Gerardo

2017-01-01

Even though home automation is a well-known research and development area, recent technological improvements in different areas such as context recognition, sensing, wireless communications or embedded systems have boosted wireless smart homes. This paper focuses on some of those areas related to home automation. The paper draws attention to wireless communications issues on embedded systems. Specifically, the paper discusses the multi-hop networking together with Bluetooth technology and latency, as a quality of service (QoS) metric. Bluetooth is a worldwide standard that provides low power multi-hop networking. It is a radio license free technology and establishes point-to-point and point-to-multipoint links, known as piconets, or multi-hop networks, known as scatternets. This way, many Bluetooth nodes can be interconnected to deploy ambient intelligent networks. This paper introduces the research on multi-hop latency done with park and sniff low power modes of Bluetooth over the test platform developed. Besides, an empirical model is obtained to calculate the latency of Bluetooth multi-hop communications over asynchronous links when links in scatternets are always in sniff or the park mode. Smart home devices and networks designers would take advantage of the models and the estimation of the delay they provide in communications along Bluetooth multi-hop networks. PMID:28468294

Bluetooth Low Power Modes Applied to the Data Transportation Network in Home Automation Systems.

Science.gov (United States)

Etxaniz, Josu; Aranguren, Gerardo

2017-04-30

Even though home automation is a well-known research and development area, recent technological improvements in different areas such as context recognition, sensing, wireless communications or embedded systems have boosted wireless smart homes. This paper focuses on some of those areas related to home automation. The paper draws attention to wireless communications issues on embedded systems. Specifically, the paper discusses the multi-hop networking together with Bluetooth technology and latency, as a quality of service (QoS) metric. Bluetooth is a worldwide standard that provides low power multi-hop networking. It is a radio license free technology and establishes point-to-point and point-to-multipoint links, known as piconets, or multi-hop networks, known as scatternets. This way, many Bluetooth nodes can be interconnected to deploy ambient intelligent networks. This paper introduces the research on multi-hop latency done with park and sniff low power modes of Bluetooth over the test platform developed. Besides, an empirical model is obtained to calculate the latency of Bluetooth multi-hop communications over asynchronous links when links in scatternets are always in sniff or the park mode. Smart home devices and networks designers would take advantage of the models and the estimation of the delay they provide in communications along Bluetooth multi-hop networks.

An interview with: Stephen Paliska on valet parking.

Science.gov (United States)

Paliska, S

1993-04-01

Stephen Paliska is general manager and co-founder, with his brother, Paul, of Professional Parking Services, Inc., based in Irvine, CA. The company has been in operation for eight years. PPS's 600 valets provide parking services for more than 80 clients, including hotels, shopping centers, restaurants, and hospitals. In this interview, Paliska discusses the benefits and some potential risks of valet parking and spells out how a training program for valet attendants should be carried out.

Effect of home care service on the quality of life in patients with gynecological cancer.

Science.gov (United States)

Aktas, Demet; Terzioglu, Fusun

2015-01-01

The purpose of the research was to determine the effect of home care service on the quality of life in patients with gynecological cancer. This randomized case control study was carried out in a womans hospital between September 2011 and February 2012. Women undergoing gynecological cancer treatment were separated into intervention and control groups, of 35 patients each. The intervention group was provided with nursing care service through hospital and home visits (1st, 12th weeks) within the framework of a specifically developed nursing care plan. The control group was monitored without any intervention through the hospital routine protocols (1st, 12th weeks). Data were collected using An Interview Form, Home Visit Monitoring Form and Quality of Life Scale/Cancer Survivors. Effects of home care service on the quality of life in gynecological cancer patients were investigated using chi-square tests, McNemar's test, independent t-test and ANOVA. This study found that the intervention group receiving home care service had a moderately high quality of life (average mean: 6.01±0.64), while the control group had comparatively lower quality (average mean: 4.35±0.79) within the 12 week post- discharge period (phome care services to be efficient in improving the quality of life in patients with gynecological cancer.

Contemporary trends and predictors of postacute service use and routine discharge home after stroke.

Science.gov (United States)

Prvu Bettger, Janet; McCoy, Lisa; Smith, Eric E; Fonarow, Gregg C; Schwamm, Lee H; Peterson, Eric D

2015-02-23

Returning home after the hospital is a primary aim for healthcare; however, additional postacute care (PAC) services are sometimes necessary for returning stroke patients to their pre-event status. Recent trends in hospital discharge disposition specifying PAC use have not been examined across age groups or health insurance types. We examined trends in discharge to inpatient rehabilitation facilities (IRFs), skilled nursing facilities (SNFs), home with home health (HH), and home without services for 849 780 patients ≥18 years of age with ischemic or hemorrhagic stroke at 1687 hospitals participating in Get With The Guidelines-Stroke. Multivariable analysis was used to identify factors associated with discharge to any PAC (IRF, SNF, or HH) versus discharge home without services. From 2003 to 2011, there was a 2.1% increase (unadjusted P=0.001) in PAC use after a stroke hospitalization. Change was greatest in SNF use, an 8.3% decrease over the period. IRF and HH increased 6.9% and 3.6%, respectively. The 2 strongest clinical predictors of PAC use after acute care were patients not ambulating on the second day of their hospital stay (ambulation odds ratio [OR], 3.03; 95% confidence interval [CI], 2.86 to 3.23) and those who failed a dysphagia screen or had an order restricting oral intake (OR, 2.48; 95% CI, 2.37 to 2.59). Four in 10 stroke patients are discharged home without services. Although little has changed overall in PAC use since 2003, further research is needed to explain the shift in service use by type and its effect on outcomes. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

National Park Service Organic Act prohibits turning the doorstep of Canyonlands National Park into a nuclear wasteland

International Nuclear Information System (INIS)

Bryan, J.A.

1986-01-01

The protection national parks enjoy under the Organic Act of 1916 is now threatened by the enlarging and advancing needs of American society, with the most destructive threat posed by excessive or incongruent development on land adjacent to the parks. The need to store high-level nuclear waste has prompted DOE to ignore the protective mandate of the Act, and the Interior Secretary has made no move to correct DOE's error. Judicial intervention is not available until park values are immediately threatened. Federal action could violate the Act's standards and irreparably scar Canyonlands National Park. Decisions of this magnitude should be made in the open, with the federal government and public cooperating in an informed manner and acknowledging what is at stake

45 CFR 3.23 - Parking.

Science.gov (United States)

2010-10-01

... DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL ADMINISTRATION CONDUCT OF PERSONS AND TRAFFIC ON THE NATIONAL INSTITUTES OF HEALTH FEDERAL ENCLAVE Traffic Regulations § 3.23 Parking. (a) A person may not stand (vehicle... sign, crosswalk, or traffic control signal; (5) In a double-parked position; (6) At a curb painted...

Improving Older Adults' Functional Ability through Service Use in a Home Care Program in Hong Kong

Science.gov (United States)

Cheung, Chau-kiu; Ngan, Raymond Man-hung

2005-01-01

Objective: Despite past findings about the contribution of home care services to older users' functional ability, the effective processes and components of the services are not transparent. Such processes appear to rely on the actual use of component services of the home care program. Method: The study gathered 116 observations during 2 years…

Specialist home-based nursing services for children with acute and chronic illnesses.

Science.gov (United States)

Parab, Chitra S; Cooper, Carolyn; Woolfenden, Susan; Piper, Susan M

2013-06-15

Specialist paediatric home-based nursing services have been proposed as a cost-effective means of reducing distress resulting from hospital admissions, while enhancing primary care and reducing length of hospital stay. This review is an update of our original review, which was published in 2006. To evaluate specialist home-based nursing services for children with acute and chronic illnesses. We searched the following databases in February 2012: the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library 2012 Issue 2, Ovid MEDLINE, EMBASE, PsycINFO, CINAHL and Sociological Abstracts. We also searched ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. No language restrictions were applied. Randomised controlled trials (RCTs) of children from birth to age 18 years with acute or chronic illnesses allocated to specialist home-based nursing services compared with conventional health care. Outcomes included utilisation of health care, physical and mental health, satisfaction, adverse health outcomes and costs. Two review authors extracted data from the studies independently and resolved any discrepancies by recourse to a third author. Meta-analysis was not appropriate because of the clinical diversity of the studies and the lack of common outcome measures. We screened 4226 titles to yield seven RCTs with a total of 840 participants. Participants, interventions and outcomes were diverse. No significant differences were reported in health outcomes; two studies reported a reduction in the hospital stay with no difference in the hospital readmission rates. Three studies reported a reduction in parental anxiety and improvement in child behaviours was reported in three studies. Overall increased parental satisfaction was reported in three studies. Also, better parental coping and family functioning was reported in one study. By contrast, one study each reported no impact on parental burden of care or on functional status of

Applying the International Classification of Functioning, Disability and Health to guide home health care services planning and delivery in Thailand.

Science.gov (United States)

Pimdee, Atipong; Nualnetr, Nomjit

2017-01-01

Home health care is an essential service for home-bound patients in Thailand. In this action research study, we used the International Classification of Functioning, Disability and Health (ICF) framework to modify home health care services provided by a university hospital. Staff responsible for delivering the services (physical therapist, nurses, and Thai traditional medicine practitioners) participated in the development of an ICF-based assessment tool and home health care service procedure. After an 8-month trial of implementing these changes, professional satisfaction and empowerment were high among the home health care team members. Patients and their caregivers were also satisfied with the services. In conclusion, the ICF is an effective means of guiding home health care.

Transitioning a home telehealth project into a sustainable, large-scale service: a qualitative study.

Science.gov (United States)

Wade, Victoria A; Taylor, Alan D; Kidd, Michael R; Carati, Colin

2016-05-16

This study was a component of the Flinders Telehealth in the Home project, which tested adding home telehealth to existing rehabilitation, palliative care and geriatric outreach services. Due to the known difficulty of transitioning telehealth projects services, a qualitative study was conducted to produce a preferred implementation approach for sustainable and large-scale operations, and a process model that offers practical advice for achieving this goal. Initially, semi-structured interviews were conducted with senior clinicians, health service managers and policy makers, and a thematic analysis of the interview transcripts was undertaken to identify the range of options for ongoing operations, plus the factors affecting sustainability. Subsequently, the interviewees and other decision makers attended a deliberative forum in which participants were asked to select a preferred model for future implementation. Finally, all data from the study was synthesised by the researchers to produce a process model. 19 interviews with senior clinicians, managers, and service development staff were conducted, finding strong support for home telehealth but a wide diversity of views on governance, models of clinical care, technical infrastructure operations, and data management. The deliberative forum worked through these options and recommended a collaborative consortium approach for large-scale implementation. The process model proposes that the key factor for large-scale implementation is leadership support, which is enabled by 1) showing solutions to the problems of service demand, budgetary pressure and the relationship between hospital and primary care, 2) demonstrating how home telehealth aligns with health service policies, and 3) achieving clinician acceptance through providing evidence of benefit and developing new models of clinical care. Two key actions to enable change were marketing telehealth to patients, clinicians and policy-makers, and building a community of

Live-In Versus Live-Out Home Care in Israel: Satisfaction With Services and Caregivers' Outcomes.

Science.gov (United States)

Ayalon, Liat; Green, Ohad

2015-08-01

The present study provides a preliminary examination of the relationship between the type of home care services (live-in vs. live-out; i.e., round the clock vs. several hours per week), the caregiver's satisfaction with services, and the caregiver's burden, distress, well-being, and subjective health status within the conceptual framework of caregiving outcomes proposed by Yates and colleagues (Yates, M. E., Tennstedt, S., & Chang, B. H. [1999]. Contributors to and mediators of psychological well-being for informal caregivers. Journal of Gerontology: Psychological Sciences, 54, P12 -P22. doi:10.1093/geronb/54B.1.P12). A random stratified sample of family caregivers of older adults more than the age of 70 who receive live-in (442) or live-out (244) home care services through the financial assistance of the National Insurance institute of Israel was selected. A path analysis was conducted. Satisfaction with services was higher among caregivers under the live-in home care arrangement and positively related to well-being. Among caregivers, live-in home care was directly associated with higher levels of subjective health and indirectly associated with better well-being via satisfaction with services. The present study emphasizes the potential benefits of live-in home care services for caregivers of older adults who suffer from high levels of impairment and the importance of assessing satisfaction with services as a predictor of caregivers' outcomes. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Discrepancies in assessing home care workers' working conditions in a Norwegian home care service: differing views of stakeholders at three organizational levels.

Science.gov (United States)

Andersen, Gunn Robstad; Westgaard, Rolf H

2015-07-25

The present study is a follow-up study of factors contributing to an undesirable quality of work environment and sick leave rate in the home care services in a Norwegian municipality. The underlying assumption is that organizational discrepancies in the perceptions and appraisals of significant factors and processes in an organization have detrimental effects on the management of the organization and on work environment conditions. Thus, the study aim is to explore potential organizational discrepancies in the appraisals of factors relating to home care workers' working conditions. The study, using a mixed-methods design, comprised six home care units. It included survey responses of home care workers (80 respondents, response rate 54 %) and qualitative descriptions of stakeholders' appraisals of organizational issues gathered through semi-structured interviews (33 interviews with stakeholders at three organizational levels). Employees at different organizational levels in the home care services expressed divergent appraisals of factors related to the working conditions of home care workers, including impact of organizational measures (i.e. time pressure, work tasks, a new work program, organizational changes, budget model, budget allocation and coping strategies). Survey responses supported interview descriptions by home care workers. Results suggest that organizational discrepancy serve as an important barrier to a sustainable, well-functioning organization in general and to quality-enhancing changes to work procedures in particular. It is recommended to improve communication channels and facilitate the exchange of information across levels to ensure a common understanding of matters significant to the organization of the home care services and to the work environment of home care workers. The prevalence and impact of organizational discrepancy should be included in organization research, particularly when exploring explanatory factors of an unhealthy

Adaptive software architecture based on confident HCI for the deployment of sensitive services in Smart Homes.

Science.gov (United States)

Vega-Barbas, Mario; Pau, Iván; Martín-Ruiz, María Luisa; Seoane, Fernando

2015-03-25

Smart spaces foster the development of natural and appropriate forms of human-computer interaction by taking advantage of home customization. The interaction potential of the Smart Home, which is a special type of smart space, is of particular interest in fields in which the acceptance of new technologies is limited and restrictive. The integration of smart home design patterns with sensitive solutions can increase user acceptance. In this paper, we present the main challenges that have been identified in the literature for the successful deployment of sensitive services (e.g., telemedicine and assistive services) in smart spaces and a software architecture that models the functionalities of a Smart Home platform that are required to maintain and support such sensitive services. This architecture emphasizes user interaction as a key concept to facilitate the acceptance of sensitive services by end-users and utilizes activity theory to support its innovative design. The application of activity theory to the architecture eases the handling of novel concepts, such as understanding of the system by patients at home or the affordability of assistive services. Finally, we provide a proof-of-concept implementation of the architecture and compare the results with other architectures from the literature.

77 FR 64544 - Minor Boundary Revision at Chickamauga and Chattanooga National Military Park

Science.gov (United States)

2012-10-22

... DEPARTMENT OF THE INTERIOR National Park Service [NPS-SER-CHCH-10687; 5220-726] Minor Boundary Revision at Chickamauga and Chattanooga National Military Park AGENCY: National Park Service, Interior.... 460l- 9(c)(1)(ii), the boundary of Chickamauga and Chattanooga National Military Park is modified to...

Regional variations in the use of home care services in Ontario, 1993/95

OpenAIRE

Coyte, P C; Young, W

1999-01-01

BACKGROUND: Although regional variations in the use of many health care services have been reported, little attention has been devoted to home care practices. Given the dramatic shift in care settings from hospitals to private homes, it is important to determine the extent to which home care practices vary by geographic region. METHODS: Data from the Canadian Institute for Health Information and the Ontario Home Care Administration System database were used to assess regional variations in ra...

Landscape of Industry: Transformation of (Eco Industrial Park through history

Directory of Open Access Journals (Sweden)

Archana Sharma

2013-11-01

Full Text Available The landscape of industry has been changing over time. Industry has transformed and many tangents have emerged from the sporadic home-based cottage industries to geographically scattered large manufacturing industries to co-located industrial parks to environment friendly eco-industrial parks. Curiosity about the catalysts that bring about the transformation of industrial landscape is the motivation of this article. Through the narrative on Industrial Park and the gradual shift towards Eco-Industrial Park, this article aims to shed light on the context and conditions that act as catalysts for industrial transformations, so as to serve as a reference for predicting future changes in industrial landscape.

Building-Based Analysis of the Spatial Provision of Urban Parks in Shenzhen, China

Directory of Open Access Journals (Sweden)

Wenxiu Gao

2017-12-01

Full Text Available Urban parks provide important environmental, social, and economic benefits to people and urban areas. The literature demonstrates that proximity to urban parks is one of the key factors influencing people’s willingness to use them. Therefore, the provision of urban parks near residential areas and workplaces is one of the key factors influencing quality of life. This study designed a solution based on the spatial association between urban parks and buildings where people live or work to identify whether people in different buildings have nearby urban parks available for their daily lives. A building density map based on building floor area (BFA was used to illustrate the spatial distribution of urban parks and five indices were designed to measure the scales, service coverage and potential service loads of urban parks and reveal areas lacking urban park services in an acceptable walking distance. With such solution, we investigated the provision of urban parks in ten districts of Shenzhen in China, which has grown from several small villages to a megacity in only 30 years. The results indicate that the spatial provision of urban parks in Shenzhen is not sufficient since people in about 65% of the buildings cannot access urban parks by walking 10-min. The distribution and service coverage of the existing urban parks is not balanced at the district level. In some districts, the existing urban parks have good numbers of potential users and even have large service loads, while in some districts, the building densities surrounding the existing parks are quite low and at the same time there is no urban parks nearby some high-density areas.

Building-Based Analysis of the Spatial Provision of Urban Parks in Shenzhen, China.

Science.gov (United States)

Gao, Wenxiu; Lyu, Qiang; Fan, Xiang; Yang, Xiaochun; Liu, Jiangtao; Zhang, Xirui

2017-12-06

Urban parks provide important environmental, social, and economic benefits to people and urban areas. The literature demonstrates that proximity to urban parks is one of the key factors influencing people's willingness to use them. Therefore, the provision of urban parks near residential areas and workplaces is one of the key factors influencing quality of life. This study designed a solution based on the spatial association between urban parks and buildings where people live or work to identify whether people in different buildings have nearby urban parks available for their daily lives. A building density map based on building floor area (BFA) was used to illustrate the spatial distribution of urban parks and five indices were designed to measure the scales, service coverage and potential service loads of urban parks and reveal areas lacking urban park services in an acceptable walking distance. With such solution, we investigated the provision of urban parks in ten districts of Shenzhen in China, which has grown from several small villages to a megacity in only 30 years. The results indicate that the spatial provision of urban parks in Shenzhen is not sufficient since people in about 65% of the buildings cannot access urban parks by walking 10-min. The distribution and service coverage of the existing urban parks is not balanced at the district level. In some districts, the existing urban parks have good numbers of potential users and even have large service loads, while in some districts, the building densities surrounding the existing parks are quite low and at the same time there is no urban parks nearby some high-density areas.

A review of the present state and future policy alternatives for home visit nursing services in Korea.

Science.gov (United States)

Lim, Ji Young; Noh, Wonjung; Kim, Eunjoo; Choi, Kyung Won

2014-01-01

The aim of this study was to describe the current state of home visit nursing services in the Korean context and to suggest future policy directions. First, the three home visit nursing services that have developed in Korea are compared using the analytic framework provided by Gilbert and Terrell in 2012. The framework is based on four dimensions of social welfare: users, services, source of funds, and service delivery process. Second, we perform a strength, weakness, opportunity, and threat analysis to suggest comprehensive and constructive home visit nursing service policies for the future. Specifically, we advocate the creation of an organization that steers the central government to operate an integrated management organization to distribute services and reduce redundancy for preventing the waste of both medical and state financial resources. This study also recommends the development of educational programs to improve the quality of services and service evaluation criteria for the objective assessment of those services. These policy guidelines may prove useful both for Korea and for other countries that intend to prepare or revise their home visit nursing service systems. © 2014 Wiley Periodicals, Inc.

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

Science.gov (United States)

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

2017-11-01

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

Mapping outdoor recreationists' perceived social values for ecosystem services at Hinchinbrook Island National Park, Australia

Science.gov (United States)

van Riper, Carena J.; Kyle, Gerard T.; Sutton, Stephen G.; Barnes, Melinda; Sherrouse, Benson C.

2012-01-01

Coastal ecosystems are increasingly faced with human impacts. To better understand these changing conditions, biophysical and economic values of nature have been used to prioritize spatial planning efforts and ecosystem-based management of human activities. Less is known, however, about how to characterize and represent non-material values in decision-making. We collected on-site and mailback survey data (n = 209), and analyzed these data using the Social Values for Ecosystem Services (SolVES) GIS application to incorporate measures of social value and natural resource conditions on Hinchinbrook Island National Park, Australia. Our objectives in this paper are to: 1) determine the spatial distribution and point density of social values for ecosystem services; 2) examine the relationship between social values and natural resource conditions; and 3) compare social value allocations between two subgroups of outdoor recreationists. Results suggest that high priority areas exist on Hinchinbrook's land and seascapes according to the multiple values assigned to places by outdoor recreationists engaged in consumptive (e.g., fishing) and non-consumptive (e.g., hiking) activities. We examine statistically significant spatial clustering across two subgroups of the survey population for three value types that reflect Recreation, Biological Diversity, and Aesthetic qualities. The relationship between the relative importance of social values for ecosystem services and spatially-defined ecological data is explored to guide management decision-making in the context of an island national park setting.

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

Directory of Open Access Journals (Sweden)

Gandi J Moetlo

2011-01-01

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

Home Garden Ecosystem Services Valuation through a Gender Lens: A Case Study in the Catalan Pyrenees

Directory of Open Access Journals (Sweden)

Laura Calvet-Mir

2016-07-01

Full Text Available Ecosystem services have become a critical issue in the environmental literature, however knowledge on whether women and men similarly value ecosystem services is still nascent. We aim at advancing the understanding of the relation between gender and environmental perceptions through the analysis of values assigned by women and men to ecosystem services supplied by home gardens in Vall Fosca (Catalan Pyrenees, north-eastern Spain. We found that women give a higher value than men to all ecosystem services. Overall, women’s valuation of the full range of ecosystem services provided by home gardens was 7.55% higher than men’s valuation. Gender socialization influences the way people interact with and value the environment, including highly managed environments such as home gardens. We argue that considering gendered differences in ecosystem services valuation may lead to policies more effective in enhancing ecosystem services provision.

A City Parking Integration System Combined with Cloud Computing Technologies and Smart Mobile Devices

Science.gov (United States)

Yeh, Her-Tyan; Chen, Bing-Chang; Wang, Bo-Xun

2016-01-01

The current study applied cloud computing technology and smart mobile devices combined with a streaming server for parking lots to plan a city parking integration system. It is also equipped with a parking search system, parking navigation system, parking reservation service, and car retrieval service. With this system, users can quickly find…

75 FR 4842 - Winter Use Plan, Environmental Impact Statement, Yellowstone National Park

Science.gov (United States)

2010-01-29

... DEPARTMENT OF THE INTERIOR National Park Service Winter Use Plan, Environmental Impact Statement... to prepare an Environmental Impact Statement for a Winter Use Plan, Yellowstone National Park... Park Service (NPS) is preparing an Environmental Impact Statement (EIS) for a Winter Use Plan for...

Proposal of a service delivery integration index of home care for older persons: application in several European cities

Directory of Open Access Journals (Sweden)

Jean-Claude Henrard

2006-07-01

Full Text Available Purpose: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. Theory: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure approach. Method: Items considered as part of both dimensions according to an expert consensus (face validity were extracted from a standardised questionnaire used in “Aged in Home care” (AdHoc study to capture basic characteristics of home care services. Their summation leads to a services' delivery integration index. This index was applied to AdHoc services. A factor analysis was computed in order to empirically test the validity of the theoretical constructs. The plot of the settings was performed. Results: Application of the index ranks home care services in four groups according to their score. Factor analysis identifies a first factor which opposes working arrangement within service to organisational structure bringing together provisions for social care. A second factor corresponds to basic nursing care and therapies. Internal consistency for those three domains ranges from 0.78 to 0.93. When plotting the different settings different models of service delivery appear. Conclusion: The proposed index shows that behind a total score several models of care delivery are hidden. Comparison of service delivery integration should take into account this heterogeneity.

Automated Car Park Management System

Science.gov (United States)

Fabros, J. P.; Tabañag, D.; Espra, A.; Gerasta, O. J.

2015-06-01

This study aims to develop a prototype for an Automated Car Park Management System that will increase the quality of service of parking lots through the integration of a smart system that assists motorist in finding vacant parking lot. The research was based on implementing an operating system and a monitoring system for parking system without the use of manpower. This will include Parking Guidance and Information System concept which will efficiently assist motorists and ensures the safety of the vehicles and the valuables inside the vehicle. For monitoring, Optical Character Recognition was employed to monitor and put into list all the cars entering the parking area. All parking events in this system are visible via MATLAB GUI which contain time-in, time-out, time consumed information and also the lot number where the car parks. To put into reality, this system has a payment method, and it comes via a coin slot operation to control the exit gate. The Automated Car Park Management System was successfully built by utilizing microcontrollers specifically one PIC18f4550 and two PIC16F84s and one PIC16F628A.

78 FR 68364 - Payment for Home Health Services and Hospice Care to Non-VA Providers; Delay of Effective Date

Science.gov (United States)

2013-11-14

... providers of home health services and hospice care. The preamble of that final rule stated the effective... 17.56, applicable to non-VA home health services and hospice care. Section 17.56 provides, among... DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 17 RIN 2900-AN98 Payment for Home Health Services and...

Examining visitors' behavioral intentions and behaviors in a Taiwan National Park

Science.gov (United States)

Chieh-Lu Li; Garry E. Chick

2011-01-01

In 2007-2008, some visitors to Taroko National Park in Taiwan were surveyed to allow testing of a behavioral prediction model in the context of national park recreation. This model includes three constructs: values (a cultural anthropology factor), perceptions of service quality (service marketing factors), and perceptions of crowding (a national park recreation factor...

Mental health services for homebound elders from home health nursing agencies and home care agencies.

Science.gov (United States)

Zeltzer, Barry B; Kohn, Robert

2006-04-01

This study examined the practices of home care agencies and home health nursing agencies in the management and treatment of homebound clients with behavioral problems, dementia, and undiagnosed mental illnesses. A survey was mailed to all 54 directors of agencies in Rhode Island in 2003; 53 responded, either by mail or telephone. Data indicated a lack of psychiatric services, a reluctance to address behavioral problems, and a failure to identify undiagnosed disorders. There was also a bias against accepting individuals with primary psychiatric disorders. Although the population of homebound elders with mental illness is increasing, their needs are not being met by these agencies.

Adaptive Software Architecture Based on Confident HCI for the Deployment of Sensitive Services in Smart Homes

Science.gov (United States)

Vega-Barbas, Mario; Pau, Iván; Martín-Ruiz, María Luisa; Seoane, Fernando

2015-01-01

Smart spaces foster the development of natural and appropriate forms of human-computer interaction by taking advantage of home customization. The interaction potential of the Smart Home, which is a special type of smart space, is of particular interest in fields in which the acceptance of new technologies is limited and restrictive. The integration of smart home design patterns with sensitive solutions can increase user acceptance. In this paper, we present the main challenges that have been identified in the literature for the successful deployment of sensitive services (e.g., telemedicine and assistive services) in smart spaces and a software architecture that models the functionalities of a Smart Home platform that are required to maintain and support such sensitive services. This architecture emphasizes user interaction as a key concept to facilitate the acceptance of sensitive services by end-users and utilizes activity theory to support its innovative design. The application of activity theory to the architecture eases the handling of novel concepts, such as understanding of the system by patients at home or the affordability of assistive services. Finally, we provide a proof-of-concept implementation of the architecture and compare the results with other architectures from the literature. PMID:25815449

AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for the National Park Service: Golden Gate National Recreation Area

Energy Technology Data Exchange (ETDEWEB)

Stephen Schey; Jim Francfort

2014-03-01

charging events could occur at the vehicle home base, high-use work areas, or intermediately along routes that the vehicles frequently travel. Replacement of vehicles in the current fleet would result in significant reductions in the emission of greenhouse gases and petroleum use, while also reducing fuel costs. The San Francisco Bay Area is a leader in the adoption of PEVs in the United States. PEV charging stations, or more appropriately identified as electric vehicle supply equipment, located on the GGNRA facility would be a benefit for both GGNRA fleets and general public use. Fleet drivers and park visitors operating privately owned PEVs benefit by using the charging infrastructure. ITSNA recommends location analysis of the GGNRA site to identify the optimal placement of the electric vehicle supply equipment station. ITSNA recognizes the support of Idaho National Laboratory and ICF International for their efforts to initiate communication with the National Parks Service and GGNRA for participation in the study. ITSNA is pleased to provide this report and is encouraged by the high interest and support from the National Park Service and GGNRA personnel.

Care pathways as boundary objects between primary and secondary care: Experiences from Norwegian home care services.

Science.gov (United States)

Håland, Erna; Røsstad, Tove; Osmundsen, Tonje C

2015-11-01

The need for integration of healthcare services and collaboration across organisational boundaries is highlighted as a major challenge within healthcare in many countries. Care pathways are often presented as a solution to this challenge. In this article, we study a project of developing, introducing and using a care pathway across healthcare levels focusing on older home-dwelling patients in need of home care services after hospital discharge. In so doing, we use the concept of boundary object, as described by Star and Griesemer, to explore how care pathways can act as tools for translation between specialist healthcare services and home care services. Based on interviews with participants in the project, we find that response to existing needs, local tailoring, involvement and commitment are all crucial for the care pathway to function as a boundary object in this setting. Furthermore, the care pathway, as we argue, can be used to push boundaries just as much as it can be used as a tool for bridging across them, thus potentially contributing to a more equal relationship between specialist healthcare services and home care services. © The Author(s) 2015.

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

Science.gov (United States)

2014-01-16

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

78 FR 78380 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Fort...

Science.gov (United States)

2013-12-26

... completion of an inventory of human remains under the control of Fort Bowie National Historic Site, Bowie, AZ....R50000] Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Fort... completed an inventory of human remains, in consultation with the appropriate Indian tribes or Native...

Energy intensity and greenhouse gas emission of a purchase in the retail park service sector: An integrative approach

International Nuclear Information System (INIS)

Farreny, Ramon; Gabarrell, Xavier; Rieradevall, Joan

2008-01-01

The aim of this paper is to describe the energetic metabolism of a retail park service system under an integrative approach. Energy flow accounting was applied to a case study retail park in Spain, representative of the sector across Europe, after redefining the functional unit to account for both direct energy use (buildings, gardens and outdoor lighting) and indirect energy use (employee and customer transportation). A life cycle assessment (LCA) was then undertaken to determine energy global warming potential (GWP) and some energy intensity and greenhouse gases (GHG) emission indicators were defined and applied. The results emphasise the importance of service systems in global warming policies, as a potential emission of 9.26 kg CO 2 /purchase was obtained for the case study, relating to a consumption of 1.64 KOE of energy, of which 21.9% was spent on buildings and 57.9% on customer transportation. Some strategies to reduce these emissions were considered: increased supply, energy efficiency, changes in distribution of modes of transport, changes in location and changes in the mix of land uses. A combination of all of these elements in a new retail park could reduce GHG emissions by more than 50%, as it is planning strategies, which seem to be the most effective. (author)

Design Of Toyota Home Service Applications For AUTO2000 Based On Android

OpenAIRE

Aswin, Arief Rahmadian

2016-01-01

AUTO2000 is a network of sales services, maintenance, repair and supply of spare parts Toyota that was established in 1975 under the name Astra Motor Sales, in 1989 changed its name to AUTO2000 with management that has been handled entirely by PT. Astra International Tbk. Services provided by AUTO2000 one of which is a service of Toyota Home Service, a service provided by the service vehicle Auto 2000 where customers can service their vehicles without having to come to the dealership Auto 200...

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

Science.gov (United States)

Fogler, Sarah

2009-11-01

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

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

Science.gov (United States)

Gnass, I; Krutter, S; Nestler, N

2018-03-21

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

Incidence and seasonality of falls amongst old people receiving home help services in a municipality in northern Sweden.

Science.gov (United States)

Vikman, Irene; Nordlund, Anders; Näslund, Annika; Nyberg, Lars

2011-04-01

Falls among old people is a well-documented phenomenon; however, falls among people living in the community and receiving home help services have been under-researched. The aim of this study was to investigate the incidence, including possible seasonal variation, circumstances and injuries related to falls among community living home help receivers, and to investigate whether fall incidence is associated with the type and amount of home help services received. Prospective cohort study. All 614 persons aged 65 and over who were living in a particular northern Swedish community and receiving municipality home help were included. Data on age, sex and home help service use were collected from home help service records, and falls were reported by staff on report forms specifically designed for the study. Results. A total number of 264 falls were recorded among 122 participants. The overall fall incidence was 626 per 1,000 PY, and incidence rate ratios were significantly correlated to the total amount of services used (pfalls reported as resulting in injury was 33%. The monthly fall incidence was significantly associated to daylight photoperiod, however it was not associated to temperature. Fall incidence among home help receivers aged 65 and over seems correlated to the amount of services they receive. This is probably explained by the fact that impairments connected to ADL limitations and home help needs also are connected to an increased risk of falls. This implies that fall prevention should be considered when planning home help care for old people with ADL limitations. Further research on the connection between daylight photoperiod and fall incidence in populations at different latitudes is needed.

[Cooperation between nursing homes and intellectual disability care services : State of affairs in Flanders].

Science.gov (United States)

Campens, J; Schiettecat, T; Vervliet, M; Van Heck, L; Lesseliers, J; Goethals, I; De Witte, N

2017-10-01

Considering the increasing life expectancy of people with intellectual disabilities (ID), the importance of cooperation between services for people with ID and elderly care services has been stressed in Flanders and the Netherlands, as well as internationally. However, the prevalence, intensity and content of such a cooperation are yet unknown. In order to gain information to address this issue, an online-survey was delivered to directors of all nursing homes in Flanders (n = 781). 229 surveys were completed.In more than 75% of the nursing homes, people with ID were among the residents over the past decade. However, at the same time a lack of expertise has been identified as a barrier to provide them optimal care and support. Hence, the respondents point out that a cooperation with ID care services could be beneficial. Nevertheless, those partnerships only arose in a quarter of the nursing homes so far, primarily for the purpose of exchange of expertise. Intersectoral multidisciplinary consultations and intersectoral care team consultations have been taking place as well, be it mainly in the context of a persons' transition from an ID care service to a nursing home. Until now, radical cooperations which involve an exchange of staff, seem to be rather rare.

Home visits during pregnancy: consequences on pregnancy outcome, use of health services, and women's situations.

Science.gov (United States)

Blondel, B; Bréart, G

1995-08-01

This review of eight randomized controlled trials assessed two different types of home visits during pregnancy: (1) those offering social support to high-risk women; and (2) those providing medical care to women with complications. In both categories, pregnancy outcome was not improved when women received home visits. The summary odds ratio for preterm delivery (better integration of hospital and home services might allow a more rational use of health services for women with complications. In addition, we need to define more precisely the content of home visits providing social support. For this, further research is required on how emotional support, health education, and advice influence the health of women and infants and mother-child interactions.

Impact of specialist home-based palliative care services in a tertiary oncology set up: a prospective non-randomized observational study.

Science.gov (United States)

Dhiliwal, Sunil R; Muckaden, Maryann

2015-01-01

Home-based specialist palliative care services are developed to meet the needs of the patients in advanced stage of cancer at home with physical symptoms and distress. Specialist home care services are intended to improve symptom control and quality of life, enable patients to stay at home, and avoid unnecessary hospital admission. Total 690 new cases registered under home-based palliative care service in the year 2012 were prospectively studied to assess the impact of specialist home-based services using Edmonton symptom assessment scale (ESAS) and other parameters. Out of the 690 registered cases, 506 patients received home-based palliative care. 50.98% patients were cared for at home, 28.85% patients needed hospice referral and 20.15% patients needed brief period of hospitalization. All patients receiving specialist home care had good relief of physical symptoms (P care (OOH) through liaising with local general practitioners; 42.68% received home based bereavement care and 91.66% had good bereavement outcomes. Specialist home-based palliative care improved symptom control, health-related communication and psychosocial support. It promoted increased number of home-based death, appropriate and early hospice referral, and averted needless hospitalization. It improved bereavement outcomes, and caregiver satisfaction.

AVTA Federal Fleet PEV Readiness Data Logging and Characterization Study for the National Park Service: Fort Vancouver National Historic Site

Energy Technology Data Exchange (ETDEWEB)

Stephen Schey; Jim Francfort

2014-03-01

Battelle Energy Alliance, LLC, managing and operating contractor for the U.S. Department of Energy’s Idaho National Laboratory, is the lead laboratory for the U.S. Department of Energy’s Advanced Vehicle Testing. Battelle Energy Alliance, LLC contracted with Intertek Testing Services, North America (ITSNA) to collect data on federal fleet operations as part of the Advanced Vehicle Testing Activity’s Federal Fleet Vehicle Data Logging and Characterization study. The Advanced Vehicle Testing Activity study seeks to collect data to validate the use of advanced electric drive vehicle transportation. This report focuses on the Fort Vancouver National Historic Site (FVNHS) fleet to identify daily operational characteristics of select vehicles and report findings on vehicle and mission characterizations to support the successful introduction of electric vehicles (EVs) into the agencies’ fleet. Individual observations of the selected vehicles provided the basis for recommendations related to EV adoption and whether a battery electric vehicle (BEV) or plug-in hybrid electric vehicle (PHEV) (collectively plug-in electric vehicles) could fulfill the mission requirements. FVNHS identified three vehicles in its fleet for consideration. While the FVNHS vehicles conduct many different missions, only two (i.e., support and pool missions) were selected by agency management to be part of this fleet evaluation. The logged vehicles included a pickup truck and a minivan. This report will show that BEVs and PHEVs are capable of performing the required missions and providing an alternative vehicle for both mission categories, because each has sufficient range for individual trips and time available each day for charging to accommodate multiple trips per day. These charging events could occur at the vehicle’s home base, high-use work areas, or in intermediate areas along routes that the vehicles frequently travel. Replacement of vehicles in the current fleet would result in

78 FR 78378 - Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grant...

Science.gov (United States)

2013-12-26

... Repatriation Act (NAGPRA), 25 U.S.C. 3003, of the completion of an inventory of human remains under the control....R50000] Notice of Inventory Completion: U.S. Department of the Interior, National Park Service, Grant... Historic Site has completed an inventory of human remains, in consultation with the appropriate Indian...

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

Assessing the impact of a restorative home care service in New Zealand: a cluster randomised controlled trial.

Science.gov (United States)

King, Anna I I; Parsons, Matthew; Robinson, Elizabeth; Jörgensen, Diane

2012-07-01

Due to the ageing population, there is an increased demand for home care services. Restorative care is one approach to improving home care services, although there is little evidence to support its use in the community setting. The objective of this trial was to evaluate the impact of a restorative home care service for community-dwelling older people. The study was a cluster randomised controlled trial undertaken at a home care agency in New Zealand. The study period was from December 2005 to May 2007. Older people were interviewed face-to-face at baseline, four and 7 months. A total of 186 older people who received assistance from a home care agency participated in the study, 93 received restorative home care and 93 older people received usual home care. The primary outcome measure was change in health-related quality of life (measured by the Short Form 36 [SF36] Health Survey). Secondary outcomes were the physical, mental, and social well-being of older people (Nottingham Extended Activities of Daily Living, Timed Up and Go, Mastery scale, Duke Social Support Index). Findings revealed that compared with usual care, the intervention demonstrated a statistically significant benefit in health-related quality of life (SF36) at 7 months for older people (mean difference 3.8, 95% CI -0.0 to 7.7, P = 0.05). There were no changes in other scale measurements for older people in either group over time. There was a statistically significant difference in the number of older people in the intervention group identified for reduced hours or discharge (29%) compared with the control group (0%) (P home care service may be of benefit to older people, and improves home care service efficacy. © 2011 Blackwell Publishing Ltd.

The Home Independence Program with non-health professionals as care managers: an evaluation

Directory of Open Access Journals (Sweden)

Lewin G

2016-06-01

Full Text Available Gill Lewin,1 Karyn Concanen,2 David Youens3 1School of Nursing, Midwifery and Paramedicine, Curtin University, Perth, WA, Australia; 2Silver Chain Group, Osborne Park, WA, Australia; 3Faculty of Health Science, Curtin University, Perth, WA, Australia Abstract: The Home Independence Program (HIP, an Australian restorative home care/reablement service for older adults, has been shown to be effective in reducing functional dependency and increasing functional mobility, confidence in everyday activities, and quality of life. These gains were found to translate into a reduced need for ongoing care services and reduced health and aged care costs over time. Despite these positive outcomes, few Australian home care agencies have adopted the service model – a key reason being that few Australian providers employ health professionals, who act as care managers under the HIP service model. A call for proposals from Health Workforce Australia for projects to expand the scope of practice of health/aged care staff then provided the opportunity to develop, implement, and evaluate a service delivery model, in which nonprofessionals replaced the health professionals as Care Managers in the HIP service. Seventy older people who received the HIP Coordinator (HIPC service participated in the outcomes evaluation. On a range of personal outcome measures, the group showed statistically significant improvement at 3 and 12 months compared to baseline. On each outcome, the improvement observed was larger than that observed in a previous trial in which the service was delivered by health professionals. However, differences in the timing of data collection between the two studies mean that a direct comparison cannot be made. Clients in both studies showed a similarly reduced need for ongoing home care services at both follow-up points. The outcomes achieved by HIPC, with non-health professionals as Care Managers, were positive and can be considered to compare favorably

Potential and challenges in home care service process optimization : a route optimization approach

OpenAIRE

Nakari, Pentti J. E.

2016-01-01

Aging of the population is an increasing problem in many countries, including Finland, and it poses a challenge to public services such as home care. Vehicle routing optimization (VRP) type optimization solutions are one possible way to decrease the time required for planning home visits and driving to customer addresses, as well as decreasing transportation costs. Although VRP optimization is widely and succesfully applied to commercial and industrial logistics, the home care ...

Modeling and Detecting Feature Interactions among Integrated Services of Home Network Systems

Science.gov (United States)

Igaki, Hiroshi; Nakamura, Masahide

This paper presents a framework for formalizing and detecting feature interactions (FIs) in the emerging smart home domain. We first establish a model of home network system (HNS), where every networked appliance (or the HNS environment) is characterized as an object consisting of properties and methods. Then, every HNS service is defined as a sequence of method invocations of the appliances. Within the model, we next formalize two kinds of FIs: (a) appliance interactions and (b) environment interactions. An appliance interaction occurs when two method invocations conflict on the same appliance, whereas an environment interaction arises when two method invocations conflict indirectly via the environment. Finally, we propose offline and online methods that detect FIs before service deployment and during execution, respectively. Through a case study with seven practical services, it is shown that the proposed framework is generic enough to capture feature interactions in HNS integrated services. We also discuss several FI resolution schemes within the proposed framework.

The Influence of Urinary Incontinence on Publicly Financed Home Care Services to Low-Income Elderly People.

Science.gov (United States)

Baker, Dorothy I.; Bice, Thomas W.

1995-01-01

A retrospective cohort design is used to estimate the effect of urinary incontinence (UI) on the public costs of home care services to elderly individuals. Multivariate analyses controlling for other individual, household, and supply characteristics demonstrate that those with UI generate significantly greater public costs for home care services.…

Effects of home-based long-term care services on caregiver health according to age.

Science.gov (United States)

Chen, Ming-Chun; Kao, Chi-Wen; Chiu, Yu-Lung; Lin, Tzu-Ying; Tsai, Yu-Ting; Jian, Yi-Ting Zhang; Tzeng, Ya-Mei; Lin, Fu-Gong; Hwang, Shu-Ling; Li, Shan-Ru; Kao, Senyeong

2017-10-23

Caregiver health is a crucial public health concern due to the increasing number of elderly people with disabilities. Elderly caregivers are more likely to have poorer health and be a care recipient than younger caregivers. The Taiwan government offers home-based long-term care (LTC) services to provide formal care and decrease the burden of caregivers. This study examined the effects of home-based LTC services on caregiver health according to caregiver age. This cross-sectional study included a simple random sample of care recipients and their caregivers. The care recipients had used LTC services under the Ten-Year Long-Term Care Project (TLTCP) in Taiwan. Data were collected through self-administered questionnaires from September 2012 to January 2013. The following variables were assessed for caregivers: health, sex, marital status, education level, relationship with care recipient, quality of relationship with care recipient, job, household monthly income, family income spent on caring for the care recipient (%) and caregiving period. Furthermore, the following factors were assessed for care recipients: age, sex, marital status, education level, living alone, number of family members living with the care recipient, quality of relationship with family and dependency level. The health of the caregivers and care recipients was measured using a self-rated question (self-rated health [SRH] was rated as very poor, poor, fair, good and very good). The study revealed that home nursing care was significantly associated with the health of caregivers aged 65 years or older; however, caregivers aged less than 65 who had used home nursing care, rehabilitation or respite care had poorer health than those who had not used these services. In addition, the following variables significantly improved the health of caregivers aged 65 years or older: caregiver employment, 20% or less of family income spent on caregiving than 81%-100% and higher care recipient health. The

75 FR 51103 - Notice of Public Meetings for the National Park Service (NPS) Alaska Region's Subsistence...

Science.gov (United States)

2010-08-18

... SRC and Wrangell-St. Elias SRC plan to meet to develop and continue work on National Park Service (NPS... reconvene on Thursday, October 7, 2010, from 9 a.m. to 5 p.m. or until business is completed. This meeting will be held at Fast Eddy's Motel and Restaurant located at Mile 1313 on the Alaska Highway in Tok, AK...

National Park Service Vegetation Inventory Program, Cuyahoga Valley National Park, Ohio

Science.gov (United States)

Hop, Kevin D.; Drake, J.; Strassman, Andrew C.; Hoy, Erin E.; Menard, Shannon; Jakusz, J.W.; Dieck, J.J.

2013-01-01

The National Park Service (NPS) Vegetation Inventory Program (VIP) is an effort to classify, describe, and map existing vegetation of national park units for the NPS Natural Resource Inventory and Monitoring (I&M) Program. The NPS VIP is managed by the NPS Biological Resources Management Division and provides baseline vegetation information to the NPS Natural Resource I&M Program. The U.S. Geological Survey (USGS) Vegetation Characterization Program lends a cooperative role in the NPS VIP. The USGS Upper Midwest Environmental Sciences Center, NatureServe, and NPS Cuyahoga Valley National Park (CUVA) have completed vegetation classification and mapping of CUVA.Mappers, ecologists, and botanists collaborated to identify and describe vegetation types within the National Vegetation Classification Standard (NVCS) and to determine how best to map them by using aerial imagery. The team collected data from 221 vegetation plots within CUVA to develop detailed descriptions of vegetation types. Data from 50 verification sites were also collected to test both the key to vegetation types and the application of vegetation types to a sample set of map polygons. Furthermore, data from 647 accuracy assessment (AA) sites were collected (of which 643 were used to test accuracy of the vegetation map layer). These data sets led to the identification of 45 vegetation types at the association level in the NVCS at CUVA.A total of 44 map classes were developed to map the vegetation and general land cover of CUVA, including the following: 29 map classes represent natural/semi-natural vegetation types in the NVCS, 12 map classes represent cultural vegetation (agricultural and developed) in the NVCS, and 3 map classes represent non-vegetation features (open-water bodies). Features were interpreted from viewing color-infrared digital aerial imagery dated October 2010 (during peak leaf-phenology change of trees) via digital onscreen three-dimensional stereoscopic workflow systems in geographic

A Service-Oriented Framework for the Development of Home Robots

Directory of Open Access Journals (Sweden)

Tsung-Hsien Yang

2013-02-01

Full Text Available In recent years, researchers have been building home robots able to interact and work with people. Yet, because of the complicated and independent robot development environments, it is not always easy to share and reuse robot code created by different providers. In this work, we present an ontology-based framework that integrates service-oriented computing environments with the standard web interface to develop reusable robotic services. In addition to the service discovery, selection, and composition processes often performed by traditional web services, our work also includes an adaptive mechanism through which the user can iteratively modify composite robotic services to suit his or her needs. The proposed methodology has been implemented and evaluated, and the results show that our framework can be used to build robotic services successfully.

Improved Clinical Efficacy with Wound Support Network Between Hospital and Home Care Service.

Science.gov (United States)

Bergersen, Tone Kristin; Storheim, Elisabeth; Gundersen, Stina; Kleven, Linn; Johnson, Maria; Sandvik, Leiv; Kvaerner, Kari Jorunn; Ørjasæter, Nils-Otto

2016-11-01

The aim of this study was to test the efficacy of a wound support network model between the primary home care service and the hospital. The impact on wound healing rate, cost benefit, and transfer of knowledge was investigated. The intervention group was exposed to a wound support network (n = 32), and the control group continued standard organization of treatment (n = 21). Nonrandomized controlled study; observations were made before (baseline) and after the implementation of the intervention (12 weeks). Patients with chronic wounds (lasting >6 weeks and with wound area >1 cm) in Oslo, Norway. Closure of the observation wound; wound size; total number of wounds; presence of eczema, edema, and pain; number of dressings per week; time spent per dressing; and number of control appointments at the hospital. The economic impact is calculated for the hospital and for the community of Oslo, Norway. The number of control appointments (t = 3.80, P home care service and the hospital is cost-effective, improves clinical efficacy of the home care services' work, and reduces the need for consultations at the hospital.

Role of parking in the hotel supply chain management

Directory of Open Access Journals (Sweden)

Robert Maršanić

2015-12-01

Full Text Available Background: Supply chain management in tourism has only recently become the topic of the scientific research. The hotel product as a tourist product presents a specific mix of services and products The focus of this study has been placed on the hotel company, that, in order to create such a product, builds its own network of partners (companies, co-workers, to bring together and coordinate activities intended to result in the desired features of the hotel product. This study was evaluated as a scientifically relevant because until now the position of parking services in the hotel product has not been analyzed from the perspective of the hotel efforts and abilities to provide parking places for their guests by analyzing to which extent a good and available parking space really affects the quality of the hotel product. The aim of the study was to define the framework in which the supply chain management acts with reference to the parking service and stakeholders in the network. Methods: The method of interviewing hotel managers was used to obtain necessary data. Through the simple numerical calculations including the number of parking spaces and the capacity of the hotel accommodation we tried to identify the interrelationship, i.e. the degree of alignment of the respective sizes. Results: It turned out that towns of Rijeka and Opatija are faced with a shortage of parking spaces, especially during the tourist season. The trend of providing parking services for guests in hotel-owned garages or car parks is typical for the everyday hotel operation and the shortage of such an option, is resolved through the lease of a certain number of parking spaces in public garages and car parks. These parking spaces are away from the hotel, the guests' dissatisfaction is a normal consequence of such a decision and it is mitigated through the commercial measures. Hotel management considers a provided parking space an important element of the hotel product quality

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

Science.gov (United States)

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

2015-01-01

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

PREREQUISITES FOR CREATING A COMPETITIVE ADVANTAGE IN NATURE PARKS THROUGH DIFFERENTIATION

Directory of Open Access Journals (Sweden)

Vesna Vučemilović

2017-01-01

Full Text Available Differentiation is a way for gaining a sustainable competitive advantage or achieving a market position which enables companies to satisfy customers’ needs better than the competition. Differentiation can manifest itself through four dimensions: product, services, personnel and image. Nature parks, national parks, strict reserves and special reserves are categories of protected areas of national importance. Nature parks and national parks have exceptional potential for visiting system development, but are also responsible for the management of these activities. There are numerous nature protection restrictions arising from legislation and management documents. The principal task is to protect and preserve the natural and landscape values and ecological characteristics. Creating and realizing visiting activities as a part of tourist services supplied trough Public institutions are also specific. These services must be differentiated on the market in relation to the competition. Income generated from tourist services in the income structure of nature parks, will be even more important in the future, because of self-financing development and central budget dependency reduction. It must be emphasized that nature parks help the larger community through development of complementary economic activities. This paper is based on market research conducted in the period from 16 May to 10 June 2016 in Nature Park Kopački rit, which is one of the most visited nature parks in the Republic of Croatia. A poll survey was carried out among 300 randomly selected visitors. The research results may be used for policy suggestions for how to create adequate products, services and promotional activities, ensure quality education for visitors about natural, historical and cultural protected area values and minimize visitors’ impact on natural resources.

Administration of care to older patients in transition from hospital to home care services: home nursing leaders' experiences

Directory of Open Access Journals (Sweden)

Dale B

2013-10-01

Full Text Available Bjørg Dale,1 Sigrun Hvalvik21Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, 2Centre for Caring Research – Southern Norway, Faculty of Health and Social Studies, Telemark University College, Porsgrunn, NorwayBackground: Older persons in transition between hospital and home care services are in a particularly vulnerable situation and risk unfortunate consequences caused by organizational inefficiency. The purpose of the study reported here was to elucidate how home nursing leaders experience the administration of care to older people in transition from hospital to their own homes.Methods: A qualitative study design was used. Ten home nursing leaders in two municipalities in southern Norway participated in individual interviews. The interview texts were audio taped, transcribed verbatim and analyzed by use of a phenomenological-hermeneutic approach.Results: Three main themes and seven subthemes were deduced from the data. The first main theme was that the home nursing leaders felt challenged by the organization of home care services. Two subthemes were identified related to this. The first was that the leaders lacked involvement in the transitional process, and the second was that they were challenged by administration of care being decided at another level in the municipality. The second main theme found was that the leaders felt that they were acting in a shifting and unsettled context. Related to this, they had to adjust internal resources to external demands and expectations, and experienced lack of communication with significant others. The third main theme identified was that the leaders endeavored to deliver care in accordance with professional values. The two related subthemes were, first, that they provided for appropriate internal systems and routines, and, second, that they prioritized available professional competence, and made an effort to promote a professional

77 FR 19690 - Notice of Inventory Completion: California Department of Parks and Recreation, Sacramento, CA

Science.gov (United States)

2012-04-02

...: California Department of Parks and Recreation, Sacramento, CA AGENCY: National Park Service, Interior. ACTION... Department of Parks and Recreation, 1416 9th Street, Room 902, Sacramento, CA 95814, telephone (916) 653-8893... located in San Diego County, CA. This notice is published as part of the National Park Service's...

77 FR 19689 - Notice of Inventory Completion: California Department of Parks and Recreation, Sacramento, CA

Science.gov (United States)

2012-04-02

...: California Department of Parks and Recreation, Sacramento, CA AGENCY: National Park Service, Interior. ACTION... Department of Parks and Recreation, 1416 9th Street, Room 902, Sacramento, CA 95814, telephone (916) 653-8893... located in San Diego County, CA. This notice is published as part of the National Park Service's...

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

Science.gov (United States)

Friedman, Carli; VanPuymbrouck, Laura

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

Occupational Therapy in Medicaid Home and Community-Based Services Waivers

Science.gov (United States)

VanPuymbrouck, Laura

2018-01-01

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

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

Science.gov (United States)

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

2008-08-01

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

Promoting father involvement in early home visiting services for vulnerable families: Findings from a pilot study of "Dads matter".

Science.gov (United States)

Guterman, Neil B; Bellamy, Jennifer L; Banman, Aaron

2018-02-01

Despite mounting evidence on the importance of fathers in children's development, evidence-based perinatal home visitation programs have largely overlooked fathers in the design and delivery of services. This paper describes the design, development, and pilot testing of the "Dads Matter" enhancement to standard home visiting services. Dads Matter is a manualized intervention package designed to fully incorporate fathers into perinatal home visiting services. Twenty-four families were enrolled in a pilot study to assess the feasibility, acceptability, and preliminary outcomes of the intervention. Using a quasi-experimental time-lagged design, 12 families received standard home visiting services and completed baseline and four-month post-tests. Home visitor staff were then trained and supervised to implement the Dads Matter enhancement in addition to standard services. Twelve additional families were then enrolled and completed baseline and four-month post-tests. Implementation data indicated that Dads Matter was implemented as planned. Cohen's d scores on outcome measures indicate positive trends associated with Dads Matter in the quality of the mother-father relationship, perceived stress reported by both parents, fathers' involvement with the child, maltreatment indicators, and fathers' verbalizations toward the infant. Effect sizes generally ranged from moderate to large in magnitude and were larger than overall effect sizes of home visitation services alone reported in prior meta-analyses. Dads Matter appears to be a feasible, acceptable, and promising approach to improving fathers' engagement in home visiting services and promoting family and child well-being. Copyright © 2017. Published by Elsevier Ltd.

Undermining the rules in home care services for the elderly in Norway: flexibility and cooperation.

Science.gov (United States)

Wollscheid, Sabine; Eriksen, John; Hallvik, Jørgen

2013-06-01

This study explores the provision of home care services (home nursing and domiciliary help) for the elderly in Norwegian municipalities with purchaser-provider split model. The study draws on the assumption that flexibility in adjusting services to the care receivers' needs, and cooperation between provider and purchasers are indicators of good quality of care. Data were collected through semi-structured telephone interviews with 22 team leaders of provider units in nine municipalities. Data were collected in 2008-2009. The study has been approved by the Norwegian Social Science Data Services. We identified four different ways of organising home care services under a purchaser-provider split model: Provider empowerment, New Public Management, Vague instructions and undermining the rules. High flexibility in providing care and cooperation with the purchaser unit were identified by the team leaders as characteristics for good care. Our findings suggest that the care providers use individual strategies that allow flexibility and cooperation rather than rigidly abiding to the regulations the purchaser-provider split models implies. Ironically, in provider units where the 'rules were undermined', the informants (team leaders of provider units) seemed to be most satisfied with the quality of home care that they delivered. © 2012 Nordic College of Caring Science.

Getting some insight into the home care nursing service in Croatia.

Science.gov (United States)

Kostanjšek, Diana; Nižetić, Vlatka Topolovec; Razum, Zeljko; Kovačić, Luka

2014-12-01

Croatia, as the other Western societies are facing with the increasing share of the population over 65 years and consequently with more care-dependant people. Community living and care, including home care, is stimulating not just because of efficiency of care but also because of the peopleis preferences that home is a place of emotional and physical associations, memories and comfort. The aim of the study was to see if there is lack or surplus of Home care nursing services within the health care system. Data from the Croatian Health Insurance Fond Data base were analysed. The results of this research indicated that the number of inhabitants per one home nurse and physiotherapist contracted by the Croatian Health Insurance Fond was below the defined Standard. The average number of inhabitants per one home care nurse contracted by the CHIF for 2013 was 3373.9 compared to 3500 defined by the Standard. There was found also the huge regional differences in their distributions. The average number of contracted home physiotherapists for the same year was 9805.2 in comparison to the Standard, which was setup at the level of 15000 inhabitants per one physiotherapist.

Developing services to support parents caring for a technology-dependent child at home.

Science.gov (United States)

Kirk, S; Glendinning, C

2004-05-01

A group of children with complex health care needs have emerged as a result of medical advances and government policies emphasizing the community as the arena for care. Some of these children remain dependent on the medical technology that enabled them to survive and require care of a complex and intensive nature to be carried out by their parents at home. To explore the experiences of families caring at home for a technology-dependent child; to examine their needs for practical and other support; and to examine how far services are currently meeting these needs. Methods In-depth interviews were conducted with the parents of 24 technology-dependent children and with 44 health, social care and other professionals. Services in the community were not sufficiently developed to support this group of families. Major problems were identified in the purchasing and provision of both short-term care/home support services and specialist equipment/therapies in the community. Service provision could be poorly planned and co-ordinated at an operational level and few families had a designated key worker. Parents felt that professionals did not always recognize either the emotional costs entailed in providing care of this nature or their expertise in caregiving. Information-giving to parents was often described as poor and participants reported that hospital professionals failed to negotiate the transfer of caregiving responsibility to parents. Services need to work in partnership with families and with each other at both strategic and operational levels, to develop integrated and co-ordinated services that can meet the needs of this group of families.

77 FR 37438 - Draft Trail Management Plan and Environmental Impact Statement for Cuyahoga Valley National Park...

Science.gov (United States)

2012-06-21

... DEPARTMENT OF THE INTERIOR National Park Service [NPS-MWR-CUVA-10100; 6065-4000-409] Draft Trail... Park Service, Interior. ACTION: Notice of Availability. SUMMARY: The National Park Service (NPS... blueprint to guide the expansion, elimination, restoration, management, and use of the trail system and its...

Estimating savings in parking demand using shared vehicles for home-work commuting

OpenAIRE

Kondor, Dániel; Zhang, Hongmou; Tachet, Remi; Santi, Paolo; Ratti, Carlo

2017-01-01

The increasing availability and adoption of shared vehicles as an alternative to personally-owned cars presents ample opportunities for achieving more efficient transportation in cities. With private cars spending on the average over 95\\% of the time parked, one of the possible benefits of shared mobility is the reduced need for parking space. While widely discussed, a systematic quantification of these benefits as a function of mobility demand and sharing models is still mostly lacking in th...

Does empowering resident families or nursing home employees in decision making improve service quality?

Science.gov (United States)

Hamann, Darla J

2014-08-01

This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

Home and community care services: a major opportunity for preventive health care

Directory of Open Access Journals (Sweden)

Lujic Sanja

2010-05-01

Full Text Available Abstract Background In Australia, the Home and Community Care (HACC program provides services in the community to frail elderly living at home and their carers. Surprisingly little is known about the health of people who use these services. In this study we sought to describe health-related factors associated with use of HACC services, and to identify potential opportunities for targeting preventive services to those at high risk. Methods We obtained questionnaire data from the 45 and Up Study for 103,041 men and women aged 45 years and over, sampled from the general population of New South Wales, Australia in 2006-2007, and linked this with administrative data about HACC service use. We compared the characteristics of HACC clients and non-clients according to a range of variables from the 45 and Up Study questionnaire, and estimated crude and adjusted relative risks for HACC use with generalized linear models. Results 4,978 (4.8% participants used HACC services in the year prior to completing the questionnaire. Increasing age, female sex, lower pre-tax household income, not having a partner, not being in paid work, Indigenous background and living in a regional or remote location were strongly associated with HACC use. Overseas-born people and those speaking languages other than English at home were significantly less likely to use HACC services. People who were underweight, obese, sedentary, who reported falling in the past year, who were current smokers, or who ate little fruit or vegetables were significantly more likely to use HACC services. HACC service use increased with decreasing levels of physical functioning, higher levels of psychological distress, and poorer self-ratings of health, eyesight and memory. HACC clients were more likely to report chronic health conditions, in particular diabetes, stroke, Parkinson's disease, anxiety and depression, cancer, heart attack or angina, blood clotting problems, asthma and osteoarthritis

Home Visit Services Provided for Elderly Dwellers in Isfahan Province: A Cross-Sectional Study

Directory of Open Access Journals (Sweden)

Zamane Vafaei

2015-06-01

Conclusion: As the home visit services might be effective for providing health care for the aged people and increasing their quality of life, policymaking to spread these services seems to be crucial especially for Iran.

Medicaid Home Care Services and Survival in New York City

Science.gov (United States)

Albert, Steven M.; Simone, Bridget; Brassard, Andrea; Stern, Yaakov; Mayeux, Richard

2005-01-01

Purpose: New York City's Medicaid Home Care Services Program provides an integrated program of housekeeping and personal assistance care along with regular nursing assessments. We sought to determine if this program of supportive care offers a survival benefit to older adults. Design and Methods: Administrative data from New York City's Medicaid…

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

Science.gov (United States)

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

2012-01-01

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

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.

75 FR 8920 - Grant of Authority for Subzone Status; IKEA Distribution Services (Distribution of Home...

Science.gov (United States)

2010-02-26

... Status; IKEA Distribution Services (Distribution of Home Furnishings and Accessories); Baltimore, MD... subzone at the warehouse and distribution facility of IKEA Distribution Services, located in Perryville... and distribution at the facility of IKEA Distribution Services, located in Perryville, Maryland...

People diagnosed with dementia in Sweden: What type of home care services and housing are they granted? A cross-sectional study.

Science.gov (United States)

Odzakovic, Elzana; Hydén, Lars-Christer; Festin, Karin; Kullberg, Agneta

2018-02-01

This study aims to examine what types of home care services and housing are granted to people with a dementia diagnosis and how these types are associated with socio-demographic factors (sex, age, marital status, native or foreign born, and regional area). A cross-sectional study of all people diagnosed with dementia in three Swedish counties was conducted from the medical records in 2012. Logistic regression analysis was carried out to investigate associations between home care services and housing and socio-demographic variables. In total, 17,405 people had a dementia diagnosis, and the majority were women, aged 80+ years, and unmarried. Some 72% were living in ordinary housing and 28% lived in special housing. Of those who lived in ordinary housing, 50% did not receive any home care service. Not receiving any type of home care services was less common for older people and was also associated with being married and living in rural municipalities. The most common home care services granted were home help and personal care. Special housing was more common for older people, unmarried persons, and those living in rural municipalities. Most people with a dementia diagnosis were living in ordinary housing, and, surprisingly, half of those did not receive any type of home care service. This knowledge is essential for making the living conditions and needs of people living with dementia more visible and to provide good home care services for people with dementia and their families.

75 FR 27574 - United States Park Police; 60-Day Notice of Intention To Request Clearance of Collection of...

Science.gov (United States)

2010-05-17

... DEPARTMENT OF THE INTERIOR National Park Service United States Park Police; 60-Day Notice of... States Park Police, National Park Service, Interior. ACTION: Notice and request for comments. SUMMARY... Keeping Requirements, the United States Park Police (USPP) invites public comments on an extension of a...

Mortality and health services utilisation among older people with advanced cognitive impairment living in residential care homes.

Science.gov (United States)

Luk, James K H; Chan, W K; Ng, W C; Chiu, Patrick K C; Ho, Celina; Chan, T C; Chan, Felix H W

2013-12-01

To study the demography, clinical characteristics, service utilisation, mortality, and predictors of mortality in older residential care home residents with advanced cognitive impairment. Cohort longitudinal study. Residential care homes for the elderly in Hong Kong West. Residents of such homes aged 65 years or more with advanced cognitive impairment. In all, 312 such residential care home residents (71 men and 241 women) were studied. Their mean age was 88 (standard deviation, 8) years and their mean Barthel Index 20 score was 1.5 (standard deviation, 2.0). In all, 164 (53%) were receiving enteral feeding. Nearly all of them had urinary and bowel incontinence. Apart from Community Geriatric Assessment Team clinics, 119 (38%) of the residents attended other clinics outside their residential care homes. In all, 107 (34%) died within 1 year; those who died within 1 year used significantly more emergency and hospital services (P<0.001), and utilised more services from community care nurses for wound care (P=0.001), enteral feeding tube care (P=0.018), and urinary catheter care (P<0.001). Independent risk factors for 1-year mortality were active pressure sores (P=0.0037), enteral feeding (P=0.008), having a urinary catheter (P=0.0036), and suffering from chronic obstructive pulmonary disease (P=0.011). A history of pneumococcal vaccination was protective with respect to 1-year mortality (P=0.004). Residents of residential care homes for the elderly with advanced cognitive impairment were frail, exhibited multiple co-morbidities and high mortality. They were frequent users of out-patient, emergency, and in-patient services. The development of end-of-life care services in residential care homes for the elderly is an important need for this group of elderly.

Health care and social service professionals' perceptions of a home-visit program for young, first-time mothers.

Science.gov (United States)

Li, S A; Jack, S M; Gonzalez, A; Duku, E; MacMillan, H L

2015-01-01

Little is known about health care and social service professionals' perspective on the acceptability of long-term home-visit programs serving low-income, first-time mothers. This study describes the experiences and perspectives of these community care providers involved with program referrals or service delivery to mothers who participated in the Nurse-Family Partnership (NFP), a targeted nurse home-visit program. The study included two phases. Phase I was a secondary qualitative data analysis used to analyze a purposeful sample of 24 individual interviews of community care providers. This was part of a larger case study examining adaptations required to increase acceptability of the NFP in Hamilton, Ontario, Canada. In Phase II (n = 4), themes identified from Phase I were further explored through individual, semi-structured interviews with community health care and social service providers, giving qualitative description. Overall, the NFP was viewed as addressing an important service gap for first-time mothers. Providers suggested that frequent communication between the NFP and community agencies serving these mothers could help improve the referral process, avoid service duplication, and streamline the flow of service access. The findings can help determine key components required to enhance the success of integrating a home-visit program into an existing network of community services. The function of home-visit programs should not be viewed in isolation. Rather, their potential can be maximized when they collaborate and share information with other agencies to provide better services for first-time mothers.

Investigation on nursing service satisfaction of the elderly living in nursing home and influencing factors--Taking Zhengzhou City as an example

Directory of Open Access Journals (Sweden)

Xing Wenhui

2016-01-01

Full Text Available Objective: Investigate the status quo of the elderly living in the nursing home and their satisfaction and needs of nursing services, and analyze the service needs of the elderly living in the nursing home of Zhengzhou City. Methods: Randomly select 312 elderly people from 84 nursing homes for questionnaire survey and in-depth interview. Results: More than 60% of the respondents show their satisfaction on the current life in the nursing home. Sex, occupation, physical condition, dietary level, accommodation level, service level and health care conditions of the nursing home have a significant impact on the satisfaction of the elderly. Conclusion: With the growth of the aging of population, improving the level of service for the elderly and improve the service facilities is an essential way to improve the satisfaction and urgent needs of the elderly.

78 FR 53478 - Proposed Information Collection; United States Park Police Personal History Statement

Science.gov (United States)

2013-08-29

...] Proposed Information Collection; United States Park Police Personal History Statement AGENCY: National Park... about this IC, contact Major Scott Fear, United States Park Police, 1100 Ohio Drive SW., Washington, DC... INFORMATION: I. Abstract The United States Park Police (USPP) is a unit of the National Park Service...

Parks beyond parks : genuine community-based wildlife eco-tourism or just another loss of land for Maasai pastoralists in Kenya?

NARCIS (Netherlands)

Rutten, M.M.E.M.

2002-01-01

In 1996 the Kenya Wildlife Services (KWS) embarked on a "Parks beyond Parks" programme, which aimed to bring some of the benefits of wildlife tourism to the local population. Under this programme, local people were allowed to start tented camps and other tourist activities in areas bordering

Contracting out local road and park services: Economic effects and their strategic, contractual, and competitive conditions

DEFF Research Database (Denmark)

Lindholst, Andrej Christian; Petersen, Ole Helby; Houlberg, Kurt

2018-01-01

such as markets, contracts, municipal strategies and contracting history influence these outcomes. Drawing on original survey data from Danish municipalities, we find that competitive tendering has on average reduced costs. Further analysis shows that savings are not associated with lower quality, thus indicating......The economic rationale for contracting out local services is increasingly contested by empirical research. This article aims to contribute to this literature, first by scrutinising the economic effects of contracting out in local road and park services and, second, by exploring how characteristics...... realise larger savings, whereas the characteristics of markets and contracts do not seem to explain variations in cost savings....

Predictors of hospital stay and home care services use: a population-based, retrospective cohort study in stage IV gastric cancer.

Science.gov (United States)

Mahar, Alyson L; Coburn, Natalie G; Viola, Raymond; Johnson, Ana P

2015-02-01

Home care services use has been proposed as a means of reducing costs in palliative care by decreasing hospital stay without impacting quality of clinical care; however, little is known about utilization of these services in the time following a terminal cancer diagnosis. To examine disease, patient and healthcare system predictors of hospital stay, and home care services use in metastatic gastric cancer patients. This is a population-based, retrospective cohort study. Chart review and administrative data were linked, using a 26-month time horizon to collect health services data. All patients diagnosed with metastatic gastric cancer in the province of Ontario between 2005 and 2008 were included in the study (n = 1433). Age, comorbidity, tumor location, and burden of metastatic disease were identified as predictors of hospital stay and receipt of home care services. Individuals who received home care services spent fewer days in hospital than individuals who did not (relative risk: 0.44; 95% confidence interval: 0.38-0.51). Patients who interacted with a high-volume oncology specialist had shorter cumulative hospital stay (relative risk: 0.62; 95% confidence interval: 0.54-0.71) and were less likely to receive home care services (relative risk: 0.80; 95% confidence interval: 0.72-0.88) than those who did not. Examining how differences in hospital stay and home care services use impact clinical outcomes and how policies may reduce costs to the healthcare system is necessary. © The Author(s) 2014.

The acoustic climate at the rest and service areas – parking lots by the Silesian section of A4 motorway

Directory of Open Access Journals (Sweden)

Robert WIESZAŁA

2012-01-01

Full Text Available The aim of this article is to describe the state of the acoustic climate at the rest and service areas (MOPs situated by A4 motorway in Silesia The analysis includes the research results conducted at these parking lots from May till August 2010. The research was conducted with the digital noise meter, which was connected with the computer during measurement. The research results indicate the essential differences in the noise intensity between the particular rest and service area reaching up to 12 dB(A, in spite of the similar value of the traffic noise in all of the places where the research was conducted. It was assumed that the level of noise on each of the parking lots should be similar to standing norms for the recreation areas i.e. below 55 dB(A. The research conducted at 4 MOPs indicated that only at two of them, MOP Halemba and Wirek, these norms are fulfilled. The lack of the proper anti-noise protection in the form of the sound absorbing screens at the parking lots situated by the motorway causes the situation in which the level of noise at the places devoted to rest highly decreases the possibility to relax before the next stage of a journey.

75 FR 39581 - Yosemite Valley Plan; Yosemite National Park; Mariposa, Madera, and Tuolumne Counties, California...

Science.gov (United States)

2010-07-09

... DEPARTMENT OF THE INTERIOR National Park Service Yosemite Valley Plan; Yosemite National Park; Mariposa, Madera, and Tuolumne Counties, California; Notice of Revised Record of Decision SUMMARY: On December 29, 2000, the National Park Service (NPS) executed a Record of Decision selecting Alternative 2...

Care satisfaction among older people receiving public care and service at home or in special accommodation.

Science.gov (United States)

Karlsson, Staffan; Edberg, Anna-Karin; Jakobsson, Ulf; Hallberg, Ingalill R

2013-02-01

To explore care satisfaction in relation to place of living, health-related quality of life, functional dependency and health complaints among people 65 years or older, receiving public care and service. The concept public care and service concerns formal care from the municipality, including home help, home nursing care, rehabilitation and a special accommodation. To be able to provide care and service of high quality to older people, knowledge about factors influencing their experience of satisfaction with the care is essential. Cross-sectional, including comparison and correlation. One-hundred sixty-six people receiving public care and service from the municipality were interviewed regarding demography, functional ability, perceived health complaints and care. Health-related quality of life was measured with SF-12, and self-rated care satisfaction was measured with a questionnaire. Low self-rated care satisfaction was associated with dependency in Instrumental Activities of Daily Living, blindness, faeces incontinence and anxiety, while high self-rated care satisfaction was associated with dependency in Personal Activities of Daily Living. Those at home rated an overall higher care satisfaction and were more satisfied with care continuity and personal relations; they thought that the staff had more time and were more respectful and quiet, than the ratings by those in a special accommodation (equivalent to a nursing home). Care satisfaction and health-related quality of life among older people was more associated with functional impairment and health complaints than to whether care and service was received at home or in a special accommodation. An approach using intervention focused on functional ability and health complaints is important for development of improved care satisfaction for older people receiving public care and service. © 2013 Blackwell Publishing Ltd.

Heterogeneous Parking Market Subject to Parking Rationing

Directory of Open Access Journals (Sweden)

Saeed Asadi Bagloee

2015-01-01

Full Text Available Different types of drivers and parking spaces delineate a heterogeneous parking market for which the literature has yet to provide a model applicable to the real world. The main obstacle is computational complexities of considering various parking restrictions along with traffic congestion on the road network. In this study, the heterogeneity aspects are considered within a Logit parking choice model. A mathematical programming problem was introduced to explicitly consider parking capacities and parking rationing constraints. The parking rationing is defined as any arrangement to reserve parking space for some specific demand such as parking permit, private parking, VIP parking, and different parking durations. Introduction of parking rationing in the presence of other constraints is a unique factor in this study which makes the model more realistic. The algorithm was tested on a central business district case study. The results prove that the algorithm is able to converge rapidly. Among the algorithm’s output are shadow prices of the parking capacity and parking rationing constraints. The shadow prices contain important information which is key to addressing a variety of parking issues, such as the location of parking shortages, identification of fair parking charges, viability of parking permits, and the size of reserved parking.

Tools for valuing tree and park services

Science.gov (United States)

E.G. McPherson

2010-01-01

Arborists and urban foresters plan, design, construct, and manage trees and parks in cities throughout the world. These civic improvements create walkable, cool environments, save energy, reduce stormwater runoff, sequester carbon dioxide, and absorb air pollutants. The presence of trees and green spaces in cities is associated with increases in property values,...

Which need characteristics influence healthcare service utilization in home care arrangements in Germany?

Science.gov (United States)

Dorin, Lena; Turner, Suzi C; Beckmann, Lea; große Schlarmann, Jörg; Faatz, Andreas; Metzing, Sabine; Büscher, Andreas

2014-05-22

We see a growing number of older adults receiving long-term care in industrialized countries. The Healthcare Utilization Model by Andersen suggests that individual need characteristics influence utilization. The purpose of this study is to analyze correlations between need characteristics and service utilization in home care arrangements. 1,152 respondents answered the questionnaire regarding their integration of services in their current and future care arrangements. Care recipients with high long-term care needs answered the questionnaire on their own, the family caregiver assisted the care recipient in answering the questions, or the family caregiver responded to the questionnaire on behalf of the care recipient. They were asked to rank specific needs according to their situation. We used descriptive statistics and regression analysis. Respondents are widely informed about services. Nursing services and counseling are the most used services. Short-term care and guidance and training have a high potential for future use. Day care, self-help groups, and mobile services were the most frequently rejected services in our survey. Women use more services than men and with rising age utilization increases. Long waiting times and bad health of the primary caregiver increases the chance of integrating services into the home care arrangements. The primary family caregiver has a high impact on service utilization. This indicates that the whole family should be approached when offering services. Professionals should react upon the specific needs of care dependents and their families.

Comparing consumer-directed and agency models for providing supportive services at home.

Science.gov (United States)

Benjamin, A E; Matthias, R; Franke, T M

2000-04-01

To examine the service experiences and outcomes of low-income Medicaid beneficiaries with disabilities under two different models for organizing home-based personal assistance services: agency-directed and consumer-directed. A survey of a random sample of 1,095 clients, age 18 and over, who receive services in California's In-Home Supportive Services (IHSS) program funded primarily by Medicaid. Other data were obtained from the California Management and Payrolling System (CMIPS). The sample was stratified by service model (agency-directed or consumer-directed), client age (over or under age 65), and severity. Data were collected on client demographics, condition/functional status, and supportive service experience. Outcome measures were developed in three areas: safety, unmet need, and service satisfaction. Factor analysis was used to reduce multiple outcome measures to nine dimensions. Multiple regression analysis was used to assess the effect of service model on each outcome dimension, taking into account the client-provider relationship, client demographics, and case mix. Recipients of IHSS services as of mid-1996 were interviewed by telephone. The survey was conducted in late 1996 and early 1997. On various outcomes, recipients in the consumer-directed model report more positive outcomes than those in the agency model, or they report no difference. Statistically significant differences emerge on recipient safety, unmet needs, and service satisfaction. A family member present as a paid provider is also associated with more positive reported outcomes within the consumer-directed model, but model differences persist even when this is taken into account. Although both models have strengths and weaknesses, from a recipient perspective the consumer-directed model is associated with more positive outcomes. Although health professionals have expressed concerns about the capacity of consumer direction to assure quality, particularly with respect to safety, meeting unmet

Pre-service Home Economics Teachers’ Attitudes on Selected Aspects of Practical Teaching

Directory of Open Access Journals (Sweden)

Francka Lovšin Kozina

2016-09-01

Full Text Available This paper presents the results of a study conducted among pre-service home economics teachers from the Faculty of Education of the University of Ljubljana with different levels of practical experience in teaching. The pre-service Home Economics teachers in the 3rd year of their studies had just completed their first class of teaching experience in contrast to the pre-service teachers from the 4th year of their faculty studies, who had conducted more teaching lessons. The results showed that the 4th-year pre-service teachers had fewer doubts and problems concerning the planning and conducting of a lesson. They also statistically significantly agreed that they are sufficiently prepared to teach than the 3rd-year pre-service teachers are. The results showed that the majority of the pre-service teachers agreed that the feedback from their colleagues was helpful for their professional development. The results suggest the importance of practical teaching experience in the context of professional development and the intention to continue a career in education. However, the results also revealed some critical points in the teacher’s development of competency. The results suggest problems related to the application of theoretical knowledge on the children’s development in practice and problems related to classroom management in specific situations.

the Avian Park Service Learning Centre story

African Journals Online (AJOL)

The Ukwanda Centre for Rural Health (UCRH) opened in 2001, followed 10 years later by the establishment of the Ukwanda Rural Clinical School in one of the rural health districts of the Western Cape. This paper relates the journey of the Faculty with the underserviced community of Avian Park through the provision of ...

Modeling the Association Between Home Care Service Use and Entry Into Residential Aged Care: A Cohort Study Using Routinely Collected Data.

Science.gov (United States)

Jorgensen, Mikaela; Siette, Joyce; Georgiou, Andrew; Warland, Andrew; Westbrook, Johanna

2018-02-01

To examine home care service-related and person-based factors associated with time to entry into permanent residential aged care. Longitudinal cohort study using routinely collected client management data. A large aged care service provider in New South Wales and the Australian Capital Territory, Australia. A total of 1116 people aged 60 years and older who commenced home care services for higher-level needs between July 1, 2015 and June 30, 2016. Survival analysis methods were used to examine service-related and person-based factors that were associated with time between first home care service and entry into permanent residential aged care. Predictors included service hours per week, combination of service types, demographics, needs, hospital leave, and change in care level. Cluster analysis was used to determine patterns of types of services used. By December 31, 2016, 21.1% of people using home care services had entered into permanent residential care (n = 235). After adjusting for significant factors such as age and care needs, each hour of service received per week was associated with a 6% lower risk of entry into residential care (hazard ratio = 0.94, 95% confidence interval 0.90-0.98). People who were predominant users of social support services, those with an identified carer, and those born in a non-main English-speaking country also remained in their own homes for longer. Greater volume of home care services was associated with significantly delayed entry into permanent residential care. This study provides much-needed evidence about service outcomes that could be used to inform older adults' care choices. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

Denali Park wolf studies: Implications for Yellowstone

Science.gov (United States)

Mech, L. David; Meier, Thomas J.; Burch, John W.

1991-01-01

The Northern Rocky Mountain Wolf Recovery Plan approved by the U.S. Fish and Wildlife Service (1987) recommends re-establishment of wolves (Canis lupus) in Yellowstone National Park. Bills proposing wolf re-establishment in the Park have been introduced into the U.S. House and Senate. However, several questions have been raised about the possible effects of wolf re-establishment on other Yellowstone Park fauna, on human use of the Park and on human use of surrounding areas. Thus the proposed wolf re-establishment remains controversial.Information pertinent to some of the above questions is available from a current study of wolf ecology in Denali National Park and Preserve, Alaska, which we began in 1986. Although Denali Park differs from Yellowstone in several ways, it is also similar enough in important respects to provide insight into questions raised about wolf re-establishment in Yellowstone.

From service quality in organisations to self-determination at home.

Science.gov (United States)

Martínez-Tur, V; Moliner, C; Peñarroja, V; Gracia, E; Peiró, J M

2015-10-01

In our proposed model, family members' perceptions of service quality in organisations improve communication about self-determination. In turn, family perceptions of communication openness have a positive relationship with self-determination attitudes of family members. Finally, these attitudes predict self-determination behaviours of individuals with intellectual disability, as reported by family members. We tested this model with a sample of 625 family members (196 using 'day care services' and 429 using 'occupational services'). Multi-sample structural equation modelling (SEM) supported the model. Communication and attitudes fully mediated the link from service quality to self-determination behaviours. Improving family members' perceptions of service quality and opening channels of communication between professionals and family members are useful strategies to facilitate parents' positive attitudes and increase the frequency of self-determination behaviours at home. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.

Characteristics of care management agencies affect expenditure on home help and day care services: A population-based cross-sectional study in Japan.

Science.gov (United States)

Feng, Mei; Igarashi, Ayumi; Noguchi-Watanabe, Maiko; Yoshie, Satoru; Iijima, Katsuya; Yamamoto-Mitani, Noriko

2017-11-01

The financial interests of care management agencies can affect how care managers assist clients' use of long-term care insurance services. The present study examined the relationship between clients' service expenditures, and whether the home help and day care service agencies belonged to the same organization as the care management agency. Population-based data were obtained from a suburban municipality in Japan. We investigated 4331 persons with care needs certificates (levels 1-5), including those using home help (n = 1780) or day care (n = 2141) services. Data on the service expenditures, and clients' and agencies' characteristics were analyzed using multiple linear regression analyses controlling for potential confounders. Home help service users spent an average of US$558.1 ± 590.1 for home help service, and day care service users spent US$665.0 ± 415.9 for day care service. Living alone, living in a condominium/apartment, higher care needs, more severe cognitive impairment and lower use of other services were associated with higher home help service expenditure. Day care service expenditure increased with older age, female sex, higher care needs, more severe cognitive impairment and higher physical function. Clients whose service agencies and care management agencies belonged to the same organization had higher expenditures, even after adjusting for confounders (home help: β = 0.126, P = 0.007; day care: β = 0.085, P = 0.002, respectively). Financial interests of care management agencies might significantly influence clients' service expenditure. We should develop an effective system to minimize this influence. Geriatr Gerontol Int 2017; 17: 2224-2231. © 2017 Japan Geriatrics Society.

Mental status of the elderly receiving home health services and the associated stress of home helpers.

Science.gov (United States)

Nagatomo, I; Takigawa, M

1998-01-01

One hundred and ninety elderly people receiving home health service were investigated. The intellectual levels, depressive state evaluated by the Cornell scale for depression in dementia (CSDD) scale, abnormal behaviors evaluated by the dementia behavior disturbance (DBD) scale, and activities of daily living (ADL) were examined. These assessments were performed by 72 skilled home helpers who also assessed the severity of their own level of stress using the Burnout scale. The intellectual level and mood-related signs, based on the CSDD scale, of the elderly living with families or with a spouse were diminished significantly as compared to the elderly living alone. The elderly living with families also performed worse on all ADL categories except for visual acuity as compared to the elderly living with a spouse or living alone. There was no significant correlation between the Burnout scale score and age or frequency of working as a home helper. These results suggest that elderly people living with families as compared to the elderly living with a spouse or living alone have greater mental health needs as well as more profound physical limitations.

NPDES Permit for Mesa Verde National Park Wastewater Treatment Facility in Colorado

Science.gov (United States)

Under NPDES permit number CO-0034398, the United States Department of the Interior, National Park Service, Mesa Verde National Park is authorized to discharge from the Mesa Verde National Park wastewater treatment plant, in Montezuma County, Colo.

75 FR 28055 - General Management Plan; Joshua Tree National Park; San Bernardino and Riverside Counties, CA...

Science.gov (United States)

2010-05-19

... kinds of resource management activities, visitor activities, and developments that would be appropriate... DEPARTMENT OF THE INTERIOR National Park Service General Management Plan; Joshua Tree National... National Park Service is updating the General Management Plan (GMP) for Joshua Tree National Park...

Provision and perceived quality of mental health services for older care home residents in England: a national survey.

Science.gov (United States)

Stewart, Karen; Hargreaves, Claire; Jasper, Rowan; Challis, David; Tucker, Sue; Wilberforce, Mark

2018-02-01

This study examined the nature, extent and perceived quality of the support provided by community mental health teams for older people (CMHTsOP) to care home residents. A postal survey was sent to all CMHTsOP in England. Information was collected about teams' staffing and their involvement in case finding, assessment, medication reviews, care planning and training as well as team managers' rating of the perceived quality of the service they provided for care home residents. Data were analysed using chi-squared tests of association and ordinal regression. Responses were received from 225 (54%) CMHTsOP. Only 18 per cent of these teams contained staff with allocated time for care home work. Services for care home residents varied considerably between teams. Two-fifths of teams provided formal training to care home staff. Team managers were more likely to perceive the quality of their service to care homes as good if they had a systematic process in place for reviewing antipsychotic drugs or routine mental health reviews, including contact with a GP. The findings suggested that more evidence is needed on the best approach for supporting care home residents with mental health needs. Areas to consider are the potential benefits of training to care home staff and regular mental health reviews, utilising links between GPs and CMHTsOP. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

The Overseas Service Veteran At Home Pilot: How Choice of Care May Affect Use of Nursing Home Beds and Waiting Lists. Brief Report

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Pedlar, David; Walker, John

2004-01-01

In 1999 Veterans Affairs Canada (VAC) implemented the Overseas Service Veterans (OSV) At Home Pilot Project in response to the problem that a growing number of clients were on waiting lists for beds in long-term care facilities. The At Home pilot offered certain clients on waiting lists, who met nursing-level care and military-service…

36 CFR 3.19 - May I operate a submersible within park waters?

Science.gov (United States)

2010-07-01

... 36 Parks, Forests, and Public Property 1 2010-07-01 2010-07-01 false May I operate a submersible within park waters? 3.19 Section 3.19 Parks, Forests, and Public Property NATIONAL PARK SERVICE... waters? The use of manned or unmanned submersibles may only occur in accordance with a permit issued by...

Home-end and activity-end preferences for access to and egress from train stations in the Copenhagen region

DEFF Research Database (Denmark)

Halldórsdóttir, Katrín; Nielsen, Otto Anker; Prato, Carlo Giacomo

2017-01-01

. Moreover, model results emphasize the role of bicycle parking in terms of the sheer number of spaces to be increased as well as covered places to be offered at the activity end, de facto giving the possibility to leave a bicycle at that end during the night. Lastly, model results show that it is a matter......Increasing public transport use with the aim of improving the sustainability of cities should focus not only on enhancing level and quality of the service offered, but also on understanding determinants of the choice of access and egress modes to and from the railway network. This study analyzes...... the difference in preferences at the home-end and activity-end for travelers who have chosen train as their main travel mode while investigating the effect of policy variables such as car parking availability, bicycle parking availability and type, and bicycle on train possibility. Specifically, this study...

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...

Exploring the Barriers of Home Care Services in Iran: A Qualitative Study

Directory of Open Access Journals (Sweden)

Heshmatolah Heydari

2016-01-01

Full Text Available With increasing chronic diseases, the use of home care is rising in the world. Home care in Iran has many challenges and to improve that, we should identify the challenges and barriers of home care. The aim of this study was to identify and explore the barriers of home care in Iran. This is a qualitative study with content analysis approach that was conducted in Iran in 2015. Fourteen key informants comprising health policymakers, faculty members, nurses, and physicians as well as patients and families engaged in home care purposefully participated in this study. Data was obtained using face-to-face semistructured interviews. A focus group discussion was also used to complete the findings. Graneheim and Lundman’s approach was used for analysis of data and Lincoln and Guba’s criteria were used to confirm the trustworthiness of study’s findings. The data were divided into three main categories and eight subcategories. Main categories included treatment-based approach in the healthcare system, cultural dimensions, and the lack of adequate infrastructure. A position for home care in the healthcare system, considering cultural dimensions in Iranian society and providing an appropriate infrastructure, can be beneficial to improve the situation of home care services in Iran.

Health patterns of cardiac surgery clients using home health care nursing services.

Science.gov (United States)

Redeker, N S; Brassard, A B

1996-12-01

The purpose of this study was to examine the health patterns of cardiac surgical patients in the home health care population and their relationships to outcomes and duration of home health care using Gordon's Functional Health Pattern framework. Home health care records of 96 cardiac surgical clients were reviewed. Admission health pattern data, reasons for admission, duration and outcomes of home care services, characteristics of hospital experience, and demographic data were analyzed. Dysfunctional health patterns were primarily in the area of activity/exercise. The most common reasons for admission were monitoring of cardiopulmonary status, wound care, and instruction on diet, medications, and cardiac regimen. The mean duration of home care was 28.8 days. Thirty percent of the sample were readmitted to the hospital. Duration of home care was shorter for those who were married and for those who reported weakness, tiredness, or fatigue as a chief complaint. Readmission to the hospital was more likely for those who had complications during their initial hospital stay and those who required at least partial assistance with bathing, dressing, feeding, or toileting. Implications for practice and research are discussed.

36 CFR 3.9 - May I operate my personal watercraft (PWC) in park waters?

Science.gov (United States)

2010-07-01

... watercraft (PWC) in park waters? 3.9 Section 3.9 Parks, Forests, and Public Property NATIONAL PARK SERVICE...) in park waters? (a) A person may operate a PWC only in park areas where authorized by special... on park waters is subject to the following conditions: (1) No person may operate a PWC unless each...

Effect of the economic crisis on the use of health and home care services among Spanish COPD patients.

Science.gov (United States)

de Miguel-Diez, Javier; Lopez-de-Andres, Ana; Herandez-Barrera, Valentin; Jimenez-Trujillo, Isabel; Puente-Maestu, Luis; Cerezo-Lajas, Alicia; Jimenez-Garcia, Rodrigo

2018-01-01

Chronic obstructive pulmonary disease (COPD) is a major cause of disability and death worldwide. Consequently, COPD patients are frequent users of health and social resources. Therefore, they are highly vulnerable to decreases in investment in healthcare services. We aimed to describe the utilization of health and home care services among Spanish COPD patients during the economic crisis to identify factors independently associated with changes in the utilization of these services and to study the time trends from 2009 to 2014. We used data from the European Health Interview Surveys for Spain (EHSS) conducted between 2009/2010 (n=22,188) and 2014 (n=22,842). We included responses from adults with COPD aged 40 years or over. Dependent variables included self-reported hospitalizations during the previous year, general practitioner (GP) visits during the last 4 weeks, other health care services used during the previous year (nursing, rehabilitation, and psychological services), and home care services use during the previous year. Independent variables included demographic and socioeconomic characteristics, health status variables, and lifestyles. We identified 1,328 and 1,008 COPD patients from EHSS 2009 and EHSS 2014, respectively. We observed a significant increase in non-GP services use (30.6% in 2009 vs 39.11% in 2014; p home care services use over time. Multivariable models showed that associated factors with a higher use included any chronic comorbidity and worse self-rated health. Physical activity was a strong predictor of fewer hospitalizations and less home care service use. Female sex was associated with significantly fewer hospitalizations (OR 0.72; 95% CI 0.58-0.89). We found an increase in the use of non-GP services (nursing, rehabilitation, and psychological) but not in other health and home care services. The only differences in hospitalizations were observed according to sex. Therefore, the effect of the economic crisis, if any, seems to have been of

Accessible Internet-of-Things and Internet-of-Content Services for All in the Home or on the Move

Directory of Open Access Journals (Sweden)

Dimitris Tektonidis

2012-10-01

Full Text Available Public authorities and national healthcare service providers across the European Union and beyond are increasingly under pressure to deliver better services with diminishing resources. Users, quite rightly, demand a high standard of service and increasingly also convenience focused on the needs of the users rather than how the services are organised to deliver them. Users, on the whole, also prefer to be supported in their homes, and be free to move as much as possible. While users without impairments and generally well provided for, there are increasingly also users who have special needs, including the aged and those with a range of physical and mental disabilities who are unable to make effective use of such services from their homes due to the lack of proactive and accessible services. The idea we promote in the chapter is to provide better support to users with disabilities and impairments from the comfort of their home by means of providing them with a set of scalable services which can be either offered for free or purchased through some central form of a marketplace repository.

Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports

Science.gov (United States)

Newquist, Deborah D.; DeLiema, Marguerite; Wilber, Kathleen H.

2016-01-01

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. PMID:26062611

[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.

Integration of Tactical EMS in the National Park Service.

Science.gov (United States)

Smith, William Will R

2017-06-01

The National Park Service (NPS) has domestic responsibility for emergency medical services (EMS) in remote and sometimes tactical situations in 417 units covering over 34 million hectares (84 million acres). The crossover between conflicting patient care priorities and complex medical decision making in the tactical, technical, and wilderness/remote environments often has many similarities. Patient care in these diverse locations, when compared with military settings, has slightly different variables but often similar corresponding risks to the patients and providers. The NPS developed a Tactical EMS (TEMS) program that closely integrated many principles from: 1) Tactical Combat Casualty Care (TCCC); 2) Tactical Emergency Casualty Care (TECC); 3) and other established federal and civilian TEMS programs. Combining these best practices into the NPS TEMS Program allowed for standardized training and implementation across not only the NPS, but also paralleled other military/federal/civilian TEMS programs. This synchronization is critical when an injury occurs in a joint tactical operation, either planned (drug interdiction) or unplanned (active shooter response), so that patient care can be uniform and efficient. The components identified for a sustainable TEMS program began with strong medical oversight, protocol development with defined phases of care, identifying specialized equipment, and organized implementation with trained TEMS instructors. Ongoing TEMS program management is continuously improving situationally appropriate training and integrating current best practices as new research, equipment, and tactics are developed. The NPS TEMS Program continues to provide ongoing training to ensure optimal patient care in tactical and other NPS settings. Copyright © 2017 Wilderness Medical Society. All rights reserved.

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

Science.gov (United States)

2010-10-01

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

Urban Park: an Integral Part of Welfare for Citizens — A Case Study of Shangzhi and Qinbin Parks in Harbin Metropolis, China

DEFF Research Database (Denmark)

Yang, Binzhang; Zhao, Chunli

2008-01-01

Abstract: As a key part of the urban green spaces, urban park plays important role in city citizens’ life. The significances of park treating as a green lung in urban area demonstrate its unique contribution to people’s life not only in physical and tangible aspects such as environment, ecology a...... management and service have been contributed by this study. Specifically, the awareness for treating the urban park as an integral part of citizens’ welfare should be arose and educated in entire society. Key words: Harbin Metropolis, urban park, activity, public life...... in their daily life, second one tries to learn what problems they meet during their visit and using, third one focuses on what problems and challenges of urban park need to be resolved by administrative officers and park managers. The research samples, Shanzhi Park and Qingbin Park, were selected in two...... spaces in both numbers and sizes as the form of park. It also showed some problems and challenges faced in park design and management had to be enhanced. Finally, some suggestions aimed to improve the situation of urban spaces included constructing new urban parks and promoting the quality of park...

Association of comorbidities with home care service utilization of patients with heart failure while receiving telehealth.

Science.gov (United States)

Radhakrishnan, Kavita; Jacelon, Cynthia S; Bigelow, Carol; Roche, Joan P; Marquard, Jenna L; Bowles, Kathryn H

2013-01-01

Comorbidities adversely impact heart failure (HF) outcomes. Telehealth can assist healthcare providers, especially nurses, in guiding their patients to follow the HF regimen. However, factors, including comorbidity patterns, that act in combination with telehealth to reduce home care nursing utilization are still unclear. The purpose of this article was to examine the association of the comorbidity characteristics of HF patients with nursing utilization along with withdrawal from telehealth service during an episode of tele-home care. A descriptive, correlational study design using retrospective chart review was used. The sample comprised Medicare patients admitted to a New England home care agency who had HF as a diagnosis and had used telehealth from 2008 to 2010. The electronic documentation at the home care agency served as the data source, which included Outcome and Assessment Information Set data of patients with HF. Logistic and multiple regression analyses were used to analyze data. The sample consisted of 403 participants, of whom 70% were older than 75 years, 55% were female, and 94% were white. Comorbidities averaged 5.19 (SD, 1.92), ranging from 1 to 11, and nearly 40% of the participants had 5 or more comorbidities. The mean (SD) nursing contacts in the sample was 9.9 (4.7), ranging from 1 to 26, and 52 (12.7%) patients withdrew from telehealth service. For patients with HF on telehealth, comorbidity characteristics of anemia, anxiety, musculoskeletal, and depression were significantly associated with nursing utilization patterns, and renal failure, cancer, and depression comorbidities were significantly associated with withdrawal from telehealth service. Knowledge of the association of comorbidity characteristics with the home care service utilization patterns of patients with HF on telehealth can assist the home health nurse to develop a tailored care plan that attains optimal patient outcomes. Knowledge of such associations would also focus home

Is there an association between spatial access to parks/green space and childhood overweight/obesity in Calgary, Canada?

Directory of Open Access Journals (Sweden)

Potestio Melissa L

2009-11-01

Full Text Available Abstract Background The recent increase in childhood obesity is expected to add significantly to the prevalence of chronic diseases. We used multivariate multilevel analysis to examine associations between parks/green space and childhood overweight/obesity across communities in Calgary, Canada, a city characterized by intensified urban sprawl and high car use. Methods Body Mass Index was calculated from measured height and weight data obtained from 6,772 children (mean age = 4.95 years attending public health clinics for pre-school vaccinations. Each child's home postal code was geocoded using ESRI ArcGIS 9.2. We examined four measures of spatial access to parks/green space (based on Geographic Information Systems: 1 the number of parks/green spaces per 10,000 residents, 2 the area of parks/green space as a proportion of the total area within a community, 3 average distance to a park/green space, and 4 the proportion of parks/green space service area as a proportion of the total area within a community. Analyses were adjusted for dissemination area median family income (as a proxy for an individual child's family income community-level education, and community-level proportion of visible minorities. Results In general, parks/green space at the community level was not associated with overweight/obesity in Calgary, with the exception of a marginally significant effect whereby a moderate number of parks/green spaces per 10,000 residents was associated with lower odds of overweight/obesity. This effect was non-significant in adjusted analyses. Conclusion Our null findings may reflect the popularity of car travel in Calgary, Canada and suggest that the role built environment characteristics play in explaining health outcomes may differ depending on the type of urban environment being studied.

Pre-school nutrition-related behaviours at home and early childhood education services: findings from the Growing Up in New Zealand longitudinal study.

Science.gov (United States)

Gerritsen, Sarah; Anderson, Sarah E; Morton, Susan Mb; Wall, Clare R

2018-05-01

Pre-school nutrition-related behaviours influence diet and development of lifelong eating habits. We examined the prevalence and congruence of recommended nutrition-related behaviours (RNB) in home and early childhood education (ECE) services, exploring differences by child and ECE characteristics. Telephone interviews with mothers. Online survey of ECE managers/head teachers. New Zealand. Children (n 1181) aged 45 months in the Growing Up in New Zealand longitudinal study. A mean 5·3 of 8 RNB were followed at home, with statistical differences by gender and ethnic group, but not socio-economic position. ECE services followed a mean 4·8 of 8 RNB, with differences by type of service and health-promotion programme participation. No congruence between adherence at home and in ECE services was found; half of children with high adherence at home attended a service with low adherence. A greater proportion of children in deprived communities attended a service with high adherence, compared with children living in the least deprived communities (20 and 12 %, respectively). Children, across all socio-economic positions, may not experience RNB at home. ECE settings provide an opportunity to improve or support behaviours learned at home. Targeting of health-promotion programmes in high-deprivation areas has resulted in higher adherence to RNB at these ECE services. The lack of congruence between home and ECE behaviours suggests health-promotion messages may not be effectively communicated to parents/family. Greater support is required across the ECE sector to adhere to RNB and promote wider change that can reach into homes.

Adoption of wireless internet parks: An empirical study in Qatar

OpenAIRE

Weerakkody, V

2008-01-01

This paper examines the adoption of free wireless internet parks (iPark) by Qatari citizens as means of accessing electronic services from public parks. The Qatar government has launched the iPark concept with a view of providing free internet access for all citizens while enjoying the outdoors. By offering free wireless Internet access, the Qatari government encourages its citizen's to actively participate in the global information society with a view of bridging the digital divide. Using a ...

Beware of Data Gaps in Home Care Research: The Streetlight Effect and Its Implications for Policy Making on Long-Term Services and Supports.

Science.gov (United States)

Newquist, Deborah D; DeLiema, Marguerite; Wilber, Kathleen H

2015-10-01

Policy initiatives increasingly seek greater use of home- and community-based services for older persons and those with chronic care needs, yet large gaps persist in our knowledge of home care, an indispensable component of long-term services and supports. Unrecognized data gaps, including the scope of home care provided by private hire and nonmedical providers, can distort knowledge and poorly inform long-term services and supports policy. The purpose of this article is to examine these gaps by describing the universe of formal home care services and provider types in relationship to major national sources. Findings reveal four distinct home care sectors and that the majority of formal home care is provided in the sectors that are understudied. We discuss the policy implications of data gaps and conclude with recommendations on where to expand and refine home care research. © The Author(s) 2015.

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

Directory of Open Access Journals (Sweden)

Chun-Feng Liao

2017-09-01

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

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

Science.gov (United States)

Liao, Chun-Feng; Chen, Peng-Yu

2017-09-21

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

Utilisation of home-based physician, nurse and personal support worker services within a palliative care programme in Ontario, Canada: trends over 2005-2015.

Science.gov (United States)

Sun, Zhuolu; Laporte, Audrey; Guerriere, Denise N; Coyte, Peter C

2017-05-01

With health system restructuring in Canada and a general preference by care recipients and their families to receive palliative care at home, attention to home-based palliative care continues to increase. A multidisciplinary team of health professionals is the most common delivery model for home-based palliative care in Canada. However, little is known about the changing temporal trends in the propensity and intensity of home-based palliative care. The purpose of this study was to assess the propensity to use home-based palliative care services, and once used, the intensity of that use for three main service categories: physician visits, nurse visits and care by personal support workers (PSWs) over the last decade. Three prospective cohort data sets were used to track changes in service use over the period 2005 to 2015. Service use for each category was assessed using a two-part model, and a Heckit regression was performed to assess the presence of selectivity bias. Service propensity was modelled using multivariate logistic regression analysis and service intensity was modelled using log-transformed ordinary least squares regression analysis. Both the propensity and intensity to use home-based physician visits and PSWs increased over the last decade, while service propensity and the intensity of nurse visits decreased. Meanwhile, there was a general tendency for service propensity and intensity to increase as the end of life approached. These findings demonstrate temporal changes towards increased use of home-based palliative care, and a shift to substitute care away from nursing to less expensive forms of care, specifically PSWs. These findings may provide a general idea of the types of services that are used more intensely and require more resources from multidisciplinary teams, as increased use of home-based palliative care has placed dramatic pressures on the budgets of local home and community care organisations. © 2016 John Wiley & Sons Ltd.

Hawaii Volcanoes National Park Air Tour Management Plan: Planning and NEPA Scoping Document

Science.gov (United States)

2004-03-03

The Federal Aviation Administration (FAA), in cooperation with the National Park Service (NPS), has initiated the development of Air Tour Management Plans (ATMPs) for Haleakala National Park, Hawaii Volcanoes National Park, Puukohola Heiau National H...

IAServ: An Intelligent Home Care Web Services Platform in a Cloud for Aging-in-Place

Directory of Open Access Journals (Sweden)

Chang-Yu Chiang

2013-11-01

Full Text Available As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients’ needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet.

IAServ: an intelligent home care web services platform in a cloud for aging-in-place.

Science.gov (United States)

Su, Chuan-Jun; Chiang, Chang-Yu

2013-11-12

As the elderly population has been rapidly expanding and the core tax-paying population has been shrinking, the need for adequate elderly health and housing services continues to grow while the resources to provide such services are becoming increasingly scarce. Thus, increasing the efficiency of the delivery of healthcare services through the use of modern technology is a pressing issue. The seamless integration of such enabling technologies as ontology, intelligent agents, web services, and cloud computing is transforming healthcare from hospital-based treatments to home-based self-care and preventive care. A ubiquitous healthcare platform based on this technological integration, which synergizes service providers with patients' needs to be developed to provide personalized healthcare services at the right time, in the right place, and the right manner. This paper presents the development and overall architecture of IAServ (the Intelligent Aging-in-place Home care Web Services Platform) to provide personalized healthcare service ubiquitously in a cloud computing setting to support the most desirable and cost-efficient method of care for the aged-aging in place. The IAServ is expected to offer intelligent, pervasive, accurate and contextually-aware personal care services. Architecturally the implemented IAServ leverages web services and cloud computing to provide economic, scalable, and robust healthcare services over the Internet.

Pattern of disability among persons who availed half-way home-care services for psychosocial rehabilitation

Directory of Open Access Journals (Sweden)

M Ranganathan

2012-01-01

Full Text Available Background: There is dearth of studies related to pattern of disability among persons who availed psychosocial rehabilitation services in India. We studied the pattern of disability among persons who availed half-way home-care services for psychosocial rehabilitation. Materials and Methods: Out of 130 case files of discharged patients, 50 files were randomly selected for data collection. Indian Disability Evaluation and Assessment Schedule was used to assess the pattern of disability in the sample. Results: The study revealed that only one-third (35% of the residents had disability in self-care, 41% in communication and understanding and 47% in interpersonal relationship. Overall, majority (76% of the respondents had moderate level of psychiatric disability at the time of discharge from half-way home. There was no significant relationship between gender and type of psychiatric illness with the level of disability. The overall disability correlated positively with the duration of illness (rs=0.39. Conclusion: Three-fourth of the residents who availed half-way home-care services had moderate level of disability.

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.

"Between the devil and the deep blue sea": the beliefs of caregivers of people with dementia regarding the use of in-home respite services.

Science.gov (United States)

Phillipson, Lyn; Jones, Sandra C

2011-04-01

This article details results from qualitative research with caregivers in regard to the beliefs they associate with the use of in-home respite services. Outcomes are perceived by caregivers in relation to care recipient personal safety and the avoidance of negative consequences through the provision of supervision in the caregiver's absence. Use of in-home services challenges normative beliefs for some caregivers, particularly for spousal caregivers who feel it is their role to provide assistance that is needed in the home. Likewise, perceived inflexibility and the inability of in-home services to provide responsive and personalized care make the use of in-home services difficult and may inform control beliefs. Implications are discussed in relation to community care pathways and the promotion and development of in-home respite services to better target caregiver beliefs and respond to caregiver perceived needs.

Effectiveness of palliative home-care services in reducing hospital admissions and determinants of hospitalization for terminally ill patients followed up by a palliative home-care team: a retrospective cohort study.

Science.gov (United States)

Riolfi, Mirko; Buja, Alessandra; Zanardo, Chiara; Marangon, Chiara Francesca; Manno, Pietro; Baldo, Vincenzo

2014-05-01

It has been demonstrated that most patients in the terminal stages of cancer would benefit from palliative home-care services. The aim of this study was to assess the effectiveness of appropriate palliative home-care services in reducing hospital admissions, and to identify factors predicting the likelihood of patients treated at home being hospitalized. Retrospective cohort study. We enrolled all 402 patients listed by the Local Health Authority No. 5, Veneto Region (North-East Italy), as dying of cancer in 2011. Of the cohort considered, 39.9% patients had been taken into care by a palliative home-care team. Irrespective of age, gender, and type of tumor, patients taken into care by the palliative home-care team were more likely to die at home, less likely to be hospitalized, and spent fewer days in hospital in the last 2 months of their life. Among the patients taken into care by the palliative home-care team, those with hematological cancers and hepatocellular carcinoma were more likely to be hospitalized, and certain symptoms (such as dyspnea and delirium) were predictive of hospitalization. Our study confirms the effectiveness of palliative home care in enabling patients to spend the final period of their lives at home. The services of a palliative home-care team reduced the consumption of hospital resources. This study also provided evidence of some types of cancer (e.g. hematological cancers and hepatocellular carcinoma) being more likely to require hospitalization, suggesting the need to reconsider the pathways of care for these diseases.

There is no place like @home!: The value of home consultations in paediatric rehabilitation.

Science.gov (United States)

van Maren-Suir, I; Ketelaar, M; Brouns, B; van der Sanden, K; Verhoef, M

2018-07-01

Family-centred services (FCS) is widely regarded as the best practice approach in early interventions. Creating a therapeutic environment, which also stimulates collaboration between parents and service professionals, is a way to conform to the principles of FCS. The present paper describes the project entitled @home, involving the implementation of home consultations by a specialized team working with children aged 0-5 years at our rehabilitation centre in the Netherlands. The objectives of this article are to (a) describe the development and implementation of home consultations as part of regular care and (b) share the experiences of parents and service providers with home consultations. The implementation process was divided into 3 steps: (1) interviewing experts, (2) adjusting current rehabilitation trajectories, and (3) service providers offering consultations to children at home. The experiences with the home consultations were immediately incorporated in the system, making the implementation an iterative process. In 82% of the 133 home conducted consultations, the service professionals reported that it was more valuable to offer home consultations than seeing the child at the rehabilitation centre. The semistructured interviews revealed that parents and service providers found that they received and provided more tailored advice, perceived a more equal partnership between service professionals and parents, and reported that the home consultations provided a good natural therapeutic environment where a child can be itself and where the child performs best. By using the @home system based on the 3 service models, home consultations are now part of the regular paediatric rehabilitation system at our rehabilitation centre. © 2018 John Wiley & Sons Ltd.

Rehabilitation therapies for older clients of the Ontario home care system: regional variation and client-level predictors of service provision.

Science.gov (United States)

Armstrong, Joshua J; Zhu, Mu; Hirdes, John P; Stolee, Paul

2015-01-01

To examine regional variation in service provision and identify the client characteristics associated with occupational therapy (OT) and physiotherapy (PT) services for older adults in the Ontario Home Care System. Secondary analyses of a provincial database containing comprehensive assessments (RAI-HC) linked with service utilization data from every older long-stay home care client in the system between 2005 and 2010 (n = 299 262). Hierarchical logistic regression models were used to model the dependent variables of OT and PT service use within 90 d of the initial assessment. Regional differences accounted for 9% of the variation in PT service provision and 20% of OT service provision. After controlling for the differences across regions, the most powerful predictors of service provision were identified for both OT and PT. The most highly associated client characteristics related to PT service provision were hip fracture, impairments in activities of daily living/instrumental activities of daily living, cerebrovascular accidents, and cognitive impairment. For OT, hazards in the home environment was the most powerful predictor of future service provision. Where a client lived was an important determinant of service provision in Ontario, raising the possibility of inequities in access to rehabilitation services. Health care planners and policy makers should review current practices and make adjustments to meet the increasing and changing needs for rehabilitation therapies of the aging population. Implications for Rehabilitation For older adults in home care, the goal of rehabilitation therapy services is to allow individuals to maintain or improve physical functioning, quality of life and overall independence while living within their community. Previous research has demonstrated that a large proportion of home care clients specifically identified as having rehabilitation potential do not receive it. This article used clinical assessment data to identify the

76 FR 35013 - Minor Boundary Revision of Boston National Historical Park

Science.gov (United States)

2011-06-15

... Historical Park AGENCY: National Park Service, Interior. ACTION: Notification of Boundary Revision. SUMMARY... Historical Park is modified to include 0.50 acre of adjacent land identified as Tract 101-13. This tract is... United States of America without cost by enactment of Chapter 37 of the Laws of 2009, on July 23, 2009...

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

Science.gov (United States)

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

2018-05-01

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

Location Planning Problem of Service Centers for Sustainable Home Healthcare: Evidence from the Empirical Analysis of Shanghai

Directory of Open Access Journals (Sweden)

Gang Du

2015-11-01

Full Text Available It is of theoretical and practical significance to understand what factors influence the sustainable development of home healthcare services in China. Based on a face-to-face survey, we find that the location planning, which is decisive for the improvement of patient satisfaction, can effectively reduce the risks, as well as the costs of redundant construction and re-construction of service centers for home healthcare and, thus, helps ensure the sustainability of health and the environment. The purposes of this paper are to investigate the existing problem of home healthcare in Shanghai and to find the optimum location planning scheme under several realistic constraints. By considering differentiated services provided by the medical staff at different levels and the degrees of patient satisfaction, a mixed integer programming model is built to minimize the total medical cost. The IBM ILOGCPLEX is used to solve the above model. Finally, a case study of Putuo district in Shanghai is conducted to validate the proposed model and methodology. Results indicate that the model used in this paper can effectively reduce the total medical cost and enhance the medical sustainability, and therefore, the results of the model can be used as a reference for decision makers on the location planning problem of home healthcare services in China.

Proposal of a service delivery integration index of home care for older persons: application in several European cities.

NARCIS (Netherlands)

Henrard, J.C.; Ankri, J.; Frijters, D.; Carpenter, I.; Topinkova, E.; Garms-Homolova, V.; Finne-Soveri, H.; Wergeland Sorbye, L.; Jonsson, P.V.; Ljunggren, G.; Schroll, M.; Wagner, C.; Bernabei, R.

2006-01-01

PURPOSE: To propose an integration index of home care delivery to older persons, to study its validity and to apply it to home care services of European cities. THEORY: Home care delivery integration was based on two dimensions referring to process-centred integration and organisational structure

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

Science.gov (United States)

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

2014-11-01

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

36 CFR 3.18 - May I snorkel or underwater dive in park waters?

Science.gov (United States)

2010-07-01

... dive in park waters? 3.18 Section 3.18 Parks, Forests, and Public Property NATIONAL PARK SERVICE... waters? (a) Snorkeling and underwater diving is allowed in park waters, subject to closures or restrictions designated by the superintendent in accordance with §§ 1.5 and 1.7 of this chapter. (b) In waters...

Kalaupapa National Historic Park Air Tour Management Plan planning and NEPA scoping study

Science.gov (United States)

2005-03-03

The Federal Aviation Administration (FAA), in cooperation with the National Park Service (NPS), has initiated the development of an Air Tour Management Plan (ATMP) for Kalaupapa Historic Park pursuant to the National Parks Air Tour Management Act of ...

A descriptive retrospective study of time consumption in home care services: how do employees use their working time?

Science.gov (United States)

Holm, Solrun G; Angelsen, Ragnhild O

2014-09-26

Home care services in Norway are provided for free, and municipalities are responsible for their provision to all those in need of them, in accordance with the Act on Municipal Health and Care Services. The costs of home care services are increasing. Many municipalities are now working to find the best cost-effective solutions to ensure that home care services are of sufficient quality but still affordable. This paper describes how nurses and health workers spend their working time, with a hypothesis that driving time and time required to document details of the care given are underestimated in weekly planning schedules. This article sets out a descriptive retrospective study of day-schedules and driving routes for staff working in home care services. Data were analyzed using GIS. The driving time was between 18% and 26% of working time in municipality A, and between 21% and 23% in municipality B. Visiting time varied between 44% and 62% in municipality A, and 40% and 56% in municipality B. Other tasks, including the legally-required documentation of the care given, varied between 19% and 32% in municipality A and 21% and 38% in municipality B. Overall, 22% of the driving routes in municipality A, and 14% in municipality B, took more time than expected. In municipality A, 22% of the day-schedules underestimated overtime; this figure was 14% in municipality B. In home care services, time taken for driving and to write statutory documentation seems to have been underestimated. Better planning and organization of driving routes would reduce driving time and allow more time for other necessary work.

Effectiveness and cost-effectiveness of home palliative care services for adults with advanced illness and their caregivers

Directory of Open Access Journals (Sweden)

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

Do Medicaid home and community based service waivers save money?

Science.gov (United States)

Harrington, Charlene; Ng, Terence; Kitchener, Martin

2011-10-01

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

Foster Youth Evaluate the Performance of Group Home Services in California

Science.gov (United States)

Green, Rex S.; Ellis, Peter T.

2008-01-01

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

[Diabetes care and incidence of severe hypoglycemia in nursing home facilities and nursing services: The Heidelberg Diabetes Study].

Science.gov (United States)

Bahrmann, A; Wörz, E; Specht-Leible, N; Oster, P; Bahrmann, P

2015-04-01

The goal of this study was to perform a structured analysis of the treatment quality and acute complications of geriatric patients with diabetes mellitus (DM) cared for by nursing services and nursing home facilities. Secondly, structural problems and potentials for improvement in the care of multimorbid older people with DM treated by nursing homes and nursing services were analysed from the viewpoint of geriatric nurses, managers of nursing homes and general practitioners. In all, 77 older persons with DM from 13 nursing homes and 3 nursing services were included in the analysis (76.6% female, HbA1c 6.9 ± 1.4%, age 81.6 ± 9.9 years). Structural problems and potentials for improvement were collected from 95 geriatric nurses, 9 managers of nursing homes and 6 general practitioners using semistandardized questionnaires. Metabolic control was too strict in care-dependent older people with DM (mean HbA1c value: 6.9 ± 1.4 %; recommended by guidelines: 7-8%). The measurement of HbA1c was performed in 16 of 77 people (20.8%) within the last year despite a high visitation frequency of the general practitioners (12.7 ± 7.7 within the last 6 months). The incidence of severe hypoglycemia was 7.8%/patient/year. Regarding the management in case of diabetes-related acute complications 33 geriatric nurses (34.7%) stated not having any written standard (nursing home 39%, geriatric services 16.7%). Complex insulin therapies are still used in older people with DM with the consequence of a high incidence of severe hypoglycemia. Concrete management standards in the case of diabetes-related acute complications for geriatric nurses are lacking for more than one third of the nursing services.

ParkIndex

DEFF Research Database (Denmark)

Kaczynski, Andrew T; Schipperijn, Jasper; Hipp, J Aaron

2016-01-01

using ArcGIS 9.3 and the Community Park Audit Tool. Four park summary variables - distance to nearest park, and the number of parks, amount of park space, and average park quality index within 1 mile were analyzed in relation to park use using logistic regression. Coefficients for significant park......, planners, and citizens to evaluate the potential for park use for a given area. Data used for developing ParkIndex were collected in 2010 in Kansas City, Missouri (KCMO). Adult study participants (n=891) reported whether they used a park within the past month, and all parks in KCMO were mapped and audited...

Context-Aware Middleware Support for the Nomadic Mobile Services on Multi-homed Handheld Mobile Devices

NARCIS (Netherlands)

Pawar, Pravin; van Beijnum, Bert-Jan; Peddemors, Arjan; van Halteren, Aart

2007-01-01

Nowadays, a variety ofhandheld mobile devices are capable of connecting to the Internet using multiple network interfaces. This is referred to as multi-homing. In addition to this, enriched computation resources allow them to host nomadic mobile services and provide these services to the clients

EINSTEIN-HOME DISCOVERY OF 24 PULSARS IN THE PARKES MULTI-BEAM PULSAR SURVEY

Energy Technology Data Exchange (ETDEWEB)

Knispel, B.; Kim, H.; Allen, B.; Aulbert, C.; Bock, O.; Eggenstein, H.-B.; Fehrmann, H.; Machenschalk, B. [Albert-Einstein-Institut, Max-Planck-Institut fuer Gravitationsphysik, D-30167 Hannover (Germany); Eatough, R. P.; Keane, E. F.; Kramer, M. [Max-Planck-Institut fuer Radioastronomie, D-53121 Bonn (Germany); Anderson, D. [University of California at Berkeley, Berkeley, CA 94720 (United States); Crawford, F.; Rastawicki, D. [Department of Physics and Astronomy, Franklin and Marshall College, P.O. Box 3003, Lancaster, PA 17604 (United States); Hammer, D.; Papa, M. A.; Siemens, X. [Physics Department, University of Wisconsin-Milwaukee, Milwaukee, WI 53211 (United States); Lyne, A. G. [Jodrell Bank Centre for Astrophysics, School of Physics and Astronomy, University of Manchester, Manchester M13 9PL (United Kingdom); Miller, R. B. [Department of Physics, West Virginia University, 111 White Hall, Morgantown, WV 26506 (United States); Sarkissian, J., E-mail: benjamin.knispel@aei.mpg.de [CSIRO Parkes Observatory, Parkes, NSW 2870 (Australia); and others

2013-09-10

We have conducted a new search for radio pulsars in compact binary systems in the Parkes multi-beam pulsar survey (PMPS) data, employing novel methods to remove the Doppler modulation from binary motion. This has yielded unparalleled sensitivity to pulsars in compact binaries. The required computation time of Almost-Equal-To 17, 000 CPU core years was provided by the distributed volunteer computing project Einstein-Home, which has a sustained computing power of about 1 PFlop s{sup -1}. We discovered 24 new pulsars in our search, 18 of which were isolated pulsars, and 6 were members of binary systems. Despite the wide filterbank channels and relatively slow sampling time of the PMPS data, we found pulsars with very large ratios of dispersion measure (DM) to spin period. Among those is PSR J1748-3009, the millisecond pulsar with the highest known DM ( Almost-Equal-To 420 pc cm{sup -3}). We also discovered PSR J1840-0643, which is in a binary system with an orbital period of 937 days, the fourth largest known. The new pulsar J1750-2536 likely belongs to the rare class of intermediate-mass binary pulsars. Three of the isolated pulsars show long-term nulling or intermittency in their emission, further increasing this growing family. Our discoveries demonstrate the value of distributed volunteer computing for data-driven astronomy and the importance of applying new analysis methods to extensively searched data.

Parking Sensing and Information System: Sensors, Deployment, and Evaluation

OpenAIRE

Chen, Xiao; Zhen; Qian; Rajagopal, Ram; Stiers, Todd; Flores, Christopher; Kavaler, Robert; Williams III, Floyd

2017-01-01

This paper describes a smart parking sensing and information system that disseminates the parking availability information for public users in a cost-effective and efficient manner. The hardware framework of the system is built on advanced wireless sensor networks and cloud service over the Internet, and the system is highly scalable. The parking information provided to the users is set in the form of occupancy rates and expected cruising time. Both are obtained from our analytical algorithm ...

Research on the model of home networking

Science.gov (United States)

Yun, Xiang; Feng, Xiancheng

2007-11-01

It is the research hotspot of current broadband network to combine voice service, data service and broadband audio-video service by IP protocol to transport various real time and mutual services to terminal users (home). Home Networking is a new kind of network and application technology which can provide various services. Home networking is called as Digital Home Network. It means that PC, home entertainment equipment, home appliances, Home wirings, security, illumination system were communicated with each other by some composing network technology, constitute a networking internal home, and connect with WAN by home gateway. It is a new network technology and application technology, and can provide many kinds of services inside home or between homes. Currently, home networking can be divided into three kinds: Information equipment, Home appliances, Communication equipment. Equipment inside home networking can exchange information with outer networking by home gateway, this information communication is bidirectional, user can get information and service which provided by public networking by using home networking internal equipment through home gateway connecting public network, meantime, also can get information and resource to control the internal equipment which provided by home networking internal equipment. Based on the general network model of home networking, there are four functional entities inside home networking: HA, HB, HC, and HD. (1) HA (Home Access) - home networking connects function entity; (2) HB (Home Bridge) Home networking bridge connects function entity; (3) HC (Home Client) - Home networking client function entity; (4) HD (Home Device) - decoder function entity. There are many physical ways to implement four function entities. Based on theses four functional entities, there are reference model of physical layer, reference model of link layer, reference model of IP layer and application reference model of high layer. In the future home network

Smart Homes for All: Collaborating Services in a for-All Architecture for Domotics

Science.gov (United States)

Catarci, Tiziana; Cincotti, Febo; de Leoni, Massimiliano; Mecella, Massimo; Santucci, Giuseppe

Nowadays, control equipments such as automobiles, home appliances, communication, control and office machines, offer their functionalities in the form of services. Such service pervasivity is particularly evident in immersive realities, i.e., scenarios in which invisible embedded systems need to continuously interact with human users, in order to provide continuous sensed information and to react to service requests from the users themselves. The sm4all project, which will be presented in this paper, is investigating an innovative middleware platform for collaborating smart embedded services in immersive and person-centric environments, through the use of composability and semantic techniques.

Nonmethane hydrocarbons in the rural southeast United States national parks

Science.gov (United States)

Kang, Daiwen; Aneja, Viney P.; Zika, Rod G.; Farmer, Charles; Ray, John D.

2001-02-01

Measurements of volatile organic compounds (VOCs) were made at three rural sites in the southeast U.S. national parks: Mammoth Cave National Park, Kentucky; Cove Mountain, Great Smoky Mountains National Park, Tennessee; and Big Meadows, Shenandoah National Park, Virginia. In 1995 the three locations were sampling sites for the Southern Oxidants Study (SOS) Nashville Intensive, and the measurements of VOCs for Shenandoah were also made under contract with the National Park Service. Starting in 1996, the National Park Service added the other two parks to the monitoring contract. Hydrocarbon measurements made during June through September for the years 1995, 1996, and 1997 were analyzed in this study. Source classification techniques based on correlation coefficient, chemical reactivity, and ratioing were developed and applied to these data. The results show that anthropogenic VOCs from automobile exhaust appeared to be dominant at Mammoth Cave National Park, and at Cove Mountain, Great Smoky Mountains National Park, but other sources were also important at Big Meadows, Shenandoah National Park. Correlation and ratio analysis based on chemical reactivity provides a basis for source-receptor relationship. The most abundant ambient VOCs varied both in concentration and order depending on park and year, but the following VOCs appeared on the top 10 list for all three sites: isoprene (6.3 to 18.4 ppbv), propane (2.1 to 12.9 ppbv), isopentane (1.3 to 5.7 ppbv), and toluene (1.0 to 7.2 ppbv). Isoprene is naturally emitted by vegetation, and the others are produced mainly by fossil fuel combustion and industrial processes. Propylene-equivalent concentrations were calculated to account for differences in reaction rates between the hydroxyl radical and individual hydrocarbons, and to thereby estimate their relative contributions to ozone formation.

Evaluation of Integrating the Invasive Species Forecasting System to Support National Park Service Decisions on Fire Management Activities and Invasive Plant Species Control

Science.gov (United States)

Ma, Peter; Morisette, T.; Rodman, Ann; McClure, Craig; Pedelty, Jeff; Benson, Nate; Paintner, Kara; Most, Neal; Ullah, Asad; Cai, Weijie;

Building an urban park increases the intention of adults to practice physical activity

Directory of Open Access Journals (Sweden)

Raphaelly Machado Felix

Full Text Available Abstract Physical activity levels in adults are low and strategies should be put in place to change this. The aim of this study was to investigate whether building an urban park can increase adult neighborhood residents' intentions to partake in physical activity. In total, 395 adults living near where the park was being built participated in the study. The following information was collected: sociodemographic characteristics, current physical activity levels, and intention to use the park for physical activity. Around 80% of the subjects intended to use the park for physical activity. This frequency was higher among those who were classified as physically active and gradually higher as the distance between the home of the subject and the park decreased (p < 0.05. The offer of a public leisure space can contribute positively to changing population behavior related to regular physical activity.

Agency Ownership, Patient Payment Source, and Length of Service in Home Care, 1992-2000

Science.gov (United States)

Han, Beth; McAuley, William J.; Remsburg, Robin E.

2007-01-01

Purpose: Little is known about whether an association exists between agency ownership and length of service among home care patients with different payment sources. This study investigated how for-profit and not-for-profit agencies responded to policy changes in the 1990s with respect to length of service. Design and Methods: We examined length of…

Non destructive testing in amusement park

International Nuclear Information System (INIS)

Dominguez Marrero, Humberto; Hernandez Torres, Debora; Sendoya Puente, Felix; Herrera Palma, Victoria; Suarez Guerra, Yarelis; Moreno Hernandez, Eduardo; Lopez Hernandez, Pedro

2009-01-01

In 2006 began the installation of Chinese amusement parks at several places in Havana City. Structural security is one of the principal tasks that should be done, since the beginning of the services of these installations. The use on Non Destructive Testing Techniques (NDT), has to be development and implemented in order to avoid the possibility of failure during services with a consequence threat to safety for the public presented. In this work it is shown the results of application of NDT techniques and recommendations for the quality control of the different welds and mechanical components presented. Techniques as Visual Examination, Liquid Penetrant and Ultrasonic have been used for these purposes in order to obtain a structural diagnostic in the amusement parks. There are also exposed the use and implementation of international recommendations and Standards, which are very rigorous in its applications for the case of recreation industry. This is a consequence to its social service fundamentally to children and teenage people. (Author)

The White-Bellied Sea Eagle at Kepulauan Seribu National Park, Java, Indonesia

Directory of Open Access Journals (Sweden)

Gunawan Gunawan

2015-12-01

Full Text Available One of the remaining habitats of The White-Bellied Sea Eagle (Haliaeetus leucogaster in Java is The National Marine Park of Kepulauan Seribu (TNKpS. Administratively, the park includes Regency of Seribu Islands (Kepulauan Seribu, Jakarta Province. The area is 107,489 hectares, and geographically lies on 05º23’ – 05º40’ S and 106º25’ – 106º37’ E. The area is among 78 islands of 110 islands spreading from the north to the south which forms a group of island with similar morphology and oceanography. For field survey we use direct observation method, semi structured interview with local people. Finding of nests on 7 islands and data compilation of entering eagle to the rehabilitation center in Kepulauan Seribu in Kotok Besar island. Based on our survey result, the population of White-Bellied Sea Eagle in Kepulauan Seribu National park was estimated on 28–32 individual. Study on home range was conducted intensively by using polygon method on breeding pair of this species at Yu Island. Based on current results, the home range of this species was estimated on 13.9 km2.

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

Science.gov (United States)

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

2018-04-06

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

Stakeholder Analysis in Utilizing of Environmental Services and Natural Attractions in Tuk Semuncar Utilization Zone of Gunung Merbabu National Park: A literature review

Science.gov (United States)

Setiawan, Muhammad Arif; Muhammad, Fuad

2018-02-01

Many stakeholders in the utilizing of environmental services and natural attraction of Tuk Semuncar Utilization Zone needs to get the attention of the Gunung Merbabu National Park Officer. The existence of natural resources has an important role for the life of the community, making the complexity of the relationship between various parties who have interests in natural resource management. The existence of stakeholders and their interests should receive attention and be considered to be accommodated as an effort to prevent the occurrence of losses to the conservation area of Gunung Merbabu National Park. Every stakeholder's interest can have a positive and negative impact on other stakeholders. Stakeholder analysis can help in understanding the conflict on the utilizing of environmental services and natural attraction that is happening, as well as input strategy in involving stakeholders for the achievement of goals.

Stakeholder Analysis in Utilizing of Environmental Services and Natural Attractions in Tuk Semuncar Utilization Zone of Gunung Merbabu National Park: A literature review

Directory of Open Access Journals (Sweden)

Setiawan Muhammad Arif

2018-01-01

Full Text Available Many stakeholders in the utilizing of environmental services and natural attraction of Tuk Semuncar Utilization Zone needs to get the attention of the Gunung Merbabu National Park Officer. The existence of natural resources has an important role for the life of the community, making the complexity of the relationship between various parties who have interests in natural resource management. The existence of stakeholders and their interests should receive attention and be considered to be accommodated as an effort to prevent the occurrence of losses to the conservation area of Gunung Merbabu National Park. Every stakeholder's interest can have a positive and negative impact on other stakeholders. Stakeholder analysis can help in understanding the conflict on the utilizing of environmental services and natural attraction that is happening, as well as input strategy in involving stakeholders for the achievement of goals.

Kaloko-Honokohau National Historical Park Air Tour Management Plan planning and NEPA scoping document

Science.gov (United States)

2004-03-03

The Federal Aviation Administration (FAA), in cooperation with the National Park Service (NPS), has initiated the development of an Air Tour Management Plan (ATMP) for Kaloko-Honokohau Historic Park pursuant to the National Parks Air Tour Management ...

Field Guide to the Plant Community Types of Voyageurs National Park

Science.gov (United States)

Faber-Langendoen, Don; Aaseng, Norman; Hop, Kevin; Lew-Smith, Michael

2007-01-01

INTRODUCTION The objective of the U.S. Geological Survey-National Park Service Vegetation Mapping Program is to classify, describe, and map vegetation for most of the park units within the National Park Service (NPS). The program was created in response to the NPS Natural Resources Inventory and Monitoring Guidelines issued in 1992. Products for each park include digital files of the vegetation map and field data, keys and descriptions to the plant communities, reports, metadata, map accuracy verification summaries, and aerial photographs. Interagency teams work in each park and, following standardized mapping and field sampling protocols, develop products and vegetation classification standards that document the various vegetation types found in a given park. The use of a standard national vegetation classification system and mapping protocol facilitate effective resource stewardship by ensuring compatibility and widespread use of the information throughout the NPS as well as by other Federal and state agencies. These vegetation classifications and maps and associated information support a wide variety of resource assessment, park management, and planning needs, and provide a structure for framing and answering critical scientific questions about plant communities and their relation to environmental processes across the landscape. This field guide is intended to make the classification accessible to park visitors and researchers at Voyageurs National Park, allowing them to identify any stand of natural vegetation and showing how the classification can be used in conjunction with the vegetation map (Hop and others, 2001).

36 CFR 3.16 - May I swim or wade in park waters?

Science.gov (United States)

2010-07-01

... waters? 3.16 Section 3.16 Parks, Forests, and Public Property NATIONAL PARK SERVICE, DEPARTMENT OF THE INTERIOR BOATING AND WATER USE ACTIVITIES § 3.16 May I swim or wade in park waters? Swimming or wading is allowed in waters, subject to closures or restrictions designated by the superintendent in accordance with...

Optimal taxation with home production

OpenAIRE

Olovsson, Conny

2014-01-01

Optimal taxes for Europe and the U.S. are derived in a realistically calibrated model in which agents buy consumption goods and services and use home capital and labor to produce household services. The optimal tax rate on services is substantially lower than the tax rate on goods. Specifically, the planner cannot tax home production directly and instead lowers the tax rate on market services to increase the relative price of home production. The optimal tax rate on the return to home capital...

Occupational accidents among nursing professionals in a home care service in the state of São Paulo

Directory of Open Access Journals (Sweden)

Jéssica Fernanda Corrêa Cordeiro

2016-10-01

Full Text Available This is a cross-sectional study whose objective is to identify and describe accidents with biological material as told by nursing professionals in a home care service in a city in the state of São Paulo. Of the 30 subjects who provided that service in the data collection period, 28 agreed to participate and 12 (42.8% claimed to have suffered at least one accident with biological material while carrying out professional procedures for that service. Most of the exposures were percutaneous (91.7% and blood was the most often involved fluid (75%. Regarding procedures, 75% of the individuals were administering drugs when the accident happened and 50% admitted that they were recapping hollow needles. The current study enabled the identification of situations described by the professionals and which led to the occurrence of accidents with biological material during home care. These findings can support preventive measures and guide future studies that involve this type of accident at homes.

Opinion versus practice regarding the use of rehabilitation services in home care: an investigation using machine learning algorithms.

Science.gov (United States)

Cheng, Lu; Zhu, Mu; Poss, Jeffrey W; Hirdes, John P; Glenny, Christine; Stolee, Paul

2015-10-09

Resources for home care rehabilitation are limited, and many home care clients who could benefit do not receive rehabilitation therapy. The interRAI Contact Assessment (CA) is a new screening instrument comprised of a subset of interRAI Home Care (HC) items, designed to be used as a preliminary assessment to identify which potential home care clients should be referred for a full assessment, or for services such as rehabilitation. We investigated which client characteristics are most relevant in predicting rehabilitation use in the full interRAI HC assessment. We applied two algorithms from machine learning and data mining - the LASSO and the random forest - to frequency matched interRAI HC and service utilization data for home care clients in Ontario, Canada. Analyses confirmed the importance of functional decline and mobility variables in targeting rehabilitation services, but suggested that other items in use as potential predictors may be less relevant. Six of the most highly ranked items related to ambulation. Diagnosis of cancer was highly associated with decreased rehabilitation use; however, cognitive status was not. Inconsistencies between variables considered important for classifying clients who need rehabilitation and those identified in this study based on use may indicate a discrepancy in the client characteristics considered relevant in theory versus actual practice.

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

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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

Remote diagnosis as used for mechanized parking systems

Science.gov (United States)

Humberg, Heinz; Maeder, Hans Friedrich; Will, Frank

1992-10-01

The new possibilities offered by worldwide data transmission networks, which are being used for the remote diagnosis of mechanized parking systems are discussed. This has led to a reduction in service costs for systems installed in Asia and elsewhere. The principles of the mechanized multistorey car park and their control concept are described. The parking facilities are fully geared up for remote diagnosis, the key functions of which are: data collection, data storage, data transmission, and data evaluation. The reports transmitted from the parking facility are analyzed using an evaluation system. The objectives are to detect impending component failures and to quickly identify the causes of irregularities which have occurred. The evaluation system can be easily adapted for other applications.

76 FR 9780 - Notification of Deletion of System of Records; EPA Parking Control Office File (EPA-10) and EPA...

Science.gov (United States)

2011-02-22

... System of Records; EPA Parking Control Office File (EPA-10) and EPA Transit and Guaranteed Ride Home... Environmental Protection Agency (EPA) is deleting the systems of records for EPA Parking Control Office File... through the EPA Internet under the ``Federal Register'' listings at http://www.epa.gov/fedrgstr/ . Dated...

Home Care Services as Teaching Sites for Geriatrics in Family Medicine Residencies.

Science.gov (United States)

Laguillo, Edgardo

1988-01-01

A national survey of family medicine programs and residency training in geriatrics found almost half using home care services as teaching sites. In the program design preferred by residents, the resident followed the patient long-term and discussed management with a multidisciplinary team. An alternative combined rotation is discussed. (Author/MSE)

Measurements of seasonal and daily radon daughter concentration fluctuations in National Park Service caves

International Nuclear Information System (INIS)

Yarborough, K.A.

1977-01-01

The National Park Service (NPS) is studying levels of airborne alpha radiation from radon and thoron in all NPS administered caves in which tours for visitors are regularly conducted. The NPS research has the dual but complementary objectives of safeguarding health at the NPS administered caves, and to develop data on alpha radiation levels and on natural airflows in NPS caves. The results reported here for NPS caves describe concepts hypothesized for the objectives. In addition the data can be used by various agencies to clarify health standards for exposures to low airborne alpha radiation levels in cave environments. These results show daily and seasonal trends and the influence of natural ventilation by air circulation for each cave investigated

Utilizing Social Network Services for Enhanced Communication with Elderly Living at Home

DEFF Research Database (Denmark)

Wagner, Stefan

2009-01-01

This paper discusses whether social network services, like Facebook and Twitter, may be used by elderly living in their own homes to enhance communication with their relatives and friends. It introduces a prototype solution based on the iRobot Roomba 560, iRobot, USA, robot vacuum cleaner, which...... has been enhanced with Facebook and Twitter communication capabilities. The paper points out a number of other relevant applications where the use of social network services may provide better communication for ambient assisted living solutions and intelligent environments....

NPDES Permit for Mesa Verde National Park Water Treatment Plant in Colorado

Science.gov (United States)

Under NPDES permit number CO-0034462, the United States Department of the Interior, National Park Service is authorized to discharge from the Mesa Verde National Park water treatment plant, in Montezuma County, Colo.

Strategic and tactiocal planning for managing national park resources

Science.gov (United States)

Daniel L. Schmoldt; David L. Peterson

2001-01-01

Each National Park Service unit in the United States produces a resource management plan (RMP) every four years or less. These plans constitute a strategic agenda for a park. Later, tactical plans commit budgets and personnel to specific projects over the planning horizon. Yet, neither planning stage incorporates much quantitative and analytical rigor and is devoid of...

IoT-Based Image Recognition System for Smart Home-Delivered Meal Services

Directory of Open Access Journals (Sweden)

Hsiao-Ting Tseng

2017-07-01

Full Text Available Population ageing is an important global issue. The Taiwanese government has used various Internet of Things (IoT applications in the “10-year long-term care program 2.0”. It is expected that the efficiency and effectiveness of long-term care services will be improved through IoT support. Home-delivered meal services for the elderly are important for home-based long-term care services. To ensure that the right meals are delivered to the right recipient at the right time, the runners need to take a picture of the meal recipient when the meal is delivered. This study uses the IoT-based image recognition system to design an integrated service to improve the management of image recognition. The core technology of this IoT-based image recognition system is statistical histogram-based k-means clustering for image segmentation. However, this method is time-consuming. Therefore, we proposed using the statistical histogram to obtain a probability density function of pixels of a figure and segmenting these with weighting for the same intensity. This aims to increase the computational performance and achieve the same results as k-means clustering. We combined histogram and k-means clustering in order to overcome the high computational cost for k-means clustering. The results indicate that the proposed method is significantly faster than k-means clustering by more than 10 times.

Volcanism in national parks: summary of the workshop convened by the U.S. Geological Survey and National Park Service, 26-29 September 2000, Redding, California

Science.gov (United States)

Guffanti, Marianne; Brantley, Steven R.; McClelland, Lindsay

2001-01-01

Spectacular volcanic scenery and features were the inspiration for creating many of our national parks and monuments and continue to enhance the visitor experience today (Table 1). At the same time, several of these parks include active and potentially active volcanoes that could pose serious hazards - earthquakes, mudflows, and hydrothermal explosions, as well as eruptions - events that would profoundly affect park visitors, employees, and infrastructure. Although most parks are in relatively remote areas, those with high visitation have daily populations during the peak season equivalent to those of moderate-sized cities. For example, Yellowstone and Grand Teton national parks can have a combined daily population of 80,000 during the summer, with total annual visitation of 7 million. Nearly 3 million people enter Hawai`i Volcanoes National Park every year, where the on-going (since 1983) eruption of Kilauea presents the challenge of keeping visitors out of harm's way while still allowing them to enjoy the volcano's spellbinding activity.

Smart Home and Smart City Solutions enabled by 5G, IoT, AAI and CoT Services

DEFF Research Database (Denmark)

Skouby, Knud Erik; Lynggaard, Per

2014-01-01

Future 5G technologies are expected to connect the world from the largest megacities to the smallest internet of things in an always online fashion. Such a connected hierarchy must combine the smart cities, the smart homes, and the internet of things into one large coherent infrastructure...... such as interconnected internet of things, smart homes with artificial intelligence, and a platform for new combined smart home and smart city services based on big-data....

75 FR 36109 - Notice of Intent to Repatriate Cultural Items: California Department of Parks and Recreation...

Science.gov (United States)

2010-06-24

...: California Department of Parks and Recreation, Sacramento, CA AGENCY: National Park Service, Interior. ACTION... California Department of Parks and Recreation, Sacramento, CA, that meet the definition of unassociated..., California Department of Parks and Recreation, 1416 Ninth St., Room 902, Sacramento, CA 95814, telephone (916...

77 FR 6581 - Winter Use Plan, Supplemental Environmental Impact Statement, Yellowstone National Park, Idaho...

Science.gov (United States)

2012-02-08

... DEPARTMENT OF THE INTERIOR National Park Service [2310-0070-422] Winter Use Plan, Supplemental... the Winter Use Plan, Yellowstone National Park. SUMMARY: Pursuant to the National Environmental Policy... Statement (SEIS) for a Winter Use Plan for Yellowstone National Park, located in Idaho, Montana and Wyoming...

78 FR 79005 - Charter Renewal for the National Park System Advisory Board

Science.gov (United States)

2013-12-27

... amended. Certification: I hereby certify that the renewal of the National Park System Advisory Board is... of the Interior by the National Park Service Organic Act (16 U.S.C. 1 et seq.), and other statutes...

Effects of Housing Costs and Home Sales on Local Government Revenues and Services

OpenAIRE

Allee, David J.

1991-01-01

The subtitle of this paper should be " How recession and federal devolution have caused local governments to cut services and raise property taxes --now, what should be done in response to the resulting clamor for local government consolidation?" Housing drives local government services. Home sales represent opportunities for more income and more costs. Intergovernmental competition for tax base and the role of state and federal aid to provide equity between jurisdictions are central to the q...

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

Science.gov (United States)

2010-04-01

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

Ectomycorrhizal Fungal Communities in Urban Parks Are Similar to Those in Natural Forests but Shaped by Vegetation and Park Age.

Science.gov (United States)

Hui, Nan; Liu, Xinxin; Kotze, D Johan; Jumpponen, Ari; Francini, Gaia; Setälä, Heikki

2017-12-01

Ectomycorrhizal (ECM) fungi are important mutualists for the growth and health of most boreal trees. Forest age and its host species composition can impact the composition of ECM fungal communities. Although plentiful empirical data exist for forested environments, the effects of established vegetation and its successional trajectories on ECM fungi in urban greenspaces remain poorly understood. We analyzed ECM fungi in 5 control forests and 41 urban parks of two plant functional groups (conifer and broadleaf trees) and in three age categories (10, ∼50, and >100 years old) in southern Finland. Our results show that although ECM fungal richness was marginally greater in forests than in urban parks, urban parks still hosted rich and diverse ECM fungal communities. ECM fungal community composition differed between the two habitats but was driven by taxon rank order reordering, as key ECM fungal taxa remained largely the same. In parks, the ECM communities differed between conifer and broadleaf trees. The successional trajectories of ECM fungi, as inferred in relation to the time since park construction, differed among the conifers and broadleaf trees: the ECM fungal communities changed over time under the conifers, whereas communities under broadleaf trees provided no evidence for such age-related effects. Our data show that plant-ECM fungus interactions in urban parks, in spite of being constructed environments, are surprisingly similar in richness to those in natural forests. This suggests that the presence of host trees, rather than soil characteristics or even disturbance regime of the system, determine ECM fungal community structure and diversity. IMPORTANCE In urban environments, soil and trees improve environmental quality and provide essential ecosystem services. ECM fungi enhance plant growth and performance, increasing plant nutrient acquisition and protecting plants against toxic compounds. Recent evidence indicates that soil-inhabiting fungal communities

Does hospital at home for palliative care facilitate death at home? Randomised controlled trial

Science.gov (United States)

Grande, Gunn E; Todd, Chris J; Barclay, Stephen I G; Farquhar, Morag C

1999-01-01

Objective To evaluate the impact on place of death of a hospital at home service for palliative care. Design Pragmatic randomised controlled trial. Setting Former Cambridge health district. Participants 229 patients referred to the hospital at home service; 43 randomised to control group (standard care), 186 randomised to hospital at home. Intervention Hospital at home versus standard care. Main outcome measures Place of death. Results Twenty five (58%) control patients died at home compared with 124 (67%) patients allocated to hospital at home. This difference was not significant; intention to treat analysis did not show that hospital at home increased the number of deaths at home. Seventy three patients randomised to hospital at home were not admitted to the service. Patients admitted to hospital at home were significantly more likely to die at home (88/113; 78%) than control patients. It is not possible to determine whether this was due to hospital at home itself or other characteristics of the patients admitted to the service. The study attained less statistical power than initially planned. Conclusion In a locality with good provision of standard community care we could not show that hospital at home allowed more patients to die at home, although neither does the study refute this. Problems relating to recruitment, attrition, and the vulnerability of the patient group make randomised controlled trials in palliative care difficult. While these difficulties have to be recognised they are not insurmountable with the appropriate resourcing and setting. Key messagesTerminally ill patients allocated to hospital at home were no more likely to die at home than patients receiving standard careAlthough the subsample of patients actually admitted to hospital at home did show a significant increase in likelihood of dying at home, whether this was due to the service itself or the characteristics of patients admitted to hospital at home could not be determinedThe need to

Design of a terminal solution for integration of in-home health care devices and services towards the Internet-of-Things

Science.gov (United States)

Pang, Zhibo; Zheng, Lirong; Tian, Junzhe; Kao-Walter, Sharon; Dubrova, Elena; Chen, Qiang

2015-01-01

In-home health care services based on the Internet-of-Things are promising to resolve the challenges caused by the ageing of population. But the existing research is rather scattered and shows lack of interoperability. In this article, a business-technology co-design methodology is proposed for cross-boundary integration of in-home health care devices and services. In this framework, three key elements of a solution (business model, device and service integration architecture and information system integration architecture) are organically integrated and aligned. In particular, a cooperative Health-IoT ecosystem is formulated, and information systems of all stakeholders are integrated in a cooperative health cloud as well as extended to patients' home through the in-home health care station (IHHS). Design principles of the IHHS includes the reuse of 3C platform, certification of the Health Extension, interoperability and extendibility, convenient and trusted software distribution, standardised and secured electrical health care record handling, effective service composition and efficient data fusion. These principles are applied to the design of an IHHS solution called iMedBox. Detailed device and service integration architecture and hardware and software architecture are presented and verified by an implemented prototype. The quantitative performance analysis and field trials have confirmed the feasibility of the proposed design methodology and solution.

Effectiveness of a lifestyle exercise program for older people receiving a restorative home care service: a pragmatic randomized controlled trial

Directory of Open Access Journals (Sweden)

Burton E

2013-12-01

Full Text Available Elissa Burton,1,2 Gill Lewin,1,2 Lindy Clemson,3 Duncan Boldy41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain, Perth, WA, Australia; 3Health and Work Research Unit, The University of Sydney, Sydney, NSW, Australia; 4School of Nursing and Midwifery, Curtin University, Perth, WA, AustraliaBackground: Restorative home care services are short-term and aimed at maximizing a person’s ability to live independently. They are multidimensional and often include an exercise program to improve strength, mobility, and balance. The aim of this study was to determine whether a lifestyle exercise program would be undertaken more often and result in greater functional gains than the current structured exercise program delivered as part of a restorative home care service for older adults.Methods: A pragmatic randomized controlled trial was conducted in an organization with an established restorative home care service. Individuals who were to have an exercise program as part of their service were randomized to receive either a lifestyle and functional exercise program called LiFE (as this was a new program, the intervention or the structured exercise program currently being used in the service (control. Exercise data collected by the individuals throughout and pre and post intervention testing was used to measure balance, strength, mobility, falls efficacy, vitality, function, and disability.Results: There was no difference between the groups in the amounts of exercise undertaken during the 8-week intervention period. Outcome measurement indicated that the LiFE program was as effective, and on 40% of the measures, more effective, than the structured exercise program.Conclusion: Organizations delivering restorative home care services that include an exercise component should consider whether LiFE rather than the exercise program they are currently using could help their clients achieve better outcomes

A Cloud-Based Car Parking Middleware for IoT-Based Smart Cities: Design and Implementation

Directory of Open Access Journals (Sweden)

Zhanlin Ji

2014-11-01

Full Text Available This paper presents the generic concept of using cloud-based intelligent car parking services in smart cities as an important application of the Internet of Things (IoT paradigm. This type of services will become an integral part of a generic IoT operational platform for smart cities due to its pure business-oriented features. A high-level view of the proposed middleware is outlined and the corresponding operational platform is illustrated. To demonstrate the provision of car parking services, based on the proposed middleware, a cloud-based intelligent car parking system for use within a university campus is described along with details of its design, implementation, and operation. A number of software solutions, including Kafka/Storm/Hbase clusters, OSGi web applications with distributed NoSQL, a rule engine, and mobile applications, are proposed to provide ‘best’ car parking service experience to mobile users, following the Always Best Connected and best Served (ABC&S paradigm.

A Cloud-Based Car Parking Middleware for IoT-Based Smart Cities: Design and Implementation

Science.gov (United States)

Ji, Zhanlin; Ganchev, Ivan; O'Droma, Máirtín; Zhao, Li; Zhang, Xueji

2014-01-01

This paper presents the generic concept of using cloud-based intelligent car parking services in smart cities as an important application of the Internet of Things (IoT) paradigm. This type of services will become an integral part of a generic IoT operational platform for smart cities due to its pure business-oriented features. A high-level view of the proposed middleware is outlined and the corresponding operational platform is illustrated. To demonstrate the provision of car parking services, based on the proposed middleware, a cloud-based intelligent car parking system for use within a university campus is described along with details of its design, implementation, and operation. A number of software solutions, including Kafka/Storm/Hbase clusters, OSGi web applications with distributed NoSQL, a rule engine, and mobile applications, are proposed to provide ‘best’ car parking service experience to mobile users, following the Always Best Connected and best Served (ABC&S) paradigm. PMID:25429416

A cloud-based car parking middleware for IoT-based smart cities: design and implementation.

Science.gov (United States)

Ji, Zhanlin; Ganchev, Ivan; O'Droma, Máirtín; Zhao, Li; Zhang, Xueji

2014-11-25

This paper presents the generic concept of using cloud-based intelligent car parking services in smart cities as an important application of the Internet of Things (IoT) paradigm. This type of services will become an integral part of a generic IoT operational platform for smart cities due to its pure business-oriented features. A high-level view of the proposed middleware is outlined and the corresponding operational platform is illustrated. To demonstrate the provision of car parking services, based on the proposed middleware, a cloud-based intelligent car parking system for use within a university campus is described along with details of its design, implementation, and operation. A number of software solutions, including Kafka/Storm/Hbase clusters, OSGi web applications with distributed NoSQL, a rule engine, and mobile applications, are proposed to provide 'best' car parking service experience to mobile users, following the Always Best Connected and best Served (ABC&S) paradigm.