WorldWideScience

Sample records for program home publications

  1. Enrolled Home Study Partners with Public Schools

    Science.gov (United States)

    Lines, Patricia M.

    2004-01-01

    Home-based programs provide opportunities at a level far beyond what a traditional public school program can offer. To stem enrollment losses to homeschooling, or simply to help families interested in home-based option, public schools are enrolling children and sending them home, where they follow the school's curriculum under their parents'…

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... ACS Careers at ACS About ACS Career Types Working at ACS ... Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy ...

  4. Ostomy Home Skills Program

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    Full Text Available ... Program Commission on Cancer National Accreditation Program for Breast Centers National Cancer Database National Accreditation Program for Rectal Cancer Oncology Medical Home Accreditation Program Stereotactic Breast Biopsy Accreditation Program Cancer Programs Staff Information Children's ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Ostomy Home Skills Program Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo ...

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit ...

  7. The political economy of a public health case management program's transition into medical homes.

    Science.gov (United States)

    Wells, Rebecca; Cilenti, Dorothy; Issel, L Michele

    2015-11-01

    Throughout the United States, public health leaders are experimenting with how best to integrate services for individuals with complex needs. To that end, North Carolina implemented a policy incorporating both local public health departments and other providers into medical homes for low income pregnant women and young children at risk of developmental delays. To understand how this transition occurred within local communities, a pre-post comparative case study was conducted. A total of 42 people in four local health departments across the state were interviewed immediately before the 2011 policy change and six months later: 32 professionals (24 twice) and 10 pregnant women receiving case management at the time of the policy implementation. We used constant comparative analysis of interview and supplemental data to identify three key consequences of the policy implementation. One, having medical homes increased the centrality of other providers relative to local health departments. Two, a shift from focusing on personal relationships toward medical efficiency diverged in some respects from both case managers' and mothers' goals. Three, health department staff re-interpreted state policies to fit their public health values. Using a political economy perspective, these changes are interpreted as reflecting shifts in public health's broader ideological environment. To a large extent, the state successfully induced more connection between health department-based case managers and external providers. However, limited provider engagement may constrain the implementation of the envisioned medical homes. The increased focus on medical risk may also undermine health departments' role in supporting health over time by attenuating staff relationships with mothers. This study helps clarify how state public health policy innovations unfold at local levels, and why front line practice may in some respects diverge from policy intent. Published by Elsevier Ltd.

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Donate American College of Surgeons Education Patients and Family Skills Programs ... The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn ...

  9. Ostomy Home Skills Program

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    Full Text Available ... entire surgical team with quality, comprehensive education. The standardized interactive program has been developed by the American ... Ostomy Home Skills Hospital Quality Improvement Package The standardized interactive program has been developed by the American ...

  10. Ostomy Home Skills Program

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    Full Text Available ... Stay Up to Date with ACS Association Management Jobs Events Find a Surgeon Patients and Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills Program Ostomy Home Skills ...

  11. Ostomy Home Skills Program

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    Full Text Available ... checklist Evaluation (Complete the Ostomy Patient Survey . We need your opinion!) Program outcomes The ACS Ostomy Home Skills Kit program covers: Adult Ostomy Pediatric Ostomy Ostomía Adulto Order Today Ostomy Home Skills Kit (login or create account ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Program for Hospitals Trauma Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters National Trauma System Injury ...

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Life Support Verification, Review, and Consultation Program for Hospitals Trauma Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters ...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn and ...

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with educational and simulation ...

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit ...

  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Ostomy Programa de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with ...

  18. Ostomy Home Skills Program

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    Full Text Available ... Complete the Ostomy Patient Survey . We need your opinion!) Program outcomes The ACS Ostomy Home Skills Kit ... ACS Links About ACS ACS Foundation Have a Question? Press Releases Shop My Profile American College of ...

  19. Ostomy Home Skills Program

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    Full Text Available ... Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement Package The standardized interactive program has been developed by the ... and Associates Medical Students International Surgeons ...

  20. Ostomy Home Skills Program

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    Full Text Available ... at ACS Careers at ACS About ACS Career Types Working at ACS ... Family Contact My Profile Shop ( 0 ) Cart Donate American College of Surgeons Education Patients and Family Skills Programs Ostomy Home Skills ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Conference Publications and Posters National Trauma System Injury Prevention and Control Quality and Safety Conference Quality and ... Safety Resources About the Patient Education Program The Recovery Room Choosing Wisely Educational Programs Educational Programs Educational ...

  2. Ostomy Home Skills Program

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    Full Text Available ... of Education ACS Education and Training Courses Publications Education Program Videos Contact Us Clinical Congress Clinical Congress 2017 ... Treatment Center Patient Safety Resources About the Patient Education Program The Recovery Room Choosing Wisely Educational Programs Educational ...

  3. Home audit program: management manual

    Energy Technology Data Exchange (ETDEWEB)

    1980-09-01

    Many public power systems have initiated home energy audit programs in response to the requests of their consumers. The manual provides smaller public power systems with the information and specific skills needed to design and develop a program of residential energy audits. The program is based on the following precepts: locally owned public systems are the best, and in many cases the only agencies available to organize and coordinate energy conservation programs in many smaller communities; consumers' rights to energy conservation information and assistance should not hinge on the size of the utility that serves them; in the short run, public power systems of all sizes should offer residential energy conservation assistance to their consumers, because such assistance is desirable, necessary, and in the public interest; and in the long run, such programs will complement national energy goals and will produce economic benefits for both consumers and the public power system. A detailed description of home audit program planning, organization, and management are given. (MCW)

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... Matters NIH-ACS Symposium Symposium Findings Search Relevant Publications Optimal Access Resources Members Contact Us Publications ACS ...

  5. Ostomy Home Skills Program

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    Full Text Available ... About Trauma Programs BleedingControl.org Trauma Quality Programs Violence Prevention National Trauma Data Bank Trauma Quality Improvement ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

  6. Ostomy Home Skills Program

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    Full Text Available ... You Want to Be a Surgeon Resident Resources Teaching Resources Online Guide to Choosing a Surgical Residency ... de Destrezas para manejo Doméstico de Ostomía Ostomy Home Skills Program Adult Ostomy Pediatric Ostomy Programa de ...

  7. Ostomy Home Skills Program

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    Full Text Available ... Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters National Trauma System Injury ... Education Trauma Education Trauma Education Achieving Zero Preventable Deaths Trauma Systems Conference Advanced Surgical Skills for Exposure ...

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

  9. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and Participation Medicare ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

  10. Ostomy Home Skills Program

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    Full Text Available ... ACS NSQIP Now Participants Downloads NSQIP in the Literature Newsroom Contact Us Hospital Compare Quality and Safety ... Program Trauma Education Achieving Zero Preventable Deaths Conference Publications and Posters National Trauma System Injury Prevention and ...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... 2017 Clinical Congress 2017 About Clinical Congress CME Credit Media Information Educational Program Resources Clinical Congress App ... Optimal Access Matters NIH-ACS Symposium Symposium Findings Search Relevant Publications Optimal Access Resources Members Contact Us ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Workforce Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative Issues Regulatory Issues Regulatory Issues Regulatory Issues EHR Incentive Program ... Rectal Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of America (UOAA). The skills kit contains: A booklet with information on the operation, home skills such as emptying ...

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... UOAA). The skills kit contains: A booklet with information on the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma ...

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Bundled Payment Models Surgeons as Institutional Employees Our Changing Health Care System ACS Surgery News Statements About ... the operation, home skills such as emptying and changing a pouch, problem solving, and home management. A ...

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Safety Conference Registry Login SCR Training and Testing Cancer Cancer Programs Cancer Programs Overview of Cancer Programs Cancer Programs News American Joint Committee on ...

  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Publications Optimal Access Resources Members Contact Us Publications ACS Publications ACS Catalog About the ACS Catalog About the ... Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in the News Stay Up to Date ...

  18. Ostomy Home Skills Program

    Science.gov (United States)

    ... Publications Optimal Access Resources Members Contact Us Publications ACS Publications ACS Catalog About the ACS Catalog About the ... Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in the News Stay Up to Date ...

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Destrezas para manejo Doméstico de Ostomía The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn ... skills needed for optimal postoperative recovery. The kit supports the entire surgical ... on the operation, home skills such as emptying and changing a pouch, ...

  20. Ostomy Home Skills Program

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    Full Text Available ... Inspiring Quality Initiative Resources Continuous Quality Improvement ACS Clinical Scholars in Residence AHRQ Safety Program for ISCR ... Advocacy Efforts Cancer Liaison Program Cancer Programs Conference Clinical Research Program Commission on Cancer National Accreditation Program ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Accreditation Program Stereotactic Breast Biopsy Accreditation Program Cancer Programs Staff Information Children's Surgery Children's Surgery Children's Surgery Children's Surgery Verification ...

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    Full Text Available ... Quality Improvement Program About Standards Apply Participant Use Data File (PUF) Resources & FAQs Find a MBSAQIP Center ... Programs BleedingControl.org Trauma Quality Programs National Trauma Data Bank Trauma Quality Improvement Program Mentoring for Excellence ...

  3. Ostomy Home Skills Program

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    Full Text Available ... Overview of Cancer Programs Cancer Programs News American Joint Committee on Cancer Cancer Advocacy Efforts Cancer Liaison ... Validation Programs Accredited Education Institutes CME Accreditation CME Joint Providership Program Verification of Knowledge and Skills Resources ...

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... The Ostomy Home Skills Kit supports patients with educational and simulation materials to learn and practice the ...

  5. Ostomy Home Skills Program

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    Full Text Available ... System (PQRS) Value-Based Payment Modifier Accountable Care Organizations Regulatory Burden Reduction Stark Law and Anti-Kickback ... Order Today Ostomy Home Skills Kit (login or create account first) Skills Kits Broadcast Rights for Hospitals ...

  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement ... American College of Surgeons, Chicago, IL 60611-3211 | Privacy Policy | Terms of Use

  7. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Subscribe ACS Case Reviews Login CME Test Login Author Instructions Sample Article Chapter Competition Contact Resources in ... login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement ...

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample ...

  9. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education ... Home Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed ...

  10. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Specific Registry Surgeon Specific Registry News and Updates Account Setup Resources and FAQs Features of the SSR ... Today Ostomy Home Skills Kit (login or create account first) Skills Kits Broadcast Rights for Hospitals Ostomy ...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... create account first) Skills Kits Broadcast Rights for Hospitals Ostomy Home Skills Hospital Quality Improvement Package The ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Trauma Quality Programs National Trauma Data Bank Trauma Quality Improvement Program Mentoring for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals ...

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... 2016 Annual Meeting Women's Committee Mentorship Program Outside Activities ACS Archives Contact Us Quality Programs Quality Programs ... Quality in Geriatric Surgery Project Project Goals and Activities Stakeholder Organizations Project Team Resources News Contact Us ...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Accreditation Program for Breast Centers About NAPBC Accreditation Education NAPBC Standards Cancer Programs News Quality in Geriatric ... 4 and Recertification SSR Login MIPS Resources and Education Quality and Safety Conference Trauma Trauma Programs Trauma ...

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Meeting Women's Committee Mentorship Program Outside Activities ACS Archives Contact Us Quality Programs Quality Programs Overview About ... The Hartford Consensus News Coverage Stop the Bleed Archives and History Archives and History Archives and History ...

  16. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Data Bank Trauma Quality Improvement Program Mentoring for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, ... Patients Medical Professionals Skills Programs Find a Treatment Center Patient Safety Resources About the Patient Education Program ...

  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... with educational and simulation materials to learn and practice the skills needed for optimal postoperative recovery. The kit supports ... home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, ...

  18. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... emptying and changing a pouch, problem solving, and home management. A DVD with demonstration of each skill Stoma Practice Model Stoma supplies (measurement guide, marking pen, scissors, sample pouch) Ostomy self-care checklist Evaluation (Complete the Ostomy Patient Survey . We ...

  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Stereotactic Breast Biopsy Accreditation Program Cancer Programs Staff Information Children's Surgery Children's Surgery Children's Surgery Children's Surgery Verification ACS NSQIP Pediatric Fees and Invoices Quality and ...

  20. Ostomy Home Skills Program

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    Full Text Available ... ACS Insurance Programs ACS Discount Programs FACS Resources Career Connection Update Your Profile Member Communities Leadership Opportunities ... Group Icons in Surgery Archives Catalog Contact Us Careers at ACS Careers at ACS Careers at ACS ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Safety Conference Upcoming Educational Opportunities MBSAQIP News Contact Us Breast Disease National Accreditation Program for Breast Centers National Accreditation Program for Breast Centers About NAPBC ...

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... System Strategic Partnership Military Health System Strategic Partnership Military Health System Strategic Partnership About Excelsior Surgical Society ... Quality Programs Overview About Quality Programs ACS Leadership in Quality ACS Leadership in Quality Setting the ...

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Accreditation Program for Breast Centers About NAPBC Accreditation Education NAPBC Standards News Quality in Geriatric Surgery Coalition ... 4 and Recertification SSR Login MIPS Resources and Education Quality and Safety Conference Trauma Trauma Programs Trauma ...

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... and Invoices Quality and Safety Conference Bariatric Surgery Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program ...

  5. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... OR EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and Participation ...

  6. Ostomy Home Skills Program

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    Full Text Available ... Associate Fellows Residents Medical Students Affiliate Members ACS Insurance Programs ACS Discount Programs FACS Resources Career Connection ... and Awards Overview Scholarships, Fellowships, and Awards Overview Health Policy Scholarships Scholarships for International Surgeons Research Scholarships ...

  7. Ostomy Home Skills Program

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  8. Ostomy Home Skills Program

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  9. Ostomy Home Skills Program

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    Full Text Available ... Be a YFA Leader Meetings and Events YFA Mentor Programs Top 10 Reasons to Participate Resources Webinars ... National Trauma Data Bank Trauma Quality Improvement Program Mentoring for Excellence in Trauma Surgery Advanced Trauma Life ...

  10. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... My OR EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and Participation ... self-care checklist Evaluation (Complete the Ostomy Patient Survey . We need your opinion!) Program outcomes The ACS ...

  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Member Fellows International Fellows Associate Fellows Residents Medical Students Affiliate Members Fees and Dues Realize the Potential ... and Canada) International Fellows Associate Fellows Residents Medical Students Affiliate Members ACS Insurance Programs ACS Discount Programs ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals Trauma Systems Consultation Program Trauma Education Achieving Zero Preventable Deaths ...

  13. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education Quality Education Quality and Safety Conference ...

  14. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Health Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier ... Practice Management Practice Management Practice Management CPT Coding Bulletin Articles ...

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Maintenance of Certification Quality Quality Quality Electronic Health Records (EHR) Incentive Program ... Practice Management Practice Management Practice Management CPT Coding Bulletin Articles ...

  16. Ostomy Home Skills Program

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  17. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and ... Quality Electronic Health Records (EHR) Incentive Program Physician Quality Reporting ...

  18. Ostomy Home Skills Program

    Medline Plus

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  19. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Pediatric Fees and Invoices Quality and Safety Conference Bariatric Surgery Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program Metabolic and Bariatric ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... CME Accreditation CME Joint Providership Program Verification of Knowledge and Skills ... Practice Management Workshops Patients and Family Patient Education Patient Education ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Online Guide to Choosing a Surgical Residency Practice Management Workshops Patients and Family Patient Education Patient Education Patients Medical Professionals Skills Programs Find ...

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ...

  3. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... to Enhance Survival in Active Shooter and Intentional Mass Casualty Events Surgeons and Medical Liability Surgeons as ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

  4. Ostomy Home Skills Program

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  5. Ostomy Home Skills Program

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  6. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Trauma and EMS Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ...

  7. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Benefits Current Openings Newsroom Newsroom Newsroom Press Releases Media Resources The FIRST Trial ACS Publications ACS in ... Surgeons Residents and Associates Medical Students International Surgeons Media ACS Links About ACS ACS Foundation Have a ...

  8. Ostomy Home Skills Program

    Medline Plus

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  9. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Safety Conference ACS Clinical Scholars in Residence Clinical Trials Methods Course Health Services Research Methods Course Surgeon ... Institute Featured Articles Nora Institute Mission The FIRST Trial Advocacy Advocacy Overview Quality Payment Program QPP Resource ...

  10. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... supports the entire surgical team with quality, comprehensive education. The standardized interactive program has been developed by the American College of Surgeons (ACS) in collaboration with the American Society of Colon and Rectal Surgeons (ASCRS), American Urological ...

  11. Ostomy Home Skills Program

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  13. Ostomy Home Skills Program

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  18. Ostomy Home Skills Program

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    Full Text Available ... EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and Participation Medicare Inpatient & Outpatient Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Accountable Care Organizations ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Inpatient & Outpatient Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Accountable Care Organizations Regulatory Burden ... Records (EHR) Incentive Program Physician Quality Reporting System Value-Based Payment Modifier Quality and Resource Use Reports ...

  1. Ostomy Home Skills Program

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  2. Ostomy Home Skills Program

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    Full Text Available ... to Participate Resources Webinars for Young Surgeons YFA E-News Resident and Associate Society Resident and Associate ... ACS Leader International Exchange Scholar Program Resources RAS E-News Medical Students Operation Giving Back Operation Giving ...

  3. Ostomy Home Skills Program

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    Full Text Available ... Education Patients Medical Professionals Skills Programs Find a Treatment Center Patient Safety Resources About the Patient Education ... Surgeons (ASCRS), American Urological Association (AUA), Certified Enterostomal Therapy Nurses (CETN), and the United Ostomy Associations of ...

  4. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... CME Accreditation CME Joint Providership Program Verification of Knowledge and Skills Resources Educational Resources Educational Resources E- ... Disaster Management and Emergency Preparedness Rural Trauma Team Development Course Trauma Evaluation and Management Trauma CME Nora ...

  5. Ostomy Home Skills Program

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    Full Text Available ... Issues Stop Overregulating My OR EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and Participation Medicare Inpatient & Outpatient Rules Physician Quality Reporting System (PQRS) Value-Based Payment Modifier Accountable Care ...

  6. Ostomy Home Skills Program

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  7. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... of Master Surgeon Educators ACS Fundamentals of Surgery Curriculum Transition to Practice Program ACS/APDS Surgery Resident Skills Curriculum ACS/APDS/ASE Resident Prep Curriculum ACS/ASE ...

  8. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... a Member Fellows International Fellows Associate Fellows Residents Medical Students Affiliate Members Fees and Dues Realize the ... US and Canada) International Fellows Associate Fellows Residents Medical Students Affiliate Members ACS Insurance Programs ACS Discount ...

  9. Ostomy Home Skills Program

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  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Mentoring for Excellence in Trauma Surgery Advanced Trauma Life Support Verification, Review, and Consultation Program for Hospitals ... Surgical Skills for Exposure in Trauma Advanced Trauma Life Support Advanced Trauma Operative Management Basic Endovascular Skills ...

  12. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... at ACS Careers at ACS About ACS Career Types Working at ACS ACS and Veterans Diversity at ...

  13. Ostomy Home Skills Program

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    Full Text Available ... Participate in Improvement Activities How to Participate in Cost Steps for Avoiding a Penalty Quality Payment Program ... Skills Kit supports patients with educational and simulation materials to learn and practice the skills needed for ...

  14. Ostomy Home Skills Program

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    Full Text Available ... Advocacy Summit Webinars Practice Management Practice Management Practice Management CPT Coding Bulletin Articles CPT Coding Workshops ICD-10 Coding Physicians as Assistants at Surgery Webinars Primers and Compendiums Quality Payment Program AMA House of Delegates ACS in ...

  15. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Participate Resources Webinars for Young Surgeons YFA E-News Resident and Associate Society Resident and Associate Society ... Leader International Exchange Scholar Program Resources RAS E-News Medical Students Operation Giving Back Operation Giving Back ...

  16. Ostomy Home Skills Program

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    Full Text Available ... Surgical Education Academy of Master Surgeon Educators ACS Fundamentals of Surgery Curriculum Transition to Practice Program ACS/ ... Workforce Trauma and EMS Cancer and Research ... Value-Based Payment Modifier Accountable Care Organizations ...

  17. Ostomy Home Skills Program

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    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education Quality Education Quality and Safety Conference ACS Clinical Scholars in Residence Clinical Trials ...

  18. Ostomy Home Skills Program

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    Full Text Available ... ASE Medical Student Core Curriculum ACS/ASE Medical Student Simulation-Based Surgical Skills Curriculum Cancer Education Cancer Education Cancer Education Cancer Programs Conference: Creating ...

  19. Ostomy Home Skills Program

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    Full Text Available ... Issues EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and Participation ... History History of the American College of Surgeons Collections Highlights Research 25- and 50-Year Fellows Recognition ...

  20. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Management Practice Management Practice Management CPT Coding Bulletin Articles CPT Coding Workshops ICD-10 Coding Physicians as Assistants at Surgery Webinars Primers and Compendiums Quality Payment Program AMA ...

  1. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... YFA Mentor Programs YFA Speakers Bureau Top 10 Reasons to Participate Resources Webinars for Young Surgeons YFA ... Scholarships, Competitions, Awards, and Project Work Top 10 Reasons to Participate Grand Rounds Webinar Series RAS-JACS ...

  2. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Cancer and Research Health Information Technology Scope of Practice Pediatric Issues Other Federal Legislative Issues Regulatory Issues Regulatory Issues Regulatory Issues EHR Incentive Program Global Codes and Data Collection New Medicare Card Project Medicare Enrollment and Participation ...

  3. Ostomy Home Skills Program

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    Full Text Available ... Grant Program State Legislation Tracked by the College Maintenance of Certification Quality Quality Quality Electronic Health Records ( ... Test Login SRGS Online Login Subscribe to SRGS Issues Contact and FAQs ACS Case Reviews in Surgery ...

  4. Ostomy Home Skills Program

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  7. Ostomy Home Skills Program

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  8. Ostomy Home Skills Program

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    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... Saint Clair Street Chicago, IL 60611-3211 Toll free: 800-621-4111 (P) 312-202-5000 (F) ...

  9. Ostomy Home Skills Program

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    Full Text Available ... Education Cancer Education Cancer Programs Conference: Creating a Culture of Quality CoC Events Quality Education Quality Education ... System (PQRS) Value-Based Payment Modifier Accountable Care Organizations Regulatory Burden Reduction Stark Law and Anti-Kickback ...

  10. Ostomy Home Skills Program

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  11. Ostomy Home Skills Program

    Medline Plus

    Full Text Available ... Liability Reform GME and Workforce Trauma and EMS ... the entire surgical team with quality, comprehensive education. The standardized interactive program has been developed by the American College of Surgeons (ACS) in collaboration with the American Society of Colon and Rectal Surgeons (ASCRS), American Urological Association (AUA), ...

  12. Ostomy Home Skills Program

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  13. Public authority over home care.

    NARCIS (Netherlands)

    Genet, N.A.; Boerma, W.G.W.; Kroneman, M.

    2011-01-01

    Background: The ageing society, decreasing resources and financial constraints are putting governments under pressure. Across Europe, division of responsibilities for long-term care are being reconsidered. Under these pressures, the role of governments in home care could be changing. This paper will

  14. ACED Allegheny Home Improvement Loan Program (AHILP)

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — The Allegheny Home Improvement Loan Program (AHILP) is the most affordable way for eligible Allegheny County residents to rehabilitate and improve their homes....

  15. Home Schooling in Alabama: Perspectives of Public School Superintendents and Home Schooling Families.

    Science.gov (United States)

    Kozlowski, Anna T.

    This paper describes home schooling in Alabama from the perspectives of public-school superintendents and home-schooling families. It is based on a study that investigated the extent, causes, and experiences of home schooling; concerns about the practice of home schooling; and the relationship between home schoolers and public-school systems. Home…

  16. Assessing Quality in Home Visiting Programs

    Science.gov (United States)

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

    2013-01-01

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

  17. Outcomes of the Montana Asthma Home Visiting Program: A home-based asthma education program.

    Science.gov (United States)

    Fernandes, Jessie C; Biskupiak, William W; Brokaw, Sarah M; Carpenedo, Dorota; Loveland, Katie M; Tysk, Sonja; Vogl, Shea

    2018-02-09

    Asthma is a common disease in children. Home-based, multi-trigger, multi-component interventions with an environmental focus have been shown to be effective to address asthma in children. The objective of this study was to assess the outcomes and feasibility of implementing a specific asthma home visiting (HV) program in a rural area. Children aged 0-17 years with uncontrolled asthma were enrolled in an asthma HV program that included six contacts over a 12-month period delivered by a registered nurse specifically trained in asthma education and trigger removal in eleven counties in the rural state of Montana. Between June 2010 and December 2016, data on asthma symptoms and asthma self-management skills were collected at baseline and throughout the program. In June 2017, they were analyzed to assess changes in asthma control and quality of life over time among participants completing all six contacts. Since June 2010, 152 of 338 enrolled children completed all six contacts outlined in the program (45%). Participants who completed the program reported significant improvements in asthma control test scores, self-management skills, and self-efficacy related to asthma management. These results improved the longer participants remained in the program. These findings suggest that it is feasible to implement a 12-month HV program using local public health resources in a rural area as outcomes improved over this time period.

  18. Public Risk Assessment Program

    Science.gov (United States)

    Mendeck, Gavin

    2010-01-01

    The Public Entry Risk Assessment (PERA) program addresses risk to the public from shuttle or other spacecraft re-entry trajectories. Managing public risk to acceptable levels is a major component of safe spacecraft operation. PERA is given scenario inputs of vehicle trajectory, probability of failure along that trajectory, the resulting debris characteristics, and field size and distribution, and returns risk metrics that quantify the individual and collective risk posed by that scenario. Due to the large volume of data required to perform such a risk analysis, PERA was designed to streamline the analysis process by using innovative mathematical analysis of the risk assessment equations. Real-time analysis in the event of a shuttle contingency operation, such as damage to the Orbiter, is possible because PERA allows for a change to the probability of failure models, therefore providing a much quicker estimation of public risk. PERA also provides the ability to generate movie files showing how the entry risk changes as the entry develops. PERA was designed to streamline the computation of the enormous amounts of data needed for this type of risk assessment by using an average distribution of debris on the ground, rather than pinpointing the impact point of every piece of debris. This has reduced the amount of computational time significantly without reducing the accuracy of the results. PERA was written in MATLAB; a compiled version can run from a DOS or UNIX prompt.

  19. Predictors of Home Care Expenditures and Death at Home for Cancer Patients in an Integrated Comprehensive Palliative Home Care Pilot Program

    Science.gov (United States)

    Howell, Doris M.; Abernathy, Tom; Cockerill, Rhonda; Brazil, Kevin; Wagner, Frank; Librach, Larry

    2011-01-01

    Purpose: Empirical understanding of predictors for home care service use and death at home is important for healthcare planning. Few studies have examined these predictors in the context of the publicly funded Canadian home care system. This study examined predictors for home care use and home death in the context of a “gold standard” comprehensive palliative home care program pilot in Ontario where patients had equal access to home care services. Methods: Secondary clinical and administrative data sources were linked using a unique identifier to examine multivariate factors (predisposing, enabling, need) on total home care expenditures and home death for a cohort of cancer patients enrolled in the HPCNet pilot. Results: Subjects with gastrointestinal symptoms (OR: 1.64; p=0.03) and those with higher income had increased odds of dying at home (OR: 1.14; phome care expenditures. Conclusions: Predictors of home death found in earlier studies appeared less important in this comprehensive palliative home care pilot. An income effect for home death observed in this study requires examination in future controlled studies. Relevance: Access to palliative home care that is adequately resourced and organized to address the multiple domains of issues that patients/families experience at the end of life has the potential to enable home death and shift care appropriately from limited acute care resources. PMID:22294993

  20. Homes and Frontiers: Literacy, Home Schooling, and Articulations of the Public and the Private

    Science.gov (United States)

    Marzluf, Phillip P.

    2009-01-01

    This interview-based study suggests that the home schooling movement represents another literacy crisis. Home-schooled students may define their commitments to the public sphere in ways that conflict with the assumptions of community literacy and other pedagogical projects. Home schoolers may adopt the values of the "literacy frontier,"…

  1. Public Relations for Invisible Programs.

    Science.gov (United States)

    Pucciani, Linda

    1983-01-01

    The positive features of nonperformance programs such as general music and music appreciation should be communicated often and effectively to the community. There are many effective publicity media appropriate for nonperformance programs. (AM)

  2. The Caring Home Program: In-Home Interventions for Alzheimer's Disease Patients and Their Caregivers.

    Science.gov (United States)

    Pynoos, Jon; Ohta, Russell J.

    The home is clearly the major setting in which care is provided to individuals suffering from Alzheimer's disease. The Caring Home Program was a multi-disciplinary program designed to complement existing efforts to assist caregivers (N=12) with the in-home care of Alzheimer's disease patients. The program components consisted of an assessment of…

  3. Public Service Communication Satellite Program

    Science.gov (United States)

    Brown, J. P.

    1977-01-01

    The proposed NASA Public Service Communication Satellite Program consists of four different activities designed to fulfill the needs of public service sector. These are: interaction with the users, experimentation with existing satellites, development of a limited capability satellite for the earliest possible launch, and initiation of an R&D program to develop the greatly increased capability that future systems will require. This paper will discuss NASA efforts in each of these areas.

  4. Winners announced in Student Programs' sixth annual Home Sweet Home recipe contest

    OpenAIRE

    Dawson, Brandi

    2007-01-01

    Eight recipes were selected from the more than 250 submitted by students' family members during the sixth annual Home Sweet Home Recipe Contest sponsored by the Virginia Tech Office of Student Programs' Housing and Dining Services.

  5. Home Visiting Family Support Programs: Benefits of the Maternal, Infant, and Early Childhood Home Visiting Program. Fact Sheet

    Science.gov (United States)

    Home Visiting Campaign, 2015

    2015-01-01

    The federally funded, locally administered Maternal, Infant, and Early Childhood Home Visiting Program sponsors family support programs that are often called "home visiting" because they take place in the homes of at-risk families. These families often lack support, experience, and knowledge of basic parenting skills. Because children…

  6. The Effect of Publicized Quality Information on Home Health Agency Choice

    Science.gov (United States)

    Jung, Jeah Kyoungrae; Wu, Bingxiao; Kim, Hyunjee; Polsky, Daniel

    2016-01-01

    We examine consumers’ use of publicized quality information in Medicare home health care markets, where consumer cost sharing and travel costs are absent. We report two findings. First, agencies with high quality scores are more likely to be preferred by consumers after the introduction of a public reporting program than before. Second, consumers’ use of publicized quality information differs by patient group. Community-based patients have slightly larger responses to public reporting than hospital-discharged patients. Patients with functional limitations at the start of their care, at least among hospital-discharged patients, have a larger response to the reported functional outcome measure than those without functional limitations. In all cases of significant marginal effects, magnitudes are small. We conclude that the current public reporting approach is unlikely to have critical impacts on home health agency choice. Identifying and releasing quality information that is meaningful to consumers may help increase consumers’ use of public reports. PMID:26719047

  7. HomeRules: A Tangible End-User Programming Interface for Smart Homes

    OpenAIRE

    De Russis, Luigi; Corno, Fulvio

    2015-01-01

    A considerable amount of research has been carried out towards enabling average users to customize their smart homes through trigger-action ("if... then...") programming. However, inhabitants of such smart environments keep having problems understanding, administering, troubleshooting, and deriving benefits from the technologies employed in their homes. By synthesizing a broad body of research on end-user programming in smart homes with observations of commercial products and our own experien...

  8. 41 CFR 302-14.100 - How should we administer our home marketing incentive payment program?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false How should we administer our home marketing incentive payment program? 302-14.100 Section 302-14.100 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE TRANSACTION ALLOWANCES...

  9. Predicting effectiveness of the Home-Start parenting support program

    NARCIS (Netherlands)

    Asscher, J.J.; Hermanns, J.M.A.; Dekovic, M.; Reitz, E.

    2007-01-01

    The current study examines predictive effects of participant's characteristics, program characteristics, and their interaction, on changes in parenting behavior of mothers who participated in the Home-Start parenting support program. The results confirm previous findings that effects of

  10. Designing and Managing Public Housing Self-Sufficiency Programs: The Youngs Lake Commons Program

    Science.gov (United States)

    Kleit, Rachel Garshick

    2004-01-01

    This article evaluates an experimental public housing self-sufficiency program that encourages home ownership among low-income families. A quasi-experimental design, in combination with focus groups, records review, and key informant interviews, provides data to focus on four questions: (a) Do these programs simply accelerate move-outs for those…

  11. 75 FR 32836 - Pipeline Safety: Workshop on Public Awareness Programs

    Science.gov (United States)

    2010-06-09

    ... communities, and identify critical elements of a successful operator public awareness program. Pipeline trade... time. Refer to the meeting Web site for updated agenda and times and live webcast at: http://primis.phmsa.dot.gov/meetings/MtgHome.mtg?mtg=65&nocache=9351 . Please note that all workshop presentations...

  12. Leaving Public Schools for Home Schooling: Implications for School Public Relations.

    Science.gov (United States)

    McLeod, Suzanne E.; Osterman, Karen F.

    2003-01-01

    Addresses the sources of dissatisfaction from parents who had removed their children from public schools to begin home schooling. Implications for public schools' community relations and practice specifically focus on three areas of greatest concern: student grouping practices, peer relationships, and the extension of the school day via homework.…

  13. Strength at Home Couples Program to Prevent Military Partner Violence

    Science.gov (United States)

    2017-10-01

    AWARD NUMBER: W81XWH-15-1-0374 TITLE: Strength at Home Couples Program to Prevent Military Partner Violence PRINCIPAL INVESTIGATOR: Casey T...SUBTITLE 5a. CONTRACT NUMBER Strength at Home Couples Program to Prevent Military Partner Violence 5b. GRANT NUMBER W81XWH-15-1-0374 5c. PROGRAM...Health 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON USAMRMC a. REPORT U b

  14. Human dignity at home and in public – introduction

    Directory of Open Access Journals (Sweden)

    Frits De Lange

    2011-12-01

    Full Text Available

    A genuine concern for human dignity fosters a public culture of human rights. A concern for  dignity contributes to equality, justice and respect in civil life. But how about dignity at home? The life people live privately in their intimate relationships, within their families, is mostly withheld from public debate. Though the relationships between men and women, parents and children are evidently unequal in power and vulnerability, and thereby susceptible for abuse, they are hardly subject of public evaluation. What about dignity at home? Families are thought to be places where human dignity feels ‘at home’. The image of home as a ‘safe haven’ however, is heavily disputed by the facts. Domestic violence is widespread. Home is a paradoxical environment: it is the place where new generations are nurtured and educated in human values, and where respect and love is practised. At the same time it is the place where the dignity of especially women and children is often contested and violated. There is no other place where people are living together so intimately, and so vulnerable. This hidden side of dignity was the theme of the conference “Dignity at home and in public” that the Protestant Theological University organised together with the Faculty of Theology of the Stellenbosch University, October 25- 26, 2010 at Kampen University, the Netherlands. A selection of the contributions are gathered in this volume. By engaging in intense, personal North-South and South-North dialogues around themes as the family in the Reformed tradition, vulnerability and autonomy, domestic violence, cultural shifts in the relationships between generations, and end of life decisions, the conference continued a five-year long partnership between the two theological faculties around the theme of human dignity. This volume explores from a

  15. Engaging Parents in Early Head Start Home-Based Programs: How Do Home Visitors Do This?

    Science.gov (United States)

    Shanti, Caroline

    2017-01-01

    Parental engagement is considered elemental to successful outcomes for parents and their children in early childhood home visiting programs. Engagement is that piece of parental involvement that refers to the working relationship between the parent and the home visitor. Multiple papers have called for research to pinpoint the ways in which home visitors work with parents to form these working relationships, and form partnerships to achieve positive outcomes. Analysis revealed that in individualizing their efforts to each family, home visitors follow semi-sequential steps in implementing engagement. This article presents a model of the process home visitors describe that resulted from analysis. Grounded theory techniques were used to analyze 29 interviews with Early Head Start (EHS) home visitors and 11 supervisors across four EHS programs in one region of the United States. The process of engagement as described emerges in three phases: (1) learning the parent's culture and style; (2) deepening the working partnership; and (3) balancing the ongoing work. Analysis further revealed specific strategies and goals that guide the work of home visitors in each of these three phases. This not only adds rich detail to the literature, but also provides a useful guide for programs and policy makers through identifying the areas where training and support will increase home visitor ability to engage parents.

  16. Impact of a Home Leisure Educational Program for Older Adults Who Have Had a Stroke (Home Leisure Educational Program).

    Science.gov (United States)

    Nour, Kareen; Desrosiers, Johanne; Gauthier, Pierre; Carbonneau, Helene

    2002-01-01

    Examined the effectiveness of leisure education for older adults having difficulty adjusting psychologically after a stroke. Participants received either an experimental home leisure education program (intervention group) or a friendly home visit (control group) after discharge from rehabilitation. The intervention group performed significantly…

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

    Directory of Open Access Journals (Sweden)

    Katherine Solís Cordero

    2015-07-01

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

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

    Directory of Open Access Journals (Sweden)

    Kayoko Ichikawa

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

  19. Evaluating the effectiveness of a multimedia program on home safety.

    Science.gov (United States)

    Sweeney, Mary Anne; Chiriboga, David A

    2003-06-01

    This study was designed to test the effectiveness and acceptance of multimedia home safety programming by community-dwelling seniors. A prototype CD-ROM was produced that required no reading or computer skills because the program included an audio narration of content and directions for operating the program on a touchscreen computer monitor. Volunteers (N = 126) from a senior center aged 55 and older were randomly assigned to (1) a multimedia group that used the interactive program to learn about home safety, (2) a traditional learning group that read well-established booklets on home safety, and (3) a control group that received no instruction on safety between the pre- and posttests. Repeated-measures multivariate analysis of variance showed that the multimedia group was the only group to improve in knowledge. The group was also very satisfied with the approach. Multimedia formats can effectively and economically provide information to older clients.

  20. 77 FR 75441 - Healthy Home and Lead Hazard Control Grant Programs Data Collection; Progress Reporting

    Science.gov (United States)

    2012-12-20

    ... progress of Healthy Homes Demonstration Program, Healthy Homes Technical Studies Program, Lead Base paint... through the use of appropriate automated collection techniques or other forms of information technology, e... of Healthy Homes Demonstration Program, Healthy Homes Technical Studies Program, Lead Base paint...

  1. Medicare Home Visit Program Associated With Fewer Hospital And Nursing Home Admissions, Increased Office Visits.

    Science.gov (United States)

    Mattke, Soeren; Han, Dan; Wilks, Asa; Sloss, Elizabeth

    2015-12-01

    Clinical home visit programs for Medicare beneficiaries are a promising approach to supporting aging in place and avoiding high-cost institutional care. Such programs combine a comprehensive geriatric assessment by a clinician during a home visit with referrals to community providers and health plan resources to address uncovered issues. We evaluated UnitedHealth Group's HouseCalls program, which has been offered to Medicare Advantage plan members in Arkansas, Georgia, Missouri, South Carolina, and Texas since January 2008. We found that, compared to non-HouseCalls Medicare Advantage plan members and fee-for-service beneficiaries, HouseCalls participants had reductions in admissions to hospitals (1 percent and 14 percent, respectively) and lower risk of nursing home admission (0.67 percent and 1.3 percent, respectively). In addition, participants' numbers of office visits--chiefly to specialists--increased 2-6 percent (depending on the comparison group). The program's effects on emergency department use were mixed. These results indicate that a thorough home-based clinical assessment of a member's health and home environment combined with referral services can support aging in place, promote physician office visits, and preempt costly institutional care. Project HOPE—The People-to-People Health Foundation, Inc.

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

    Science.gov (United States)

    Clark, Thomas C.; Watkins, Susan

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

  3. Evaluation of the Pilot Program for Home School and ChalleNGe Program Recruits

    National Research Council Canada - National Science Library

    Garcia, F

    2001-01-01

    The National Defense Authorization Act for Fiscal Year 1999 (FY 99) directed a 5-year pilot program to treat graduates of home schools and graduates of the National Guard Youth ChalleNGe Program holding General Education Development (GED...

  4. Sustaining Arts Programs in Public Education

    Science.gov (United States)

    Dunstan, David

    2016-01-01

    The purpose of this qualitative research case study was to investigate leadership and funding decisions that determine key factors responsible for sustaining arts programs in public schools. While the educational climate, financial constraints, and standardized testing continue to impact arts programs in public education, Eastland High School, the…

  5. Fluorides in dental public health programs.

    Science.gov (United States)

    Kumar, Jayanth V; Moss, Mark E

    2008-04-01

    The use of fluorides in dental public health programs has a long history. With the availability of fluoridation and other forms of fluorides, dental caries have declined dramatically in the United States. This article reviews some of the ways fluorides are used in public health programs and discusses issues related to their effectiveness, cost, and policy.

  6. Impact of home-delivered meal programs on diet and nutrition among older adults: a review.

    Science.gov (United States)

    Zhu, Huichen; An, Ruopeng

    2013-04-01

    Poor diet quality and insufficient nutrient intake is of particular concern among older adults. The Older Americans Act of 1965 authorizes home-delivered meal services to homebound individuals aged 60 years and older. The purpose of this study was to review scientific evidence on the impact of home-delivered meal services on diet and nutrition among recipients. Keyword and reference searches were conducted in Cochrane Library, Google Scholar, PubMed and Web of Science. Inclusion criteria included: study design (randomized controlled trials, cohort studies, pre-post studies, or cross-sectional studies); main outcome (food and nutrient intakes); population (home-delivered meal program participants); country (US); language (articles written in English); and article type (peer-reviewed publications or theses). Eight studies met the inclusion criteria, including two randomized controlled trial studies (from the same intervention), one cohort study, two pre-post studies, and three cross-sectional studies. All but two studies found home-delivered meal programs to significantly improve diet quality, increase nutrient intakes, and reduce food insecurity and nutritional risk among participants. Other beneficial outcomes include increased socialization opportunities, improvement in dietary adherence, and higher quality of life. Home-delivered meal programs improve diet quality and increase nutrient intakes among participants. These programs are also aligned with the federal cost-containment policy to rebalance long-term care away from nursing homes to home- and community-based services by helping older adults maintain independence and remain in their homes and communities as their health and functioning decline. © The Author(s) 2014.

  7. Infections in Nursing Homes: Epidemiology and Prevention Programs.

    Science.gov (United States)

    Montoya, Ana; Cassone, Marco; Mody, Lona

    2016-08-01

    This review summarizes current literature pertaining to infection prevention in nursing home population including post-acute care patients and long-term care residents. Approximately 2 million infections occur each year and more than one-third of older adults harbor multidrug-resistant organisms in this setting. Surveillance, hand hygiene, isolation precautions, resident and employee health programs, education, and antibiotic stewardship are essential elements of infection prevention and control programs in nursing homes. This article discusses emerging evidence suggesting the usefulness of interactive multimodal bundles in reducing infections and antimicrobial resistance, thereby enhancing safety and quality of care for older adults in nursing homes. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. 41 CFR 302-14.101 - What policies must we establish to govern our home marketing incentive payment program?

    Science.gov (United States)

    2010-07-01

    ... 41 Public Contracts and Property Management 4 2010-07-01 2010-07-01 false What policies must we establish to govern our home marketing incentive payment program? 302-14.101 Section 302-14.101 Public Contracts and Property Management Federal Travel Regulation System RELOCATION ALLOWANCES RESIDENCE...

  9. 75 FR 32459 - National Energy Rating Program for Homes

    Science.gov (United States)

    2010-06-08

    ... Efficiency and Renewable Energy National Energy Rating Program for Homes AGENCY: Energy Efficiency and Renewable Energy, Department of Energy. ACTION: Request for Information (RFI). SUMMARY: The Department of Energy (DOE) is seeking comments and information from interested parties to assist DOE in developing a...

  10. [Therapy of fecal incontinence in elderly patients: Study of a home biofeedback training program].

    Science.gov (United States)

    Musial, F; Hinninghofen, H; Frieling, T; Enck, P

    2000-12-01

    The increased prevalence of urinary and fecal incontinence is one of the most important factors in the loss of independence and mobility in the elderly population. It is also one of the major reasons for elderly people to give up their household and move into a nursing home. Anorectal biofeedback therapy is a very effective treatment for fecal incontinence. However, due to the increased immobility of elderly people, ambulatory biofeedback training programs which require the participants to leave their homes and travel to the next available outpatient clinic on a regular basis, especially when depending on public transportation, may prove particularly difficult for elderly, incontinent subjects. Supervised home biofeedback training programs may offer an alternative for those patients, who are motivated enough and not mentally impaired. Two different age groups of women (between 49 and 63; and between 65 and 78 years old) suffering from fecal incontinence due to external anal sphincter impairment, received a supervised home biofeedback program, after extensive anorectal diagnostics including manometry. The program focused on improving voluntary sphincter contraction. After an average of 9 months, anorectal manometry was repeated, and anal resting and squeeze pressure as well as minimal rectal perception threshold were determined. There was no effect on anal resting pressure and rectal perception. However, anal maximum squeeze pressure as well as squeeze pressure over 10 s was substantially increased with no difference between the age groups. Supervised home biofeedback for sphincter insufficiency was effective in improving the voluntary contraction of the anorectum in both age groups. Therefore, biofeedback home training programs may offer an alternative to ambulatory programs for those individuals, who are not mobile enough to regularly attend an outpatient clinic.

  11. Evaluation of patients with stroke monitored by home care programs

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

  12. Evaluation of patients with stroke monitored by home care programs

    Directory of Open Access Journals (Sweden)

    Ana Railka de Souza Oliveira

    2013-10-01

    Full Text Available The purpose of this study was to evaluate the patient with a stroke in home treatment, investigating physical capacity, mental status and anthropometric analysis. This was a cross-sectional study conducted in Fortaleza/CE, from January to April of 2010. Sixty-one individuals monitored by a home care program of three tertiary hospitals were investigated, through interviews and the application of scales. The majority of individuals encountered were female (59%, elderly, bedridden, with a low educational level, a history of other stroke, a high degree of dependence for basic (73.8% and instrumental (80.3 % activities of daily living, and a low cognitive level (95.1%. Individuals also presented with tracheostomy, gastric feeding and urinary catheter, difficulty hearing, speaking, chewing, swallowing, and those making daily use of various medications. It was concluded that home care by nurses is an alternative for care of those individuals with a stroke.

  13. A study of ways home schooling families in southwest Virginia believe public schools can better interface and assist families who choose to home school their children

    OpenAIRE

    Golding, Patricia Surratt

    1995-01-01

    As more and more families opt to home school their children, public schools are being faced with the need to know more about the families that home school their children within their division because many of these children will later enroll in public school. The purpose of this study was to determine ways that home schooling parents believe public schools can better interface and assist families who choose to home school their children. In light of the i...

  14. Return to nursing home investment: Issues for public policy

    Science.gov (United States)

    Baldwin, Carliss Y.; Bishop, Christine E.

    1984-01-01

    Because Government policy does much to determine the return available to nursing home investment, the profitability of the nursing home industry has been a subject of controversy since Government agencies began paying a large portion of the Nation's nursing home bill. Controversy appears at several levels. First is the rather narrow concern, often conceived in accounting terms, of the appropriate reimbursement of capital-related expense under Medicaid and Medicare. Second is the concern about how return to capital affects the flow of investment into nursing homes, leading either to inadequate access to care or to over-capacity. Third is the concern about how-sources of return to nursing home investment affect the pattern of nursing home ownership and the amount of equity held by owners since the pattern of ownership and amount of equity have been linked to quality of care. PMID:10310945

  15. Formulation: Implementing Successful Public Montessori Programs.

    Science.gov (United States)

    Epstein, Paul

    1994-01-01

    Draws on the experiences of the OEkos Foundation for Education in implementing successful Montessori programs in 12 public school districts to present essential elements and key decisions needed for establishing such programs. Includes a schematic for the Decision Tree developed by the foundation. (ETB)

  16. The use of public policy analysis to enhance the Nursing Home Reform Act of 1987.

    Science.gov (United States)

    Breen, Gerald-Mark; Matusitz, Jonathan; Wan, Thomas T H

    2009-01-01

    Given the prevalence of abuse and neglect in nursing home care delivery vis-à-vis elderly and frail residents, and despite the advent and implementation of the Nursing Home Reform Act of 1987 (a policy that sought to diminish such conduct in such institutional settings), deficiency citations in nursing home care and services remain both problematic and common. By employing public policy analysis, and by analyzing various social science theories applicable to the improvement of care delivery and quality, this article seeks to develop methods to enhance compliance with the Nursing Home Reform Act and reduce care deficiencies in nursing homes.

  17. New Whole-House Solutions Case Study: Meeting DOE Challenge Home Program Certification - Chicago, IL; Denver, CO; Devens, MA

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-01-01

    In this project, three production home builders—K. Hovnanian Homes, David Weekley Homes, and Transformations, Inc.—partnered with Building America team Building Science Corporation to evaluate the certification of five test homes to the new DOE Challenge Home program performance standard (now DOE Zero Energy Ready Home program). The builders identified key benefits and barriers that impacted the certification of the test homes, and the likelihood of whether DOE Challenge Home certification would be pursued in future homes

  18. A Comparison of the Academic Achievement of Home School and Public School Students

    Directory of Open Access Journals (Sweden)

    Lyn Boulter

    2017-04-01

    Full Text Available This study added to existing data on home school effectiveness by comparing the academic achievement of 66 home school students with 66 of their grade-level peers in traditional public schools. The two groups of students were matched on gender, race, and grade level and were administered the Woodcock-Johnson Psychoeducational Battery III. No significant difference in overall academic achievement was found between the groups.  Both home school and public school students had average or above average scores in reading, math, written language, and broad knowledge (science, social studies, and humanities.  The results further revealed a downward trend in math, reading and broad knowledge scores with increasing grade level. This trend suggests that home school and public school students experience a “developmental mismatch” between the changes that occur in adolescence and their school/home experiences, resulting in lower motivation, confidence, and academic performance.

  19. Institute for International Public Policy Program

    Science.gov (United States)

    Office of Postsecondary Education, US Department of Education, 2012

    2012-01-01

    The Institute for International Public Policy program provides a single grant to assist a consortia of institutions of higher education in establishing an institute designed to increase the representation of minorities in international service, including private international voluntary organizations and the Foreign Service of the United States. A…

  20. Patterns of depression among adolescent mothers: Resilience related to father support and home visiting program.

    Science.gov (United States)

    Easterbrooks, M Ann; Kotake, Chie; Raskin, Maryna; Bumgarner, Erin

    2016-01-01

    The negative consequences of maternal depression are a major public health concern, both for mothers and for their children. Despite the high prevalence of depression among adolescent mothers, little is known about the patterns of adolescent mothers' depression in the early parenting years. The present study examined mothers' depression during the first 2 years following childbirth in a sample of 428 young mothers (20 or younger at first childbirth) who were participants in a randomized controlled trial of a home visiting parenting support program. Depressive symptoms were assessed using the self-reported Center for Epidemiological Studies Depression Scale (CES-D). Mothers were classified into groups based on whether their depressive symptoms were below or above the cutoff for clinically significant symptomatology. Depression groups (stable nondepressed, stable depressed, remitted depression) were associated with variations in mothers' satisfaction with support from the baby's father and enrollment in the home visiting program. Maternal depression was more likely to remit when mothers were satisfied with father support; assignment to the home visiting program was associated with mothers remaining mentally healthy. Results have clinical and policy implications for prevention and intervention programs. (c) 2016 APA, all rights reserved).

  1. Wyandotte Neighborhood Stabilization Program: Retrofit of Two Homes

    Energy Technology Data Exchange (ETDEWEB)

    Lukachko, A.; Grin, A.; Bergey, D.

    2013-04-01

    The Wyandotte NSP2 project aims to build 20 new houses and retrofit 20 existing houses in Wyandotte, MI. This report will detail the retrofit of 2 existing houses in the program. Wyandotte is part of a Michigan State Housing Development Authority-led consortium that is funded by HUD under the NSP2 program. The City of Wyandotte has also been awarded DOE EE&CBG funds that are being used to develop a district GSHP system to service the project. This draft report examines the energy efficiency recommendations for retrofit construction at these homes. The report will be of interest to anyone planning an affordable, high performance retrofit of an existing home in a Cold Climate zone. Information from this report will also be useful to retrofit or weatherization program staff as some of the proposed retrofit solutions will apply to a wide range of projects. Preliminary results from the first complete house suggest that the technology package employed (which includes spray foam insulation and insulating sheathing) does meet the specific whole house water, air, and thermal control requirements, as well as, the project's affordability goals. Monitoring of the GSHP system has been recommended and analysis of this information is not yet available.

  2. Wyandotte Neighborhood Stabilization Program: Retrofit of Two Homes

    Energy Technology Data Exchange (ETDEWEB)

    Lukachko, A. [Building Science Corporation (BSC), Somerville, MA (United States); Grin, A. [Building Science Corporation (BSC), Somerville, MA (United States); Bergey, D. [Building Science Corporation (BSC), Somerville, MA (United States)

    2013-04-01

    The Wyandotte NSP2 project aims to build 20 new houses and retrofit 20 existing houses in Wyandotte, MI. Wyandotte is part of a Michigan State Housing Development Authority-led consortium that is funded by HUD under the NSP2 program. The City of Wyandotte has also been awarded DOE EE&CBG funds that are being used to develop a district ground source heat pump (GSHP) system to service the project. This report details the retrofit of two existing houses in the program, and examines the energy efficiency recommendations for the homes. The report will be of interest to anyone planning an affordable, high performance retrofit of an existing home in a cold climate zone. Information from this report will also be useful to retrofit or weatherization program staff as some of the proposed retrofit solutions will apply to a wide range of projects. Preliminary results from the first complete house suggest that the technology package employed (which includes spray foam insulation and insulating sheathing) does meet the specific whole house water, air, and thermal control requirements, as well as, the project’s affordability goals. Monitoring of the GSHP system has been recommended and analysis of this information is not yet available.

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

    Science.gov (United States)

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

    2017-12-01

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

  4. The family-oriented home visiting program: a longitudinal study.

    Science.gov (United States)

    Gray, S W; Ruttle, K

    1980-11-01

    Designed and tested a home-based intervention program for low-income mothers with toddler and at least one other child under five. Sex of toddlers and race (black or white) about equally divided. Nine months of weekly home visits were specifically planned for each mother to enhance her effectiveness as an educational change agent. Treatment was planned to promote skills and understandings applicable over range of ages. Pretests, immediate posttests, and posttests one and two years later were administered to 27 experimental families and to a randomly assigned control group of 20. At .05 level of significance or beyond, experimentals excelled controls on receptive language test (toddler), on the Caldwell HOME (mother was indirectly rated as an educational change agent), and on a measure of teaching style (mother). They were also significantly superior on the Binet (toddler) at second posttest. No differences found with older siblings on Slosson Intelligence Test. Differences at third posttest were at least as great as earlier ones on mother measures. Relationships among child and mother measures are discussed.

  5. Home Delivery Medicament Program: access, inactivity and cardiovascular risk

    Directory of Open Access Journals (Sweden)

    Roque da Silva Araújo

    Full Text Available ABSTRACT Objective: to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. Methods: cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. Results: half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. Conclusions: due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (she stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample, diabetic (44% and dyslipidemic patients (31%.

  6. Going to Bed with Captain Marvel and a Flashlight Is Not a Home Reading Program

    Science.gov (United States)

    Greenfeld, Stuart

    1971-01-01

    Described is a home reading program for educationally disadvantaged elementary school children who need motivation to read at home. Principles of behavior change and parent role are the major motivation factors used in developing the children's reading ability. (CB)

  7. Enhancing a public health nursing shelter program.

    Science.gov (United States)

    Minnich, Margo; Shirley, Nancy

    2017-11-01

    The Shelter Nurse Program offers important nursing care and resources that help meet the health needs of the homeless population and improve the health of homeless individuals and families. However, formalized program goals and objectives, along with an evaluation plan that demonstrates population outcomes, had never been developed even as the program has evolved over time. Thus, the agency sought our assistance as public health nursing consultants to enhance the overall program to improve the health of the homeless population. To accomplish this, we worked with the agency and the shelter nurses throughout each step of the process to assess the needs of the program, develop appropriate goals and objectives, and develop an effective outcome evaluation plan for the existing Shelter Nurse Program. Lessons learned included the value and applicability of the selected program development model, the importance of agency ownership and active participation by front-line workers, and the value of educating the workers and introducing resources throughout the process. © 2017 Wiley Periodicals, Inc.

  8. Integrating Advanced Practice Nurses in Home Care. Recommendations for a Teaching Home Care Program.

    Science.gov (United States)

    Mitty, Ethel; Mezey, Mathy

    1998-01-01

    A telephone survey of home care agencies and providers revealed a need for the following: evidence of the effectiveness of nurse practitioners in home care, regulatory and financial support for nurse practitioner home care, and development of home care agencies as clinical sites for training. (SK)

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

    Directory of Open Access Journals (Sweden)

    Thomas Saïas

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

  10. A home program of rehabilitation for moderately severe traumatic brain injury patients. The DVHIP Study Group.

    Science.gov (United States)

    Warden, D L; Salazar, A M; Martin, E M; Schwab, K A; Coyle, M; Walter, J

    2000-10-01

    We have recently reported the results of a prospective controlled randomized trial comparing home versus inpatient cognitive rehabilitation for patients with moderate to severe head injury. That study showed no overall difference in outcomes between the two groups.(1) In this article, we provide further details of the home program arm of the study. All patients in the home program received medical treatment as needed, a multidisciplinary in-hospital evaluation, and TBI counseling before entering the eight-week home program, which then included guidance on home activities, as well as weekly telephone calls from a psychiatric nurse.

  11. Weatherizing the Homes of Low-Income Home Energy Assistance Program Clients: A Programmatic Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Tonn, B.

    2002-09-16

    The purpose of this project was to assess the relationships between two federal programs that support low income households, the Weatherization Assistance Program (WAP) and the Low Income Home Energy Assistance Program (LIHEAP). The specific question addressed by this research is: what impact does weatherizing homes of LIHEAP recipients have on the level of need for LIHEAP assistance? The a priori expectation is that the level of need will decrease. If this is the case, then it can be argued that a non-energy benefit of WAP is the reduction in the level of need for LIHEAP assistance for households receiving weatherization assistance. The study area for this project was Boston, Massachusetts, which is representative of large northern urban areas. Additionally, Boston was chosen because one of its social service agencies, Action for Boston Community Development (ABCD), administers both WAP and LIHEAP programs. ABCD has a substantial client base of low-income households and was willing to cooperate in this study. In the State of Massachusetts, an income test is used to determine whether low-income households qualify for standard LIHEAP benefits. Benefits provided to eligible households are determined by a schedule that gauges benefit levels based on household income and number of members in the household. Additionally, households that consume large amounts of primary heating fuel can also qualify an additional high energy subsidy. It was expected that weatherization's biggest influence on the LIHEAP program would be in reducing the number of households qualifying for high energy subsidies. Data were collected for three groups of households that received both weatherization and LIHEAP assistance and for one control group that only received LIHEAP assistance. Table ES-1 indicates the sample sizes, weatherization dates, and winter time periods when changes in energy consumption and receipt of LIHEAP benefits could be expected to be observed. The reason why there is

  12. Public Reporting and Demand Rationing: Evidence from the Nursing Home Industry.

    Science.gov (United States)

    He, Daifeng; Konetzka, R Tamara

    2015-11-01

    This paper examines an under-explored unintended consequence of public reporting: the potential for demand rationing. Public reporting, although intended to increase consumer access to high-quality products, may have provided the perverse incentive for high-quality providers facing fixed capacity and administrative pricing to avoid less profitable types of residents. Using data from the nursing home industry before and after the implementation of the public reporting system in 2002, we find that high-quality nursing homes facing capacity constraints reduced admissions of less profitable Medicaid residents while increasing the more profitable Medicare and private-pay admissions, relative to low-quality nursing homes facing no capacity constraints. These effects, although small in magnitude, are consistent with provider rationing of demand on the basis of profitability and underscore the important role of institutional details in designing effective public reporting systems for regulated industries. Copyright © 2014 John Wiley & Sons, Ltd.

  13. Association of public health initiatives with outcomes for out-of-hospital cardiac arrest at home and in public locations

    DEFF Research Database (Denmark)

    Christopher B., Fordyce; Carolina M., Hansen; Kragholm, Kristian

    2017-01-01

    cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs public location and their association with survival and neurological outcomes.Design, Setting, and Participants  This observational study reviewed 8269 patients with OHCAs (5602 [67.7%] at home and 2667 [32...... to improve bystander and first-responder interventions included training members of the general population in CPR and in the use of automated external defibrillators, teaching first responders about team-based CPR (eg, automated external defibrillator use and high-performance CPR), and instructing dispatch......), the median age was 68 years, and 61.5% were male. After comprehensive public health initiatives, the proportion of patients receiving bystander CPR increased at home (from 28.3% [275 of 973] to 41.3% [498 of 1206], P 

  14. Content analysis of public opinion on sexual expression and dementia: Implications for nursing home policy development.

    Science.gov (United States)

    Syme, Maggie L; Yelland, Erin; Cornelison, Laci; Poey, Judith L; Krajicek, Ryan; Doll, Gayle

    2017-08-01

    We examined public opinion of sexual expression and dementia to inform nursing home policy and practice. A content analysis was conducted on public comments (N=1194) posted in response to a New York Times article about a highly publicized legal case involving a husband engaging in sexual acts with his wife who had dementia, living in a nursing home. Researchers utilized constant comparative analysis to code the comments; reliability analysis showed moderately strong agreement at the subcategory level. Data were also coded to indicate whether the commenter thought the couple should or should not have been allowed to be sexual. One primary theme was identified: conditions necessary for someone to be sexual. Six categories were identified within this theme, with the public commentary considering factors such as marital relationships, intimacy needs and several sexual consent-related issues as key conditions necessary to be sexual in a nursing home setting. Overall, the majority of commenters were in support of sexual expression for an individual with dementia in the described situation. This study revealed sexual expression among individuals with dementia is a contentious issue with strong public opinions about how this should be managed in a nursing home setting. These opinions should be considered as policy related to sexual expression in nursing homes is developed. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

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

    National Research Council Canada - National Science Library

    Peacock, Shelley; Konrad, Stephanie; Watson, Erin; Nickel, Darren; Muhajarine, Nazeem

    2013-01-01

    .... The purpose of this paper is to systematically review the effectiveness of paraprofessional home-visiting programs on developmental and health outcomes of young children from disadvantaged families...

  16. Home Visitation Programs for At-risk Young Families: A Systematic Literature Review

    National Research Council Canada - National Science Library

    J.E. Drummond; A.E. Weir; G.M. Kysela

    2002-01-01

    ... home visitation for at-risk young families as the major delivery method. Objectives: To describe the program components, practices, outcomes, and reliability of the evaluation approaches. Methods...

  17. Impact of a home-based social welfare program on care for palliative patients in the Basque Country (SAIATU Program).

    Science.gov (United States)

    Molina, Emilio Herrera; Nuño-Solinis, Roberto; Idioaga, Gorka Espiau; Flores, Silvia Librada; Hasson, Naomi; Orueta Medía, Juan F

    2013-01-30

    SAIATU is a program of specially trained in-home social assistance and companionship which, since February 2011, has provided support to end-of-life patients, enabling the delivery of better clinical care by healthcare professionals in Osakidetza (Basque Health Service), in Guipúzcoa (Autonomous Community of the Basque Country).In January 2012, a retrospective observational study was carried out, with the aim of describing the characteristics of the service and determining if the new social service and the associated socio-health co-ordination had produced any effect on the use of healthcare resources by end-of-life patients.The results of a comparison of a cohort of cases and controls demonstrated evidence that the program could reduce the use of hospital resources and promote the continuation of living at home, increasing the home-based activity of primary care professionals.The objective of this study is to analyse whether a program of social intervention in palliative care (SAIATU) results in a reduction in the consumption of healthcare resources and cost by end-of-life patients and promotes a shift towards a more community-based model of care. Comparative prospective cohort study, with randomised selection of patients, which will systematically measure patient characteristics and their consumption of resources in the last 30 days of life, with and without the intervention of a social support team trained to provide in-home end-of-life care.For a sample of approximately 150 patients, data regarding the consumption of public healthcare resources, SAIATU activity, home hospitalisation teams, and palliative care will be recorded. Such data will also include information dealing with the socio-demographic and clinical characteristics of the patients and attending carers, as well as particular characteristics of patient outcomes (Karnofsky Index), and of the outcomes of palliative care received (Palliative Outcome Scale).Ethical approval for the study was given by

  18. Impact of a home-based social welfare program on care for palliative patients in the Basque Country (SAIATU Program

    Directory of Open Access Journals (Sweden)

    Molina Emilio Herrera

    2013-01-01

    Full Text Available Abstract Background SAIATU is a program of specially trained in-home social assistance and companionship which, since February 2011, has provided support to end-of-life patients, enabling the delivery of better clinical care by healthcare professionals in Osakidetza (Basque Health Service, in Guipúzcoa (Autonomous Community of the Basque Country. In January 2012, a retrospective observational study was carried out, with the aim of describing the characteristics of the service and determining if the new social service and the associated socio-health co-ordination had produced any effect on the use of healthcare resources by end-of-life patients. The results of a comparison of a cohort of cases and controls demonstrated evidence that the program could reduce the use of hospital resources and promote the continuation of living at home, increasing the home-based activity of primary care professionals. The objective of this study is to analyse whether a program of social intervention in palliative care (SAIATU results in a reduction in the consumption of healthcare resources and cost by end-of-life patients and promotes a shift towards a more community-based model of care. Method/design Comparative prospective cohort study, with randomised selection of patients, which will systematically measure patient characteristics and their consumption of resources in the last 30 days of life, with and without the intervention of a social support team trained to provide in-home end-of-life care. For a sample of approximately 150 patients, data regarding the consumption of public healthcare resources, SAIATU activity, home hospitalisation teams, and palliative care will be recorded. Such data will also include information dealing with the socio-demographic and clinical characteristics of the patients and attending carers, as well as particular characteristics of patient outcomes (Karnofsky Index, and of the outcomes of palliative care received (Palliative

  19. Antibiotic Stewardship Programs in Nursing Homes: A Systematic Review.

    Science.gov (United States)

    Feldstein, Diana; Sloane, Philip D; Feltner, Cynthia

    2017-08-07

    Antibiotic stewardship programs (ASPs) are coordinated interventions promoting the appropriate use of antibiotics to improve patient outcomes and reduce microbial resistance. These programs are now mandated in nursing homes (NHs) but it is unclear if these programs improve resident outcomes. This systematic review evaluated the current evidence regarding outcomes of ASPs in the NH. PubMed, CINAHL, EMBASE, and the Cochrane Library were systematically searched for intervention trials of ASPs performed in NHs that evaluated final health outcomes (mortality and Clostridium difficile infections), healthcare utilization outcomes (emergency department visits and hospital admissions) and intermediate health outcomes (number of antibiotics prescribed, adherence to recommended guidelines). A total of 14 studies rated good or fair quality were included. Eight studies reported a reduction in antibiotic prescriptions. Ten found an increase in adherence to guidelines proposed by the studied ASP. None reported a statistically significant change in NH mortality rates, C. difficile infection rates, or hospitalizations. The limited research to date suggests that NH ASPs can affect intermediate health outcomes, but not key health outcomes or health care utilization. Larger trials evaluating more intensive interventions over longer durations may be needed to determine whether ASPs in NHs improve health outcomes as they have in hospitals. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  20. Building the foundation for health system transformation: Oregon's Patient-Centered Primary Care Home program.

    Science.gov (United States)

    Rissi, Jill Jamison; Gelmon, Sherril; Saulino, Evan; Merrithew, Nicole; Baker, Robin; Hatcher, Paige

    2015-01-01

    Health system reform is largely dependent upon the transformation of primary care in addition to the alignment of incentives that mediate the allocation of resources. The Patient-Centered Medical Home (PCMH) is a model of enhanced primary care that encourages coordination, patient-centered care, integration of public health services, and innovative methods for improving population health-all critical elements of health system reform. Because it changes the way primary care is organized and delivered, the PCMH model has been adopted as a foundational component of Oregon's health system transformation. This article presents insights drawn from an evaluation of the implementation of Oregon's Patient-Centered Primary Care Home (PCPCH) program and the adoption of the model by primary care providers. We used a mixed-methods approach consisting of 2 surveys of recognized PCPCH practices, qualitative document analysis, and key informant interviews. Evaluation research findings were triangulated with findings from PCPCH clinic site visits conducted as part of a regulatory verification process. Survey results describe a broad range of strategies and practices adopted by recognized PCPCH clinics within 6 defined core attributes: (1) access to care; (2) accountability; (3) comprehensive whole-person care; (4) continuity; (5) coordination and integration; and (6) person- and family-centered care. We also identify 4 key factors that influenced the conceptualization, development, and implementation of the PCPCH program: (1) support and motivations; (2) administrative barriers and resource constraints; (3) alignment of short- and long-term financial incentives; and (4) leadership and interpersonal relationships. This evaluation provides insights into the factors that influence implementation of a primary care home program as public policy; the strategies and challenges associated with implementation of the model; and the implications of both for other states that are engaged in

  1. Vesper Home Care Alzheimer Case Management and In-Home Respite Program, September 1, 1985-August 30, 1986.

    Science.gov (United States)

    Rosenheimer, Lilia

    This document describes the Alzheimer Case Management and In-Home Respite Program begun in 1985 in California. Training provided to nurses and selected homemakers in the program is discussed and sources of referrals are identified. Initial nursing visits which involved physical and behavioral assessment of the patient and discussions with stressed…

  2. Weatherization and Indoor Air Quality: Measured Impacts in Single Family Homes Under the Weatherization Assistance Program

    Energy Technology Data Exchange (ETDEWEB)

    Pigg, Scott [Energy Center of Wisconsin, Madison, WI (United States); Cautley, Dan [Energy Center of Wisconsin, Madison, WI (United States); Francisco, Paul [Univ. of Illinois, Urbana-Champaign, IL (United States); Hawkins, Beth A [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Brennan, Terry M [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-09-01

    This report summarizes findings from a national field study of indoor air quality parameters in homes treated under the Weatherization Assistance Program (WAP). The study involved testing and monitoring in 514 single-family homes (including mobile homes) located in 35 states and served by 88 local weatherization agencies.

  3. 78 FR 21215 - Energy Conservation Program for Consumer Products: Association of Home Appliance Manufacturers...

    Science.gov (United States)

    2013-04-10

    ... Conservation Program for Consumer Products: Association of Home Appliance Manufacturers Petition for... (DOE) denial of a petition from the Association of Home Appliance Manufacturers (AHAM) requesting... DOE's responses are set forth in the paragraphs that follow. BSH Home Appliances Corporation (BSH) \\4...

  4. 77 FR 76952 - Energy Conservation Program for Consumer Products: Association of Home Appliance Manufacturers...

    Science.gov (United States)

    2012-12-31

    ... Part 430 Energy Conservation Program for Consumer Products: Association of Home Appliance Manufacturers...) received a petition from the Association of Home Appliance Manufacturers (AHAM) requesting reconsideration..., amendment, or repeal of a rule.'' (5 U.S.C. 553(e)). The Association of Home Appliance Manufacturers (AHAM...

  5. Effectiveness of the Home-Start Parenting Support Program: Behavioral outcomes for parents and children.

    NARCIS (Netherlands)

    Asscher, J.J.; Hermanns, J.M.A.; Deković, M.

    2008-01-01

    This study examined effectiveness of Home-Start, a program designed to support parents with young children. The aims were (a) to examine whether Home-Start improved maternal well-being and (b) to examine whether Home-Start led to changes in the behavior of mothers or children. Self-reported and

  6. Wildfire ignition resistant home design(WIRHD) program: Full-scale testing and demonstration final report.

    Energy Technology Data Exchange (ETDEWEB)

    Quarles, Stephen, L.; Sindelar, Melissa

    2011-12-13

    The primary goal of the Wildfire ignition resistant home design(WIRHD) program was to develop a home evaluation tool that could assess the ignition potential of a structure subjected to wildfire exposures. This report describes the tests that were conducted, summarizes the results, and discusses the implications of these results with regard to the vulnerabilities to homes and buildings.

  7. A national program for energy-efficient mortgages and home energy rating systems: A blueprint for action. Review draft

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    This Review Draft reports findings and recommendations of the National Collaborative on Home Energy Rating Systems and Mortgage Incentives for Energy Efficiency. The US Department of Energy, in cooperation with the US Department of Housing and Urban Development, formed this National Collaborative as a National Energy Strategy initiative. Participating in the Collaborative were representatives of the primary and secondary mortgage markets, builder and remodeler organizations, real estate and appraiser associations, the home energy rating system industry, utility associations, consumer and public interest groups, state and local government interest groups, and environmental organizations. The Collaborative`s purpose was to develop a voluntary national program encouraging energy efficiency in homes through mortgage incentives linked to home energy ratings.

  8. A national program for energy-efficient mortgages and home energy rating systems: A blueprint for action

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    This Review Draft reports findings and recommendations of the National Collaborative on Home Energy Rating Systems and Mortgage Incentives for Energy Efficiency. The US Department of Energy, in cooperation with the US Department of Housing and Urban Development, formed this National Collaborative as a National Energy Strategy initiative. Participating in the Collaborative were representatives of the primary and secondary mortgage markets, builder and remodeler organizations, real estate and appraiser associations, the home energy rating system industry, utility associations, consumer and public interest groups, state and local government interest groups, and environmental organizations. The Collaborative's purpose was to develop a voluntary national program encouraging energy efficiency in homes through mortgage incentives linked to home energy ratings.

  9. Do public nursing home care providers deliver higher quality than private providers? Evidence from Sweden.

    Science.gov (United States)

    Winblad, Ulrika; Blomqvist, Paula; Karlsson, Andreas

    2017-07-14

    Swedish nursing home care has undergone a transformation, where the previous virtual public monopoly on providing such services has been replaced by a system of mixed provision. This has led to a rapidly growing share of private actors, the majority of which are large, for-profit firms. In the wake of this development, concerns have been voiced regarding the implications for care quality. In this article, we investigate the relationship between ownership and care quality in nursing homes for the elderly by comparing quality levels between public, for-profit, and non-profit nursing home care providers. We also look at a special category of for-profit providers; private equity companies. The source of data is a national survey conducted by the Swedish National Board of Health and Welfare in 2011 at 2710 nursing homes. Data from 14 quality indicators are analyzed, including structure and process measures such as staff levels, staff competence, resident participation, and screening for pressure ulcers, nutrition status, and risk of falling. The main statistical method employed is multiple OLS regression analysis. We differentiate in the analysis between structural and processual quality measures. The results indicate that public nursing homes have higher quality than privately operated homes with regard to two structural quality measures: staffing levels and individual accommodation. Privately operated nursing homes, on the other hand, tend to score higher on process-based quality indicators such as medication review and screening for falls and malnutrition. No significant differences were found between different ownership categories of privately operated nursing homes. Ownership does appear to be related to quality outcomes in Swedish nursing home care, but the results are mixed and inconclusive. That staffing levels, which has been regarded as a key quality indicator in previous research, are higher in publicly operated homes than private is consistent with earlier

  10. Changes in clinical and hotel expenditures following publication of the nursing home compare report card.

    Science.gov (United States)

    Mukamel, Dana B; Spector, William D; Zinn, Jacqueline; Weimer, David L; Ahn, Richard

    2010-10-01

    Nursing Home Compare first published clinical quality measures at the end of 2002. It is a quality report card that for the first time offers consumers easily accessible information about the clinical quality of nursing homes. It led to changes in consumers' demand, increasing the relative importance of clinical versus hotel aspects of quality in their search and choice of a nursing home. To examine the hypothesis that nursing homes responding to these changes in demand shifted the balance of resources from hotel to clinical activities. The study included 10,022 free-standing nursing homes nationwide during 2001 to 2006. RESEARCH DESIGN AND DATA: A retrospective multivariate statistical analysis of trends in the ratio of clinical to hotel expenditures, using Medicare cost reports, Minimum Data Set and Online Survey, Certification and Reporting data, controlling for changes in residents' acuity and facility fixed effects. Inference is based on robust standard errors. The ratio of clinical to hotel expenditures averaged 1.78. It increased significantly (P hotel expenditures following publication of the report card suggests that nursing homes responded as expected to the changes in the elasticity of demand with respect to clinical quality brought about by the public reporting of clinical quality measures. The response was stronger among nursing homes facing stronger incentives.

  11. The influences on women who choose publicly-funded home birth in Australia.

    Science.gov (United States)

    Catling, Christine; Dahlen, Hannah; Homer, Caroline S E

    2014-07-01

    to explore the influences on women who chose a publicly-funded home birth in one Australian state. a constructivist grounded theory methodology was used. a publicly-funded home birth service located within a tertiary referral hospital in the southern suburbs of Sydney, Australia. data were collected though semi-structured interviews of 17 women who chose to have a publicly-funded home birth. six main categories emerged from the data. These were feeling independent, strong and confident, doing it my way, protection from hospital related activities, having a safety net, selective listening and telling, and engaging support. The core category was having faith in normal. This linked all the categories and was an overriding attitude towards themselves as women and the process of childbirth. The basic social process was validating the decision to have a home birth. women reported similar influences to other studies when choosing home birth. However, the women in this study were reassured by the publicly-funded system׳s 'safety net' and apparent seamless links with the hospital system. The flexibility of the service to permit women to change their minds to give birth in hospital, and essentially choose their birthplace at any time during pregnancy or labour was also appreciated. women that choose a publicly-funded home birth service describe strong influences that led them to home birth within this model of care. Service managers and health professionals need to acknowledge the importance of place of birth choice for women. Copyright © 2014 Elsevier Ltd. All rights reserved.

  12. Establishing a public-private partnership program : a primer.

    Science.gov (United States)

    2012-11-01

    Establishing a Public-Private Partnership (P3) program within a public agency involves issues from : enabling legislation through identification, evaluation, negotiation and management of P3 projects. : Public agencies will need: : A legal framew...

  13. [Effectiveness of a home hospitalization program for patients with urinary tract infection after discharge from an emergency department].

    Science.gov (United States)

    Soledad Gallardo, María; Antón, Ane; Pulido Herrero, Esther; Itziar Larruscain, Miren; Guinea Suárez, Rocío; García Gutiérrez, Susana; Sandoval Negral, Julio César

    2017-10-01

    To compare outcomes of urinary tract infections (UTIs) in patients referred to a home hospitalization program or admitted to a conventional ward after initial management in the emergency department. Prospective, quasi-experimental study of patients with UTIs attended in 3 hospital emergency departments in the public health system of the Basque Country, Spain, between January 2012 and June 2013. Patients were assigned to 2 groups according to site of treatment (home or hospital ward) after discharge from the emergency department. We collected sociodemographic data, history of kidney or urologic symptoms, concomitant diseases, risk for complicated UTI, presentation on admission to the emergency department, diagnostic findings, and prescribed treatments. The main outcome was poor clinical course (local complications during hospital or home care, recurrence, or readmission related to UTI. Multivariate logistic modeling was used to analyze factors related to poor clinical course. Home hospitalization was the main independent variable of interest. Patients referred to home hospitalization were more often women (70.6% vs 57.1% men, P=.04). Fewer cases of prior admission were recorded in the group treated at home (2.4% vs 9.5% of hospitalized patients, P=.03). Likewise, fewer home-hospitalization patients had risk factors for complicated UTI (58.7% vs 83.3% in the hospitalized group, Phome hospitalization (0.8% vs 8.3% in hospitalized patients, P=.007). The frequency of poor clinical course was similar in home-hospitalized and ward-admitted patients. The clinical course of UTI is similar whether patients are hospitalized after emergency department management or discharged to a home hospitalization program.

  14. Factors associated with rehospitalizations of very low birthweight infants: impact of a transition home support and education program.

    Science.gov (United States)

    Vohr, Betty R; Yatchmink, Yvette E; Burke, Robert T; Stephens, Bonnie E; Cavanaugh, Ellen C; Alksninis, Barbara; Nye, Julie H; Bacani, Deborah; McCourt, Maureen F; Collins, Amy M; Tucker, Richard

    2012-07-01

    To determine the effects of a transition-home education and support program, BPD, and health insurance type on VLBW infant rehospitalizations at 3 and 7 months corrected age. It was hypothesized that the transition-home program would be associated with decreased rehospitalizations between Phase 1 and 2, and public health insurance and BPD would be associated with increased rehospitalizations. 274 infants with birth weight Infants with public insurance had twice as many rehospitalizations by 3 months (28% versus 11%; p=0.018) in Phase 1. In regression analyses the intervention effects did not achieve significance for the cohort at 3 months (OR=0.63; CI=0.33 to 1.20) or 7 months (OR=0.61; CI=0.33 to 1.13). BPD and public insurance did not reach significance in the models whereas siblings were significantly associated with increased odds of rehospitalization. In subgroup analyses for infants on pubic health insurance the intervention significantly decreased the odds of rehospitalization between Phase 1 and 2(OR=0.43; CI=0.19 to 0.96) at 3 months. Our findings suggest that a transition-home program may be beneficial to reduce the rehospitalization rate for VLBW infants, and infants on public insurance may derive greater benefit. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Effects of a Home Visiting Program on Parenting: Mediating Role of Intimate Partner Violence.

    Science.gov (United States)

    Easterbrooks, M Ann; Fauth, Rebecca C; Lamoreau, Renee

    2017-10-01

    Young women aged 18 to 24 years are in the highest risk group for intimate partner violence (IPV), and adolescent mothers are at particularly high risk for IPV and for risky health behaviors. Exposure to IPV may contribute to parenting stress and risky behaviors, and may compromise parenting behavior and healthy child development. The present study examined whether program effects of a statewide home visiting program for adolescent parents on young mothers' parenting stress and risky behaviors measured 2 years post program enrollment were mediated by program effects on their exposure to IPV measured 1 year post enrollment. Using longitudinal data from a subsample of young mothers ( n = 448; 58% program, 42% control) who participated in a randomized controlled trial evaluation of a statewide home visiting program, Healthy Families Massachusetts (HFM), we estimated path analyses to examine whether home visiting program effects observed on IPV mediated home visiting program effects on subsequent assessments of parenting distress and mothers' risky behaviors. Findings indicated that IPV mediated associations between home visiting program effects on mothers' parenting distress and risky behavior. Although most newborn home visiting programs do not have an explicitly stated goal of reducing IPV, helping mothers and their partners to reduce violent behavior can have further-reaching impacts on other key goals of home visiting programs, such as parenting stress and risky behaviors.

  16. Changes in the relationship between nursing home financial performance and quality of care under public reporting.

    Science.gov (United States)

    Park, Jeongyoung; Werner, Rachel M

    2011-07-01

    The relationship between financial performance and quality of care in nursing homes is not well defined and prior work has been mixed. The recent focus on improving the quality of nursing homes through market-based incentives such as public reporting may have changed this relationship, as public reporting provides nursing homes with increased incentives to engage in quality-based competition. If quality improvement activities require substantial production costs, nursing home profitability may become a more important predictor of quality under public reporting. This study explores the relationship between financial performance and quality of care and test whether this relationship changes under public reporting. Using a 10-year (fiscal years 1997-2006) panel data set of 9444 skilled nursing facilities in the US, this study employs a facility fixed-effects with and without instrumental variables approach to test the effect of finances on quality improvement and correct for potential endogeneity. The results show that better financial performance, as reflected by the 1-year lagged total profit margin, is modestly associated with higher quality but only after public reporting is initiated. These findings have important policy implications as federal and state governments use market-based incentives to increase demand for high-quality care and induce providers to compete based on quality. Copyright © 2010 John Wiley & Sons, Ltd.

  17. 76 FR 71979 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2011-11-21

    ... status, school readiness, and domestic violence); (b) the effectiveness of such programs on different... HUMAN SERVICES Administration for Children and Families Health Resources and Services Administration...) The effect of early childhood home visiting programs on outcomes for parents, children, and...

  18. Physical Activity and Beverages in Home- and Center-Based Child Care Programs

    Science.gov (United States)

    Tandon, Pooja S.; Garrison, Michelle M.; Christakis, Dimitri A.

    2012-01-01

    Objective: To describe and compare obesity prevention practices related to physical activity and beverages in home- and center-based child care programs. Methods: A telephone survey of licensed home- and center-based child care programs in Florida, Massachusetts, Michigan, and Washington between October and December 2008. Results: Most programs…

  19. Evaluation of a Nurse-Led Fall Prevention Education Program in Turkish Nursing Home Residents

    Science.gov (United States)

    Uymaz, Pelin E.; Nahcivan, Nursen O.

    2016-01-01

    Falls are a major cause of morbidity and mortality among the elderly living in nursing homes. There is a need to implement and evaluate fall prevention programs in nursing homes to reduce the number of falls. The purpose of this research was to examine the effect of a nurse-led fall prevention education program in a sample of nursing home…

  20. Nursing Home Price and Quality Responses to Publicly Reported Quality Information

    Science.gov (United States)

    Clement, Jan P; Bazzoli, Gloria J; Zhao, Mei

    2012-01-01

    Objective To assess whether the release of Nursing Home Compare (NHC) data affected self-pay per diem prices and quality of care. Data Sources Primary data sources are the Annual Survey of Wisconsin Nursing Homes for 2001–2003, Online Survey and Certification Reporting System, NHC, and Area Resource File. Study Design We estimated fixed effects models with robust standard errors of per diem self-pay charge and quality before and after NHC. Principal Findings After NHC, low-quality nursing homes raised their prices by a small but significant amount and decreased their use of restraints but did not reduce pressure sores. Mid-level and high-quality nursing homes did not significantly increase self-pay prices after NHC nor consistently change quality. Conclusions Our findings suggest that the release of quality information affected nursing home behavior, especially pricing and quality decisions among low-quality facilities. Policy makers should continue to monitor quality and prices for self-pay residents and scrutinize low-quality homes over time to see whether they are on a pathway to improve quality. In addition, policy makers should not expect public reporting to result in quick fixes to nursing home quality problems. PMID:22092366

  1. Do Restrictions on Smoking at Home, at School and in Public Places Influence Teenage Smoking?

    OpenAIRE

    Wakefield, Melanie A. PhD; Chaloupka, Frank J. PhD; Kaufman, Nancy J. RN, MS; Orleans, C. Tracy PhD; Barker, Dianne C. MHS; Ruel, Erin E. MA

    2000-01-01

    Objectives - To determine the relationship between extent of restrictions on smoking at home, at school and in public places, and smoking uptake, smoking prevalence and monthly cigarette consumption by school students. Design - Cross-sectional survey with merged records of extent of restrictions on smoking in public places. Setting – United States. Participants – 17,287 high school students. Main outcome measures – Five-point scale of smoking uptake; 30-day...

  2. Exposure to nontraditional pets at home and to animals in public settings: risks to children.

    Science.gov (United States)

    Pickering, Larry K; Marano, Nina; Bocchini, Joseph A; Angulo, Frederick J

    2008-10-01

    Exposure to animals can provide many benefits during the growth and development of children. However, there are potential risks associated with animal exposures, including exposure to nontraditional pets in the home and animals in public settings. Educational materials, regulations, and guidelines have been developed to minimize these risks. Pediatricians, veterinarians, and other health care professionals can provide advice on selection of appropriate pets as well as prevention of disease transmission from nontraditional pets and when children contact animals in public settings.

  3. Effect of a home intervention program on pediatric asthma in an environmental justice community.

    Science.gov (United States)

    Shani, Zalika; Scott, Richard G; Schofield, Lynne Steuerle; Johnson, John H; Williams, Ellen R; Hampton, Janiene; Ramprasad, Vatsala

    2015-03-01

    Asthma prevalence rates are at an all-time high in the United States with over 25 million persons diagnosed with asthma. African Americans and other minorities have higher asthma prevalence and higher exposure to environmental factors that worsen asthma as compared to Caucasians. This article describes the evaluation of an inner-city home-based asthma education and environmental remediation program that addressed both indoor and outdoor triggers through collaboration between a health system and local environmental justice organization. The program enrolled 132 children older than 2.5 years and centers on a 4- to 6-week intervention with peer counselors using the U.S. Environmental Protection Agency Asthma Home Environment Checklist and the You Can Control Asthma curriculum. Families receive asthma-friendly environmental home kits. Peer counselors reinforce key asthma management messages and facilitate the completion of Asthma Action Plans. The environmental justice community partner organized block cleanups to reduce outdoor triggers. The evaluation used a pretest-posttest design to assess changes in client behavior and asthma symptoms. Data were collected at baseline and during a 6-month postintervention period. Participants saw enhanced conditions on asthma severity and control. The improvement was greatest for children whose asthma was considered "severe" based on the validated Asthma Control Test. Other positive results include the following: greater completion of Asthma Action Plans, significant reduction in the number of emergency room visits (p = .006), and substantial decreases in school absenteeism (p = .008) and use of rescue medications (p = .049). The evaluation suggests that the program was effective in improving asthma self-management in a high-risk population living within an environmental justice community. © 2014 Society for Public Health Education.

  4. Dawn Mission's Education and Public Outreach Program

    Science.gov (United States)

    McFadden, Lucy-Ann A.; Wise, J.; Ristvey, J.; Warner, E. M.

    2007-10-01

    NASA's Dawn mission, the 9th Discovery mission, is the first to orbit two solar system bodies: Vesta (Oct 2011-Apr 2012), then Ceres (Feb-Jul 2015), the most massive Main Belt asteroids. The Education and Public Outreach (EPO) goals are to inspire the next generation of explorers; motivate students to pursue careers in science, technology, engineering and mathematics (STEM); to enhance the quality of STEM education at the K-13 level and engage the public in exploration and discovery. Dawn's website (dawn.jpl.nasa.gov) is central to the dissemination of products and activities. The Dawn E-Newsletter, with 2,301 subscribers, is produced on a quarterly basis. Leonard Nimoy narrated the mission video available on Google videos. Dawn Young Engineers build a paper model of the Dawn spacecraft and submit photos with their constructions. 366,050 names were collected to send to the asteroids. Speaker's kits for the Solar System Ambassadors are online and a poster can be printed via web at a local Office Max. Educational materials about dwarf planets, history and discovery of asteroids, ion propulsion and finding meteorites have been developed. In addition, numerous activities including an interactive activity on ion propulsion, identifying craters (ClickWorkers) and observing asteroids (Telescopes in Education and Amateur Observers' Program) appeal to formal and informal educational audiences. Educators from over 20 states convened in Florida for a workshop in June with the opportunity to meet mission scientists, learn about the modules and activities, observe Vesta through a telescope and tour KSFC. Plans for the coming years include developing modules on instrumentation, theories of the origin of the solar system and data analysis. A planetarium show, museum displays, a video field trip to the asteroid belt and additional educator workshops are planned. This work is funded by NASA's Discovery Program.

  5. Public, Private, and Home School Children's Views of Forgiveness and Retribution in "Cinderella."

    Science.gov (United States)

    Knafle, June D.; Wescott, Alice Legenza

    Fifth Graders (N=626) from public, Catholic, Christian, and home schools reacted to values of forgiveness versus retribution in the two main versions of "Cinderella" by choosing which ending they preferred for themselves, for a 4-year old sister, and for a 4-year old brother. Girls preferred the forgiveness ending for themselves…

  6. 77 FR 12588 - Long Fence & Home, LLLP; Analysis of Proposed Consent Order To Aid Public Comment

    Science.gov (United States)

    2012-03-01

    ... Home Page (for February 22, 2012), on the World Wide Web, at http://www.ftc.gov/os/actions.shtm . A... reasonable basis substantiating these representations when it made them. Many factors determine the savings... facilitate public comment on the proposed order. It is not intended to constitute an official interpretation...

  7. Feeling at home in public: diasporic Moroccan women negotiating leisure in Morocco and the Netherlands

    NARCIS (Netherlands)

    Wagner, L.B.; Peters, K.B.M.

    2014-01-01

    Muslim women are often cited as subject to restriction in their mobility through public space, especially in European contexts, in comparison with non-Muslim community members. Yet any woman might face restriction in her access to leisure outside the home through geographies of risk and fear, as

  8. Energy expenditure of three public and three home-based active video games in children

    NARCIS (Netherlands)

    Simons, Monique; De Vries, Sanne I.; Jongert, Tinus; Verheijden, Marieke W.

    2014-01-01

    The purpose of this study was to assess the energy expenditure (EE) experienced by children when playing six active video games, which can be used in a home environment and in a public setting (e.g. game center), and to evaluate whether the intensity of playing these games can meet the threshold for

  9. Studying the implementation of public programs

    Energy Technology Data Exchange (ETDEWEB)

    Yin, R.K.

    1980-02-01

    This report describes and critically assesses approaches that have been employed to study the implementation of public programs. Implementation is defined as the process by which new policies and/or practices are installed in organizations. The report was produced because of the increased interest among researchers and policy makers alike in the linkages between policy and outcome. The study of implementation has barely begun, and it was recognized that methodological issues of a particularly complex nature arise because of certain unique characteristics of the implementation processes: (1) they involve a series of decisions that occur over a long period of time, with no clear beginning or end points; (2) their outcomes have direct or indirect implications that are too complex for single-factor theories; (3) they involve a large number of participants; and (4) they involve situations that are rather unique in terms of agency context, historical moment in time, and other key elements. The approach employed in the report was to examine the methods that have been used in a number of exemplary studies of implementation. These studies are commonly cited in publications and informally in research circles. Descriptive material from each study was used to address three questions: (1) How is evidence collected in studies of implementation; (2) How is evidence analyzed; (3) What are the reasons for believing the conclusions from such studies. The report concludes with recomendations for the conduct of future studies of implementation.

  10. A Programming Language Approach to Safety in Home Networks

    DEFF Research Database (Denmark)

    Mortensen, Kjeld Høyer; Schougaard, Kari Rye; Schultz, Ulrik Pagh

    Home networks and the interconnection of home appliances is a classical theme in pervasive computing research. Security is usually addressed through the use of encryption and authentication, but there is a lack of awareness of safety: reventing the computerized house from harming the inhabitants......-based restrictions on operations. This model has been implemented in a middleware for home AV devices written in Java, using infrared communication and a FireWire network to implement location awareness....

  11. A Programming Language Approach to Safety in Home Networks

    DEFF Research Database (Denmark)

    Mortensen, Kjeld Høyer; Schougaard, Kari Sofie Fogh; Schultz, Ulrik Pagh

    2003-01-01

    Home networks and the interconnection of home appliances is a classical theme in pervasive computing research. Security is usually addressed through the use of encryption and authentication, but there is a lack of awareness of safety: preventing the computerized house from harming the inhabitants......-based restrictions on operations. This model has been implemented in a middleware for home AV devices written in Java, using infrared communication and a FireWire network to implement location awareness....

  12. 78 FR 41013 - Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014...

    Science.gov (United States)

    2013-07-09

    ... Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality... technical errors that appeared in the proposed rule with comment period titled ``Medicare and Medicaid Programs; Home Health Prospective Payment System Rate Update for CY 2014, Home Health Quality Reporting...

  13. Evaluation of NASA's Mars Public Engagement Program

    Science.gov (United States)

    Viotti, M.; Bowman, C.

    2014-12-01

    From 2009-2014, NASA's Mars Public Engagement (MPE) Program developed and implemented project-level logic models and associated impacts and indicators tables using the NSF's "Framework for Evaluating Impacts of Informal Science Education Projects" (Friedman, 2008) as a key guiding document. This Framework was selected given the national-expert-level evaluation committee who synthesized evaluation in a way that allows project-to-project comparisons in key areas of measurable change, while also allowing variation for appropriate project-specific measures and outcomes. These logic models, revisited and refined annually, provide guidance for all measures developed, tested, and implemented with MPE projects, including the Mars Student Imaging Project (MSIP), the Imagine Mars Project, and Mars Educator Professional Development. Project questionnaires were developed, tested, refined, retested, and finalized following standard procedures outlined in Converse & Presser (1986), Dillman, Smyth, & Christian (2009), Krosnick & Presser (2010), and Presser, et al. (2004). Interview questions were drafted, reviewed by project staff, and revised following established interview question development guidelines (e.g., Kvale, 1996; Maxwell, 2005; Maykut & Morehouse, 1994; Strauss & Corbin, 1998). For MSIP final projects, a rubric guided by Lantz (2004) was developed to evaluate systematically the quality and completeness of the final projects. We will discuss our instruments as well as the important issue of nonresponse error, which is relevant to a wide range of NASA programs because most data is collected from customers who are voluntary participants, as opposed to grantees who must report as a condition of their grant. NASA programs that consider data and report results from voluntary samples must be cautious about claims or decisions based on those data. We will discuss the ways in which we consider and address this challenge.

  14. Comprehensive Guide for Exploratory Home Economics Programs. Instructor's Guide.

    Science.gov (United States)

    Hansen, Joan

    This teacher's guide for exploratory home economics on the middle school level emphasizes a hands-on, fun-filled, active approach to a variety of topics in home economics. It is organized in five units covering the following topics: personal management, resource management, parenting and babysitting education, clothing management, and food and…

  15. 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.…

  16. 76 FR 44394 - Public Transportation on Indian Reservations Program; Tribal Transit Program

    Science.gov (United States)

    2011-07-25

    ... Federal Transit Administration Public Transportation on Indian Reservations Program; Tribal Transit... availability of $15,075,000 in funding provided by the Public Transportation on Indian Reservations Program... establishing the Public Transportation on Indian Reservations Program (Tribal Transit Program) (TTP). This...

  17. 77 FR 14465 - Public Transportation on Indian Reservations Program; Tribal Transit Program

    Science.gov (United States)

    2012-03-09

    ... Federal Transit Administration Public Transportation on Indian Reservations Program; Tribal Transit... Surface and Air Transportation Programs Extension Act of 2011, Public Law No.112-30 continues the... establishing the Public Transportation on Indian Reservations Program (Tribal Transit Program or TTP). This...

  18. Living and ageing in the technological landscapes of homes and public places - an international perspective

    DEFF Research Database (Denmark)

    Helle, Tina; Kottorp, Anders; Gudetti, Susanne

    phones, cash machines) and assistive technology (e.g. electronic calendars/reminders). Occupational therapy can here play a major role in supporting older people to access and use everyday technology and public spaces, but the evidence-base is still sparse how to approach, evaluate and intervene...... and social activities (Nygård and Kottorp, 2014, Nygard et al., 2012). These relationships are indicators of the significance of being able to use ET for managing daily life activities, especially outside the home among older people. Recently there has been increased emphasis on accessibility...... and participation in public places for people with functional impairments, while little is still known of the cognitive aspects of accessibility. In order to access and use homes and public spaces (including health care services, crucial challenges are associated with technology, both everyday technology (e.g. cell...

  19. Public reporting and the quality of care of German nursing homes.

    Science.gov (United States)

    Herr, Annika; Nguyen, Thu-Van; Schmitz, Hendrik

    2016-10-01

    Since 2009, German nursing homes have been evaluated regularly by an external institution with quality report cards published online. We follow recent debates and argue that most of the information in the report cards does not reliably measure quality of care. However, a subset of up to seven measures does. Do these measures that reflect "risk factors" improve over time? Using a sample of more than 3000 German nursing homes with information on two waves, we assume that the introduction of public reporting is an exogenous institutional change and apply before-after-estimations to obtain estimates for the relation between public reporting and quality. We find a significant improvement of the identified risk factors. Also, the two employed outcome quality indicators improve significantly. The improvements are driven by nursing homes with low quality in the first evaluation. To the extent that this can be interpreted as evidence that public reporting positively affects the (reported) quality in nursing homes, policy makers should carefully choose indicators reflecting care-sensitive quality. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Using Home-Program Adherence App in Pediatric Therapy: Case Study of Sensory Processing Disorder.

    Science.gov (United States)

    Gal, Eynat; Steinberg, Oren

    2017-12-18

    Pediatric therapies adopt a family-centered approach that encourages a caregiver's involvement in therapy. Contextual interventions in the child's natural environment have been effective in generalization of skills and increasing of child participation in daily activities. The use of home programs is common across a variety of conditions, but adherence has been challenging. Apps have been demonstrated to promote medication adherence and physical activity maintenance. This study suggested and tested a construct for features required for caregivers' behavioral modification during home programs in pediatric therapy. SensoryTreat is an adherence promoting app for home-program treatments of children with sensory processing disorders. The app was evaluated by testing availability of desired features, usage frequency, impact on adherence with home programs, and parental sense of competence. Results suggest a strong significant correlation between SensoryTreat usage frequency and families' adherence with home programs, as well as a strong significant correlation between relevancy and usefulness of SensoryTreat's interventional content, and parental competence and their adherence with home programs. Using SensoryTreat twice or more per week increases parental adherence with home programs. Content plays an important role in promoting adherence and parental sense of competence, yet, as usage frequency grows the interventional content habituates, and other features as goal setting and feedback logs have significant impact on parental competence and adherence with home programs over time. These findings indicate that the content and features of SensoryTreat app have the potential to promote adherence of families with pediatric therapy home programs.

  1. Implementation and evaluation of a nursing home fall management program.

    Science.gov (United States)

    Rask, Kimberly; Parmelee, Patricia A; Taylor, Jo A; Green, Diane; Brown, Holly; Hawley, Jonathan; Schild, Laura; Strothers, Harry S; Ouslander, Joseph G

    2007-03-01

    To evaluate the feasibility and effectiveness of a falls management program (FMP) for nursing homes (NHs). A quality improvement project with data collection throughout FMP implementation. NHs in Georgia owned and operated by a single nonprofit organization. All residents of participating NHs. A convenience sample of 19 NHs implemented the FMP. The FMP is a multifaceted quality improvement and culture change intervention. Key components included organizational leadership buy-in and support, a designated facility-based falls coordinator and interdisciplinary team, intensive education and training, and ongoing consultation and oversight by advanced practice nurses with expertise in falls management. Process-of-care documentation using a detailed 24-item audit tool and fall and physical restraint use rates derived from quality improvement software currently used in all Georgia NHs (MyInnerView). Care process documentation related to the assessment and management of fall risk improved significantly during implementation of the FMP. Restraint use decreased substantially during the project period, from 7.9% to 4.4% in the intervention NHs (a relative reduction of 44%), and decreased in the nonintervention NHs from 7.0% to 4.9% (a relative reduction of 30%). Fall rates remained stable in the intervention NHs (17.3 falls/100 residents per month at start and 16.4 falls/100 residents per month at end), whereas fall rates increased 26% in the NHs not implementing the FMP (from 15.0 falls/100 residents/per month to 18.9 falls/100 residents per month). Implementation was associated with significantly improved care process documentation and a stable fall rate during a period of substantial reduction in the use of physical restraints. In contrast, fall rates increased in NHs owned by the same organization that did not implement the FMP. The FMP may be a helpful tool for NHs to manage fall risk while attempting to reduce physical restraint use in response to the Centers for

  2. Reducing Children's Susceptibility to Alcohol Use: Effects of a Home-Based Parenting Program.

    Science.gov (United States)

    Jackson, Christine; Ennett, Susan T; Reyes, H Luz McNaughton; Hayes, Kim A; Dickinson, Denise M; Choi, Seulki; Bowling, J Michael

    2016-07-01

    This 4-year efficacy trial tested whether a home-based, self-administered parenting program could have a long-term effect on children's cognitive susceptibility to alcohol use, and it tested hypothesized moderators and mediators of any such program effect. Using a two-group randomized controlled design, 1076 children (540 treatment; 536 control; mean age of 9.2 years at baseline) completed telephone interviews prior to randomization and follow-up interviews 12, 24, 36, and 48 months post-baseline. Mothers of children randomized to treatment received a 5-month-long parenting program during year 1, followed by two 1-month-long boosters in years 2 and 3. Exposure to the program was significantly inversely associated with susceptibility to alcohol use 48 months post-baseline (b = -0.03, p = .04), with no variation in program effects by parental alcohol use or mother's race/ethnicity or education, suggesting broad public health relevance of the parenting program. Path analyses of simple indirect effects through each hypothesized mediator showed that program exposure positively influenced parental communication to counter pro-drinking influences in the family and media domains and parental rule setting 36 months post-baseline; these variables, in turn, predicted reduced susceptibility to alcohol use 48 months post-baseline. Parallel (multiple) mediation analysis showed that the program had a significant indirect effect on susceptibility through parental rule setting. Together, the findings indicate that internalization of protective alcohol-related expectancies and intentions is possible among children whose mothers provide early exposure to alcohol-specific socialization. Additional research is needed to link alcohol-specific socialization during childhood with adolescent drinking outcomes.

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

    Science.gov (United States)

    2016-11-03

    This final rule updates the Home Health Prospective Payment System (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor; effective for home health episodes of care ending on or after January 1, 2017. This rule also: Implements the last year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates; updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the 2nd-year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between CY 2012 and CY 2014; finalizes changes to the methodology used to calculate payments made under the HH PPS for high-cost "outlier" episodes of care; implements changes in payment for furnishing Negative Pressure Wound Therapy (NPWT) using a disposable device for patients under a home health plan of care; discusses our efforts to monitor the potential impacts of the rebasing adjustments; includes an update on subsequent research and analysis as a result of the findings from the home health study; and finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model, which was implemented on January 1, 2016; and updates to the Home Health Quality Reporting Program (HH QRP).

  4. Home programs for upper extremity recovery post-stroke: a survey of occupational therapy practitioners.

    Science.gov (United States)

    Donoso Brown, Elena V; Fichter, Renae

    2017-12-01

    Upper extremity hemiparesis is an impairment post-stroke that impacts quality of life. Home programs are an intervention strategy used by many occupational therapists to support continued motor recovery post-stroke, yet little is known about how these programs are designed and implemented. The purpose of this study was to describe how occupational therapy practitioners approach this task and specifically what strategies they use to support adherence and what types of technology are most commonly used. An on-line survey methodology was used. Participants were recruited through multiple sources including state associations and occupational therapy educational program directors. A total of 73 occupational therapy practitioners submitted complete surveys. It was found that majority of occupational therapy practitioners in the sample (n = 53) reported creating home programs focused on upper extremity motor recovery more than 80% of the time. Range of motion and strengthening were reported as being in the top three most commonly used interventions by more than half the sample, however incorporating clients' goals and interests were reported most often as strategies to create meaning in the home program. Respondents also reported limited incorporation of technology and strategies to support adherence. Personal motivation was reported by occupational therapy practitioners to be a key moderator of adherence to a home program. Occupational therapy practitioners often provide home programs for individuals post-stroke focusing on upper extremity function. Future research that aims to understand stakeholders' perspectives on home programs and determine effective strategies for ensuring adherence is needed.

  5. The effect of a home physiotherapy program for persons with Parkinson's disease

    NARCIS (Netherlands)

    Nieuwboer, A; De Weerdt, W; Dom, R; Truyen, M; Janssens, L; Kamsma, Y

    2001-01-01

    The purpose of this study was to evaluate the effect of a home physiotherapy program for persons with Parkinson's disease. Thirty-three patients took part in the study using a within-subject controlled design. Functional activities including walking and carrying out transfers were measured at home

  6. Creating a Child Care Center in a Nursing Home and Implementing an Intergenerational Program.

    Science.gov (United States)

    Foster, Karen B.

    The success of the Champaign County Nursing Home Child Care Center (CCNHCCC) in Illinois provides a model for the establishment of child care centers in nursing homes. Needs assessment, financial support, licensing, staff hiring and training are all important factors that need to addressed in the start up and running of such a program. The…

  7. The Parent-Child Home Program in Western Manitoba: A 20-Year Evaluation

    Science.gov (United States)

    Gfellner, Barbara M.; McLaren, Lorraine; Metcalfe, Arron

    2008-01-01

    This article is a 20-year evaluation of the Parent-Child Home Program (PCHP) of Child and Family Services in Western Manitoba. Following Levenstein's (1979, 1988) approach, home visitors model parent-child interchanges using books and toys to enhance children's cognitive development through appropriate parenting behaviors. The evaluation provides…

  8. Quantifying Carbon and distributional benefits of solar home system programs in Bangladesh

    OpenAIRE

    Wang, Limin; Bandyopadhyay, Sushenjit; Cosgrove-Davies, Mac; Samad, Hussain

    2011-01-01

    Scaling-up adoption of renewable energy technology, such as solar home systems, to expand electricity access in developing countries can accelerate the transition to low-carbon economic development. Using a purposely collected national household survey, this study quantifies the carbon and distributional benefits of solar home system programs in Bangladesh. Three key findings are generated...

  9. Enriched Home Environment Program for Preschool Children with Autism Spectrum Disorders

    Science.gov (United States)

    Sood, Divya; Szymanski, Monika; Schranz, Caren

    2015-01-01

    This study discusses the impact of the Enriched Home Environment Program (EHEP) on participation in home activities among two children with ASD using case study methodology. EHEP involves occupational therapists to collaborate with families of children with ASD to educate them about the impact of factors that influence child's participation within…

  10. 7 CFR 37.11 - Publication of program assessment status.

    Science.gov (United States)

    2010-01-01

    ... CONTAINER REGULATIONS PROGRAM TO ASSESS ORGANIC CERTIFYING AGENCIES § 37.11 Publication of program... assessment; effective date of assessment; and control number(s) of official certificate(s), as applicable. (b...

  11. Home-based exercise program in TSP/HAM individuals: a feasibility and effectiveness study.

    Science.gov (United States)

    Facchinetti, Lívia D; Araújo, Abelardo Q; Silva, Marcus Tt; Leite, Ana Claudia C; Azevedo, Mariana F; Chequer, Gisele L; Oliveira, Raquel Vc; Ferreira, Arthur S; Lima, Marco Antonio

    2017-04-01

    To investigate the feasibility and effectiveness of a home-based exercise program in TSP/HAM individuals. Twenty-three TSP/HAM individuals divided in two groups according to Timed Up and Go (TUG) score (TSP/HAM.

  12. Medicaid Home Care for Tribal Health Services: A Tool Kit for Developing New Programs

    OpenAIRE

    Wallace, Steven P.; Satter, Delight E.; Zubiate, Andrea

    2003-01-01

    Planning and financing long-term care services for American Indian and Alaska Native (AIAN) elders is a challenge. Institutional care (i.e. nursing homes) is not desired by most elders and has high costs for both the elders and tribal governments. In contrast, less expensive home care can provide enough assistance to keep most disabled elders in their own or their relatives’ homes, where they prefer to be. State Medicaid programs are one source of funding for home and community based long-ter...

  13. AED use in businesses, public facilities and homes by minimally trained first responders.

    Science.gov (United States)

    Jorgenson, Dawn B; Skarr, Teresa; Russell, James K; Snyder, David E; Uhrbrock, Karen

    2003-11-01

    Automated external defibrillators (AEDs) have become increasingly available outside of the Emergency Medical Systems (EMS) community to treat sudden cardiac arrest (SCA). We sought to study the use of AEDs in the home, businesses and other public settings by minimally trained first responders. The frequency of AED use, type of training offered to first responders, and outcomes of AED use were investigated. In addition, minimally trained responders were asked if they had encountered any safety problems associated with the AED. We conducted a telephone survey of businesses and public facilities (2683) and homes (145) owning at least one AED for at least 12 months. Use was defined as an AED taken to a medical emergency thought to be a SCA, regardless of whether the AED was applied to the patient or identified a shockable rhythm. Of owners that participated in the survey, 13% (209/1581) of businesses and 5% (4/73) of homes had responded with the AED to a suspected cardiac arrest. Ninety-five percent of the businesses/public facilities offered training that specifically covered AED use. The rate of use for the AEDs was highest in residential buildings, public places, malls and recreational facilities with an overall usage rate of 11.6% per year. In-depth interviews were conducted with lay responders who had used the AED in a suspected cardiac arrest. In the four cases where the AED was used solely by a lay responder, all four patients survived to hospital admission and two were known to be discharged from the hospital. There were no reports of injury or harm. This survey demonstrates that AEDs purchased by businesses and homes were frequently taken to suspected cardiac arrests. Lay responders were able to successfully use the AEDs in emergency situations. Further, there were no reports of harm or injury to the operators, bystanders or patients from lay responder use of the AEDs.

  14. [Multidisciplinary intervention program for caregivers of patients in a home care program].

    Science.gov (United States)

    Guerrero Caballero, Laura; Ramos Blanes, Rafel; Alcolado Aranda, Ana; López Dolcet, Maria Josep; Pons La Laguna, Juan Lucas; Quesada Sabaté, Miquel

    2008-01-01

    To improve quality of life, anxiety and depression in caregivers of patients in home care. We performed a randomized clinical trial in 79 main caregivers (39 control group and 40 intervention group) of patients in the home care program of a primary care health center between 2000 and 2001. Quality of life, anxiety and depression were measured by the COOP/WONCA and Goldberg questionnaires, respectively, at the beginning and at the end of the study. Interventions consisted of two medical visits to take a bio-psychosocial history of the caregiver and a nurse visit for health education. Two letters, adapted to each carer's needs, were sent and two telephone calls were made. The intervention group scored significantly better than the control group in relation to WONCA-feelings (p=0.03), WONCA-social activities (p=0.05), and WONCA-quality of life (p=0.02). A short multidisciplinary intervention program adapted to routine consultations could prevent deterioration in caregivers' quality of life.

  15. 78 FR 27284 - Public Transportation on Indian Reservations Program; Tribal Transit Program

    Science.gov (United States)

    2013-05-09

    ... Federal Transit Administration Public Transportation on Indian Reservations Program; Tribal Transit... 5311(j) of MAP-21, Public Law 112-41 (July 6, 2012), authorizes the Public Transportation on Indian...) Fiscal Year 2013 Public Transportation on Indian Reservation Program: Request for comment, Announcement...

  16. Home Delivery Medicament Program: access, inactivity and cardiovascular risk.

    Science.gov (United States)

    Araújo, Roque da Silva; Arcuri, Edna Apparecida Moura; Lopes, Victor Cauê

    2016-10-10

    to verify causes of inactivity in the Home Delivery Medicament Program, as referred by users from a Primary Health Care Service in São Paulo, comparing them to the causes registered in the program and analyzing them in the theoretical model Concept of Access to Health. cross-sectional study, interviewing 111 inactive users; and documentary study in the program records. half of the users did not know the condition of inactivity. Discrepancies were found between the user's and the program's information, observing different levels of agreement: Absence of physician and administrative staff member 0%; Transfer to other service 25%; Death 50%; Option to quit 50%; Address change 57% and Change in therapeutic schedule 80%. The users' feeling of accepting the program was observed. In the health access concept, inactivity can be explained in the information dimension, in the degree of asymmetry between the patient's and the health professional's knowledge, identified through the indicators: education, knowledge and information sources. due to the low education level, the user does not assimilate the information on the steps of the program flowchart, does not return for the assessment that guarantees its continuity. Consequently, (s)he stops receiving the medication and spends a long time without treatment, increasing the cardiovascular risk of hypertensive (92% of the sample), diabetic (44%) and dyslipidemic patients (31%). verificar causas de inatividade no Programa Remédio em Casa, referidas por usuários de Unidade Básica de Saúde de São Paulo, comparando-as às registradas pelo programa e analisando-as no modelo teórico Conceito de Acesso à Saúde. estudo transversal entrevistando 111 usuários inativos; e documental, nos registros do programa. metade dos usuários desconhecia a condição de inatividade. Constatadas discrepâncias nas informações usuário versus programa, observando-se diferentes níveis de concordância: Falta de médico e funcion

  17. Improving patients' home cooking - A case series of participation in a remote culinary coaching program.

    Science.gov (United States)

    Polak, Rani; Pober, David M; Budd, Maggi A; Silver, Julie K; Phillips, Edward M; Abrahamson, Martin J

    2017-08-01

    This case series describes and examines the outcomes of a remote culinary coaching program aimed at improving nutrition through home cooking. Participants (n = 4) improved attitudes about the perceived ease of home cooking (p culinary skills (p = 0.02); and also improved in confidence to continue online learning of culinary skills and consume healthier food. We believe this program might be a viable response to the need for effective and scalable health-related culinary interventions.

  18. A Community-Based Home Visitation Program's Impact on Birth Outcomes.

    Science.gov (United States)

    Guo, Yuqing; Pimentel, Pamela; Lessard, Jared; Rousseau, Julie; Lee, Jung-Ah; Bojorquez, Yvette; Silva, Michele; Olshansky, Ellen

    2016-01-01

    MOMS Orange County is a coordinated home visitation program in which trained paraprofessional home visitors work under the close supervision of registered nurses. This model was developed to address health disparities in birth outcomes in a Hispanic community in Orange County, CA. The primary objective was to test the impact of MOMS Orange County on birth outcomes. The second objective was to examine the breadth of prenatal health education topics as a mediator of the relationship between home visits and birth outcomes. A retrospective cohort design was used. Paraprofessional home visitors collected prenatal and postnatal data during home visits. Only those whose birth outcomes were obtained were included in the analysis (N = 2,027 participants). Regression models were conducted to test the associations between prenatal home visits and birth outcomes, adjusting for 10 covariates. Number of prenatal home visits predicted higher birthweight and greater gestational age at birth. Breadth of health education topics partially mediated the associations between home visits and birthweight. The same mediation was revealed with gestational age at birth. The MOMS Orange County prenatal home visitation program may be a promising approach to decrease adverse birth outcomes in disadvantaged communities. Rigorously designed studies are needed to further test this model.

  19. Public health program capacity for sustainability: a new framework.

    Science.gov (United States)

    Schell, Sarah F; Luke, Douglas A; Schooley, Michael W; Elliott, Michael B; Herbers, Stephanie H; Mueller, Nancy B; Bunger, Alicia C

    2013-02-01

    Public health programs can only deliver benefits if they are able to sustain activities over time. There is a broad literature on program sustainability in public health, but it is fragmented and there is a lack of consensus on core constructs. The purpose of this paper is to present a new conceptual framework for program sustainability in public health. This developmental study uses a comprehensive literature review, input from an expert panel, and the results of concept-mapping to identify the core domains of a conceptual framework for public health program capacity for sustainability. The concept-mapping process included three types of participants (scientists, funders, and practitioners) from several public health areas (e.g., tobacco control, heart disease and stroke, physical activity and nutrition, and injury prevention). The literature review identified 85 relevant studies focusing on program sustainability in public health. Most of the papers described empirical studies of prevention-oriented programs aimed at the community level. The concept-mapping process identified nine core domains that affect a program's capacity for sustainability: Political Support, Funding Stability, Partnerships, Organizational Capacity, Program Evaluation, Program Adaptation, Communications, Public Health Impacts, and Strategic Planning. Concept-mapping participants further identified 93 items across these domains that have strong face validity-89% of the individual items composing the framework had specific support in the sustainability literature. The sustainability framework presented here suggests that a number of selected factors may be related to a program's ability to sustain its activities and benefits over time. These factors have been discussed in the literature, but this framework synthesizes and combines the factors and suggests how they may be interrelated with one another. The framework presents domains for public health decision makers to consider when developing

  20. Student stress and academic performance: home hospital program.

    Science.gov (United States)

    Yucha, Carolyn B; Kowalski, Susan; Cross, Chad

    2009-11-01

    The purpose of this study was to evaluate whether nursing students assigned to a home hospital experience less stress and improved academic performance. Students were assigned to a home hospital clinical placement (n = 78) or a control clinical placement (n = 79). Stress was measured using the Student Nurse Stress Index (SNSI) and Spielberger's State Anxiety Inventory. Academic performance included score on the RN CAT, a standardized mock NCLEX-RN(®)-type test; nursing grade point average; and first attempt pass-fail on the NCLEX-RN. There were no statistically significant differences between the two groups for age, gender, marital status, ethnicity, or score on the nurse entrance examination. There were significant changes in SNSI over time but not between groups. Academic load and state anxiety showed an interaction of time by group, with the home hospital group showing reductions over time, compared with the control group. Copyright 2009, SLACK Incorporated.

  1. 77 FR 67439 - Fiscal Year 2013 Public Transportation on Indian Reservations Program

    Science.gov (United States)

    2012-11-09

    ... Federal Transit Administration Fiscal Year 2013 Public Transportation on Indian Reservations Program.... SUMMARY: This notice announces changes in the Public Transportation on Indian Reservations program (Tribal... Public Transportation on Indian Reservations Program (Tribal Transit Program). The program authorized...

  2. Technical and scale efficiency in public and private Irish nursing homes - a bootstrap DEA approach.

    Science.gov (United States)

    Ni Luasa, Shiovan; Dineen, Declan; Zieba, Marta

    2016-10-27

    This article provides methodological and empirical insights into the estimation of technical efficiency in the nursing home sector. Focusing on long-stay care and using primary data, we examine technical and scale efficiency in 39 public and 73 private Irish nursing homes by applying an input-oriented data envelopment analysis (DEA). We employ robust bootstrap methods to validate our nonparametric DEA scores and to integrate the effects of potential determinants in estimating the efficiencies. Both the homogenous and two-stage double bootstrap procedures are used to obtain confidence intervals for the bias-corrected DEA scores. Importantly, the application of the double bootstrap approach affords true DEA technical efficiency scores after adjusting for the effects of ownership, size, case-mix, and other determinants such as location, and quality. Based on our DEA results for variable returns to scale technology, the average technical efficiency score is 62 %, and the mean scale efficiency is 88 %, with nearly all units operating on the increasing returns to scale part of the production frontier. Moreover, based on the double bootstrap results, Irish nursing homes are less technically efficient, and more scale efficient than the conventional DEA estimates suggest. Regarding the efficiency determinants, in terms of ownership, we find that private facilities are less efficient than the public units. Furthermore, the size of the nursing home has a positive effect, and this reinforces our finding that Irish homes produce at increasing returns to scale. Also, notably, we find that a tendency towards quality improvements can lead to poorer technical efficiency performance.

  3. Public programming in the archival literature: revelations from a ...

    African Journals Online (AJOL)

    The purpose of this study was to identify keywords that can be used to assist in the construction and development of public programming projects since public programming is not an indexing term in key bibliographic databases. The study was conducted using informetrics approaches and more specifically content analysis ...

  4. 18 CFR 1312.20 - Public awareness programs.

    Science.gov (United States)

    2010-04-01

    ... 18 Conservation of Power and Water Resources 2 2010-04-01 2010-04-01 false Public awareness programs. 1312.20 Section 1312.20 Conservation of Power and Water Resources TENNESSEE VALLEY AUTHORITY PROTECTION OF ARCHAEOLOGICAL RESOURCES: UNIFORM REGULATIONS § 1312.20 Public awareness programs. (a) Each...

  5. Assessment of radio frequency exposures in schools, homes, and public places in Belgium.

    Science.gov (United States)

    Verloock, Leen; Joseph, Wout; Goeminne, Francis; Martens, Luc; Verlaek, Mart; Constandt, Kim

    2014-12-01

    Characterization of exposure from emerging radio frequency (RF) technologies in areas where children are present is important. Exposure to RF electromagnetic fields (EMF) was assessed in three "sensitive" microenvironments; namely, schools, homes, and public places located in urban environments and compared to exposure in offices. In situ assessment was conducted by performing spatial broadband and accurate narrowband measurements, providing 6-min averaged electric-field strengths. A distinction between internal (transmitters that are located indoors) and external (outdoor sources from broadcasting and telecommunication) sources was made. Ninety-four percent of the broadband measurements were below 1 V m(-1). The average and maximal total electric-field values in schools, homes, and public places were 0.2 and 3.2 V m(-1) (WiFi), 0.1 and 1.1 V m(-1) (telecommunication), and 0.6 and 2.4 V m(-1) (telecommunication), respectively, while for offices, average and maximal exposure were 0.9 and 3.3 V m(-1) (telecommunication), satisfying the ICNIRP reference levels. In the schools considered, the highest maximal and average field values were due to internal signals (WiFi). In the homes, public places, and offices considered, the highest maximal and average field values originated from telecommunication signals. Lowest exposures were obtained in homes. Internal sources contributed on average more indoors (31.2%) than outdoors (2.3%), while the average contributions of external sources (broadcast and telecommunication sources) were higher outdoors (97.7%) than at indoor positions (68.8%). FM, GSM, and UMTS dominate the total downlink exposure in the outdoor measurements. In indoor measurements, FM, GSM, and WiFi dominate the total exposure. The average contribution of the emerging technology LTE was only 0.6%.

  6. 45 CFR 1306.33 - Home-based program option.

    Science.gov (United States)

    2010-10-01

    ... socialization activities must be focused on both the children and parents. They may not be conducted by the home..., DEPARTMENT OF HEALTH AND HUMAN SERVICES THE ADMINISTRATION FOR CHILDREN, YOUTH AND FAMILIES, HEAD START... hours each. (2) Provide, at a minimum, two group socialization activities per month for each child (a...

  7. Medicare Home Health Services: A Difficult Program to Control

    Science.gov (United States)

    1981-09-25

    second only to skilled nursing visits at 55.7 percent. Physical therapy visits were a distant third at 10.0 per- cent. The growth in the use of home health...from their parents. Thire are several methods available to measure the ability of an inividual to care for him or herself. For example, the Duke

  8. Social Skills and Satisfaction with Social Relationships in Home-Schooled, Private-Schooled, and Public-Schooled Children

    Science.gov (United States)

    McKinley, Marcia J.; Asaro, Jesika N.; Bergin, Jamie; D'Auria, Nicole; Gagnon, Katherine E.

    2007-01-01

    Despite the fact that 1.5 to 2.1 million children are home-schooled, there is limited research on the impact of home-schooling on children's social skills. This study compares 53 home-schooled, 49 private-schooled, and 48 public-schooled children between the ages of 8 and 12 on social skills, as measured by the Parent and Student Forms of the…

  9. Home

    Directory of Open Access Journals (Sweden)

    Rokeya Sakhawat Hossain

    2012-11-01

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

  10. Preparing tomorrow's nursing home nurses: the wisconsin long term care clinical scholars program.

    Science.gov (United States)

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J

    2015-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This article reports on the development, implementation, and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working both with older adults and in nursing homes, while increasing the capacity of nursing homes to provide a positive student experience.

  11. Preparing Tomorrow’s Nursing Home Nurses: The Wisconsin-Long Term Care Clinical Scholars Program

    Science.gov (United States)

    Nolet, Kim; Roberts, Tonya; Gilmore-Bykovskyi, Andrea; Roiland, Rachel; Gullickson, Colleen; Ryther, Brenda; Bowers, Barbara J.

    2014-01-01

    Preparing future nurses to care for the growing population of older adults has become a national priority. The demand for long term care services is expected to double between 2000 and 2040, yet the field remains stigmatized as an undesirable place for highly-skilled nurses to work. Recent efforts to increase student preparation in geriatrics have been shown to improve student attitudes toward working with older adults and increase knowledge, but long term care settings remain unattractive to students. This paper reports on development, implementation and evaluation of The Wisconsin Long Term Care Clinical Scholars Program, a nursing home internship for baccalaureate nursing students. The program couples a paid nursing home work experience with an evidence-based long term care nursing curriculum. The program increased student preparation and interest in working with older adults and in nursing homes, while concurrently increasing the capacity of nursing homes to provide a positive student experience. PMID:25162659

  12. Consideration of an applied model of public health program infrastructure.

    Science.gov (United States)

    Lavinghouze, René; Snyder, Kimberly; Rieker, Patricia; Ottoson, Judith

    2013-01-01

    Systemic infrastructure is key to public health achievements. Individual public health program infrastructure feeds into this larger system. Although program infrastructure is rarely defined, it needs to be operationalized for effective implementation and evaluation. The Ecological Model of Infrastructure (EMI) is one approach to defining program infrastructure. The EMI consists of 5 core (Leadership, Partnerships, State Plans, Engaged Data, and Managed Resources) and 2 supporting (Strategic Understanding and Tactical Action) elements that are enveloped in a program's context. We conducted a literature search across public health programs to determine support for the EMI. Four of the core elements were consistently addressed, and the other EMI elements were intermittently addressed. The EMI provides an initial and partial model for understanding program infrastructure, but additional work is needed to identify evidence-based indicators of infrastructure elements that can be used to measure success and link infrastructure to public health outcomes, capacity, and sustainability.

  13. Public Relations Program for a Shopping Mall.

    Science.gov (United States)

    Feigley, David A.

    1980-01-01

    An account is given of a highly successful sports, health, and recreation exhibit run by Rutgers University (New Jersey) in a public shopping mall. Organization and entertainment were the keynotes of the success. (LH)

  14. Modeling School Choice: A Comparison of Public, Private-Independent, Private-Religious and Home-Schooled Students

    Science.gov (United States)

    Belfield, Clive R.

    2004-01-01

    U.S. students now have four choices of schooling: public schooling, private-religious schooling, private-independent schooling, and home-schooling. Of these, home-schooling is the most novel: since legalization across the states in the last few decades, it has grown in importance and legitimacy as an alternative choice. Thus, it is now possible to…

  15. Institutions of Higher Education as Public Diplomacy Tools: China-Based University Programs for the 21st Century

    Science.gov (United States)

    Metzgar, Emily T.

    2016-01-01

    Two flagship Chinese universities are home to newly established English-language graduate programs intended to arm international cohorts of future leaders with the skills, knowledge, and insights necessary to thrive in a world in which China will play a leading role. Employing the literature of international education and public diplomacy, this…

  16. Effect of restrictions on smoking at home, at school, and in public places on teenage smoking: cross sectional study

    National Research Council Canada - National Science Library

    Wakefield, Melanie A; Chaloupka, Frank J; Kaufman, Nancy J; Orleans, C Tracy; Barker, Dianne C; Ruel, Erin E

    2000-01-01

    Abstract Objective: To determine the relation between extent of restrictions on smoking at home, at school, and in public places and smoking uptake and smoking prevalence among school students. Design...

  17. Building America: The Advanced Whole-Home Efficiency Program (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Engebrecht, C.

    2012-02-01

    This presentation discusses the Building America Program. This presentation discusses the background and goals of the program. A few hot topic technologies are discussed. Outreach activities are discussed as well.

  18. A Guide to Successful Public Private Partnerships for Youth Programs

    Science.gov (United States)

    Relave, Nanette; Deich, Sharon

    2007-01-01

    This publication is part of a series of tools and resources on financing and sustaining youth programming. These tools and resources are intended to help policymakers, program developers, and community leaders develop innovative strategies for implementing, financing, and sustaining effective programs and policies. This guide provides practical…

  19. HOME VISIT QUALITY VARIATIONS IN TWO EARLY HEAD START PROGRAMS IN RELATION TO PARENTING AND CHILD VOCABULARY OUTCOMES.

    Science.gov (United States)

    Roggman, Lori A; Cook, Gina A; Innocenti, Mark S; Jump Norman, Vonda; Boyce, Lisa K; Christiansen, Katie; Peterson, Carla A

    2016-05-01

    Home-visiting programs aiming to improve early child development have demonstrated positive outcomes, but processes within home visits to individual families are rarely documented. We examined family-level variations in the home-visiting process (N = 71) from extant video recordings of home visits in two Early Head Start programs, using an observational measure of research-based quality indicators of home-visiting practices and family engagement, the Home Visit Rating Scales (HOVRS). HOVRS scores, showing good interrater agreement and internal consistency, were significantly associated with parent- and staff-reported positive characteristics of home visiting as well as with parenting and child language outcomes tested at program exit. When home-visiting processes were higher quality during the program, home visit content was more focused on child development, families were more involved in the overall program, and most important, scores on measures of the parenting environment and children's vocabulary were higher at the end of the program. Results showed that home visit quality was indirectly associated with child language outcomes through parenting outcomes. Observation ratings of home visit quality could be useful for guiding program improvement, supporting professional development, and increasing our understanding of the links between home-visiting processes and outcomes. © 2016 Michigan Association for Infant Mental Health.

  20. Clinical impact of a home-based palliative care program: a hospice-private payer partnership.

    Science.gov (United States)

    Kerr, Christopher W; Tangeman, John C; Rudra, Carole B; Grant, Pei C; Luczkiewicz, Debra L; Mylotte, Kathleen M; Riemer, William D; Marien, Melanie J; Serehali, Amin M

    2014-11-01

    Outpatient programs have been traditionally offered in the U.S. under programs such as the Medicare Hospice Benefit. Recommendations now emphasize a blended model in which palliative care is offered concurrently with curative approaches at the onset of serious or life-limiting disease. The efficacy of nonhospice outpatient palliative care programs is not well understood. The aim of the study was to evaluate the clinical impact of a home-based palliative care program, Home Connections, implemented as a partnership between a not-for-profit hospice and two private insurers. This was a prospective, observational, database study of 499 Home Connections participants enrolled between July 1, 2008, and May 31, 2013. Measured outcomes were advance directive completion, site of death, symptom severity over time, program satisfaction, and hospice referral and average length of stay. Seventy-one percent of participants completed actionable advance directives after enrollment, and the site of death was home for 47% of those who died during or after participation in the program. Six of eight symptom domains (anxiety, appetite, dyspnea, well-being, depression, and nausea) showed improvement. Patients, caregivers, and physicians gave high program satisfaction scores (93%-96%). Home Connections participants who subsequently enrolled in hospice care had a longer average length of stay of 77.9 days compared with all other hospice referrals (average length of stay 56.5 days). A home-based palliative care program was developed between two local commercial payers and a not-for-profit hospice. Not only did this program improve symptom management, advance directive completion, and satisfaction, but it also facilitated the transition of patients into hospice care, when appropriate. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  1. Building Our Future: The Public Library Leadership Fellows Program

    Directory of Open Access Journals (Sweden)

    Lita Barrie

    2012-06-01

    Full Text Available As the 21st Century unfolds, public libraries and their leaders will face unique issues that warrant focused thought, research, discussion and visioning. The Canadian Urban Libraries Council (CULC, in partnership with the iSchool Institute, University of Toronto is seeking to help prepare leaders with the launch of the new executive Public Library Leadership Fellows (PLLF program. The goal of the PLLF program is to contribute to the vitality and success of public libraries and the diverse communities they serve by positioning public library professionals to be proactive, effective leaders in the global information environment. The Public Library Leadership Fellows program (PLLF is about the future of public libraries and the changing communities they serve.

  2. Impact of NASA's Astrophysics Education and Public Outreach Programs

    Science.gov (United States)

    Smith, Denise A.; Hasan, H.

    2014-01-01

    NASA has through the years developed a diverse portfolio of Education and Public Outreach (E/PO) programs that have taken the science of NASA's Astrophysics missions into classrooms, museums, planetaria and other public venues. From lesson plans, teacher workshops, public exhibitions, to social media and citizen science, these programs have reached vast audiences internationally. NASA's Science and Education Outreach Forums have developed valuable resources, such as NASA Wavelength, which is a user friendly website of a catalog of NASA's E/PO programs. A sample of programs and their metrics will be presented to demonstrate the impact of the NASA Science Mission Directorate E/PO program in providing a direct return on the public's investment in NASA science.

  3. EFFECT OF A HOME EXERCISE TRAINING-PROGRAM IN PATIENTS WITH CYSTIC-FIBROSIS

    NARCIS (Netherlands)

    DEJONG, W; GREVINK, RG; ROORDA, RJ; KAPTEIN, AA; VANDERSCHANS, CP

    Physical training in patients with pulmonary diseases, including cystic fibrosis (CF), may improve exercise tolerance in these patients. Most training programs are performed in a clinical setting. Little information is available concerning the effect of home exercise training programs in CF

  4. Jump-Starting Early Childhood Education at Home: Early Learning, Parent Motivation, and Public Policy.

    Science.gov (United States)

    Maloney, Erin A; Converse, Benjamin A; Gibbs, Chloe R; Levine, Susan C; Beilock, Sian L

    2015-11-01

    By the time children begin formal schooling, their experiences at home have already contributed to large variations in their math and language development, and once school begins, academic achievement continues to depend strongly on influences outside of school. It is thus essential that educational reform strategies involve primary caregivers. Specifically, programs and policies should promote and support aspects of caregiver-child interaction that have been empirically demonstrated to boost early learning and should seek to impede "motivational sinkholes" that threaten to undermine caregivers' desires to engage their children effectively. This article draws on cognitive and behavioral science to detail simple, low-cost, and effective tools caregivers can employ to prepare their children for educational success and then describes conditions that can protect and facilitate caregivers' motivation to use those tools. Policy recommendations throughout focus on using existing infrastructure to more deeply engage caregivers in effective early childhood education at home. © The Author(s) 2015.

  5. Preliminary Data on a Care Coordination Program for Home Care Recipients.

    Science.gov (United States)

    Dean, Katie M; Hatfield, Laura A; Jena, Anupam B; Cristman, David; Flair, Michael; Kator, Kylie; Nudd, Geoffrey; Grabowski, David C

    2016-09-01

    Home care recipients are often hospitalized for potentially avoidable reasons. A pilot program (Intervention in Home Care to Improve Health Outcomes (In-Home)) was designed to help home care providers identify acute clinical changes in condition and then manage the condition in the home and thereby avoid a costly hospitalization. Caregivers answer simple questions about the care recipient's condition during a telephone-based "clock-out" at the end of each shift. Responses are electronically captured in the agency management software that caregivers use to "clock-in," manage care, and "clock-out" on every shift. These are transmitted to the agency's care manager, who follows up on the change in condition and escalates appropriately. A description of the In-Home model is presented, and pilot data from 22 home care offices are reported. In the pilot, caregivers reported a change in condition after 2% of all shifts, representing an average of 1.9 changes per care recipient in a 6-month period. Changes in behavior and skin condition were the most frequently recorded domains. Interviews with participating caregivers and care managers suggested positive attitudes regarding the intervention; challenges included resistance to change on the part of home care staff and difficulties in applying a uniform intervention to individuals with varying needs in home care offices with varying capacities. In an ongoing randomized trial, the success of the overall program will be measured primarily according to the potential reduction in avoidable hospitalizations of home care recipients and the effect this potential reduction has on spending and healthcare outcomes. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  6. 76 FR 45253 - Public Water Supply Supervision Program; Program Revision for the State of Alaska

    Science.gov (United States)

    2011-07-28

    ... AGENCY Public Water Supply Supervision Program; Program Revision for the State of Alaska AGENCY... State of Alaska has revised its approved State Public Water Supply Supervision Primacy Program. Alaska has adopted regulations analogous to the EPA's Ground Water Rule. The EPA has determined that these...

  7. 76 FR 5157 - Public Water Supply Supervision Program; Program Revision for the State of Alaska

    Science.gov (United States)

    2011-01-28

    ... AGENCY Public Water Supply Supervision Program; Program Revision for the State of Alaska AGENCY... that the State of Alaska has revised its approved State Public Water Supply Supervision Primacy Program...; Long Term 2 Enhanced Surface Water Treatment Rule; and Lead and Copper Short-Term Regulatory Revisions...

  8. 78 FR 42945 - Public Water Supply Supervision Program; Program Revision for the State of Oregon

    Science.gov (United States)

    2013-07-18

    ... AGENCY Public Water Supply Supervision Program; Program Revision for the State of Oregon AGENCY... that the State of Oregon has revised its approved State Public Water Supply Supervision Primacy Program...; Long Term 2 Enhanced Surface Water Treatment Rule; Ground Water Rule; and Lead and Copper Short-Term...

  9. [Home parenteral nutrition (HPN): feasibility of its implementation from a public hospital].

    Science.gov (United States)

    Fabeiro, M; Dalieri, M; Martínez, M; Galarraga, M; Prozzi, M; Barcellandi, P; Hernández, J; Alberti, M J; Fernández, A

    2011-01-01

    The intensive care of patients at home had probed important beneficialness for the patient and the Health System. There are very few experiences of this kind of care from the Public Hospitals. To develop a social-sanitary analysis of the feasibility of the implementation of HPN on patients with short bowel syndrome (SBS) from a Public Hospital. Patients hospitalized between 1985-2009 were included. We analyzed: age, residual intestine length (RIL), time between de indication and the beginning of HPN, HPN duration, treatment modality and clinical outcome. Social determinants: home place, habitat conditions, employment conditions, educational level, social security and Low Socioeconomic Status (LSS). The group were divided in two: 1- patients with feasibility of HPN when it was prescribed; 2- patients without feasibility of HPN. 61 patients were included, RIL x: 21.7 ± 11.6 cm. The HPN was feasible (G1) in 32 patients (52.4%) and no feasible (G2) in 29 (47.6%). The home treatment modality was in self-caring 25 (81%) and with nurses support 7 (19 %). The social determinants associated with the HPN feasibility were: more than one takecare (p 0.03), educational level (p 0.01), adequate habitat conditions (p 0.02) and Low Socioeconomis Status (LSS) (p 0.07). 17 patients reached intestinal adaptation (28%), 6 (10%) were transplanted, 19 (31%) died and 19 (31%) are actually on HPN. The HPN realized from the Public Hospital is feasible. Different social determinants were observed. The care of this group of patients must be done by an interdisciplinary group including general aspects of the child and the family.

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

    Science.gov (United States)

    Walus, Ashley N; Woloschuk, Donna M M

    2017-01-01

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

  11. [The "Duisgurg model" of intensified control of nursing homes and homes for the aged by the Duisberg public health services in cooperation with the Duisburg social welfare offices].

    Science.gov (United States)

    Martin, U; Behler, R

    1999-07-01

    This is a report on the joint cooperative control of nursing and old-age homes by the Public Health and Social Welfare Offices in Duisburg, Germany. A total of 40 of such homes were inspected and checked jointly by the physician and pharmacist of the local Public Health Office within a one-year period while collecting data on the intensity and quality of care in these homes. A total of 3883 inmates were covered. These data included, inter alia, information on the intensity of care, prevalence of urinary and fecal incontinence, feeding by means of percutaneous endoscopic gastrostomy, prevalence of bedridden patients and of cases of pressure sores. The data conveyed information on the overall situation (frequencies for all the Duisburg nursing and old-age homes) on the one hand, and for each individual home on the basis of its particular data on the other hand. It became evident that two-thirds of all the inmates of nursing homes were classified as belonging to nursing stages II and III. Urinary incontinence was present in 63 per cent of the cases, fecal incontinence in 43 per cent, whereas 32 per cent were severely confused. Of a total of 447 permanently bedridden patients (11.5 per cent of all the inmates) 131 had pressure sores or necroses of the heels (3.37 per cent of the total population). More than one-half of the pressure sores had been acquired by the patients during their hospital stay, i.e. before their referral to a home, whereas 56 inmates developed their pressure sores in the homes concerned.

  12. A comparison of Tier 1 and Tier 3 medical homes under Oklahoma Medicaid program.

    Science.gov (United States)

    Kumar, Jay I; Anthony, Melody; Crawford, Steven A; Arky, Ronald A; Bitton, Asaf; Splinter, Garth L

    2014-04-01

    The patient-centered medical home (PCMH) is a team-based model of care that seeks to improve quality of care and control costs. The Oklahoma Health Care Authority (OHCA) directs Oklahoma's Medicaid program and contracts with 861 medical home practices across the state in one of three tiers of operational capacity: Tier 1 (Basic), Tier 2 (Advanced) and Tier 3 (Optimal). Only 13.5% (n = 116) homes are at the optimal level; the majority (59%, n = 508) at the basic level. In this study, we sought to determine the barriers that prevented Tier 1 homes from advancing to Tier 3 level and the incentives that would motivate providers to advance from Tier 1 to 3. Our hypotheses were that Tier 1 medical homes were located in smaller practices with limited resources and the providers are not convinced that the expense of advancing from Tier 1 status to Tier 3 status was worth the added value. We analyzed OHCA records to compare the 508 Tier 1 (entry-level) with 116 Tier 3 (optimal) medical homes for demographic differences with regards to location: urban or rural, duration as medical home, percentage of contracts that were group contracts, number of providers per group contract, panel age range, panel size, and member-provider ratio. We surveyed all 508 Tier 1 homes with a mail-in survey, and with focused follow up visits to identify the barriers to, and incentives for, upgrading from Tier 1 to Tier 2 or 3. We found that Tier 1 homes were more likely to be in rural areas, run by solo practitioners, serve exclusively adult panels, have smaller panel sizes, and have higher member-to-provider ratios in comparison with Tier 3 homes. Our survey had a 35% response rate. Results showed that the most difficult changes for Tier 1 homes to implement were providing 4 hours of after-hours care and a dedicated program for mental illness and substance abuse. The results also showed that the most compelling incentives for encouraging Tier 1 homes to upgrade their tier status were less

  13. Bennett Public Schools Principal Induction Program

    Science.gov (United States)

    Wilson, Ross; Beaudoin, Colleen; Carmona, Ruben; Delahanty, Michael; Gartside, William; Oyedele, Abidemi; Teta, Lynne Mooney

    2012-01-01

    Ensuring equity in education and academic success for all students requires a highly skilled principal engages others in continually improving the instructional program in order to meet the needs of students. Over the past few years, a number of reports have indicated that the role of principal is becoming more challenging. School districts are…

  14. Strength at Home Couples Program to Prevent Military Partner Violence

    Science.gov (United States)

    2016-10-01

    occurring in military families and to develop skills to build resilience with respect to the impacts of trauma on relationships. 15. SUBJECT TERMS- 16...Couples Program to Prevent Military Partner Violence PT140092, Psychological Health/Traumatic Brain Injury Research Program W81XWH-14-PHTBI-PHRA PI

  15. Understanding social media program usage in public transit agencies

    OpenAIRE

    Jenny H. Liu; Wei Shi; O.A. (Sam) Elrahman; Xuegang (Jeff) Ban; Jack M. Reilly

    2016-01-01

    Social media has been gaining prominence in public transit agencies in their communication strategies and daily management. This study aims to better understand recent trends in social media usage in public transit agencies, to examine which agencies use what kind of social media programs for what purposes, and how they measure their programs. A survey was conducted of the top transit agencies in the nation, and results are examined through descriptive statistical analysis, correlation analys...

  16. Financial Participation Programs in Polish Public Companies

    Directory of Open Access Journals (Sweden)

    Maciej Kozlowski

    2014-12-01

    Full Text Available The major purpose of this article is to analyze the most important FP programs in Poland in order to increase knowledge on the subject and to show the occurring relations between the programs applied and the socioeconomic results of enterprises. The emphasis has been put on showing the multidimensional relationships between employee financial ownership and economic results, as well as on proving the relationship mechanisms of employee ownership on productivity are complex interactions by nature. Additionally, it has helped to separate crucial characteristic features of the applied forms of FP. This empirical approach concentrates on qualitative research and not quantitative, which although broad based, does not precisely identify the aforementioned relationships too precisely.

  17. End-of-life care in U.S. nursing homes: nursing homes with special programs and trained staff for hospice or palliative/end-of-life care.

    Science.gov (United States)

    Miller, Susan C; Han, Beth

    2008-07-01

    The degree to which nursing homes have internal programs for hospice and palliative care is unknown. We used self-reported data from the 2004 National Nursing Home Survey (NNHS) to estimate the prevalence of special programs and (specially) trained staff (SPTS) for hospice or palliative/end-of-life care in U.S. nursing homes. Factors associated with the presence of SPTS for hospice or palliative/end-of-life care were identified. We merged 2004 NNHS data for 1174 nursing homes to county-level data from the 2004 Area Resource File and to Nursing Home 2004 Online Survey, Certification, and Reporting data. chi(2) tests and logistic regression models were applied. Twenty-seven percent of U.S. nursing homes reported (internal) SPTS for hospice or palliative/end-of-life care. After controlling for covariates, we found nonprofit status, being in the southern region of the United States, having an administrator certified by the American College of Health Care Administrators, contracting with an outside hospice provider, and having other specialty programs to be associated with a greater likelihood of nursing homes having SPTS for hospice or palliative/end-of-life care. The largest effects were observed for nursing homes with programs for behavioral problems (adjusted odds ratio [AOR] 3.59; 95% confidence interval [CI] 2.40, 5.37) and for pain management (AOR 5.92; 95% CI 4.09, 8.57). The presence of internal SPTS for hospice or palliative/end-of-life care is prevalent in U.S. nursing homes, and may be preceded by hospice contracting and/or the implementation of specialty programs that assist nursing homes in developing the expertise needed to establish their own palliative care programs.

  18. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program.

    Science.gov (United States)

    Markiewicz, Milissa; Bevc, Christine A; Hegle, Jennifer; Horney, Jennifer A; Davies, Megan; MacDonald, Pia D M

    2012-02-23

    In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.

  19. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program

    Directory of Open Access Journals (Sweden)

    Markiewicz Milissa

    2012-02-01

    Full Text Available Abstract Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1 elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2 examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public

  20. Perceptions of user studies as a foundation for public programming ...

    African Journals Online (AJOL)

    The purpose of this study was to examine the role of user studies and the evaluation of services in the development of effective public programming initiatives by the public archives of east and southern Africa. Users of the archives are the backbone of effective archival services. Sadly, it appears that the records are more ...

  1. 24 CFR 1003.507 - Public access to program records.

    Science.gov (United States)

    2010-04-01

    ... Development (Continued) OFFICE OF ASSISTANT SECRETARY FOR PUBLIC AND INDIAN HOUSING, DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT COMMUNITY DEVELOPMENT BLOCK GRANTS FOR INDIAN TRIBES AND ALASKA NATIVE VILLAGES Grant... 24 Housing and Urban Development 4 2010-04-01 2010-04-01 false Public access to program records...

  2. Growing interest, growing programs, growing pains: Successfully customizing public outreach

    Energy Technology Data Exchange (ETDEWEB)

    Wadkins, M.; Hill, C.; Hirsch, T. [SAIC, Las Vegas, NV (United States)

    1994-12-31

    Since the mid-1980`s, the Institutional and External Affairs staff of the Yucca Mountain Site Characterization Project (YMP) has developed, coordinated, and maintained various public outreach programs to carry out the YMP`s open door policy of keeping local communities informed. However, public involvement first requires public knowledge and, therefore, various information programs have been established over the past few years. First came the speakers bureau program, then the exhibits and science centers; and then came the tours and school district educational programs. All these programs were geared toward teaching the mainstream general public about the YMP and issues related to things nuclear. Today, the YMP outreach programs are established and known and the demand from the public has seen a shift. Over 150 top scientists and staff from around the country who have come to work at the YMP have joined the outreach participant pool to speak to the public not only about Yucca Mountain, but about their areas of expertise as well. For this reason, the public has realized a great opportunity for a general science and engineering education resource -- the YMP staff themselves. In a panel discussion, {open_quotes}Trust and credibility: The central issue{close_quotes}, proceedings of the National Conference on Risk Communication, it was shown that university professors and science teachers were among the most trusted individuals in terms of public perception and that government staff and contractors the least trusted. However, when you utilize the core educated knowledge of a YMP scientist in order to teach general science and math, you have, to some extent, placed that individual in an educational role and thus increased trust. The YMP scientists enjoy talking about their general science knowledge and we have found that the public likes to hear about it too.

  3. The Program Sustainability Assessment Tool: a new instrument for public health programs.

    Science.gov (United States)

    Luke, Douglas A; Calhoun, Annaliese; Robichaux, Christopher B; Elliott, Michael B; Moreland-Russell, Sarah

    2014-01-23

    Public health programs can deliver benefits only if they are able to sustain programs, policies, and activities over time. Although numerous sustainability frameworks and models have been developed, there are almost no assessment tools that have demonstrated reliability or validity or have been widely disseminated. We present the Program Sustainability Assessment Tool (PSAT), a new and reliable instrument for assessing the capacity for program sustainability of various public health and other programs. A measurement development study was conducted to assess the reliability of the PSAT. Program managers and staff (n = 592) representing 252 public health programs used the PSAT to rate the sustainability of their program. State and community-level programs participated, representing 4 types of chronic disease programs: tobacco control, diabetes, obesity prevention, and oral health. The final version of the PSAT contains 40 items, spread across 8 sustainability domains, with 5 items per domain. Confirmatory factor analysis shows good fit of the data with the 8 sustainability domains. The subscales have excellent internal consistency; the average Cronbach's α is 0.88, ranging from 0.79 to 0.92. Preliminary validation analyses suggest that PSAT scores are related to important program and organizational characteristics. The PSAT is a new and reliable assessment instrument that can be used to measure a public health program's capacity for sustainability. The tool is designed to be used by researchers, evaluators, program managers, and staff for large and small public health programs.

  4. Drunk Driving Public Information Program Strategies and Planning Guide.

    Science.gov (United States)

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This guide, designed to accompany a videocassette of selected television spots is a compendium of specific drunk driving topics and issues for each of the major planning steps of a public information program. The guide is organized around these steps, which are (1) select program strategies, (2) select target audiences, (3) select media channels,…

  5. SKI*HI Home-Based Programming for Children with Hearing Impairments: Demographics, Child Identification, and Program Effectiveness, 1979-1991.

    Science.gov (United States)

    Strong, Carol J.; And Others

    SKI*HI is a program designed to identify children with hearing impairments as early as possible and to provide them and their families with complete home programming that will facilitate development. The delivery model includes identification/screening services, home visit services, support services, and program management. A parent advisor makes…

  6. Denmark’s Master of Public Governance Program

    DEFF Research Database (Denmark)

    Greve, Carsten; Pedersen, Anne Reff

    2017-01-01

    This paper focuses on Denmark’s Master of Public Governance and its assessments and lessons learned. Denmark is seen to have an efficient economy and public sector, a digitalized public service delivery system, and an advanced work–life balance. The Danish government invested substantial resources...... innovative teaching ideas. Lessons learned include the necessity of securing back-up from the government for a program of this considerable size, offering a flexible array of accessible and up-to-date courses and ensuring collaboration between universities offering the program...

  7. 77 FR 19306 - Announcement of Funding Awards: Office of Healthy Homes and Lead Hazard Control Grant Programs...

    Science.gov (United States)

    2012-03-30

    ... URBAN DEVELOPMENT Announcement of Funding Awards: Office of Healthy Homes and Lead Hazard Control Grant Programs for Fiscal Year (FY) 2011 AGENCY: Office of Healthy Homes and Lead Hazard Control, HUD. ACTION... made by the Department in competitions for funding under the Office of Healthy Homes and Lead Hazard...

  8. The effect of a "surveillance nurse" telephone support intervention in a home care program.

    Science.gov (United States)

    Kelly, Ronald; Godin, Lori

    2015-01-01

    This study is an evaluation of a unique "surveillance nurse" telephone support intervention for community-dwelling elderly individuals in a home care program. A combined propensity-based covariate-matching procedure was used to pair each individual who received the intervention ("treatment" condition, nT = 930) to a similar individual who did not receive the intervention ("control" condition, nC1 = 930) from among a large pool of potential control individuals (nC0 = 4656). The intervention consisted of regularly scheduled telephone calls from a surveillance nurse to proactively assess the individual's well-being, care plan status, use of and need for services (home support, adult day program, physiotherapy, etc.) and home environment (e.g., informal caregiver support). Treatment and control conditions were compared with respect to four service utilization outcomes: (1) rate of survival in the community before institutionalization in an assisted living or nursing home facility or death, (2) rate of emergency room registrations, (3) rate of acute care hospitalizations, and (4) rate of days in hospital, during home care enrollment. Results indicated a beneficial effect of the surveillance nurse intervention on reducing rate of service utilization by increasing the duration of the home care episode. Crown Copyright © 2015. Published by Elsevier Inc. All rights reserved.

  9. HANFORDS PUBLIC TOUR PROGRAM - AN EXCELLENT EDUCATIONAL TOOL

    Energy Technology Data Exchange (ETDEWEB)

    SINCLAIR KM

    2010-12-07

    Prior to 2001, the Department of Energy (DOE) sponsored limited tours of the Hanford Site for the public, but discontinued the program after the 9/11 terrorist attacks on the U.S. In 2003, DOE's Richland Operations Office (DOE-RL) requested the site's prime contractor to reinstate the public tour program starting in 2004 under strict controls and security requirements. The planning involved a collaborative effort among the security, safety and communications departments of DOE-RL and the site's contracting companies. This paper describes the evolution of, and enhancements to, Hanford's public tours, including the addition of a separate tour program for the B Reactor, the first full-scale nuclear reactor in the world. Topics included in the discussion include the history and growth of the tour program, associated costs, and visitor surveys and assessments.

  10. 77 FR 33456 - Public Water Supply Supervision Program; Program Revision for the State of Washington

    Science.gov (United States)

    2012-06-06

    ... AGENCY Public Water Supply Supervision Program; Program Revision for the State of Washington AGENCY... that the State of Washington has revised its approved State Public Water Supply Supervision Primacy... Water, ] 243 Israel Road SE., 2nd floor, Tumwater, Washington 98501 and between the hours of 9:00 a.m...

  11. Palliative sedation for cancer patients included in a home care program: a retrospective study.

    Science.gov (United States)

    Calvo-Espinos, Claudio; Ruiz de Gaona, Estefania; Gonzalez, Cristina; Ruiz de Galarreta, Lucia; Lopez, Cristina

    2015-06-01

    Palliative sedation is a common treatment in palliative care. The home is a difficult environment for research, and there are few studies about sedation at home. Our aim was to analyze this practice in a home setting. We conducted a retrospective cross-sectional descriptive study in a home cohort during 2011. The inclusion criteria were as follows: 18 years or older and enrolled in the Palliative Home Care Program (PHCP) with advanced cancer. The variables employed were: sex, age, primary tumor location, and place of death. We also registered indication, type, drug and dose, awareness of diagnosis and prognosis, consent, survival, presence or absence of rales, painful mouth, and ulcers in patients sedated at home. We also collected the opinions of family members and professionals about the suffering of sedated patients. A total of 446 patients (56% at home) of the 617 admitted to the PHCP between January and December of 2011 passed away. The typical patient in our population was a 70-year-old man with a lung tumor. Some 35 (14%) home patients required sedation, compared to 93 (49%) at the hospital. The most frequent indication was delirium (70%), with midazolam the most common drug (mean dose, 40 mg). Survival was around three days. Rales were frequent (57%) as well as awareness of diagnosis and prognosis (77 and 71%, respectively). Perception of suffering after sedation was rare among relatives (17%) and professionals (8%). In most cases, the decision was made jointly by professionals and family members. Our study confirmed the role of palliative sedation as an appropriate therapeutic tool in the home environment.

  12. Evaluation of a public health nurse visiting program for pregnant and parenting teens.

    Science.gov (United States)

    Schaffer, Marjorie A; Goodhue, Amy; Stennes, Kaye; Lanigan, Cheryl

    2012-01-01

    A visiting nurse agency created the Pregnant and Parenting Team Program, an innovative program for serving pregnant and parenting teen mothers to promote family and child health and family self-sufficiency. Public health nurses (PHNs) provide home visits that offer social, emotional, educational, and health care support to pregnant and parenting teen mothers 19 years of age and younger and their children. Foundational program pillars include: (1) a trusting relationship between teen mothers and a PHN through home visits; (2) outreach and coordination with schools, hospital, clinics, and human service agencies; (3) a comprehensive and intensive maternal mental health curriculum; and (4) community support and caring through provision of essential items needed for success in parenting. Measures of program effectiveness included identification of pregnant and parenting adolescent mothers, birth outcomes, active enrollment in school, delay of repeat pregnancy, maternal-infant bonding and attachment, use of community resources, and infant growth and development. Participants in the program were more likely to be enrolled in school and had better birth outcomes in comparison with nonparticipants. Outcome data collected from January 1, 2008 to July 23, 2010 demonstrated progress toward stated goals. © 2012 Wiley Periodicals, Inc.

  13. A STUDY OF THE REQUIRED PUBLIC ACCOUNTING PROGRAM IN PUBLIC COMPETITIVE EXAMINATIONS HELD BY CESPE

    Directory of Open Access Journals (Sweden)

    Fátima de Souza Freire

    2012-11-01

    Full Text Available With a view to standardizing the contents offered to future Accounting professionals, the Federal Accounting Council (CFC elaborated the National Proposal for Undergraduate Accountancy Program Contents. Thus, the curriculum that Higher Education Institutions (HEI adopt serves as an ally for students’ professional conquests. Stability and favorable job conditions attract many people to the dispute for a public function, with a growing Braz ilian public competitive examination market. According to the National Association for Protection and Support to Public Competitive Examinations (Anpac, between 2003 and 2009, the number of public servants in the executive power with a higher education degree in Brazil increased by 26%. The aim of this study was to confront the CFC’s suggested knowledge with the contents required during tests applied in public competitive examinations for Accountancy professionals. The intent is to identify what Public Accounting knowledge is demanded from candidates for the public career. Through a documentary research, 561 calls from public competitive examinations exclusively for Accountancy professionals were selected for the study sample. They were classified according to the proposed program contents, the test questions by the Center for Selection and Event Promotion (Cespe, between 2000 and 2009. In conclusion, the most frequent required Public Accounting areas are contents related to Public Equity and Budget. The results demonstrate that the CFC’s suggested content is in line with the knowledge required from candidates for public functions.

  14. Keys to the House: Unlocking Residential Savings With Program Models for Home Energy Upgrades

    Energy Technology Data Exchange (ETDEWEB)

    Grevatt, Jim [Energy Futures Group (United States); Hoffman, Ian [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hoffmeyer, Dale [US Department of Energy, Washington, DC (United States)

    2017-07-05

    After more than 40 years of effort, energy efficiency program administrators and associated contractors still find it challenging to penetrate the home retrofit market, especially at levels commensurate with state and federal goals for energy savings and emissions reductions. Residential retrofit programs further have not coalesced around a reliably successful model. They still vary in design, implementation and performance, and they remain among the more difficult and costly options for acquiring savings in the residential sector. If programs are to contribute fully to meeting resource and policy objectives, administrators need to understand what program elements are key to acquiring residential savings as cost effectively as possible. To that end, the U.S. Department of Energy (DOE) sponsored a comprehensive review and analysis of home energy upgrade programs with proven track records, focusing on those with robustly verified savings and constituting good examples for replication. The study team reviewed evaluations for the period 2010 to 2014 for 134 programs that are funded by customers of investor-owned utilities. All are programs that promote multi-measure retrofits or major system upgrades. We paid particular attention to useful design and implementation features, costs, and savings for nearly 30 programs with rigorous evaluations of performance. This meta-analysis describes program models and implementation strategies for (1) direct install retrofits; (2) heating, ventilating and air-conditioning (HVAC) replacement and early retirement; and (3) comprehensive, whole-home retrofits. We analyze costs and impacts of these program models, in terms of both energy savings and emissions avoided. These program models can be useful guides as states consider expanding their strategies for acquiring energy savings as a resource and for emissions reductions. We also discuss the challenges of using evaluations to create program models that can be confidently applied in

  15. Effects of a Comprehensive Predialysis Education Program on the Home Dialysis Therapies: A Retrospective Cohort Study.

    Science.gov (United States)

    Shukla, Ashutosh M; Easom, Andrea; Singh, Manisha; Pandey, Richa; Rotaru, Dumitru; Wen, Xuerong; Shah, Sudhir V

    2017-01-01

    Improvement in the rates of home dialysis has been a desirable but difficult-to-achieve target for United States nephrology. Provision of comprehensive predialysis education (CPE) in institutes with established home dialysis programs has been shown to facilitate a higher home dialysis choice amongst chronic kidney disease (CKD) patients. Unfortunately, limited data have shown the efficacy of such programs in the United States or in institutes with small home dialysis (HoD) programs. We report the retrospective findings examining the efficacy of a CPE program in the early period after its establishment, with reference to its impact on the choice and growth of a small HoD program. Over the initial 22 months since its inception, 108 patients were enrolled in the CPE clinic. Seventy percent of patients receiving CPE chose HoD, of which 55% chose peritoneal dialysis (PD) and 15% chose home hemodialysis (HHD). Rates of HoD choice were similar across the spectrum of socio-economic variables. Of just over half (54.6%) of those choosing to return for more than 1 session, 25.3%, changed their modality preference after the first education session, and nearly all reached a final modality selection by the end of the third visit. Initiation of the CPE program resulted in a 216% growth in HoD census over the same period and resulted in near doubling of HoD prevalence to 38% of all dialysis patients. Comprehensive patient education improves the choice and prevalence of HoD therapies. We further find that 3 sessions of CPE may provide needed resources for the large majority of subjects for adequate decision-making. Copyright © 2017 International Society for Peritoneal Dialysis.

  16. Modeling school choice: A comparison of public, private-independent, private-religious and home-schooled students

    OpenAIRE

    Belfield, Clive R.

    2004-01-01

    U.S. students now have four choices of schooling: public schooling, private–religious schooling, private–independent schooling, and home-schooling. Of these, home-schooling is the most novel: since legalization across the states in the last few decades, it has grown in importance and legitimacy as an alternative choice. Thus, it is now possible to investigate the motivation for home-schooling, relative to the other schooling options. Here, we use two recent large-scale datasets to assess the ...

  17. Expanded adult day program as a transition option from hospital to home.

    Science.gov (United States)

    Jones, Katherine R; Tullai-McGuinness, Susan; Dolansky, Mary; Farag, Amany; Krivanek, Mary Jo; Matthews, Laura

    2011-02-01

    This article describes a pilot program for provision of postacute care (PAC) in an established adult day program. Demographic, clinical, utilization, and satisfaction data were abstracted retrospectively from program records; postdischarge readmission and emergency department visit data were obtained from the electronic health record. Comparative data were obtained from the health records of patients who were offered but declined the adult day program. Between 2005 and 2008, 78 patients requiring PAC were approached by the RN coordinator; 33 selected the adult day program, and 45 selected alternative destinations. The majority of patients had a neurological diagnosis, most commonly stroke. Participants and their family caregivers were highly satisfied with the program. The 30-day readmission rate for adult day program participants was significantly lower than that for nonparticipants. An expanded adult day program may represent a viable Transitional Care Model for selected patients and a feasible alternative to skilled nursing facility and home health care for PAC.

  18. 75 FR 27114 - Public Transportation on Indian Reservations Program; Tribal Transit Program

    Science.gov (United States)

    2010-05-13

    ... Federal Transit Administration Public Transportation on Indian Reservations Program; Tribal Transit... availability of $15,074,963 million in funding provided by the Public Transportation on Indian Reservations.... Overview Section 3013 of SAFETEA-LU, amended 49 U.S.C. 5311(c) by establishing the Public Transportation on...

  19. 76 FR 19087 - Energy Conservation Program for Consumer Products: Publication of the Petition for Waiver and...

    Science.gov (United States)

    2011-04-06

    ... announces receipt of and publishes the BSH Home Appliances Corporation (BSH) petition for waiver (hereafter... Home Appliances Corporation (``BSH'') hereby submits this Petition for Waiver and Application for...: Publication of the Petition for Waiver and Notice of Granting the Application for Interim Waiver of BSH Home...

  20. Pilot States Program report: Home energy ratings systems and energy-efficient mortgages

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B.

    2000-04-04

    This report covers the accomplishments of the home energy ratings systems/energy-efficient mortgages (HERS/EEMs) pilot states from 1993 through 1998, including such indicators as funding, ratings and EEMs achieved, active raters, and training and marketing activities. A brief description of each HERS program's evolution is included, as well as their directors' views of the programs' future prospects. Finally, an analysis is provided of successful HERS program characteristics and factors that appear to contribute to HERS program success.

  1. 75 FR 39641 - Medicare and Medicaid Programs; Civil Money Penalties for Nursing Homes

    Science.gov (United States)

    2010-07-12

    ... and Medicaid Programs; Civil Money Penalties for Nursing Homes AGENCY: Centers for Medicare & Medicaid... Medicare and Medicaid regulations regarding the imposition and collection of civil money penalties by CMS... one of the ways listed): 1. Electronically. You may submit electronic comments on this regulation to...

  2. Home-based alcohol prevention program for parents and children: A randomized controlled trial

    NARCIS (Netherlands)

    Mares, S.H.W.; Lichtwarck-Aschoff, A.; Verdurmen, J.E.E.; Schulten, I.G.H.; Engels, R.C.M.E.

    2016-01-01

    Objective: To evaluate the effectiveness of a home-based alcohol prevention program to delay initiation of alcohol use in children. Methods: In 2011, a total of 1349 sixth-grade children (M = 12.15, SD = 0.47) and their mothers who could read and write Dutch were recruited from primary schools in

  3. Promoting an Alcohol-Free Childhood: A Novel Home-Based Parenting Program

    Science.gov (United States)

    Dickinson, Denise M.; Hayes, Kim A.; Jackson, Christine; Ennett, Susan T.; Lawson, Caroline

    2014-01-01

    Few alcohol prevention programs focus on elementary school-aged youth, yet children develop expectancies and norms about alcohol use during the elementary school years, and many elementary school children are allowed to have sips or tastes of alcohol at home. Research on consequences of early alcohol use indicates that it can put children at…

  4. Occupational Therapy Home Program for Children with Intellectual Disabilities: A Randomized, Controlled Trial

    Science.gov (United States)

    Wuang, Yee-Pay; Ho, Guang-Sheng; Su, Chwen-Yng

    2013-01-01

    This study aimed to investigate the effectiveness of a proposed occupational therapy home program (OTHP) for children with intellectual disabilities (ID). Children with ID were randomly and equally assigned to OTHP or to no OTHP groups. The primary outcome measures were Canadian Occupational Performance, Bruininks-Oseretsky Test of Motor…

  5. The Implementation of Maternity Group Home Programs: Serving Pregnant and Parenting Teens in a Residential Setting.

    OpenAIRE

    Lara K. Hulsey; Robert G. Wood; Anu Rangarajan

    2005-01-01

    Maternity group homes offer an innovative and intensive approach to addressing the needs of an extremely vulnerable population—teenage mothers and their children who have no other suitable place to live. This report documents the implementation of such programs in seven states. Issues discussed include management, funding, target populations, services, staffing, and costs.

  6. Adherence to an online exercise program for copd patients in the home environment- a pilot study

    NARCIS (Netherlands)

    Kun, L.; van Weering, Marit; Vollenbroek-Hutten, Miriam Marie Rosé; Hermens, Hermanus J.

    2016-01-01

    The objective of this study was to determine the adherence to an online exercise program for patients with moderate to very severe COPD in their home environment. The intervention consisted of three modules: module 1 online exercising; module 2 telemonitoring and module 3 telecommunication. Patients

  7. Using Home Irrigation Users' Perceptions to Inform Water Conservation Programs

    Science.gov (United States)

    Warner, Laura A.; Chaudhary, Anil Kumar; Lamm, Alexa J.; Rumble, Joy N.; Momol, Esen

    2017-01-01

    Targeted agricultural education programs can play a role in solving complex water issues. This article applies importance-performance analysis to examine dimensions of water resources that may inform local water conservation campaigns in the United States. The purpose of this study was to generate a deep understanding of home irrigation users'…

  8. Success of the Undergraduate Public Health Program At Tulane University

    Directory of Open Access Journals (Sweden)

    Luann Ellis White

    2015-04-01

    Full Text Available Tulane University School of Public Health and Tropical Medicine (SPHTM launched the Bachelors of Science in Public Health (BSPH in 2005. The BSPH has steadily grown and comprises one third of the total enrollment in the school. A review of the organizational structure demonstrates that direct responsibility for undergraduate education by a school of public health is advantageous to the success of the program. The competency and skills-based curriculum attracts students. Outcome measures show the enrollment is steadily increasing. The majority of the BSPH graduates continue onto competitive graduate and professional degree programs. Those who seek jobs find employment related to their public health education, but outside of the traditional governmental public health agencies. The combined BSPH/MPH degree is a pipeline for students to pursue a MPH and increases the likelihood students will pursue careers in public health. The range and depth of study in the bachelors program is continually examined. Topics once within the purview of graduate education are now being incorporated into undergraduate courses. Undergraduate public health is one of a number of factors that is influencing changes in the MPH degree.

  9. Systematic review of outcomes from home-based primary care programs for homebound older adults.

    Science.gov (United States)

    Stall, Nathan; Nowaczynski, Mark; Sinha, Samir K

    2014-12-01

    To describe the effect of home-based primary care for homebound older adults on individual, caregiver, and systems outcomes. A systematic review of home-based primary care interventions for community-dwelling older adults (aged ≥65) using the Cochrane, PubMed, and MEDLINE databases from the earliest available date through March 15, 2014. Studies were included if the house calls visitor was the ongoing primary care provider and if the intervention measured emergency department visits, hospitalizations, hospital beds days of care, long-term care admissions, or long-term care bed days of care. Home-based primary care programs. Homebound community-dwelling older adults (N = 46,154). Emergency department visits, hospitalizations, hospital bed days of care, long-term care admissions, long-term care bed days of care, costs, program design, and individual and caregiver quality of life and satisfaction with care. Of 357 abstracts identified, nine met criteria for review. The nine interventions were all based in North America, with five emerging from the Veterans Affairs system. Eight of nine programs demonstrated substantial effects on at least one inclusion outcome, with seven programs affecting two outcomes. Six interventions shared three core program components: interprofessional care teams, regular interprofessional care meetings, and after-hours support. Specifically designed home-based primary care programs may substantially affect individual, caregiver and systems outcomes. Adherence to the core program components identified in this review could guide the development and spread of these programs. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  10. Unique program aims to connect frequent ED utilizers with medical homes, resources to meet complex needs.

    Science.gov (United States)

    2014-10-01

    Sinai Hospital of Baltimore in Baltimore, MD, is partnering with HealthCare Access Maryland, a non-profit organization in the state, to link patients who frequent the ED for care with medical homes and other resources that can better meet their medical and social needs. Under the Access Health Program, ED-based care coordinators intervene with patients who meet program criteria, linking them with medical homes and other resources that address their complex needs. The hospital has devised a flag to notify the ED when a frequent-utilizing patient presents in the department for care. Care coordinators then meet with these patients and get their consent to participate in the program. Within a week of the ED visit, care coordinators schedule a home visit with the patient to establish a care plan containing specific goals and a time frame to carry out these goals. Patients remain in the program for 90 days as care coordinators work to hand them off to longer-term resources. Many of the patients enrolled in the program have substance abuse and mental health problems. Patients are also often uninsured and/or homeless. Within two months of launching the program, care coordinators enrolled 74 patients, with the goal of eventually bringing that number to 200.

  11. Parent education home visitation program: adolescent and nonadolescent mother comparison after six months of intervention.

    Science.gov (United States)

    Culp, A M; Culp, R E; Blankemeyer, M; Passmark, L

    1998-01-01

    This study examined the effect of an intervention over a 6-month period to improve first time mothers knowledge about parenting and safety in the home. The sample included 61 mothers who completed a baseline and follow-up survey. Mothers were first time adolescent (38) and nonadolescent (22) mothers recruited from rural county health departments for participation in a voluntary home visitation intervention program. Four hypotheses were tested that associated home visitation with greater parenting skill and child development knowledge and safety. Adolescent mothers were expected to make greater gains but to lag behind nonadolescent mothers in child development knowledge, parenting skills knowledge, household safety, and use of community resources. The sample included 32% with a high school degree and 12% African American. 83% were in school. 85% lived at or below the US federal poverty level. Parent Educators provided weekly in-home education based on a manual and individualized curriculum. Parenting skills knowledge was measured by the Adolescent-Adult Parenting Inventory (Bavolek, 1984). Home safety was measured by Culp's Home Safety Checklist. Educators recorded use of 13 community services. Analysis of variance revealed that infant knowledge increased to the same level among all mothers regardless of adolescents' lesser knowledge at baseline. Parenting skill knowledge of child roles increased for both ages, but older mothers scored higher. Parenting skill knowledge of alternatives to corporal punishment increased similarly for both ages. No age or interactive effects were related to improvement in safety or use of community services.

  12. 77 FR 26232 - Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers...

    Science.gov (United States)

    2012-05-03

    ... 447 RIN 0938-AO53 Medicaid Program; State Plan Home and Community-Based Services, 5-Year Period for Waivers, Provider Payment Reassignment, and Setting Requirements for Community First Choice; Correction... Federal Register entitled ``Medicaid Program; State Plan Home and Community-Based Services, 5- Year Period...

  13. 77 FR 69550 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2012-11-19

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program.... This notice solicits comments on information needed to determine patients' satisfaction with services... information technology. Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10...

  14. 75 FR 62635 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2010-10-12

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program... needed to determine patients' satisfaction with services provided by or through the Michael E. DeBakey.... Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10-0476. OMB Control...

  15. 78 FR 6851 - Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program...

    Science.gov (United States)

    2013-01-31

    ... AFFAIRS Proposed Information Collection (Patient Satisfaction Survey Michael E. DeBakey Home Care Program....'' SUPPLEMENTARY INFORMATION: Title: Patient Satisfaction Survey Michael E. DeBakey Home Care Program, VA Form 10.... Abstract: VA Form 10-0476 will be used to gather feedback from patients regarding their satisfaction with...

  16. Interpretive flexibility in mobile health: lessons from a government-sponsored home care program.

    Science.gov (United States)

    Nielsen, Jeppe Agger; Mathiassen, Lars

    2013-10-30

    Mobile technologies have emerged as important tools that health care personnel can use to gain easy access to client data anywhere. This is particularly useful for nurses and care workers in home health care as they provide services to clients in many different settings. Although a growing body of evidence supports the use of mobile technologies, the diverse implications of mobile health have yet to be fully documented. Our objective was to examine a large-scale government-sponsored mobile health implementation program in the Danish home care sector and to understand how the technology was used differently across home care agencies. We chose to perform a longitudinal case study with embedded units of analysis. We included multiple data sources, such as written materials, a survey to managers across all 98 Danish municipalities, and semistructured interviews with managers, care workers, and nurses in three selected home care agencies. We used process models of change to help analyze the overall implementation process from a longitudinal perspective and to identify antecedent conditions, key events, and practical outcomes. Strong collaboration between major stakeholders in the Danish home care sector (government bodies, vendors, consultants, interest organizations, and managers) helped initiate and energize the change process, and government funding supported quick and widespread technology adoption. However, although supported by the same government-sponsored program, mobile technology proved to have considerable interpretive flexibility with variation in perceived nature of technology, technology strategy, and technology use between agencies. What was first seen as a very promising innovation across the Danish home care sector subsequently became the topic of debate as technology use arrangements ran counter to existing norms and values in individual agencies. Government-sponsored programs can have both positive and negative results, and managers need to be aware

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

    Science.gov (United States)

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

    2016-01-01

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

  18. Program for advanced study in public science policy and administration

    Science.gov (United States)

    Rosenthal, A. H.

    1976-01-01

    The results and conclusions of the six-year effort concerned with the development and implementation of a university educational program intended to prepare scientists and engineers for upper-level management and administrative positions (as distinct from senior technical positions) were presented. This interdisciplinary program is at the graduate level, leading to a Master of Arts degree, and is given within a Division of Public Administration.

  19. Teaching family carers about home-based palliative care: final results from a group education program.

    Science.gov (United States)

    Hudson, Peter; Thomas, Tina; Quinn, Karen; Cockayne, Mark; Braithwaite, Maxine

    2009-08-01

    Without the considerable support provided by family carers, many patients receiving palliative care would be unable to remain at home. However, family carers typically lack the required information and skills to prepare them for such a role. Pilot work has demonstrated that group education programs for family carers can be readily developed; they are feasible, accessible, and useful. This project sought to build on our pilot research to further examine the effectiveness of a group education program by evaluating the outcomes with a larger number of participants. The program aimed to prepare primary family carers for the role of supporting a relative with advanced, noncurative cancer at home. The psycho-educational program consisted of three consecutive weekly sessions presented in a group format, conducted at six home-based palliative care services across metropolitan and regional Victoria, Australia. The following dependent variables were measured at three time points: carer competence, preparedness, rewards, and information needs. The three time points were: commencement of the program (Time 1), upon completion (Time 2), and two weeks later (Time 3). A total of 156 participants (including the pilot phase) completed Time 1 questionnaires and 96 completed all three time periods (62%). Between Time 1 and Time 2, the intervention had a statistically significant positive effect on preparedness, competence, rewards, and having informational needs met. Outcomes were maintained at Time 3. There was no difference in the effectiveness of the intervention for participants in regional areas compared to participants in metropolitan areas. This study demonstrated that a group education program to prepare family carers for the role of supporting a dying relative at home was effective. Implications for further research and practice are outlined.

  20. Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, Tom [Building America Partnership for Improved Residential Construction (BA-PIRC), Corvallis, OR (United States); Peeks, Brady [Building America Partnership for Improved Residential Construction (BA-PIRC), Corvallis, OR (United States)

    2013-11-01

    The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in the manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50% over typical manufactured homes produced in the northwest.

  1. Northwest Energy Efficient Manufactured Housing Program: High Performance Manufactured Home Prototyping and Construction Development

    Energy Technology Data Exchange (ETDEWEB)

    Hewes, Tom [National Renewable Energy Lab. (NREL), Golden, CO (United States); Peeks, Brady [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2013-11-01

    The Building America Partnership for Improved Residential Construction, the Bonneville Power Administration (BPA), and Northwest Energy Works (NEW), the current Northwest Energy Efficient Manufactured Housing Program (NEEM) administrator, have been collaborating to conduct research on new specifications that would improve on the energy requirements of a NEEM home. In its role as administrator, NEW administers the technical specs, performs research and engineering analysis, implements ongoing construction quality management procedures, and maintains a central database with home tracking. This project prototyped and assessed the performances of cost-effective high performance building assemblies and mechanical systems that are not commonly deployed in the manufacturing setting. The package of measures is able to reduce energy used for space conditioning, water heating and lighting by 50 percent over typical manufactured homes produced in the northwest.

  2. Home Oxygen Program review: Regionalization in Vancouver Coastal Health and British Columbia.

    Science.gov (United States)

    Sandberg, Dan

    2015-01-01

    Since its inception in the 1980s, the Home Oxygen Program in British Columbia was centrally managed by the Ministry of Health. Initially a small program with few clients across the province, it soon became a large program with many clients and increasing expenditures. A pilot program started in Victoria (British Columbia) in 1996 demonstrated that managing the program locally could offer better client care, better contract management and significant cost savings. In 2002, the pilot's model and recommendations were implemented in British Columbia's five health authorities. The present review details the experiences of regionalizing the program in the Vancouver Coastal Health authority. After fine adjustments to the model were developed and new contracts and criteria changes made, better care for clients was provided than the previous centralized model at a reduced cost to the taxpayer.

  3. Dental Homes for Children With Autism: A Longitudinal Analysis of Iowa Medicaid's I-Smile Program.

    Science.gov (United States)

    Chi, Donald L; Momany, Elizabeth T; Mancl, Lloyd A; Lindgren, Scott D; Zinner, Samuel H; Steinman, Kyle J

    2016-05-01

    Medicaid-enrolled children with autism spectrum disorder (ASD) encounter significant barriers to dental care. Iowa's I-Smile Program was implemented in 2006 to improve dental use for all children in Medicaid. This study compared dental home and preventive dental utilization rates for Medicaid-enrolled children by ASD status and within three time periods (pre-implementation, initial implementation, maturation) and determined I-Smile's longitudinal influence on ASD-related dental use disparities. Data from 2002-2011 were analyzed for newly Medicaid-enrolled children aged 3-17 years (N=30,059); identified each child's ASD status; and assessed whether the child had a dental home or utilized preventive dental care. Log-linear regression models were used to generate rate ratios. Analyses were conducted in 2015. In 2003-2011, 9.8% of children with ASD had dental homes compared with 8% of children without ASD; 36.3% of children with ASD utilized preventive care compared to 45.7% of children without ASD. There were no significant differences in dental home rates by ASD status during pre-implementation, initial implementation, or maturation. There were no significant differences in preventive dental utilization by ASD status during pre-implementation or initial implementation, but children with ASD were significantly less likely to utilize preventive care during maturation (rate ratio=0.79, pdental home and preventive dental utilization rates were not significant (p=0.54 and p=0.71, respectively). Among newly Medicaid-enrolled children in Iowa's I-Smile Program, those with ASDs were not less likely than those without ASD to have dental homes but were significantly less likely to utilize preventive dental care. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Rural Midwestern Public College Safe Ride Program Case Study

    Science.gov (United States)

    Mohfeld, Kathy I.

    2017-01-01

    The central phenomenon researched in this case study was higher education administrators' decisions to institutionalize a safe ride program at a small, rural college. The purpose of this single/within-site case study was to describe the changes that happened at a rural public institution of higher education and the surrounding community in the…

  5. China Public Budget Reform Program (CPBR) - Phase II | IDRC ...

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

    The Government of China has adopted a national reform program aimed at making budgeting more transparent and accountable through public involvement and enhanced oversight. Building on work carried out under Phase I (102965), the China Development Research Foundation (CDRF) will analyze China's current ...

  6. A Public Education Program in Water Resources Management.

    Science.gov (United States)

    Amend, John R.; Armold, Anita A.

    1983-01-01

    Describes a program designed to improve public awareness/understanding of major factors in managing water resources. Use is made of an interactive computer simulator to place lay people and teachers in decision-making situations involving real variables and alternatives and to project for them the probable consequences of their water management…

  7. Marketing and public programming in records and archives at the ...

    African Journals Online (AJOL)

    Archival institutions hold valuable collections in different forms and formats including correspondence, manuscripts, reports, and audio visual materials such as photographs,maps, plans, audiotapes, videos and films. Marketing and public programming are essential means for increasing the utilization of archival materials.

  8. China Public Budget Reform Program (CPBR) - Phase II | CRDI ...

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

    The Government of China has adopted a national reform program aimed at making budgeting more transparent and accountable through public involvement and enhanced oversight. Building on work carried out under Phase I (102965), the China Development Research Foundation (CDRF) will analyze China's current ...

  9. Examining Community-Engaged Scholarship in Public Administration Programs

    Science.gov (United States)

    Norvell, Katrina Herndon

    2010-01-01

    This study sought to broaden the understanding of the role that academic professions play in shaping the values and attitudes of faculty toward CES. This study explored faculty perceptions regarding the factors that encourage or dissuade them in the pursuit of CES within public administration programs. As a framework for research, a conceptual…

  10. An Exploratory Analysis of Public and Private Correctional Education Programs

    Science.gov (United States)

    Sadeghi, Leila

    2009-01-01

    As prison populations soar at unprecedented rates, the need for high quality education behind bars has never been greater. Prison education programs are the vehicle for reform and may be the solution to curtailing an ever-growing prison population. Yet, as the public sector increasingly contracts with the private sector for prison management,…

  11. Marketing and public programming in records and archives at the ...

    African Journals Online (AJOL)

    mpho ngoepe

    Abstract. Archival institutions hold valuable collections in different forms and formats including correspondence, manuscripts, reports, and audio visual materials such as photographs, maps, plans, audiotapes, videos and films. Marketing and public programming are essential means for increasing the utilization of archival ...

  12. Public Attitudes toward the Apollo Space Program, 1965-1975.

    Science.gov (United States)

    Krugman, Herbert E.

    1977-01-01

    Analyzes the decline in public support for the Apollo Space Program from 1965 to 1975 in spite of generally positive media coverage. Using data from 31 telephone surveys during the period, concludes that the Moon landing polarized both opponents and proponents and increased opposition because "there was nothing more to be done." (JMF)

  13. Understanding social media program usage in public transit agencies

    Directory of Open Access Journals (Sweden)

    Jenny H. Liu

    2016-10-01

    Full Text Available Social media has been gaining prominence in public transit agencies in their communication strategies and daily management. This study aims to better understand recent trends in social media usage in public transit agencies, to examine which agencies use what kind of social media programs for what purposes, and how they measure their programs. A survey was conducted of the top transit agencies in the nation, and results are examined through descriptive statistical analysis, correlation analysis and regression modeling. We found that while most agencies still lack clearly-defined goals and performance metrics to guide their social media development, many are increasing their social media capacity with more structural components. Public transit service usage and the level of transit service provision are the most significant determinants of agencies’ social media programming and resource investments. In contrast, the measurement of social media usage and outcomes is more significantly related to city attributes and demographic characteristics. We anticipate an increase in the usage of social media to convey transit related stories and livability benefits, such as environmental sensitivity or safety improvements, as these programs expand. Public transit agencies’ commitment to measuring social media outcomes underscores the future research need to develop best practices for measuring the impacts and performance of social media communications and investments.

  14. Evidence for the long term cost effectiveness of home care reablement programs

    Directory of Open Access Journals (Sweden)

    Lewin GF

    2013-10-01

    Full Text Available Gill F Lewin,1,2 Helman S Alfonso,3 Janine J Alan41Faculty of Health Sciences, Curtin University, Perth, WA, Australia; 2Research Department, Silver Chain Group, Perth, WA, Australia; 3School of Population Health, University of Western Australia, Perth, WA, Australia; 4Faculty of Health Sciences, Curtin University, Perth, WA, AustraliaBackground: The objectives of this study were to determine whether older individuals who participated in a reablement (restorative program rather than immediately receiving conventional home care services had a reduced need for ongoing support and lower home care costs over the next 57 months (nearly 5 years.Materials and methods: Data linkage was used to examine retrospectively the service records of older individuals who had received a reablement service versus a conventional home care service to ascertain their use of home care services over time.Results: Individuals who had received a reablement service were less likely to use a personal care service throughout the follow-up period or any other type of home care over the next 3 years. This reduced use of home care services was associated with median cost savings per person of approximately AU $12,500 over nearly 5 years.Conclusion: The inclusion of reablement as the starting point for individuals referred for home care within Australia's reformed aged care system could increase the system's cost effectiveness and ensure that all older Australians have the opportunity to maximize their independence as they age.Keywords: restorative, older adults, community dwelling, service costs

  15. Team-Based Learning: Successful Experience in a Public Health Graduate Program

    Directory of Open Access Journals (Sweden)

    Geraldo Bezerra da Silva Junior

    Full Text Available ABSTRACT Background: In the review of curriculum matrices, the elaboration of learning strategies that combine theory and practice is extremely important, allowing the building of new concepts and learning methods by the students. Team-based learning (TBL is growing in academic centers and refers to the pedagogic strategy grounded in constructivism. The aim of this research was to describe the application of TBL in a Public Health graduate program. Methods: TBL was applied in a class with 22 students in the discipline “Quantitative Research in Health” of the Public Health graduate program (Master degree at the University of Fortaleza, Brazil, in 2016. The discipline was structured in 8 lessons, approaching the thematic of quantitative research. Before each class the students were required to study the contents at home, a test was done for each subject in the beginning of each class (individually and then in teams of 5 or 6 students and then a brief review was performed by the professor, where the students could ask questions and solve any doubt. At the end of the semester an evaluation questionnaire was applied with objective questions and a qualitative survey. Results: The application of TBL was done in a class with 22 students of the Public health Master Program, aged 22 to 36 years, and 83.3% were female. The method was well received by the students. All the evaluations and discussions went on without any problem. There were some complaints about the requirement to study at home prior to the classes. Students’ evaluation of the discipline and the TBL method was satisfactory with answers’ average score of 4.7 (scale 0-5. The lowestscore was achieved by the question number 11 (4.3 about the students motivation for their study at home. The comparison with the evaluation of the previous semester (where a traditional method was applied evidenced higher scores for the TBL method. Conclusions: The application of TBL was satisfactory and the

  16. Effective Practices for Evaluating Education and Public Outreach Programs

    Science.gov (United States)

    Wilkerson, S.

    2013-12-01

    Stephanie Baird Wilkerson, PhD Carol Haden EdD Magnolia Consulting,LLC Education and public outreach (EPO) program developers and providers seeking insights regarding effective practices for evaluating EPO activities programs benefit from understanding why evaluation is critical to the success of EPO activities and programs, what data collection methods are appropriate, and how to effectively communicate and report findings. Based on our extensive experience evaluating EPO programs, we will share lessons learned and examples of how these practices play out in actual evaluation studies. EPO program developers, providers, and evaluators must consider several factors that influence which evaluation designs and data collection methods will be most appropriate, given the nature of EPO programs. Effective evaluation practices of EPO programs take into account a program's phase of development, duration, and budget as well as a program's intended outcomes. EPO programs that are just beginning development will have different evaluation needs and priorities than will well-established programs. Effective evaluation practices consider the 'life' of a program with an evaluation design that supports a program's growth through various phases including development, revision and refinement, and completion. It would be premature and inappropriate to expect the attainment of longer-term outcomes of activities during program development phases or early stages of implementation. During program development, EPO providers should clearly define program outcomes that are feasible and appropriate given a program's scope and expected reach. In many respects, this directly relates to the amount of time, or duration, intended audiences participate in EPO programs. As program duration increases so does the likelihood that the program can achieve longer-term outcomes. When choosing which outcomes are reasonable to impact and measure, program duration should be considered. Effective evaluation

  17. Dynamics of the public concern and risk communication program implementation.

    Science.gov (United States)

    Zaryabova, Victoria; Israel, Michel

    2015-09-01

    The public concern about electromagnetic field (EMF) exposure varies due to different reasons. A part of them are connected with the better and higher quality of information that people receive from science, media, Internet, social networks, industry, but others are based on good communication programs performed by the responsible institutions, administration and persons. Especially, in Bulgaria, public concern follows interesting changes, some of them in correlation with the European processes of concern, but others following the economic and political processes in the country. Here, we analyze the dynamics of the public concern over the last 10 years. Our explanation of the decrease of the people's complaints against EMF exposure from base stations for mobile communication is as a result of our risk communication program that is in implementation for >10 years.

  18. "Home Practice Is the Program": Parents' Practice of Program Skills as Predictors of Outcomes in the New Beginnings Program Effectiveness Trial.

    Science.gov (United States)

    Berkel, Cady; Sandler, Irwin N; Wolchik, Sharlene A; Brown, C Hendricks; Gallo, Carlos G; Chiapa, Amanda; Mauricio, Anne M; Jones, Sarah

    2016-12-08

    An examination of the content and processes of evidence-based programs is critical for empirically evaluating theories about how programs work, the "action theory" of the program (West et al. in American Journal of Community Psychology, 21, 571-605, 1993). The New Beginnings Program (NBP; Wolchik et al., 2007), a parenting-after-divorce preventive intervention, theorizes that program-induced improvements in parenting across three domains: positive relationship quality, effective discipline, and protecting children from interparental conflict, will reduce the negative outcomes that are common among children from divorced families. The process theory is that home practice of program skills related to these parenting domains is the primary mechanism leading to positive change in parenting. This theory was tested using multi-rater data from 477 parents in the intervention condition of an effectiveness trial of the NBP (Sandler et al. 2016a, 2016b). Four research questions were addressed: Does home practice of skills predict change in the associated parenting outcomes targeted by the program? Is the effect above and beyond the influence of attendance at program sessions? What indicators of home practice (i.e., attempts, fidelity, efficacy, and competence) are most predictive of improvements in parenting? Do these indicators predict parenting improvements in underserved subpopulations (i.e., fathers and Latinos)? Structural Equation Modeling analyses indicated that parent-reported efficacy and provider-rated parent competence of home practice predicted improvements in the targeted parenting domains according to both parent and child reports. Moreover, indicators of home practice predicted improvements in parenting for fathers and Latinos, although patterns of effects varied by parenting outcome.

  19. Effectiveness of a home-based exercise program on anthropometric and metabolic changes among school cooks

    Directory of Open Access Journals (Sweden)

    Mauro Felippe Felix Mediano

    2015-12-01

    Full Text Available Abstract The scope of this study was to evaluate the anthropometric and metabolic changes after low intensity home-based exercise. In the school year of 2007, 95 school cooks in the city of Niteroi (State of Rio de Janeiro, Brazil were randomly assigned to one of the following groups: home-based exercise (n = 47 or control group (n = 48. The home-based exercise program was performed three times a week, during 40 minutes at moderate intensity. Anthropometric variables were collected at the baseline and after 4 and 8 months, whereas biochemical and individual food intake were measured at the baseline and after 8 months. Energy expenditure was evaluated only at the baseline. The home-based exercise group exhibited a greater weight loss (-0.9 vs. -0.2; p = 0.05 in comparison with controls during the follow-up and the same pattern was found for BMI (-0.1 vs. +0.1; p = 0.07, although without statistical significance. Exercise showed no effects on waist circumference, lipid profile and glucose. In conclusion, greater weight loss was observed in the group that performed low intensity home-based exercise and this strategy can assist in body weight control even without alterations in terms of lipids and glucose.

  20. Exposure to Secondhand Smoke in the Home and Public areas among Adolescents in Abuja, Nigeria: Tobacco control implications

    OpenAIRE

    Uyoyo Omaduvie; Akinyele Adisa

    2015-01-01

    Introduction Secondhand smoke (SHS) causes death and disease among non-smokers. In 2008, the Nigerian Federal Capital Territory, Abuja, passed a comprehensive smoke-free law. This study assessed the baseline prevalence of SHS exposure in the home and at public areas among secondary school students in Abuja, Nigeria during 2008. Material and Methods The 2008 Global Youth Tobacco Survey was analysed for 1399 students in Abuja. Prevalence of support for smoke-free laws in public places...

  1. A home balance exercise program improves walking in people with cerebellar ataxia.

    Science.gov (United States)

    Keller, Jennifer L; Bastian, Amy J

    2014-10-01

    Physical therapy intervention is the primary treatment for gait ataxia and imbalance in individuals with cerebellar damage. Our aim was to determine if a home balance exercise program is feasible for improving locomotor and balance abilities in these individuals. A total of 14 patients with cerebellar ataxia participated in a 6-week individualized home-based balance exercise program and attended 5 testing sessions (2 pretraining, 1 midtraining, 1 posttraining, and 1 one-month follow-up visit). Pretraining, posttraining, and follow-up testing included a neurological assessment, clinical gait and balance tests, and laboratory assessments of balance and walking. Participants kept logs of the frequency and level of balance challenge during their training. Walking speed improved across visits, as did stride length, percentage double-limb support time, Timed Up and Go (TUG), and Dynamic Gait Index. Post hoc comparisons in these measures revealed that significant rehabilitative improvements occurred over the 6-week training period, and all but TUG gains were retained 1 month later. There were no changes across the other measures for the group. Regression analysis indicated that improvements in walking speed were affected by the level of balance challenge but not by age, ataxia severity, proprioception, or duration of exercise. Improvement in locomotor performance in people with cerebellar ataxia was observable after a 6-week home balance exercise program. The exercise program must be designed to provide a significant challenge to the person's balance. © The Author(s) 2014.

  2. Public dental health care program for persons with disability

    DEFF Research Database (Denmark)

    Christensen, Lisa Bøge; Hede, Børge; Petersen, Poul Erik

    2005-01-01

    The objectives of the study were (1) to describe the organization and content of the Danish public oral health care program for persons with disability, and (2) to analyse possible variations in relation to the goals and requirements set by the health authorities. Data were collected by means...... of knowledge of oral health and oral health care for persons with disability were barriers to equal access to the program. Preventive dental services were the most frequent services delivered, although relatively few oral hygienists were involved in the program. Special training was most frequent in large...... municipalities. To secure equal access for persons with disability, it is recommended that joint collaboration between smaller municipalities should be made regarding procedures of such programs. Special training of dental personnel and of the staff responsible for selecting persons for the program should...

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

    Directory of Open Access Journals (Sweden)

    Freene Nicole

    2011-11-01

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

  4. Social network analysis of public health programs to measure partnership.

    Science.gov (United States)

    Schoen, Martin W; Moreland-Russell, Sarah; Prewitt, Kim; Carothers, Bobbi J

    2014-12-01

    In order to prevent chronic diseases, community-based programs are encouraged to take an ecological approach to public health promotion and involve many diverse partners. Little is known about measuring partnership in implementing public health strategies. We collected data from 23 Missouri communities in early 2012 that received funding from three separate programs to prevent obesity and/or reduce tobacco use. While all of these funding programs encourage partnership, only the Social Innovation for Missouri (SIM) program included a focus on building community capacity and enhancing collaboration. Social network analysis techniques were used to understand contact and collaboration networks in community organizations. Measurements of average degree, density, degree centralization, and betweenness centralization were calculated for each network. Because of the various sizes of the networks, we conducted comparative analyses with and without adjustment for network size. SIM programs had increased measurements of average degree for partner collaboration and larger networks. When controlling for network size, SIM groups had higher measures of network density and lower measures of degree centralization and betweenness centralization. SIM collaboration networks were more dense and less centralized, indicating increased partnership. The methods described in this paper can be used to compare partnership in community networks of various sizes. Further research is necessary to define causal mechanisms of partnership development and their relationship to public health outcomes. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. 76 FR 366 - Public Water Supply Supervision Program; Program Revision for the State of Washington

    Science.gov (United States)

    2011-01-04

    ... Program. Washington has adopted a definition for public water system that is analogous to EPA's definition... ``Indian country'' as defined by 18 U.S.C. 1151, nor does it intend to limit existing rights of the State...

  6. Evaluation of the U.S. Department of Energy Challenge Home Program Certification of Production Builders

    Energy Technology Data Exchange (ETDEWEB)

    Kerrigan, P.; Loomis, H.

    2014-09-01

    The purpose of this project was to evaluate integrated packages of advanced measures in individual test homes to assess their performance with respect to Building America Program goals, specifically compliance with the DOE Challenge Home Program. BSC consulted on the construction of five test houses by three Cold Climate production builders in three separate US cities. BSC worked with the builders to develop a design package tailored to the cost-related impacts for each builder. Therefore, the resulting design packages do vary from builder to builder. BSC provided support through this research project on the design, construction and performance testing of the five test homes. Overall, the builders have concluded that the energy related upgrades (either through the prescriptive or performance path) represent reasonable upgrades. The builders commented that while not every improvement in specification was cost effective (as in a reasonable payback period), many were improvements that could improve the marketability of the homes and serve to attract more energy efficiency discerning prospective homeowners. However, the builders did express reservations on the associated checklists and added certifications. An increase in administrative time was observed with all builders. The checklists and certifications also inherently increase cost due to: 1. Adding services to the scope of work for various trades, such as HERS Rater, HVAC contractor; 2. Increased material costs related to the checklists, especially the EPA Indoor airPLUS and EPA WaterSense(R) Efficient Hot Water Distribution requirement.

  7. Evaluation of the U.S. Department of Energy Challenge Home Program Certification of Production Builders

    Energy Technology Data Exchange (ETDEWEB)

    Kerrigan, P. [Building Science Corporation, Somerville, MA (United States); Loomis, H. [Building Science Corporation, Somerville, MA (United States)

    2014-09-01

    The purpose of this project was to evaluate integrated packages of advanced measures in individual test homes to assess their performance with respect to Building America program goals, specifically compliance with the DOE Challenge Home Program. BSC consulted on the construction of five test houses by three cold climate production builders in three U.S. cities and worked with the builders to develop a design package tailored to the cost-related impacts for each builder. Also, BSC provided support through performance testing of the five test homes. Overall, the builders have concluded that the energy related upgrades (either through the prescriptive or performance path) represent reasonable upgrades. The builders commented that while not every improvement in specification was cost effective (as in a reasonable payback period), many were improvements that could improve the marketability of the homes and serve to attract more energy efficiency discerning prospective homeowners. However, the builders did express reservations on the associated checklists and added certifications. An increase in administrative time was observed with all builders. The checklists and certifications also inherently increase cost due to: adding services to the scope of work for various trades, such as HERS Rater, HVAC contractor; and increased material costs related to the checklists, especially the EPA Indoor airPLUS and EPA WaterSense® Efficient Hot Water Distribution requirement.

  8. Use of a new public bicycle share program in Montreal, Canada.

    Science.gov (United States)

    Fuller, Daniel; Gauvin, Lise; Kestens, Yan; Daniel, Mark; Fournier, Michel; Morency, Patrick; Drouin, Louis

    2011-07-01

    Cycling contributes to physical activity and health. Public bicycle share programs (PBSPs) increase population access to bicycles by deploying bicycles at docking stations throughout a city. Minimal research has systematically examined the prevalence and correlates of PBSP use. To determine the prevalence and correlates of use of a new public bicycle share program called BIXI (name merges the word BIcycle and taXI) implemented in May 2009 in Montreal, Canada. A total of 2502 adults were recruited to a telephone survey in autumn 2009 via random-digit dialing according to a stratified random sampling design. The prevalence of BIXI bicycle use was estimated. Multivariate logistic regression allowed for identification of correlates of use. Data analysis was conducted in spring and summer 2010. The unweighted mean age of respondents was 47.4 (SD=16.8) years and 61.4% were female. The weighted prevalence for use of BIXI bicycles at least once was 8.2%. Significant correlates of BIXI bicycle use were having a BIXI docking station within 250 m of home, being aged 18-24 years, being university educated, being on work leave, and using cycling as the primary mode of transportation to work. A newly implemented public bicycle share program attracts a substantial fraction of the population and is more likely to attract younger and more educated people who currently use cycling as a primary transportation mode. Copyright © 2011 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  9. Procedures Manual for Home School Operators in New Mexico

    Science.gov (United States)

    New Mexico Public Education Department, 2007

    2007-01-01

    Under the New Mexico Public School Code, the right of parents to home-school their children is recognized. "Home School" is defined as the operation by a parent, legal guardian, or other person having custody of a school-age person who instructs a home study program that provides a basic academic educational program, including but not…

  10. Neighborhood Effects on PND Symptom Severity for Women Enrolled in a Home Visiting Program.

    Science.gov (United States)

    Jones, David E; Tang, Mei; Folger, Alonzo; Ammerman, Robert T; Hossain, Md Monir; Short, Jodie; Van Ginkel, Judith B

    2017-10-23

    The aim of this study was to investigate the association between postnatal depression (PND) symptoms severity and structural neighborhood characteristics among women enrolled in a home visiting program. The sample included 295 mothers who were at risk for developing PND, observed as 3-month Edinburgh Postnatal Depression Scale (EPDS) scores ≥ 10. Two neighborhood predictor components (residential stability and social disadvantage) were analyzed as predictors of PND symptom severity using a generalized estimating equation. Residential stability was negatively associated with PND symptom severity. Social disadvantage was not found to be statistically significantly. The findings suggest that residential stability is associated with a reduction in PND symptom severity for women enrolled in home visiting program.

  11. Substitution Effect of Public Support Programs at Local Level

    Directory of Open Access Journals (Sweden)

    Valéria SZITÁSIOVÁ

    2014-12-01

    Full Text Available The paper evaluates the principle of addi-tionality in public support programs at local level. In the evaluation of public support policies a key question is whether the policy has made a differ-ence over what would have otherwise occurred. This could be measured by different ways as out-put, behavioral or input additionality. In this paper we analyze the impact of public support programs on input additionality as the extent to which the subsidy is refected in increased expenditures by supported subjects through the measurement of substitution effect. We studied public investment subsidies in the case of education support in Slo-vakia. We identifed the substitution effect in 10% of the analyzed municipalities. There are several differences in outcomes.An important factor is the size of the city as larger municipalities reduce their other activities when obtaining the support. We also showed that less developed regions have a lower tendency to misuse the support programs. The more de-veloped regions and cities reduce their own spending on a given priority when obtaining the support.

  12. Using Child-Parent Psychotherapy in a Home-Based Program Model

    Science.gov (United States)

    Ball, Jennifer; Smith, Mae

    2015-01-01

    This article tells the story of a single mother, Maria, who has a history of trauma, and her 2-year-old daughter, Lina, as they learn, play, and heal together through the use of Child-Parent Psychotherapy, an evidenced-based, trauma-informed therapeutic intervention in a home-based program model. Through the power of play, Maria and Lina are able…

  13. Physiotherapy after volar plating of wrist fractures is effective using a home exercise program.

    Science.gov (United States)

    Krischak, Gert D; Krasteva, Anna; Schneider, Florian; Gulkin, Daniel; Gebhard, Florian; Kramer, Michael

    2009-04-01

    To determine the effect of 2 different postoperative therapy approaches after operative stabilization of the wrist fractures: treatment by a physical therapist with 12 sessions and an unassisted home exercise program. Randomized controlled cohort study. Hospital-based care, primary center of orthopedic surgery. Volunteers (N=48) with fractures of the distal radius after internal fixation with locking plates. There were 46 patients available for follow-up after exclusion of 2 participants due to physiotherapy sessions in excess of the study protocol. Not applicable. Evaluation of grip strength using a Jamar dynamometer, range of motion (ROM), and Patient Related Wrist Evaluation (PRWE). After a 6-week period of postoperative treatment, the patients (n=23) performing an independent home exercise program using a training diary showed a significantly greater improvement of the functionality of the wrist. Grip strength reached 54% (P=.003), and ROM in extension and flexion 79% (Pwrist function with a nearly 50% lower value (Pwrist fractures, instructions in a home exercise program are an effective alternative to prescribed physical therapy treatment.

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

    Science.gov (United States)

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

    2017-05-01

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

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

    Science.gov (United States)

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

    2017-01-01

    While home visiting programs are among the most widespread interventions to support at-risk families, there is a paucity of research investigating these programs under real-world conditions. The effectiveness of Families First home visiting (FFHV) was examined for decreasing rates of being in care of child welfare, decreasing hospitalizations for maltreatment-related injuries, and improving child development at school entry. Data for 4,562 children from home visiting and 5,184 comparison children were linked to deidentified administrative health, social services, and education data. FFHV was associated with lower rates of being in care by child’s first, second, and third birthday (adjusted risk ratio [aRR] = 0.75, 0.79, and 0.81, respectively) and lower rates of hospitalization for maltreatment-related injuries by third birthday (aRR = 0.59). No differences were found in child development at kindergarten. FFHV should be offered to at-risk families to decrease child maltreatment. Program enhancements are required to improve child development at school entry. PMID:28413917

  16. Barriers to Compliance in a Home-Based Anterior Cruciate Ligament Injury Prevention Program in Female High School Athletes.

    Science.gov (United States)

    Thein-Nissenbaum, Jill; Brooks, M Alison

    2016-02-01

    Supervised injury prevention programs can decrease injuries in female high school athletes. Research regarding home-based injury prevention programs is limited. To identify barriers to compliance with a home-based injury prevention program in rural Wisconsin female high school basketball players. Cross-sectional study including participants from 9 rural Wisconsin high schools. Participants were instructed in appropriate exercise form and DVD use in a group-based format. Participants were instructed to perform the home-based program 3 times per week for 8 weeks. Participants then completed a survey regarding their program compliance. Exercise instruction and surveys were completed in the participant's high school gymnasium. Female students in grades 9-12, who intended to play basketball, were invited to participate. Of the 175 eligible students, 66 enrolled in the study. The intervention consisted of a DVD-based injury prevention program. Our hypothesis--that compliance with a home-based injury prevention program would be low--was established prior to study commencement. Outcome measures consisted of self-reported responses by participants. Statistics are descriptive. Follow-up surveys were completed by 27 of 66 participants, with 50% reporting performing the injury prevention program 0-3 times per week. The reasons for low compliance included "I did not have time to do the program," followed by "I forgot to do the program." Wisconsin female high school basketball players demonstrated very low compliance with a home-based injury prevention program. This paper identifies barriers to compliance.

  17. Perception of quality of care among residents of public nursing-homes in Spain: a grounded theory study.

    Science.gov (United States)

    Rodríguez-Martín, Beatriz; Martínez-Andrés, María; Cervera-Monteagudo, Beatriz; Notario-Pacheco, Blanca; Martínez-Vizcaíno, Vicente

    2013-06-28

    The quality of care in nursing homes is weakly defined, and has traditionally focused on quantify nursing homes outputs and on comparison of nursing homes' resources. Rarely the point of view of clients has been taken into account. The aim of this study was to ascertain what means "quality of care" for residents of nursing homes. Grounded theory was used to design and analyze a qualitative study based on in-depth interviews with a theoretical sampling including 20 persons aged over 65 years with no cognitive impairment and eight proxy informants of residents with cognitive impairment, institutionalized at a public nursing home in Spain. Our analysis revealed that participants perceived the quality of care in two ways, as aspects related to the persons providing care and as institutional aspects of the care's process. All participants agreed that aspects related to the persons providing care was a pillar of quality, something that, in turn, embodied a series of emotional and technical professional competences. Regarding the institutional aspects of the care's process, participants laid emphasis on round-the-clock access to health care services and on professional's job stability. This paper includes perspectives of the nursing homes residents, which are largely absent. Incorporating residents' standpoints as a complement to traditional institutional criteria would furnish health providers and funding agencies with key information when it came to designing action plans and interventions aimed at achieving excellence in health care.

  18. Preschool Early Literacy Programs in Ontario Public Libraries

    Directory of Open Access Journals (Sweden)

    Shelley Stagg Peterson

    2012-12-01

    Full Text Available This paper reports on research examining how library staff in 10 Ontario libraries’ preschool literacy programs support three- and four-year-old children’s early literacy and school readiness as well as their parents’ and caregivers’ literacy interactions with their children. Multiple data sources included surveys of 82 parents/caregivers, observations of a sample of 65 of the 198 children at the sessions we visited, and interviews with10 library staff. Observations were analyzed for evidence of children’s development of print motivation, phonological awareness, vocabulary, narrative skills, and print awareness: early literacy skills and knowledge that have been shown to be reliably and significantly correlated with future reading success. Analysis of the observational and interview data showed that the programs have been very successful in fostering children’s readiness to participate in school activities and their motivation to read. Participating children learned new vocabulary, demonstrated an awareness of rhymes and sounds of language, and showed an understanding of books that were read by library staff: all early literacy behaviours that are foundational to later literacy development. The programs have also provided parents/caregivers with new ways to interact with children to engage them with books and with print at home. The development of children’s school readiness skills and parents’ awareness of how to support their children’s literacy are outcomes extending beyond library staff goals for their library programs and should be included in literature advertising the programs. Print awareness is an area of literacy development that library staff could encourage to a greater extent, however. Very few instances of such behaviour were observed, with most of the observations taking place in two of the preschool early literacy programs. Concomitantly, developing children’s print awareness is a recommended topic for

  19. The public communication of science in public health graduate programs in Brazil: From the coordinators' perspective

    Science.gov (United States)

    Teixeira, C. A.; Gallo, P. R.

    2014-12-01

    Introduction - The elaboration process of public policies for science and technology in knowledge societies should include not only experts, but all society members. There are studies on lay people's perception of science and technology. However, what is the scientists' perspective on public communication of science? Objectives - To describe and characterize the concepts that coordinators of Brazilian public health graduate programs have about public communication of science. Methods - This is an analytical and descriptive report of an exploratory research (doctoral study). The answers of fifty-one coordinators to two questionnaires were submitted for content analysis. The categories were transformed into variables that allowed the data processing by the Hiérarchique Classificatoire et Cohésitive (CHIC®) software. Results - Similarity analysis strongly suggested (0,99) that coordinators understand public communication as a communication directed to academic peers and students, also as a form of participation in scientific events and communication by scientific papers. Likewise, the implication analysis suggested a strong implication (0,98) between scientific communication understood as public communication. Conclusion - The notion of public communication of science as a social right and as a commitment and responsibility of researchers and research centers is not explicitly present in the narrative of the coordinators, although in general the coordinators conceive it as a relevant activity. This study thus contributes to a reflection on the role of scientists, researchers and research centers in public communication of science and technology.

  20. Affecting culture change and performance improvement in Medicaid nursing homes: the Promote Understanding, Leadership, and Learning (PULL) Program.

    Science.gov (United States)

    Eliopoulos, Charlotte

    2013-01-01

    A growing number of nursing homes are implementing culture change programming to create a more homelike environment in which residents and direct care staff are empowered with greater participation in care activities. Although nursing homes that have adopted culture change practices have brought about positive transformation in their settings that have improved quality of care and life, as well as increased resident and staff satisfaction, they represent a minority of all nursing homes. Nursing homes that serve primarily a Medicaid population without supplemental sources of funding have been limited in the resources to support such change processes. The purpose of this project was to gain insight into effective strategies to provide culture change and quality improvement programming to low-performing, under-resourced nursing homes that represent the population of nursing homes least likely to have implemented this programming. Factors that interfered with transformation were identified and insights were gained into factors that need to be considered before transformational processes can be initiated. Effective educational strategies and processes that facilitate change in these types of nursing homes were identified. Despite limitations to the study, there was evidence that the experiences and findings can be of value to other low-performing, under-resourced nursing homes. Ongoing clinical work and research are needed to refine the implementation process and increase the ability to help these settings utilize resources and implement high quality cost effective care to nursing home residents. Copyright © 2013 Mosby, Inc. All rights reserved.

  1. Educational Programs at the Lake Afton Public Observatory

    Science.gov (United States)

    Alexander, D. R.; Novacek, G. R.

    1994-05-01

    The Lake Afton Public Observatory was founded 14 years ago as a joint project of the city, county, local schools, and Wichita State University to provide educational programs for the public and school children. A staff of 4 professional astronomers presents daytime and evening programs at the Observatory and makes presentations in schools to over 20,000 people per year. Programs are scheduled 6 days a week during the academic year and 3 days a week in the summer. Our public programs deviate significantly from the traditional observatory open house by following a specific theme. Selection and discussion of each object is centered on that theme. For example, a program on The Life Story of a Star would view a diffuse nebula (to discuss star formation), a young star cluster (to discuss one outcome of star formation), a double star (to discuss how the properties of stars are determined), and a planetary nebula (to discuss the death of a star). To complement the observing experiences of our visitors, we have developed a wide range of interactive exhibits to develop the concepts touched on in the viewing programs. We have also developed exhibit lending kits for extended use in school classrooms, educational games, activity manuals for teachers, and short videos to introduce single concepts in the classroom. In the past year we have begun to offer a series of workshops for in-service teachers to expand their knowledge of astronomy and to provide them with additional resources for teaching astronomy. This work is supported in part by NSF EPSCoR grant OSR-9255223.

  2. Process Evaluation to Explore Internal and External Validity of the "Act in Case of Depression" Care Program in Nursing Homes

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.F.J.

    2012-01-01

    Background: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): " Act in case of Depression" (AiD). Objective: Before effect analyses, to evaluate AiD

  3. 75 FR 41793 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2010-07-19

    ... 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, 2010 Through June 30, 2011 AGENCY: Food and Nutrition Service...

  4. 78 FR 45176 - Child and Adult Care Food Program: National Average Payment Rates, Day Care Home Food Service...

    Science.gov (United States)

    2013-07-26

    ... 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, 2013 Through June 30, 2014 AGENCY: Food and Nutrition Service...

  5. 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

    ... 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...

  6. Process evaluation to explore internal and external validity of the "Act in Case of Depression" care program in nursing homes.

    NARCIS (Netherlands)

    Leontjevas, R.; Gerritsen, D.L.; Koopmans, R.T.C.M.; Smalbrugge, M.; Vernooij-Dassen, M.J.F.J.

    2012-01-01

    BACKGROUND: A multidisciplinary, evidence-based care program to improve the management of depression in nursing home residents was implemented and tested using a stepped-wedge design in 23 nursing homes (NHs): "Act in case of Depression" (AiD). OBJECTIVE: Before effect analyses, to evaluate AiD

  7. Changes in parenting and child behavior after the home-start family support program: A 10 year follow-up

    NARCIS (Netherlands)

    van Aar, J.V.; Asscher, J.J.; Zijlstra, B.J.H.; Deković, M.; Hoffenaar, P.J.

    2015-01-01

    Background: Home-Start is a parenting support program in which mothers experiencing difficulties in family life and parenting, receive weekly support at home from a volunteer. The present study extends the work of Hermanns et al. (2013), by examining self-reported and observed parenting and child

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

    Directory of Open Access Journals (Sweden)

    Nemček Dagmar

    2016-05-01

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

  9. Expanding Public Outreach: The Solar System Ambassadors Program

    Science.gov (United States)

    Ferrari, K. A.

    2000-12-01

    The Solar System Ambassadors Program is a public outreach program designed to work with motivated volunteers across the nation. Those volunteers organize and conduct public events that communicate exciting discoveries and plans in Solar System research, exploration and technology through non-traditional forums, e.g. community service clubs, libraries, museums, planetariums, ``star parties," mall displays, etc. In 2001, 200 Ambassadors from almost all 50 states bring the excitement of space to the public. Ambassadors are space enthusiasts, K-12 in-service educators, retirees, community college teachers, and other members of the general public interested in providing greater service and inspiration to the community at large. Last year, Ambassadors conducted approximately 600 events that directly reached more than one-half million people in communities across the United States. The Solar System Ambassadors Program is sponsored by the Jet Propulsion Laboratory (JPL) in Pasadena, California, an operating division of the California Institute of Technology (Caltech) and a lead research and development center for the National Aeronautics and Space Administration (NASA). Participating JPL projects include Cassini, Galileo, STARDUST, Outer Planets mission, Solar Probe, Genesis, Ulysses, Voyager, Mars missions, Discovery missions NEAR-Shoemaker and Deep Impact, and the Deep Space Network. Each Ambassador participates in on-line (web-based) training sessions that provide interaction with NASA scientists, engineers and project team members. As such, each Ambassador's experience with the space program becomes personalized. Training sessions provide Ambassadors with general background on each mission and educate concerning specific mission milestones, such as launches, planetary flybys, first image returns, arrivals, and ongoing key discoveries. Additionally, projects provide videos, slide sets, booklets, pamphlets, posters, postcards, lithographs, on-line materials, resource

  10. Manufactured Homes Acquisition Program : Heat Loss Assumptions and Calculations, Heat Loss Coefficient Tables.

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Bob; Baylon, David

    1992-05-01

    This manual is intended to assist builders of manufactured homes in assessing the thermal performance of structural components used in the Manufactured Housing Acquisition Program (MAP) sponsored by the Bonneville Power Administration (BPA). U-factors for these components are calculated using the ASHRAE (1989) parallel heat loss method, with adaptations made for the construction practices found in the Pacific Northwest manufactured home industry. This report is divided into two parts. The first part describes the general assumptions and calculation procedures used to develop U-factors and R-values for specific materials used in the construction industry, overall U-factors for component sections, and the impact of complex framing and thermal configurations on various components' heat loss rates. The individual components of manufactured homes are reviewed in terms of overall thermal conductivity. The second part contains tables showing the results of heat loss calculations expressed as U-factors for various configurations of the major building components: floor systems, ceiling systems, wall systems, windows, doors and skylights. These values can be used to establish compliance with the MAP specifications and thermal performance criteria or to compare manufactured homes built to different standards.

  11. Manufactured Homes Acquisition Program : Heat Loss Assumptions and Calculations, Heat Loss Coefficient Tables.

    Energy Technology Data Exchange (ETDEWEB)

    Davis, Bob; Baylon, David.

    1992-05-01

    This manual is intended to assist builders of manufactured homes in assessing the thermal performance of structural components used in the Manufactured Housing Acquisition Program (MAP) sponsored by the Bonneville Power Administration (BPA). U-factors for these components are calculated using the ASHRAE (1989) parallel heat loss method, with adaptations made for the construction practices found in the Pacific Northwest manufactured home industry. This report is divided into two parts. The first part describes the general assumptions and calculation procedures used to develop U-factors and R-values for specific materials used in the construction industry, overall U-factors for component sections, and the impact of complex framing and thermal configurations on various components` heat loss rates. The individual components of manufactured homes are reviewed in terms of overall thermal conductivity. The second part contains tables showing the results of heat loss calculations expressed as U-factors for various configurations of the major building components: floor systems, ceiling systems, wall systems, windows, doors and skylights. These values can be used to establish compliance with the MAP specifications and thermal performance criteria or to compare manufactured homes built to different standards.

  12. Clients' safe food-handling knowledge and risk behavior in a home-delivered meal program.

    Science.gov (United States)

    Almanza, Barbara A; Namkung, Young; Ismail, Joseph A; Nelson, Douglas C

    2007-05-01

    paid to the entire period of time from onsite preparation to offsite consumption. Therefore, the success of home-delivered meal programs among older Americans highly depends on multifactorial collaborations. Continued efforts from foodservice providers on safe handling of home-delivered meals are needed to help protect older Americans. At the same time, consumers need more information on handling meals in their homes and a better understanding of the importance of proper handling for prevention of foodborne illness.

  13. Partnering to Enhance Planetary Science Education and Public Outreach Programs

    Science.gov (United States)

    Dalton, H.; Shipp, S. S.; Shupla, C. B.; Shaner, A. J.; LaConte, K.

    2015-12-01

    The Lunar and Planetary Institute (LPI) in Houston, Texas utilizes many partners to support its multi-faceted Education and Public Outreach (E/PO) program. The poster will share what we have learned about successful partnerships. One portion of the program is focused on providing training and NASA content and resources to K-12 educators. Teacher workshops are performed in several locations per year, including LPI and the Harris County Department of Education, as well as across the country in cooperation with other programs and NASA Planetary Science missions. To serve the public, LPI holds several public events per year called Sky Fest, featuring activities for children, telescopes for night sky viewing, and a short scientist lecture. For Sky Fest, LPI partners with the NASA Johnson Space Center Astronomical Society; they provide the telescopes and interact with members of the public as they are viewing celestial objects. International Observe the Moon Night (InOMN) is held annually and involves the same aspects as Sky Fest, but also includes partners from Johnson Space Center's Astromaterials Research and Exploration Science group, who provide Apollo samples for the event. Another audience that LPI E/PO serves is the NASA Planetary Science E/PO community. Partnering efforts for the E/PO community include providing subject matter experts for professional development workshops and webinars, connections to groups that work with diverse and underserved audiences, and avenues to collaborate with groups such as the National Park Service and the Afterschool Alliance. Additional information about LPI's E/PO programs can be found at http://www.lpi.usra.edu/education. View a list of LPI E/PO's partners here: http://www.lpi.usra.edu/education/partners/.

  14. Partnering to Enhance Planetary Science Education and Public Outreach Program

    Science.gov (United States)

    Dalton, Heather; Shipp, Stephanie; Shupla, Christine; Shaner, Andrew; LaConte, Keliann

    2015-11-01

    The Lunar and Planetary Institute (LPI) in Houston, Texas utilizes many partners to support its multi-faceted Education and Public Outreach (E/PO) program. The poster will share what we have learned about successful partnerships. One portion of the program is focused on providing training and NASA content and resources to K-12 educators. Teacher workshops are performed in several locations per year, including LPI and the Harris County Department of Education, as well as across the country in cooperation with other programs and NASA Planetary Science missions.To serve the public, LPI holds several public events per year called Sky Fest, featuring activities for children, telescopes for night sky viewing, and a short scientist lecture. For Sky Fest, LPI partners with the NASA Johnson Space Center Astronomical Society; they provide the telescopes and interact with members of the public as they are viewing celestial objects. International Observe the Moon Night (InOMN) is held annually and involves the same aspects as Sky Fest, but also includes partners from Johnson Space Center’s Astromaterials Research and Exploration Science group, who provide Apollo samples for the event.Another audience that LPI E/PO serves is the NASA Planetary Science E/PO community. Partnering efforts for the E/PO community include providing subject matter experts for professional development workshops and webinars, connections to groups that work with diverse and underserved audiences, and avenues to collaborate with groups such as the National Park Service and the Afterschool Alliance.Additional information about LPI’s E/PO programs can be found at http://www.lpi.usra.edu/education. View a list of LPI E/PO’s partners here: http://www.lpi.usra.edu/education/partners/.

  15. Interpretive Flexibility in Mobile Health: Lessons From a Government-Sponsored Home Care Program

    Science.gov (United States)

    Mathiassen, Lars

    2013-01-01

    Background Mobile technologies have emerged as important tools that health care personnel can use to gain easy access to client data anywhere. This is particularly useful for nurses and care workers in home health care as they provide services to clients in many different settings. Although a growing body of evidence supports the use of mobile technologies, the diverse implications of mobile health have yet to be fully documented. Objective Our objective was to examine a large-scale government-sponsored mobile health implementation program in the Danish home care sector and to understand how the technology was used differently across home care agencies. Methods We chose to perform a longitudinal case study with embedded units of analysis. We included multiple data sources, such as written materials, a survey to managers across all 98 Danish municipalities, and semistructured interviews with managers, care workers, and nurses in three selected home care agencies. We used process models of change to help analyze the overall implementation process from a longitudinal perspective and to identify antecedent conditions, key events, and practical outcomes. Results Strong collaboration between major stakeholders in the Danish home care sector (government bodies, vendors, consultants, interest organizations, and managers) helped initiate and energize the change process, and government funding supported quick and widespread technology adoption. However, although supported by the same government-sponsored program, mobile technology proved to have considerable interpretive flexibility with variation in perceived nature of technology, technology strategy, and technology use between agencies. What was first seen as a very promising innovation across the Danish home care sector subsequently became the topic of debate as technology use arrangements ran counter to existing norms and values in individual agencies. Conclusions Government-sponsored programs can have both positive and

  16. Horizon's patient-centered medical home program shows practices need much more than payment changes to transform

    National Research Council Canada - National Science Library

    Patel, Urvashi B; Rathjen, Carl; Rubin, Elizabeth

    2012-01-01

    ...' accountability for care coordination and outcomes. Horizon Healthcare Services, Inc., New Jersey's oldest and largest health insurance company, developed medical home programs that include financial incentives with essential support tools...

  17. Integrative psychotherapeutic nursing home program to reduce multiple psychiatric symptoms of cognitively impaired patients and caregiver burden: randomized controlled trial

    NARCIS (Netherlands)

    Bakker, T.J.; Duivenvoorden, H.J.; Lee, J. van der; Olde Rikkert, M.G.M.; Beekman, A.T.; Ribbe, M.W.

    2011-01-01

    OBJECTIVE: To test the effectiveness of an integrative psychotherapeutic nursing home program (integrative reactivation and rehabilitation [IRR]) to reduce multiple neuropsychiatry symptoms (MNPS) of cognitively impaired patients and caregiver burden (CB). DESIGN: Randomized controlled trial.

  18. Effect of a Home Telecare Program on Oral Health among Adults with Tetraplegia: A Pilot Study

    Science.gov (United States)

    2012-01-01

    Study design one group pre- and post-test design Objective The primary aim was to examine both the short- and long-term effects of an oral home telecare program on improving gingival health among adults with tetraplegia. Methods Eight adults with tetraplegia participated. The oral home telecare program consisted of individualized oral hygiene training in the use of assistive devices (powered toothbrush and adapted flosser and/or oral irrigator) using PC-based videoconferencing between each participant and an occupational therapist. Training was conducted on an average of five 15 to 30 min sessions across three months. During these training sessions, supervised practice of oral hygiene, and provision of immediate corrective feedback and positive reinforcement in the use of adaptive oral hygiene devices was emphasized. Gingival health assessment using the Löe-Silness gingival index (LSGI) was conducted at baseline, six months and 12 months. Results From baseline to six months, participants showed statistically significant differences (i.e., improvement with less gingival inflammation) in their LSGI scores (z=2.18, P=.03). From baseline to 12 months, participants also showed a statistically significant difference (i.e., improvement, z=2.03; P=.04) in their LSGI scores. Conclusion This study indicates that preventive oral home telecare with repeated oral hygiene training in the use of adaptive devices improved gingival health at six and 12 months among adults with tetraplegia. PMID:23318557

  19. An intercultural comparison of home case management of acute diarrhea in Mexico: implications for program planners.

    Science.gov (United States)

    Martinez, H; Ryan, G W; Guiscafre, H; Gutierrez, G

    1998-01-01

    The objective was to assess the extent to which similarities in cultural beliefs and practices related to home management of diarrhea would permit general recommendations to improve the content of health care messages. We studied six communities in Mexico, covering rural and urban conditions, different ethnic groups, and different socioeconomic levels. Systematic data collection relied on open-ended, face-to-face interviews with mothers of children under 5 years of age who had had an episode of diarrhea. Similarities among communities were assessed by means of a quadratic assignment procedure applied to signs, symptoms, and treatment matrices. Significant similarity among most of the communities sustained use of a global composite matrix to represent all communities. We suggest specific recommendations to promote sound home management of diarrhea based on significant correlations among signs and symptoms with treatments. Signs and symptoms include those promoted by the National Program for the Control of Diarrheal Diseases (diarrhea, fever, vomiting) and others commonly mentioned by mothers (stomach ache, sadness, restlessness, refusal to eat). Similarly, recommendations to use home-based treatments based on beliefs related to their use may include the feeding of rice water, soups, and broth to a child who is sad, or rice-gruel and teas for a child with a fever. Our study supports that there are enough similarities among mothers' beliefs and practices for the care of acute diarrhea in childhood to support general recommendations at the program level.

  20. Home and psycho-social benefits: The case of public housing in ...

    African Journals Online (AJOL)

    The study also found that, after controlling for other influences, people living in bungalow housing units derive more benefits from the home as a hearth and as a locus of autonomy than households in multi-apartment blocks of flats. These findings are pertinent to the design of more fitting and appropriate home environments.

  1. Extension Study Group Members View Their Clubs and Extension Home Economists. ANREI Publication No. 28.

    Science.gov (United States)

    Miller, Mason E.

    The data presented in this report were selected from a 1972 study of Michigan Extension Study Group (ESG) members. Included are data descriptive of the women themselves and their situation (area and type of home, age, income, ESG experience, and especially their attitudes toward their ESG and their Extension Home Economists). Selected findings are…

  2. Greenbelt Homes Pilot Energy Efficiency Program Phase 1 Summary: Existing Conditions and Baseline Energy Use

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J.; Del Bianco, M.; Wood, A.

    2013-02-01

    A multi-year pilot energy efficiency retrofit project has been undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 co-operative of circa 1930 and '40 homes. The three predominate construction methods of the townhomes in the community are materials common to the area and climate zone including 8" CMU block, wood frame with brick veneer and wood frame with vinyl siding. GHI has established a pilot project that will serve as a basis for decision making for the roll out of a decade-long community upgrade program that will incorporate energy efficiency to the building envelope and equipment with the modernization of other systems like plumbing, mechanical equipment, and cladding.

  3. Older persons' experiences of a home-based exercise program with behavioral change support.

    Science.gov (United States)

    Arkkukangas, Marina; Sundler, Annelie J; Söderlund, Anne; Eriksson, Staffan; Johansson, Ann-Christin

    2017-12-01

    It is a challenge to promote exercise among older persons. Knowledge is needed regarding the maintenance of exercise aiming at preventing falls and promoting health and well-being in older persons. This descriptive study used a qualitative inductive approach to describe older persons' experiences of a fall-preventive, home-based exercise program with support for behavioral change. Semi-structured interviews were conducted with 12 elderly persons aged 75 years or older, and a qualitative content analysis was performed. Four categories emerged: facilitators of performing exercise in everyday life, the importance of support, perceived gains from exercise, and the existential aspects of exercise. With support from physiotherapists (PTs), home-based exercise can be adapted to individual circumstances in a meaningful way. Including exercises in everyday life and daily routines could support the experience of being stronger, result in better physical functioning, and give hope for an extended active life in old age.

  4. Greenbelt Homes Pilot Energy Efficiency Program Phase 1 Summary. Existing Conditions and Baseline Energy Use

    Energy Technology Data Exchange (ETDEWEB)

    Wiehagen, J. [NAHB Research Center, Upper Marlboro, MD (United States); Del Bianco, M. [NAHB Research Center, Upper Marlboro, MD (United States); Wood, A. [NAHB Research Center, Upper Marlboro, MD (United States)

    2013-02-01

    A multi-year pilot energy efficiency retrofit project has been undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 co-operative of circa 1930 and '40 homes. The three predominate construction methods of the townhomes in the community are materials common to the area and climate zone including 8” CMU block, wood frame with brick veneer and wood frame with vinyl siding. GHI has established a pilot project that will serve as a basis for decision making for the roll out of a decade-long community upgrade program that will incorporate energy efficiency to the building envelope and equipment with the modernization of other systems like plumbing, mechanical equipment, and cladding.

  5. Framing the evidence for health smart homes and home-based consumer health technologies as a public health intervention for independent aging: a systematic review.

    Science.gov (United States)

    Reeder, Blaine; Meyer, Ellen; Lazar, Amanda; Chaudhuri, Shomir; Thompson, Hilaire J; Demiris, George

    2013-07-01

    There is a critical need for public health interventions to support the independence of older adults as the world's population ages. Health smart homes (HSH) and home-based consumer health (HCH) technologies may play a role in these interventions. We conducted a systematic review of HSH and HCH literature from indexed repositories for health care and technology disciplines (e.g., MEDLINE, CINAHL, and IEEE Xplore) and classified included studies according to an evidence-based public health (EBPH) typology. One thousand, six hundred and thirty-nine candidate articles were identified. Thirty-one studies from the years 1998-2011 were included. Twenty-one included studies were classified as emerging, 10 as promising and 3 as effective (first tier). The majority of included studies were published in the period beginning in the year 2005. All 3 effective (first tier) studies and 9 of 10 of promising studies were published during this period. Almost all studies included an activity sensing component and most of them used passive infrared motion sensors. The three effective (first tier) studies all used a multicomponent technology approach that included activity sensing, reminders and other technologies tailored to individual preferences. Future research should explore the use of technology for self-management of health by older adults; social support; and self-reported health measures incorporated into personal health records, electronic medical records, and community health registries. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. [How effective is the quality assurance as a result of external checking of nursing homes by the public health services].

    Science.gov (United States)

    Martin, U; Behler, R

    2001-12-01

    This is a report on the external checking of nursing homes by the Public Health Services in Duisburg, Germany, focussing on hygienic problems. For a second time in the last three-and-a-half years a total of 41 such homes were inspected and a total of 4150 residents were covered. Data on the intensity of care and on the hygienic standards were evaluated and compared with the results of 1998. 70.73 % of the homes inspected employed a nurse specifically trained in hygiene-management (1998 15 %), 53.66 % used disinfectant textile cleaning and 34.39 % possessed written standards for management of infections relevant for nursing homes. 1.45 % of all residents had pressure sores III degrees and IV degrees classified according to Shea (1998: 3.37 %). In spite of significant improvements, deficits were still registered. To achieve further improvement attention should be focussed on the effectiveness of Public Health Services' activities. Increased co-operation with other institutions engaged in the external checkings as well as a closer focus on specific subjects in hygiene could be appropriate.

  7. Modeling school choice: A comparison of public, private-independent, private-religious and home-schooled students

    Directory of Open Access Journals (Sweden)

    Clive R. Belfield

    2004-06-01

    Full Text Available U.S. students now have four choices of schooling: public schooling, private–religious schooling, private–independent schooling, and home-schooling. Of these, home-schooling is the most novel: since legalization across the states in the last few decades, it has grown in importance and legitimacy as an alternative choice. Thus, it is now possible to investigate the motivation for home-schooling, relative to the other schooling options. Here, we use two recent large-scale datasets to assess the school enrollment decision: the first is the National Household Expenditure Survey (1999, and the second is micro-data on SAT test-takers in 2001. We find that, generally, families with home-schoolers have similar characteristics to those with children at other types of school, but mother’s characteristics – specifically, her employment status – have a strong influence on the decision to home-school. Plausibly, religious belief has an important influence on the schooling decision, not only for Catholic students, but also those of other faiths.

  8. 75 FR 8971 - Medicare Program; Public Meetings in Calendar Year 2010 for All New Public Requests for Revisions...

    Science.gov (United States)

    2010-02-26

    ... HUMAN SERVICES Centers for Medicare & Medicaid Services Medicare Program; Public Meetings in Calendar Year 2010 for All New Public Requests for Revisions to the Healthcare Common Procedure Coding System... in Public Meetings for All New Public Requests for Revisions to the Healthcare Common Procedure...

  9. Cost Analysis of Physician Assistant Home Visit Program to Reduce Readmissions After Cardiac Surgery.

    Science.gov (United States)

    Nabagiez, John P; Shariff, Masood A; Molloy, William J; Demissie, Seleshi; McGinn, Joseph T

    2016-09-01

    A physician assistant home care (PAHC) program providing house calls was initiated to reduce hospital readmissions after adult cardiac surgery. The purpose of our study was to compare 30-day PAHC and pre-PAHC readmission rate, length of stay, and cost. Patients who underwent adult cardiac surgery in the 48 months from September 2008 through August 2012 were retrospectively reviewed using pre-PAHC patients as the control group. Readmission rate, length of stay, and health care cost, as measured by hospital billing, were compared between groups matched with propensity score. Of the 1,185 patients who were discharged directly home, 155 (13%) were readmitted. Total readmissions for the control group (n = 648) was 101 patients (16%) compared with the PAHC group (n = 537) total readmissions of 54 (10%), a 38% reduction in the rate of readmission (p = 0.0049). Propensity score matched groups showed a rate reduction of 41% with 17% (62 of 363) for the control compared with 10% (37 of 363) for the PAHC group (p = 0.0061). The average hospital bill per readmission was $39,100 for the control group and $56,600 for the PAHC group (p = 0.0547). The cost of providing home visits was $25,300 for 363 propensity score matched patients. The PAHC program reduced the 30-day readmission rate by 41% for propensity score matched patients. Analysis demonstrated a savings of $977,500 at a cost of $25,300 over 2 years, or $39 in health care saved, in terms of hospital billing, for every $1 spent. Therefore, a home visit by a cardiac surgical physician assistant is a cost-effective strategy to reduce readmissions after cardiac surgery. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Quality Assurance Audit of Technique Failure and 90-Day Mortality after Program Discharge in a Canadian Home Hemodialysis Program.

    Science.gov (United States)

    Shah, Nikhil; Reintjes, Frances; Courtney, Mark; Klarenbach, Scott W; Ye, Feng; Schick-Makaroff, Kara; Jindal, Kailash; Pauly, Robert P

    2017-07-24

    Little is known about patients exiting home hemodialysis. We sought to characterize the reasons, clinical characteristics, and pre-exit health care team interactions of patients on home hemodialysis who died or underwent modality conversion (negative disposition) compared with prevalent patients and those who were transplanted (positive disposition). We conducted an audit of all consecutive patients incident to home hemodialysis from January of 2010 to December of 2014 as part of ongoing quality assurance. Records were reviewed for the 6 months before exit, and vital statistics were assessed up to 90 days postexit. Ninety-four patients completed training; 25 (27%) received a transplant, 11 (12%) died, and 23 (25%) were transferred to in-center hemodialysis. Compared with the positive disposition group, patients in the negative disposition group had a longer mean dialysis vintage (3.15 [SD=4.98] versus 1.06 [SD=1.16] years; P=0.003) and were performing conventional versus a more intensive hemodialysis prescription (23 of 34 versus 23 of 60; Pday mortality among patients undergoing modality conversion was 26%. Over a 6-year period, approximately one third of patients exited the program due to death or modality conversion. Patients who die or transfer to another modality have significantly higher health care resource utilization (e.g., hospitalization, respite treatments, nursing time, etc.). Copyright © 2017 by the American Society of Nephrology.

  11. A Randomised Controlled Trial of Two Early Intervention Programs for Young Children with Autism: Centre-Based with Parent Program and Home-Based

    Science.gov (United States)

    Roberts, Jacqueline; Williams, Katrina; Carter, Mark; Evans, David; Parmenter, Trevor; Silove, Natalie; Clark, Trevor; Warren, Anthony

    2011-01-01

    This study compares outcomes of early intervention programs for young children with autism; an individualised home-based program (HB), a small group centre-based program for children combined with a parent training and support group (CB) and a non-treatment comparison group (WL). Outcome measures of interest include social and communication skill…

  12. Sponsorship of physical activity programs by the sweetened beverages industry: public health or public relations?

    Science.gov (United States)

    Gómez, Luis; Jacoby, Enrique; Ibarra, Lorena; Lucumí, Diego; Hernandez, Alexandra; Parra, Diana; Florindo, Alex; Hallal, Pedro

    2011-04-01

    The growing evidence on the association between consumption of sugar-sweetened beverages, obesity and other chronic diseases has highlighted the need to implement policy actions that go beyond programs exclusively focused on individual responsibility. In order to protect their commercial goals in Latin America, the sugar-sweetened beverage industry practices intense lobbying at high government levels in several countries across the region. This strategy is accompanied by corporate social responsibility programs that fund initiatives promoting physical activity. These efforts, although appearing altruistic, are intended to improve the industry's public image and increase political influence in order to block regulations counter to their interests. If this industry wants to contribute to human well being, as it has publicly stated, it should avoid blocking legislative actions intended to regulate the marketing, advertising and sale of their products.

  13. Changes in Consumer Demand Following Public Reporting of Summary Quality Ratings: An Evaluation in Nursing Homes.

    Science.gov (United States)

    Werner, Rachel M; Konetzka, R Tamara; Polsky, Daniel

    2016-06-01

    Limited consumer use of health care report cards may be due to the large amount of information presented in report cards, which can be difficult to understand. These limitations may be overcome with summary measures. Our objective was to evaluate consumer response to summary measures in the setting of nursing homes. 2005-2010 nursing home Minimum Data Set and Online Survey, Certification and Reporting (OSCAR) datasets. In December 2008, Medicare converted its nursing home report card to summary or star ratings. We test whether there was a change in consumer demand for nursing homes related to the nursing home's star rating after the information was released. The star rating system was associated with a significant change in consumer demand for low- and high-scoring facilities. After the star-based rating system was released, 1-star facilities typically lost 8 percent of their market share and 5-star facilities gained over 6 percent of their market share. The nursing home star rating system significantly affected consumer demand for high- and low-rated nursing homes. These results support the use of summary measures in report cards. © Health Research and Educational Trust.

  14. Out of hospital cardiac arrest outside home in Sweden, change in characteristics, outcome and availability for public access defibrillation

    OpenAIRE

    Rosenqvist Mårten; Hollenberg Jacob; Herlitz Johan; Ringh Mattias; Svensson Leif

    2009-01-01

    Abstract Background A large proportion of patients who suffer from out of hospital cardiac arrest (OHCA) outside home are theoretically candidates for public access defibrillation (PAD). We describe the change in characteristics and outcome among these candidates in a 14 years perspective in Sweden. Methods All patients who suffered an OHCA in whom cardiopulmonary resuscitation (CPR) was attempted between 1992 and 2005 and who were included in the Swedish Cardiac Arrest Register (SCAR). We in...

  15. Exercise program for nursing home residents with Alzheimer's disease: a 1-year randomized, controlled trial.

    Science.gov (United States)

    Rolland, Yves; Pillard, Fabien; Klapouszczak, Adrian; Reynish, Emma; Thomas, David; Andrieu, Sandrine; Rivière, Daniel; Vellas, Bruno

    2007-02-01

    To investigate the effectiveness of an exercise program in improving ability to perform activities of daily living (ADLs), physical performance, and nutritional status and decreasing behavioral disturbance and depression in patients with Alzheimer's disease (AD). Randomized, controlled trial. Five nursing homes. One hundred thirty-four ambulatory patients with mild to severe AD. Collective exercise program (1 hour, twice weekly of walk, strength, balance, and flexibility training) or routine medical care for 12 months. ADLs were assessed using the Katz Index of ADLs. Physical performance was evaluated using 6-meter walking speed, the get-up-and-go test, and the one-leg-balance test. Behavioral disturbance, depression, and nutritional status were evaluated using the Neuropsychiatric Inventory, the Montgomery and Asberg Depression Rating Scale, and the Mini-Nutritional Assessment. For each outcome measure, the mean change from baseline to 12 months was calculated using intention-to-treat analysis. ADL mean change from baseline score for exercise program patients showed a slower decline than in patients receiving routine medical care (12-month mean treatment differences: ADL=0.39, P=.02). A significant difference between the groups in favor of the exercise program was observed for 6-meter walking speed at 12 months. No effect was observed for behavioral disturbance, depression, or nutritional assessment scores. In the intervention group, adherence to the program sessions in exploratory analysis predicted change in ability to perform ADLs. No adverse effects of exercise occurred. A simple exercise program, 1 hour twice a week, led to significantly slower decline in ADL score in patients with AD living in a nursing home than routine medical care.

  16. More Than A Meal? A Randomized Control Trial Comparing the Effects of Home-Delivered Meals Programs on Participants' Feelings of Loneliness.

    Science.gov (United States)

    Thomas, Kali S; Akobundu, Ucheoma; Dosa, David

    2016-11-01

    Nutrition service providers are seeking alternative delivery models to control costs and meet the growing need for home-delivered meals. The objective of this study was to evaluate the extent to which the home-delivered meals program, and the type of delivery model, reduces homebound older adults' feelings of loneliness. This project utilizes data from a three-arm, fixed randomized control study conducted with 626 seniors on waiting lists at eight Meals on Wheels programs across the United States. Seniors were randomly assigned to either (i) receive daily meal delivery; (ii) receive once-weekly meal delivery; or (iii) remain on the waiting list. Participants were surveyed at baseline and again at 15 weeks. Analysis of covariance was used to test for differences in loneliness between groups, over time and logistic regression was used to assess differences in self-rated improvement in loneliness. Participants receiving meals had lower adjusted loneliness scores at follow-up compared with the control group. Individuals who received daily-delivered meals were more likely to self-report that home-delivered meals improved their loneliness than the group receiving once-weekly delivered meals. This article includes important implications for organizations that provide home-delivered meals in terms of cost, delivery modality, and potential recipient benefits. Published by Oxford University Press on behalf of the Gerontological Society of America 2015. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  17. Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program.

    Science.gov (United States)

    Meagher, Karen M; Lee, Lisa M

    2016-01-01

    Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation--deliberative public bioethics--into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice.

  18. Rehabilitation outcome in home-based versus supervised exercise programs for chronically dizzy patients.

    Science.gov (United States)

    Kao, Chung-Lan; Chen, Liang-Kung; Chern, Chang-Ming; Hsu, Li-Chi; Chen, Chih-Chun; Hwang, Shinn-Jang

    2010-01-01

    We aimed to evaluate the effectiveness of vestibular rehabilitation (VR) exercise between supervised and home-based programs in young and senior age groups of patients with chronic dizziness. Dizziness Handicap Inventory (DHI), Dynamic gait index (DGI), Tinetti fall risk performance scales and Timed "Up and Go" test (TUG) were administered to patients on their initial and follow-up visits for forty-one patients suffering from chronic dizziness. Twenty-eight patients received three 30-min vestibular training exercise sessions per week. Thirteen patients who could not visit our clinic on regular basis were instructed to do the same set of exercises at home, with the same duration and frequency. All scales were evaluated again on their follow-up visits 2 months later. Patients in both groups showed statistically significant improvement in DHI and Tinetti scales. A higher percentage of patients in the supervised-exercise-program (SP) group showed clinically significant outcome improvements. Age was not a predictive factor for rehabilitation outcome. We concluded that for all ages of chronically dizzy patients, 2 months of VR can reduce handicap, improve balance function and a consequent improvement of life quality. Health care professionals need to be educated about the importance of rehabilitation program for treatment of chronic dizziness. Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.

  19. Energy-efficient Public Procurement: Best Practice in Program Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Payne, Christopher [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Weber, Andrew [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Environmental Energy Technologies Division; Semple, Abby [Public Procurement Analysis, London (United Kingdom)

    2013-02-15

    This document illustrates the key issues and considerations involved in implementing energy-efficient public procurement. Our primary sources of information have been our partners in the Super Efficient Equipment and Appliance Deployment (SEAD) Initiative Procurement Working Group. Where applicable, we have highlighted specific ways in which working group participants have successfully overcome barriers to delivering effective programs. The following key points emerge from this analysis of programs for energy-efficient public procurement. Lessons for both developed and developing programs are highlighted throughout the guide. 1. Policy: Policy provides the initiative to begin a transition from first cost to life-cycle cost based purchasing methods and culture. Effective policy is well-communicated, establishes accountability from top to bottom of organizations and simplifies the processes necessary to comply. Flexibility and responsiveness are essential in policy development and implementation. Mandatory and voluntary policies may complement one another. 2. Procurement Criteria: Procurement staff must be confident that energy-efficient procurement criteria offer the best long-term value for their organization’s money and represent real environmental gains. Involving multiple stakeholders at the early stages of the criteria creation process can result in greater levels of cooperation from private industry. Criteria should make comparison of products easy for purchasers and require minimal additional calculations. Criteria will need to be regularly updated to reflect market developments. 3. Training: Resources for the creation of training programs are usually very limited, but well-targeted training is necessary in order for a program to be effective. Training must emphasize a process that is efficient for purchasers and simplifies compliance. Purchaser resources and policy must be well designed for training to be effective. Training program development is an

  20. Effects of a physical therapy home-based exercise program for Parkinson's disease

    Directory of Open Access Journals (Sweden)

    Viviane Vieira Santos

    Full Text Available INTRODUCTION: Parkinson's disease (PD is a neurological disorder that causes loss of functional abilities and independence. The aim of this study was to evaluate the effects of a physical therapist-supervised home-based exercise program in patients with PD using the UPDRS scale. MATERIALS AND METHODS: Thirty-three PD patients in the 1.5 to 3 Hoehn and Yahr stages participated in the trial. The patients and their relatives received a booklet with a 12-week home program, with a series of strengthening, stretching and flexibility exercises. The patients were trained by a physical therapist, and each session took 60 minutes, three times a week. RESULTS: We classified our patients in four groups: Group 1 - patients under 60 years of age and less than five years of PD; Group 2 - patients under 60 years of age and more than five years of PD; Group 3 - patients over 60 years of age and less than five years of the disease; and Group 4 - patients over 60 years of age and more than five years of PD. Significant improvement was found in group 1 in mentation, activities of daily living and motor function (p > 0.05. Group 3 presented statistically significant differences in motor function subscale (p > 0.05 and Group 4 showed no worsening in mentation subscale (p > 0.05. Group 2, however, presented no difference in all subscales (p < 0.05. CONCLUSION: Although not all patients improved their UPDRS scores, our data support the use of a home program as an alternative method of physical therapy treatment for PD patients.

  1. Therapist supervised clinic-based therapy versus instruction in a home program following distal radius fracture: a systematic review.

    Science.gov (United States)

    Valdes, Kristin; Naughton, Nancy; Michlovitz, Susan

    2014-01-01

    The primary purpose of this systematic review is to determine the effectiveness of a home program or a structured therapy program for patients following distal radius fracture. A search was performed using terms wrist fracture, supervised therapy, occupational therapy, physical therapy, splint, orthosis, distal radius fracture, exercise, and home program. Studies that met the inclusion criteria were evaluated for research quality using The Structured Effectiveness for Quality Evaluation of Study (SEQES). Five of the seven trials found no difference between outcomes for their subjects that had uncomplicated distal radius fractures. The population that has complications following distal radius fractures was not represented in the studies reviewed. The available evidence from randomized controlled trials is insufficient to support a home program or therapist supervised clinic-based program as a superior method of treatment for adults following a distal radius fracture without complications or the presence of comorbidities. Copyright © 2014 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  2. Resource and cost adjustment in the design of allocation funding formulas in public health programs.

    Science.gov (United States)

    Buehler, James W; Bernet, Patrick M; Ogden, Lydia L

    2012-01-01

    Multiple federal public health programs use funding formulas to allocate funds to states. To characterize the effects of adjusting formula-based allocations for differences among states in the cost of implementing programs, the potential for generating in-state resources, and income disparities, which might be associated with disease risk. Fifty US states and the District of Columbia. Formula-based funding allocations to states for 4 representative federal public health programs were adjusted using indicators of cost (average salaries), potential within-state revenues (per-capita income, the Federal Medical Assistance Percentage, per-capita aggregate home values), and income disparities (Theil index). Percentage of allocation shifted by adjustment, the number of states and the percentage of US population living in states with a more than 20% increase or decrease in funding, maximum percentage increase or decrease in funding. Each adjustor had a comparable impact on allocations across the 4 program allocations examined. Approximately 2% to 8% of total allocations were shifted, with adjustments for variations in income disparity and housing values having the least and greatest effects, respectively. The salary cost and per-capita income adjustors were inversely correlated and had offsetting effects on allocations. With the exception of the housing values adjustment, fewer than 10 states had more than 20% increases or decreases in allocations, and less than 10% of the US population lived in such states. Selection of adjustors for formula-based funding allocations should consider the impacts of different adjustments, correlations between adjustors and other data elements in funding formulas, and the relationship of formula inputs to program objectives.

  3. Effectiveness of public health and education programs for creating awareness of and managing cardiovascular disease

    Directory of Open Access Journals (Sweden)

    Simon White

    2011-02-01

    Full Text Available Simon WhiteSchool of Pharmacy, Keele University, Keele, Staffordshire, UKAbstract: This paper reviews the effectiveness of public health and education programs for creating awareness of, preventing and managing cardiovascular disease (CVD, with a particular focus on their impact on people’s behavior. Evidence-based guidance recommends that such programs, eg, cardiac rehabilitation, should include risk assessment, modification of lifestyle risk factors and, where appropriate, medication. However, despite substantial evidence of cardiac rehabilitation being beneficial, a significant proportion of eligible patients fail to receive cardiac rehabilitation and numerous barriers to attendance remain, particularly because cardiac rehabilitation service provision continues to be patchy and of variable quality. Evidence suggests that educational programs to prevent CVD may achieve favorable reductions in mortality and overall CVD risk. However, whilst people tend to have significant knowledge of the modifiable risk factors for CVD, this does not necessarily lead to action to reduce risk, because lay epidemiology appears to play a significant role in sophisticated determinations of CVD causation, amongst other factors. Some people, but not all, make and maintain some lifestyle changes, but not necessarily all of the changes recommended, because they may only change aspects of lifestyle that are perceived to have been likely causes of their CVD. In addition, many people experience difficulty in making and maintaining lifestyle changes. There appears to be considerable disquiet among patients about taking medicines prescribed for CVD, particularly concerning side effects, which in some instances may affect medicine-taking. New developments and patient approaches recognize the wider societal issues that influence the lifestyle choices people make. Initiatives to increase attendance and widen access to cardiac rehabilitation have included home-based and

  4. Home infusion program for Fabry disease: experience with agalsidase alfa in Argentina

    Directory of Open Access Journals (Sweden)

    Isaac Kisinovsky

    2013-02-01

    Full Text Available Fabry disease is an X-linked lysosomal storage disorder caused by inherited deficiency of the enzyme α-galactosidase A. Enzyme replacement treatment using agalsidase alfa significantly reduces pain, improves cardiac function and quality of life, and slows renal deterioration. Nevertheless, it is a life-long treatment which requires regular intravenous infusions and entails a great burden for patients. Our objective was to evaluate retrospectively the safety and tolerability of the home infusion of agalsidase alfa in patients with Fabry disease in Argentina. We evaluated all the patients with Fabry disease who received home infusion with agalsidase alfa 0.2 mg/kg between January 2005 and June 2011. The program included 87 patients; 51 males (mean age: 30 years and 36 females (mean age: 34 years. A total of 5229 infusions (mean: 59 per patient; range: 1-150 were administered. A total of 5 adverse reactions were seen in 5 patients (5.7% of patients and 0.9% of the total number of infusions. All were mild in severity and resolved by reducing the rate of infusion and by using antihistaminics. All these 5 patients were positive for IgG antibodies, but none of them presented IgE antibodies and none suffered an anaphylactic shock. In our group 18 patients were switched from agalsidase beta to agalsidase alfa without complications. Home infusion with agalsidase alfa is safe, well tolerated and is associated to high compliance.

  5. Greenbelt Homes Pilot Program: Summary of Building Envelope Retrofits, Planned HVAC Equipment Upgrades, and Energy Savings

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-05-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a decade-long community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. It presents a unique opportunity to evaluate and prioritize the wide-range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects to include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy savings benefits of improvements.

  6. The Michigan Surgical Home and Optimization Program is a scalable model to improve care and reduce costs.

    Science.gov (United States)

    Englesbe, Michael J; Grenda, Dane R; Sullivan, June A; Derstine, Brian A; Kenney, Brooke N; Sheetz, Kyle H; Palazzolo, William C; Wang, Nicholas C; Goulson, Rebecca L; Lee, Jay S; Wang, Stewart C

    2017-06-01

    The Michigan Surgical Home and Optimization Program is a structured, home-based, preoperative training program targeting physical, nutritional, and psychological guidance. The purpose of this study was to determine if participation in this program was associated with reduced hospital duration of stay and health care costs. We conducted a retrospective, single center, cohort study evaluating patients who participated in the Michigan Surgical Home and Optimization Program and subsequently underwent major elective general and thoracic operative care between June 2014 and December 2015. Propensity score matching was used to match program participants to a control group who underwent operative care prior to program implementation. Primary outcome measures were hospital duration of stay and payer costs. Multivariate regression was used to determine the covariate-adjusted effect of program participation. A total of 641 patients participated in the program; 82% were actively engaged in the program, recording physical activity at least 3 times per week for the majority of the program; 182 patients were propensity matched to patients who underwent operative care prior to program implementation. Multivariate analysis demonstrated that participation in the Michigan Surgical Home and Optimization Program was associated with a 31% reduction in hospital duration of stay (P < .001) and 28% lower total costs (P < .001) after adjusting for covariates. A home-based, preoperative training program decreased hospital duration of stay, lowered costs of care, and was well accepted by patients. Further efforts will focus on broader implementation and linking participation to postoperative complications and rigorous patient-reported outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. 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

  8. How public home care officers reason when making a needs assessment for food distribution to homebound elderly persons in Sweden.

    Science.gov (United States)

    Pajalic, Zada

    2013-05-22

    Food distribution (FD) is a part of the public social and care service in Sweden aiming to prevent improper food intake for persons that they are unable to do their own shopping, and prepare their own meals, and in that way ensure reasonable standard of living. Before a person can be granted the FD service, from any municipality, an assessment of their individual requirements has to be made by a public home care officer. The aim of this study was to explore how public home care officers reason when they make a needs assessment for homebound elderly people. The data was collected through individual interviews (n=18). The transcribed interview material was analysed by means of the grounded theory method. The findings showed that the public home care officers were confronted with many challenges when making an assessment of a person's individual needs. They are influenced by their subjective feelings related to their personal views as to what should be the right solution for the individual. However, they remained aware that they needed to be guided by the legal requirements.  Further, they described that the level of an individual's living standard is a leading concept in the governing laws that they need to interpret. Interpretation of this concept is very subjective with the possible consequence that an assessment result may lead to inefficient support. In conclusion, the concept of a reasonable standard of living needs to be clearly defined, decision regarding FD should not take long time, need assessment and decision should be based on the whole picture behind each individual case and there are needs to develop general guidelines for making needs assessment. The findings in this study have implications for public administration, nursing and gerontology.

  9. The Hubble Space Telescope Education and Public Outreach Program

    Science.gov (United States)

    Teays, T. J.; Eisenhamer, B.; Eisenhamer, J.; Amazing Space Team

    2001-05-01

    The Hubble Space Telescope has conducted a long-standing and vigorous program in education and public outreach. This program uses a variety of methods to reach a broad spectrum of audiences. Education products are developed in a team environment that partners educators, curriculum experts, scientists, and production experts, such as graphic artists, Web designers, programmers, and education evaluators. A popular Web site is maintained, and has been substantially augmented in the past year. The Amazing Space program consists of a suite of online, interactive modules for use in the kindergarten through 12th grade classroom. The program is rooted in the national education standards and benefits from a robust evaluation process. The HST images and data are used to engage students in learning basic science and mathematics concepts. The activity/lessons include extensive, online assistance for educators, so that they can be readily used in the classroom. Hardcopy products such as posters, lithographs, teacher guides, and trading cards are generally tied to online products, to provide multiple entries to the material. We also provide training for teachers in the use of our products, as appropriate. Informal science education is supported by providing services to museums, planetariums, libraries and related institutions. The very popular ViewSpace, a computer-based video service is being used by many informal science facilities. In addition, HST has supported the creation of both permanent and traveling exhibits about HST. The Space Telescope Science Institute operates the Hubble Space Telescope for NASA.

  10. Monitoring and evaluation of green public procurement programs

    Energy Technology Data Exchange (ETDEWEB)

    Adell, Aure [Ecoinstitut, Barcelona (Spain); Schaefer, Bettina [Ecoinstitut, Barcelona (Spain); Ravi, Kavita [US Department of Energy, Washington, DC (United States); Corry, Jenny [Collaborative Labeling and Appliance Standards Program (United States)

    2013-10-15

    Effective procurement policies can help governments save considerable amounts of money while also reducing energy consumption. Additionally, private sector companies which purchase large numbers of energy-consuming devices can benefit from procurement policies that minimize life-cycle energy costs. Both public and private procurement programs offer opportunities to generate market-transforming demand for energy efficient appliances and lighting fixtures. In recent years, several governments have implemented policies to procure energy efficient products and services. When deploying these policies, efforts have focused on developing resources for implementation (guidelines, energy efficiency specifications for tenders, life cycle costing tools, training, etc.) rather than defining monitoring systems to track progress against the set objectives. Implementation resources are necessary to make effective policies; however, developing Monitoring and Evaluation (M and E) mechanisms are critical to ensure that the policies are effective. The purpose of this article is to provide policy makers and procurement officials with a preliminary map of existing approaches and key components to monitor Energy Efficient Procurement (EEP) programs in order to contribute to the improvement of their own systems. Case studies are used throughout the paper to illustrate promising approaches to improve the M and E of EEP programs, from the definition of the system or data collection to complementary instruments to improve both the monitoring response and program results.

  11. Home-School Differences in Beliefs, Support, and Control during Public Pre-kindergarten and their Link to Children's Kindergarten Readiness

    OpenAIRE

    Barbarin, Oscar A.; Downer, Jason; Odom, Erica; Head, Darlene

    2010-01-01

    This study examines the prevalence of home-school match in child-rearing beliefs and socialization practices (control and support) and their relation to ethnicity and readiness skills of children (n=310) making the transition from publicly sponsored pre-k to kindergarten. Home-school match was operationalized both as a continuous absolute measure and as categories of match or mismatch. Overall, home-school match was more prevalent than mismatch. However, the results corroborate previous ethno...

  12. 76 FR 22713 - Advisory Committee on the Maternal, Infant and Early Childhood Home Visiting Program Evaluation...

    Science.gov (United States)

    2011-04-22

    ... status, school readiness, and domestic violence, among others); (b) the effectiveness of such programs on... HUMAN SERVICES Health Resources and Services Administration Administration for Children and Families... Administration for Children and Families. The meeting will be open to the public. This notice is being published...

  13. An economic evaluation of public programs for internationalization: the case of the Diagnostic Program in Spain.

    Science.gov (United States)

    Cansino, José M; Lopez-Melendo, Jaime; Pablo-Romero, María del P; Sánchez-Braza, Antonio

    2013-12-01

    This paper evaluates the Diagnostic Program in Spain which is a publicly funded program to promote internationalization of companies located in Andalusia (south of Spain). The methodology used is the propensity score-matching. The treatment group consists of companies which participated in the Program until 2008. The control group has companies which planned to participate in the Program but had not done so up to that date. The response variable measures the ratio of export to total sales for each company. Four covariates have been taken into account: activity, location, sales and number of employees. The analysis leads to the conclusion that the companies that participated in the Program improved their ratio of exports to total sales by about 10 percentage points. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Entrepreneurial program of research and service to improve nursing home care.

    Science.gov (United States)

    Rantz, Marilyn J; Mehr, David R; Hicks, Lanis; Scott-Cawiezell, Jill; Petroski, Gregory F; Madsen, Richard W; Porter, Rose; Zwygart-Stauffacher, Mary

    2006-12-01

    This is a methodological article intended to demonstrate the integration of multiple goals, multiple projects with diverse foci, and multiple funding sources to develop an entrepreneurial program of research and service to directly affect and improve the quality of care of older adults, particularly nursing home residents. Examples that illustrate how clinical ideas build on one another and how the research ideas and results build on one another are provided. Results from one study are applied to the next and are also applied to the development of service delivery initiatives to test results in the real world. Descriptions of the Quality Improvement Program for Missouri and the Aging in Place Project are detailed to illustrate real-world application of research to practice.

  15. Development of a Wheelchair Skills Home Program for Older Adults Using a Participatory Action Design Approach

    Directory of Open Access Journals (Sweden)

    Edward M. Giesbrecht

    2014-01-01

    Full Text Available Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population.

  16. Development of a Wheelchair Skills Home Program for Older Adults Using a Participatory Action Design Approach

    Science.gov (United States)

    Giesbrecht, Edward M.; Miller, William C.; Mitchell, Ian M.; Woodgate, Roberta L.

    2014-01-01

    Restricted mobility is the most common impairment among older adults and a manual wheelchair is often prescribed to address these limitations. However, limited access to rehabilitation services results in older adults typically receiving little or no mobility training when they receive a wheelchair. As an alternative and novel approach, we developed a therapist-monitored wheelchair skills home training program delivered via a computer tablet. To optimize efficacy and adherence, principles of self-efficacy and adult learning theory were foundational in the program design. A participatory action design approach was used to engage older adult wheelchair users, care providers, and prescribing clinicians in an iterative design and development process. A series of prototypes were fabricated and revised, based on feedback from eight stakeholder focus groups, until a final version was ready for evaluation in a clinical trial. Stakeholder contributions affirmed and enhanced the foundational theoretical principles and provided validation of the final product for the target population. PMID:25276768

  17. 77 FR 547 - Fiscal Year 2011 Public Transportation on Indian Reservations Program Project Selections

    Science.gov (United States)

    2012-01-05

    ... Federal Transit Administration Fiscal Year 2011 Public Transportation on Indian Reservations Program... Administration (FTA) announces the selection of projects funded with Section 5311 (c), Public Transportation on... of capital projects, operating costs, and planning activities for public transportation services on...

  18. 34 CFR 270.1 - What are the Desegregation of Public Education Programs?

    Science.gov (United States)

    2010-07-01

    ... 34 Education 1 2010-07-01 2010-07-01 false What are the Desegregation of Public Education Programs? 270.1 Section 270.1 Education Regulations of the Offices of the Department of Education OFFICE OF... are the Desegregation of Public Education Programs? The Desegregation of Public Education Programs...

  19. Action-oriented evaluation of an in-home family therapy program for families at risk for foster care placement.

    Science.gov (United States)

    McWey, Lenore M; Humphreys, Julie; Pazdera, Andrea L

    2011-04-01

    The purpose of this study was to conduct an action-oriented evaluation of an in-home family therapy program serving families deemed at risk for the placement of children in foster care. In this study, feedback was solicited from both clients and therapists. Results indicate "duality" associated with several aspects of in-home family therapy, including the opportunity to observe families in their own homes versus the vulnerability some families feel when therapy is conducted in-home; therapists suggesting that sufficient training is required for in-home family therapy to be effective versus clients' opinions that therapists' lived experiences are more relevant; and the importance of the therapeutic alliance versus feelings of abandonment upon termination. Implications for researchers and practitioners are discussed. © 2009 American Association for Marriage and Family Therapy.

  20. Home-School Differences in Beliefs, Support, and Control during Public Pre-Kindergarten and Their Link to Children's Kindergarten Readiness

    Science.gov (United States)

    Barbarin, Oscar A.; Downer, Jason; Odom, Erica; Head, Darlene

    2010-01-01

    This study examines the prevalence of home-school match in childrearing beliefs and socialization practices (control and support) and their relation to ethnicity and readiness skills of children (n = 310) making the transition from publicly sponsored Pre-k to kindergarten. Home-school match was operationalized both as a continuous absolute measure…

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

    Science.gov (United States)

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

    2009-01-01

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

  2. Public communication strategy for NASA's planetary protection program

    Science.gov (United States)

    Billings, L.

    The U.S. National Aeronautics and Space Administration (NASA) Planetary Protection Office, in the Office of Space Science, has a long-term initiative under way in communication research and planning. The possibility of extraterrestrial life and efforts to search for evidence of it is one of NASA's key missions, and of great interest to the public. Planetary protection plays a key role in the search for signs of life elsewhere, and as NASA expands its solar system exploration efforts, communication planning for planetary protection must expand to meet growing needs. NASA's Clearly Protection Office has long recognized the importance of communications in accomplishing its goals and objectives. With solar system exploration missions advancing into the era of sample return and with the science of astrobiology changing assumptions about the nature and boundaries of life, the Planetary Protection office is expanding its communication planning efforts and taking first steps toward implementation of a long-term strategy. For the past 10 years, communication research sponsored by the NASA planetary protection program has focused on reaching members of the science community and addressing legal and ethical concerns. In 2003, the program expanded its communication research efforts, initiating the development of a communication strategy based on a participatory model and intended to address the needs of a broad range of extra audiences. The Planetary Protection Office aims to ensure that its scientific, bureaucratic, and other constituencies are fully informed about planetary protection policies and procedures and prepared to communicate with a variety of public audiences about issues relating to planetary protection. This paper will describe NASA's ongoing planetary protection communication research efforts, focusing on development of a participatory communication strategy to enable broadest possible public participation in planning and development of solar system sample

  3. Preliminary Data from the Caring for Older Adults and Caregivers at Home (COACH) Program: A Care Coordination Program for Home-Based Dementia Care and Caregiver Support in a Veterans Affairs Medical Center.

    Science.gov (United States)

    D'Souza, Maria F; Davagnino, Judith; Hastings, S Nicole; Sloane, Richard; Kamholz, Barbara; Twersky, Jack

    2015-06-01

    Caring for Older Adults and Caregivers at Home (COACH) is an innovative care coordination program of the Durham Veteran's Affairs Medical Center in Durham, North Carolina, that provides home-based dementia care and caregiver support for individuals with dementia and their family caregivers, including attention to behavioral symptoms, functional impairment, and home safety, on a consultation basis. The objectives of this study were to describe the COACH program in its first 2 years of operation, assess alignment of program components with quality measures, report characteristics of program participants, and compare rates of placement outside the home with those of a nontreatment comparison group using a retrospective cohort design. Participants were community-dwelling individuals with dementia aged 65 and older who received primary care in the medical center's outpatient clinics and their family caregivers, who were enrolled as dyads (n = 133), and a control group of dyads who were referred to the program and met clinical eligibility criteria but did not enroll (n = 29). Measures included alignment with Dementia Management Quality Measures and time to placement outside the home during 12 months of follow-up after referral to COACH. Results of the evaluation demonstrated that COACH aligns with nine of 10 clinical process measures identified using quality measures and that COACH delivers several other valuable services to enhance care. Mean time to placement outside the home was 29.6 ± 14.3 weeks for both groups (P = .99). The present study demonstrates the successful implementation of a home-based care coordination intervention for persons with dementia and their family caregivers that is strongly aligned with quality measures. © 2015, Copyright the Authors Journal compilation © 2015, The American Geriatrics Society.

  4. Take a Walk! Innovative Programming from Winnipeg Public Library

    Directory of Open Access Journals (Sweden)

    Kirsten Wurmann

    2016-07-01

    Full Text Available Historical walks, literary walks, and walking book clubs – learn how Winnipeg Public Library is taking it outside. Rebecca Solnit in her book Wanderlust: A History of Walking writes: “Walking shares with making and working that crucial element of engagement of the body and the mind with the world, of knowing the world through the body and the body through the world.” As libraries work hard to share knowledge with their communities and to engage patrons in new ways, this presentation addresses the practicalities of creating a program that speaks uniquely to your own neighbourhood and patrons: Learn about the walking programs offered by various Winnipeg Public Library branches; recognize the benefits of these programs and how they can relate to library programming goals and strategic plans; and identify resources that can help you develop your own walking programs. This summary is based on a poster presentation given at the annual OLA Super Conference held in Toronto, Ontario on January 27-30, 2016. Les promenades historiques, les promenades littéraires et les clubs de marche littéraires - apprenez comment la bibliothèque publique de Winnipeg profite de l’extérieur. Dans son livre Wanderlust: A History of Walking Rebecca Solnit écrit: “Se promener partage avec faire et travailler cet élément crucial d’engagement du corps et de l’esprit avec le monde, de connaître le monde à travers le corps et le corps à travers le monde.” Comme des bibliothèques travaillent fort pour partager des informations avec leurs communautés et pour engager des clients de nouvelles façons, cette présentation porte sur l’applicabilité de créer un programme adapté aux particularités de votre propre quartier et de vos clients : renseignez-vous sur les programmes de marche offerts par des filiales différentes de la bibliothèque publique de Winnipeg; Reconnaissez des avantages de ces programmes et comment ils peuvent se rapporter aux

  5. Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs)

    NARCIS (Netherlands)

    Foebel, A.D.; van Hout, H.P.J.; van der Roest, H.G.; Topinkova, E.; Garms-Homolova, V.; Frijters, D.H.M.; Finne-Soveri, H.; Jonsson, P.V.; Hirdes, J.P.; Bernabei, R.; Onder, G.

    2015-01-01

    Background: Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the

  6. What Matters Most? A Mixed Methods Study of Critical Aspects of a Home-Based Palliative Program.

    Science.gov (United States)

    Ankuda, Claire K; Kersting, Kaileen; Guetterman, Timothy C; Haefner, Jessica; Fonger, Evan; Paletta, Michael; Hopp, Faith

    2017-01-01

    Home-based palliative care programs have shown value in improving quality of care and lowering costs for seriously ill patients. It is unknown what specific elements of these programs matter most to patients and caregivers. To identify what services are critical and why they matter to patients in a home-based palliative program. A mixed methods study of 18 participants in the At Home Support (AHS) program in Southeast Michigan. Two semistructured interviews were conducted for each participant, one while enrolled in AHS and another 3 months after the program ended to elicit the impact of AHS on their care. Qualitative theme data were merged with quantitative data on demographics, social and financial resources, symptoms, medical conditions, functional status, and utilization of health care while in AHS. Four major themes of critical services reported by distinct populations of participants were described-medical support, endorsed by nearly every participant; emotional and spiritual support, endorsed by those with serious illness and symptom burden; practical assistance, endorsed by those with functional disability and isolation; and social services, endorsed by those in poverty. Medical monitoring was also described as critical but only by healthier participants. This study presents a conceptual model of the critical services in home-based palliative care and why these services are important to high-risk patients. This model may be used to guide further research and evaluation work on the benefits of home-based palliative care.

  7. A disease management program for heart failure: collaboration between a home care agency and a care management organization.

    Science.gov (United States)

    Gorski, Lisa A; Johnson, Kathy

    2003-01-01

    This article describes a collaborative approach to manage patients with heart failure between a home care agency and a care management agency. The resulting disease management program used a combination of home visits and phone contact. Care management plans emphasized patient education on increasing adherence to medical and diet regimens, and recognizing early symptoms of exacerbation that could lead to rehospitalization. Clinician activities and patient outcomes are described.

  8. Quality of care in European home care programs using the second generation interRAI Home Care Quality Indicators (HCQIs).

    Science.gov (United States)

    Foebel, Andrea D; van Hout, Hein P; van der Roest, Henriëtte G; Topinkova, Eva; Garms-Homolova, Vjenka; Frijters, Dinnus; Finne-Soveri, Harriet; Jónsson, Pálmi V; Hirdes, John P; Bernabei, Roberto; Onder, Graziano

    2015-11-14

    Evaluating the quality of care provided to older individuals is a key step to ensure that needs are being met and to target interventions to improve care. To this aim, interRAI's second-generation home care quality indicators (HCQIs) were developed in 2013. This study assesses the quality of home care services in six European countries using these HCQIs as well as the two derived summary scales. Data for this study were derived from the Aged in Home Care (AdHOC) study - a cohort study that examined different models of community care in European countries. The current study selected a sub-sample of the AdHOC cohort from six countries whose follow-up data were complete (Czech Republic, Denmark, Finland, Germany, Italy and the Netherlands). Data were collected from the interRAI Home Care instrument (RAI-HC) between 2000 and 2002. The 23 HCQIs of interest were determined according to previously established methodology, including risk adjustment. Two summary measures, the Clinical Balance Scale and Independence Quality Scale were also determined using established methodology. A total of 1,354 individuals from the AdHOC study were included in these analyses. Of the 23 HCQIs that were measured, the highest proportion of individuals experienced declines in Instrumental Activities of Daily Living (IADLs) (48.4 %). Of the clinical quality indicators, mood decline was the most prevalent (30.0 %), while no flu vaccination and being alone and distressed were the most prevalent procedural and social quality indicators, respectively (33.4 and 12.8 %). Scores on the two summary scales varied by country, but were concentrated around the median mark. The interRAI HCQIs can be used to determine the quality of home care services in Europe and identify areas for improvement. Our results suggest functional declines may prove the most beneficial targets for interventions.

  9. 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

  10. 42 CFR 431.704 - Nursing homes designated by other terms.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 4 2010-10-01 2010-10-01 false Nursing homes designated by other terms. 431.704... Programs for Licensing Nursing Home Administrators § 431.704 Nursing homes designated by other terms. If a State licensing law does not use the term “nursing home,” the CMS Administrator will determine the term...

  11. Effects of intergenerational Montessori-based activities programming on engagement of nursing home residents with dementia

    Directory of Open Access Journals (Sweden)

    Michelle M Lee

    2007-10-01

    Full Text Available Michelle M Lee1, Cameron J Camp2, Megan L Malone21Midwestern University, Department of Behavioral Medicine, Downers Grove, IL , USA; 2Myers Research Institute of Menorah Park Center for Senior Living, Beachwood, OH, USA Abstract: Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP with 15 preschool children from the facility’s on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose – the Myers Research Institute Engagement Scale (MRI-ES. These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented “lessons” to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.Keywords: Montessori-based activities, intergenerational programming, engagement, dementia

  12. Evaluation of bluetooth low power for physiological monitoring in a home based cardiac rehabilitation program.

    Science.gov (United States)

    Martin, Timothy; Ding, Hang; D'Souza, Matthew; Karunanithi, Mohan

    2012-01-01

    Cardiovascular disease (CVD) is the leading cause of mortality in Australia, and places large burdens on the healthcare system. To assist patients with CVDs in recovering from cardiac events and mediating cardiac risk factors, a home based cardiac rehabilitation program, known as the Care Assessment Platform (CAP), was developed. In the CAP program, patients are required to manually enter health information into their mobile phones on a daily basis. The manual operation is often subject to human errors and is inconvenient for some elderly patients. To improve this, an automated wireless solution has been desired. The objectives of this paper are to investigate the feasibility of implementing the newly released Bluetooth 4.0 (BT4.0) for the CAP program, and practically evaluate BT4.0 communications between a developed mobile application and some emulated healthcare devices. The study demonstrated that BT4.0 addresses usability, interoperability and security for healthcare applications, reduces the power consumption in wireless communication, and improves the flexibility of interface for software development. This evaluation study provides an essential mobile BT4.0 framework to incorporate a large range of healthcare devices for clinical assessment and intervention in the CAP program, and hence it is useful for similar development and research work of other mobile healthcare solutions.

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

    Science.gov (United States)

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

    2017-03-01

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

  14. Celebrity Homes, Inc. d/b/a Hanover Falls Residential Construction - Clean Water Act Public Notice

    Science.gov (United States)

    The EPA is providing notice of an Administrative Penalty Assessent in the form of an Expedited Storm Water Settlement Agreement against Celebrity Homes, Inc. d/b/a Hanover Falls Residential Construction, a business located at 14002 L Street, Omaha, NE, for

  15. Private Use, Private Property and Public Policy: Home Recording and Reproduction of Protected Works.

    Science.gov (United States)

    Ladd, David

    This discussion of the difficulties of protecting copyright for audio and video recordings focuses on the application of the 1976 Copyright Act and the Fair Use principle to educational off-air taping and private home recording. Court cases such as Encyclopedia Britannica Educational Corporation versus Crooks and Universal Studios, et al. versus…

  16. Cyber and Home School Charter Schools: Adopting Policy to New Forms of Public Schooling

    Science.gov (United States)

    Huerta, Luis A.; Gonzalez, Maria-Fernanda; d'Entremont, Chad

    2006-01-01

    Cyber and home school charter schools have silently become a prominent part of the charter school movement. These alternative school models differ from conventional schools by relying on parents and the Internet to deliver much of their curriculum and instruction while minimizing the use of personnel and physical facilities. This article examines…

  17. Efficacy of a public promotion program on children's oral health.

    Science.gov (United States)

    Alves, Ana Paula S; Rank, Rise C I C; Vilela, Joana Estela R; Rank, Marcos S; Ogawa, Wataro N; Molina, Omar F

    2017-09-25

    To assess the efficacy of the Baby's Mouth early dental care prevention and promotion program in preventing oral diseases (caries, gingivitis, or malocclusions) in children attended since 2010. This was a cross-sectional and cohort study that assessed 252 children between 36 and 60 months of age in both sexes. The children were divided into three groups: G1: effective participants of the program from birth; G2: children who have stopped participating for more than 24 months, and G3: children who have never attended a prevention program. The evaluation was carried out in two stages: first, an interview with the mothers and, afterwards, a clinical children examination to assess the presence of caries, gingivitis, and malocclusion. The chi-squared test was used for statistical analysis between groups (p<0.05). The diseases assessed were: caries (G1: 5.9%, G2: 54.7%, G3: 70%), gingivitis (G1: 8.3%, G2: 17.9%, G3: 40.5%), and malocclusion (G1: 22.6%; G2: 28.6%; G3: 50%). For gingivitis, there was no significant difference when comparing G1 and G2 (p=0.107), but it was significant between G1 and G3 (p<0.001). Regarding malocclusion, a statistically significant relationship was observed (p=0.004) among all groups. The prevention and promotion program in public oral health was effective in preventing caries disease, gingivitis, and malocclusion in children under 5 years of age. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  18. Monitoring quality of care in nursing homes and making information available for the general public: state of the art.

    Science.gov (United States)

    Du Moulin, Monique F M T; van Haastregt, Jolanda C M; Hamers, Jan P H

    2010-03-01

    To improve quality of care, nursing homes need to assess and monitor their performance. This study aims to gain insight in the availability and contents of publicly accessible quality systems in northwestern Europe and the USA. This study employed a systematic search consisting of searching bibliographic sources from 2005 to September 2009, personal communication with experts, a conventional internet search, and hand-searching of references. Ten out of the 14 included countries use a quality systems. There is a large variety in type and number of indicators assessed. In general more attention is paid to the assessment of structure and process indicators, compared to outcome indicators. The countries differ in the way the results are made available to the general public. It can be concluded that monitoring and publicizing data on quality of care in nursing homes is becoming increasingly widespread. However, the systems still need further development and refinement. The systems need to be further developed regarding validity and reliability. Furthermore, the uniformity of the systems should be increased, more attention must be paid to the assessment of patient satisfaction, and additional insight must be gained in the user-friendliness of the systems. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Effects of a home-based rehabilitation program in obese type 2 diabetics.

    Science.gov (United States)

    Labrunée, M; Antoine, D; Vergès, B; Robin, I; Casillas, J-M; Gremeaux, V

    2012-09-01

    To assess, in obese type 2 diabetics (T2D), the impact of a home-based effort training program and the barriers to physical activity (PA) practice. Twenty-three obese T2D patients (52.7 ± 8.2 years, BMI = 38.5 ± 7.6 kg/m(2)) were randomized to either a control group (CG), or an intervention group (IG) performing home-based cyclergometer training during 3 months, 30 min/day, with a monthly-supervised session. The initial and final measurements included: maximal graded effort test on cyclergometer, 6-minute walk test (6MWT) and 200-meter fast walk test (200mFWT), quadriceps maximal isometric strength, blood tests and quality of life assessment (SF- 36). A long-term assessment of the amount of physical activity (PA) and the barriers to PA practice was conducted using a questionnaire by phone call. Patients in the CG significantly improved the maximal power developed at the peak of the cyclergometer effort test (P quality of life. At a mean distance of 17 ± 6.4 months, the PA score remained low in the two groups. The main barriers to PA practice identified in both groups were the perception of a low exercise capacity and a poor tolerance to effort, lack of motivation, and the existence of pain associated to PA. This home-based intervention had a positive impact on biometrics and physical ability in the short term in obese T2D patients, but limited effects in the long term. The questionnaires completed at a distance suggest considering educational strategies to increase the motivation and compliance of these patients. Copyright © 2012. Published by Elsevier Masson SAS.

  20. Home visitation program for detecting, evaluating and treating socially withdrawn youth in Korea.

    Science.gov (United States)

    Lee, Young Sik; Lee, Jae Young; Choi, Tae Young; Choi, Jin Tae

    2013-05-01

    The problems of youth social withdrawal (or hikikomori) became a hot-button social issue in Japan in the 1990s. Unfortunately, current nosology in the DSM-IV may not adequately capture the concept of socially withdrawn youth (SWY) or hikikomori. This study aimed to investigate core SWY issues, evaluate SWY's psychopathologies, and approach them therapeutically through a home visitation program. Participants were 65 youth referred by community mental health centers and psychiatric clinics around Seoul and Kyongki-Do province. Among them, only 41 participants (31 male, 10 female, mean age 15 ± 3.6 years) fit our SWY criteria. In addition, 248 middle and high school students in Seoul were recruited as a baseline control group. Caseworkers interviewed the SWY participants and their parents in their homes, using our structured interview manual and a number of psychiatric scales. Caseworkers also approached the participants therapeutically. Participants' Depression Inventory, Trait Anxiety Inventory, Social Anxiety Scale, and Internet Addiction Scale scores were significantly higher than those of baseline controls. Participants' mean number of psychotherapeutic sessions was 2.8, and the mean number of parental interview sessions was 3.4. After the therapeutic sessions, Global Assessment Functioning scores and social activities had improved somewhat in 68.3% of participants. These findings suggest that SWY is a complex phenomenon, so an individual psychopathologic process is very important for treatment. The most difficult problem in SWY treatment was therapeutic access. Hence, the home visit approach with a structured manual may be a good gateway for solving this problem. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

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

    Science.gov (United States)

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

    2015-06-01

    Retention in a mobile asthma clinic, the Breathmobile™, of ≥3 visits has previously been shown to be essential for attaining asthma control in underserved children. The objective of this study in primarily Hispanic-American children was to determine the difference in retention between those seen in the Breathmobile™ compared to those receiving an additional promotora-based home visit (HV). Children with asthma in the Breathmobile™ program were evaluated for asthma status and aeroallergen sensitivity. Indication for HV included poor asthma control, educational and environmental control needs. An initial visit consisted of environmental assessment as well as a 3-h interactive educational session covering asthma basics. A follow-up visit 1 month later assessed implementation. The primary outcome measure of retention was ≥6 months in the Breathmobile™ program. Of the 1007 asthmatic children seen between April 2002 and June of 2005, 136 received HV. These children showed significantly greater retention compared to those without HV with a median number of visits (5 visits versus 2 visits), ≥3 Breathmobile™ visits (86.0% versus 38.8%), median number of days in the program (299 versus 63 days) and percentage of patients in the program ≥6 months (67.8% versus 31.3%) p < 0.001. HV and asthma severity were each independent predictors of retention. The addition of a promotora HV program proved effective in providing greater retention in the Breathmobile™ program essential for asthma control. Randomized clinical trials will be needed to show the impact on health care utilization and asthma control.

  2. Can Organizations Learn without Political Leadership? The Case of Public Sector Reform among South African Home Affairs Officials

    DEFF Research Database (Denmark)

    Segatti, Aurelia; Hoag, Colin Brewster; Vigneswaran, Darshan

    2012-01-01

    This paper deals with the transformation of “institutional culture” in bureaucratic agencies. This is explored in the context of post-Apartheid South African public sector reform, and more particularly that of migration management within the Department of Home Affairs (DHA). The paper assesses...... the effects on staff’s perceptions and practices of a politically driven attempt at inculcating a new sense of “service delivery”. Structural factors are not found to have been prevalent determinants explaining the difficulties in implementing the reform. It is rather the failure of the political leadership...

  3. Public Perspectives in the Japanese HLW Disposal Program

    Energy Technology Data Exchange (ETDEWEB)

    Inatsugu, Shigefumi; Takeuchi, Mitsuo; Kato, Toshiaki [Nuclear Waste Management Organization of Japan (NUNIO), Tokyo (Japan)

    2006-09-15

    Following legislation entitled the 'Specified Radioactive Waste Final Disposal Act', the Nuclear Waste Management Organization of Japan (NUMO) was established in October 2000 as the implementing organization for geological disposal of vitrified high-level waste (HLW). Implementation of NUMO's disposal project will be based on three principles: 1) respecting public initiative and opinion, 2) adopting a stepwise approach and 3) ensuring transparency in information disclosure. NUMO has decided to adopt an open solicitation approach to finding volunteer municipalities for Preliminary Investigation Areas (PIAs). The official announcement of the start of the open solicitation program was made in 2002. Although no official applications had been received from volunteer municipalities by the end of 2005, NUMO has been continuing to carry out various activities aimed specifically at public communication and encouraging dialogue about the deep geological disposal project This paper summarizes the results obtained and lessons learned so far and identifies the issues that NUMO must tackle immediately in the areas of communication and dialogue.

  4. Caring About Residents' Experiences and Symptoms (CARES) Program: A Model of Palliative Care Consultation in the Nursing Home.

    Science.gov (United States)

    Morris, Deborah A; Galicia-Castillo, Marissa

    2017-06-01

    To describe the CARES program, a model of palliative care for nursing home residents. Descriptive analysis of the Caring About Residents' Experiences and Symptoms (CARES) Program that provides palliative care services to nursing home residents. The CARES Program serves as an example of collaborative efforts to meet community needs. To evaluate the program, we document the services provided as well as process outcomes (changes to care plans, hospitalizations, location of death, and hospice utilization) for residents referred. 170 nursing home residents were seen by CARES Program between February 2013 to December 2015, 48% for skilled services, and 52% for long term care. Majority of referrals were for goals of care and concurrent symptom management. Following consultation, 67% of residents had a change in code status. Of residents desiring a palliative course 90% were never hospitalized. Overall, 53% of residents died; and those in long term care dying more often with hospice. The CARES program of palliative consultation addresses the needs of nursing home residents. The model has potential to be reproducible in in other communities.

  5. Green-E general program and public information support program report, August 1, 1999 - September 30, 2000

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Kirk

    2000-09-30

    Green-E Program support from the Dept. of Energy augmented the costs of implementing the objectives of the Green-E Renewable Electricity Project; general program implementation; regional adaptation; developing strategic partnerships; and public information/education/outreach.

  6. Home-based vs supervised rehabilitation programs following knee surgery: a systematic review.

    Science.gov (United States)

    Papalia, Rocco; Vasta, Sebastiano; Tecame, Andrea; D'Adamio, Stefano; Maffulli, Nicola; Denaro, Vincenzo

    2013-01-01

    Following knee surgery, rehabilitation can dramatically affect the postoperative course and the final outcomes of the procedure. We systematically reviewed the current literature comparing clinical outcomes of home-based and outpatient supervised rehabilitation protocols following knee surgery. We searched Medline, CINAHL, Embase, Google Scholar, The Cochrane Library and SPORTDiscus. The reference lists of the previously selected articles were then examined by hand. Only studies comparing clinical outcomes of patients who had undergone knee surgery followed by different rehabilitation programs were selected. Then the methodological quality of each article was evaluated using the Coleman methodology score (CMS), a 10-criterion scoring list assessing the methodological quality of the selected studies. Eighteen studies were evaluated in the present review. Three were retrospective studies. The remaining 15 studies were prospective randomized clinical trials. The supervised and home-based protocols did not show an overall significant difference in the outcomes achieved within the studies reviewed. The mean CMS was 77.2. The heterogeneity of the rehabilitation protocols used in the studies reviewed makes it difficult to draw definite conclusion on the subject. Supervision and location does not seem to directly determine the final outcomes. Numerous variables, including comorbidities and motivation, could influence the results and deserve to be accounted for in future investigations. Better designed studies are needed to show a clear superiority of one rehabilitation approach over another and its applicability to the various surgical procedures involving the knee.

  7. Outcomes for family carers of a nurse-delivered hospital discharge intervention for older people (the Further Enabling Care at Home Program): Single blind randomised controlled trial.

    Science.gov (United States)

    Toye, Christine; Parsons, Richard; Slatyer, Susan; Aoun, Samar M; Moorin, Rachael; Osseiran-Moisson, Rebecca; Hill, Keith D

    2016-12-01

    Hospital discharge of older people receiving care at home offers a salient opportunity to identify and address their family caregivers' self-identified support needs. This study tested the hypothesis that the extent to which family caregivers of older people discharged home from hospital felt prepared to provide care at home would be positively influenced by their inclusion in the new Further Enabling Care at Home program. This single-blind randomised controlled trial compared outcomes from usual care alone with those from usual care plus the new program. The program, delivered by a specially trained nurse over the telephone, included: support to facilitate understanding of the patient's discharge letter; caregiver support needs assessment; caregiver prioritisation of urgent needs; and collaborative guidance, from the nurse, regarding accessing supports. Dyads were recruited from the medical assessment unit of a Western Australian metropolitan public hospital. Each dyad comprised a patient aged 70 years or older plus an English speaking family caregiver. The primary outcome was the caregiver's self-reported preparedness to provide care for the patient. Data collection time points were designated as: Time 1, within four days of discharge; Time 2, 15-21days after discharge; Time 3, six weeks after discharge. Other measures included caregivers' ratings of: their health, patients' symptoms and independence, caregiver strain, family well-being, caregiver stress, and positive appraisals of caregiving. Data were collected by telephone. Complete data sets were obtained from 62 intervention group caregivers and 79 controls. Groups were equivalent at baseline. Needs prioritised most often by caregivers were: to know whom to contact and what to expect in the future and to access practical help at home. Support guidance included how to: access help, information, and resources; develop crisis plans; obtain referrals and services; and organise legal requirements. Compared to

  8. Public Library Summer Reading Programs Contribute to Reading Progress and Proficiency. A Review of: Roman, S., & Fiore, C. (2010. Do public library summer reading programs close the achievement gap? Children and Libraries, (Winter, 27-31.

    Directory of Open Access Journals (Sweden)

    Gayle Bogel

    2012-03-01

    administered, as well as a structured interview of library staff.Main Results – The students who participated in the public library summer reading program did not experience summer loss in reading as measured by the post test administered in their schools.The researchers note patterns in the demographics of students who chose to participate (participation was self-selected and voluntary: predominantly Caucasian girls above poverty level, who generally scored well on reading tests. Those who participated in the study also used libraries, had more books in their homes, and parents who used libraries and provided literacy activities at home.Teachers found that students who participated in the program started the school year ready to learn, had improved reading achievement and displayed stronger motivation, enjoyment and confidence in reading. Parents of students who participated in the program also strongly agreed that their children where better prepared to begin the school year.Conclusion – The results from this study confirmed findings from an earlier study (Heyns, 1978 and subsequent related research that summer reading programs in public libraries can contribute to maintaining reading progress and proficiency, and that the recreational reading that is available to all students regardless of socioeconomic status through the public library can make a difference in reading scores.In this article the researchers presented results and conclusions based on selected subsets of the results in the full study. The participants were self-reported and no control group was established.The researchers also use the results of the study as a starting point to provide a call to action that highlights the value of public library summer reading programs, and the need for the education community to invest in partnerships with public libraries, particularly in communities that serve children and families in low-economic or depressed areas. They also note the need to include parents and

  9. A Public Choice Approach to the Unequal Treatment of Securities Market Participants and Home Borrowers

    Directory of Open Access Journals (Sweden)

    Jonathan Macey

    2017-01-01

    Full Text Available This article contrasts the protections provided to participants in U.S. securities markets with the protections provided to participants in the U.S. mortgage markets. Participants in securities markets purchase and sell equity and debt securities. Participants in the mortgage markets borrow money to buy homes, using those homes as collateral for the mortgage loans they receive. Even after Dodd-Frank, participants in securities markets are afforded significantly higher levels of protection than participants in mortgage markets. The doctrine of suitability is a prime example of this inequity. Exploring possible explanations for this odd asymmetry of treatment, I conclude that interest group politics is to blame for the anomaly.

  10. Improvements in Balance in Older Adults Engaged in a Specialized Home Care Falls Prevention Program

    Science.gov (United States)

    Whitney, Susan L.; Marchetti, Gregory F.; Ellis, Jennifer L.; Otis, Laurie

    2016-01-01

    Background and Purpose To determine if persons older than 65 years receiving a combination of physical therapy, occupational therapy, speech, or nursing interventions in their home demonstrated changes in gait/balance function after an episode of home care services. Methods Charts from 11 667 persons who were at risk for falling and who were participating in an exercise program in the home were included. Study design Data were retrieved from the Outcome and Assessment Information Set, Version B, and the computerized database of physical therapist–collected outcome data. Recorded physical therapist–data may have included a neuropathic pain rating, the Berg Balance Scale (BBS), the Performance Oriented Measurement Assessment (POMA), the Dynamic Gait Index (DGI), and the modified Clinical Test of Sensory Integration and Balance (mCTSIB). Data analysis Data were extracted by an honest broker and were analyzed. Mean (SD) change in each performance test and the percentage of participants in the total sample and in the 9 age/health condition strata that exceeded the minimum detectable change (MDC) for each gait/balance measure were described. The value of MDC95 describes the amount of true change in participant status beyond measurement error with 95% certainty. Results The gait/balance measures demonstrated MDCs ranging between 68% and 91% for the study sample. Mean (SD) of improvement on the BBS was 12 (8) points, with 88% of all participants exceeding the BBS MDC95 value of 5 points. Mean (SD) of improvement in gait/balance performance as measured by the POMA was 8 (4) points, with 91% of all participants exceeding the POMA MDC95 value of 3 points. Among all patients, mean (SD) of improvement on the DGI was 7 (4) points with 91% of all participants exceeding the DGI MDC95 value of 2 points by discharge. At admission, the median number of mCTSIB conditions that could be completed was 1 and the median number of completed conditions on the mCTSIB increased to 3 at

  11. Out of hospital cardiac arrest outside home in Sweden, change in characteristics, outcome and availability for public access defibrillation.

    Science.gov (United States)

    Ringh, Mattias; Herlitz, Johan; Hollenberg, Jacob; Rosenqvist, Mårten; Svensson, Leif

    2009-04-17

    A large proportion of patients who suffer from out of hospital cardiac arrest (OHCA) outside home are theoretically candidates for public access defibrillation (PAD). We describe the change in characteristics and outcome among these candidates in a 14 years perspective in Sweden. All patients who suffered an OHCA in whom cardiopulmonary resuscitation (CPR) was attempted between 1992 and 2005 and who were included in the Swedish Cardiac Arrest Register (SCAR). We included patients in the survey if OHCA took place outside home excluding crew witnessed cases and those taken place in a nursing home. 26% of all OHCAs (10133 patients out of 38710 patients) fulfilled the inclusion criteria. Within this group, the number of patients each year varied between 530 and 896 and the median age decreased from 68 years in 1992 to 64 years in 2005 (p for trend = 0.003). The proportion of patients who received bystander CPR increased from 47% in 1992 to 58% in 2005 (p for trend defibrillation among witnessed cases was 12 min in 1992 and 10 min in 2005 (p for trend = 0.029). Survival to one month among all patients increased from 8.1% to 14.0% (p for trend = 0.01). Among patients found in a shockable rhythm survival increased from 15.3% in 1992 to 27.0% in 2005 (p for trend defibrillation changed only moderately.

  12. Effects of intergenerational Montessori-based activities programming on engagement of nursing home residents with dementia.

    Science.gov (United States)

    Lee, Michelle M; Camp, Cameron J; Malone, Megan L

    2007-01-01

    Fourteen nursing home residents on a dementia special care unit at a skilled nursing facility took part in one-to-one intergenerational programming (IGP) with 15 preschool children from the facility's on-site child care center. Montessori-based activities served as the interface for interactions between dyads. The amount of time residents demonstrated positive and negative forms of engagement during IGP and standard activities programming was assessed through direct observation using a tool developed for this purpose--the Myers Research Institute Engagement Scale (MRI-ES). These residents with dementia displayed the ability to successfully take part in IGP. Most successfully presented "lessons" to the children in their dyads, similar to the way that Montessori teachers present lessons to children, while persons with more severe cognitive impairment took part in IGP through other methods such as parallel play. Taking part in IGP was consistently related with higher levels of positive engagement and lower levels of negative forms of engagement in these residents with dementia than levels seen in standard activities programming on the unit. Implications of using this form of IGP, and directions for future research, are discussed.

  13. Palliative Care in Your Nursing Home: Program Development and Innovation in Transitional Care.

    Science.gov (United States)

    Giuffrida, Jennifer

    2015-01-01

    Each year in the United States, 31% of elders who die do so in hospitals, accounting for over half a million deaths often involving expensive and unnecessary treatments (Zhao & Encinosa, 2010 ). Re-hospitalizations of frail elders with end-stage illnesses are a concern for the hospitals that have discharged them and for the facilities in which they live. In 2011, Schervier Nursing Care Center, a 364-bed skilled nursing and rehabilitation facility in the Bronx, NY, looked at its re-hospitalization rates. It was discovered that a large percentage of the residents being sent to the hospital were from the long-term and subacute populations with end-stage diseases that were no longer responding to treatment. This article describes the development of two innovative programs whose goals were to increase the number of residents receiving palliative care, increase the number of completed advance directives, reduce re-hospitalizations, and increase hospital referrals to the nursing home for palliative care. The key components of both programs and their outcomes are described. The development and implementation of these programs were the author's capstone project for the Zelda Foster Social Work Leadership Fellowship in Palliative and End-of-Life Care.

  14. Home monitoring program reduces interstage mortality after the modified Norwood procedure.

    Science.gov (United States)

    Siehr, Stephanie L; Norris, Jana K; Bushnell, Julie A; Ramamoorthy, Chandra; Reddy, V Mohan; Hanley, Frank L; Wright, Gail E

    2014-02-01

    From 2002 to 2005, the interstage mortality after a modified Norwood procedure was 7% in our program. An interstage home monitoring program (HMP) was established to identify Norwood procedure patients at increased risk of decompensation and to reduce interstage mortality. Results of the first 5 years of the Norwood HMP were reviewed retrospectively. Interstage was defined as the time between Norwood hospital discharge and admission for second stage surgical palliation. In the HMP, families documented oxygen saturation, heart rate, weight, and feedings daily. Nurse practitioners called each family at least weekly, and when issues arose, action plans were determined based on symptom severity. Between October 2005 and October 2010 there were 46 Norwood procedure patients who survived to hospital discharge. All were enrolled in the HMP. Forty-five patients had a Norwood procedure with right ventricle to pulmonary artery conduit, and 1 patient had a modified Blalock-Taussig shunt. Interstage survival was 100%. Nineteen patients (41%) were admitted interstage; 5 patients were admitted twice, 1 patient was admitted 4 times. Seventeen patients (37%) required interstage interventions. Eight patients (17%) required major interventions: conduit stenting, aortic arch balloon angioplasty, emergent shunt, or early Glenn surgery. Minor interventions included supplemental oxygen, blood transfusion, intravenous hydration, diuresis, anti-arrhythmic therapy, or feeding adjustments. In the first 5 years of the HMP, all infants discharged after a modified Norwood procedure survived the interstage period. The HMP altered clinical management in 37% of patients. Home monitoring of oxygen saturation, heart rate, weight, and feedings, along with comprehensive care coordination, allowed timely interventions and reduced interstage mortality from 7% to 0%. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  15. Incorporating robotic-assisted telerehabilitation in a home program to improve arm function following stroke.

    Science.gov (United States)

    Linder, Susan M; Reiss, Aimee; Buchanan, Sharon; Sahu, Komal; Rosenfeldt, Anson B; Clark, Cindy; Wolf, Steven L; Alberts, Jay L

    2013-09-01

    After stroke, many individuals lack resources to receive the intensive rehabilitation that is thought to improve upper extremity motor function. This case study describes the application of a telerehabilitation intervention using a portable robotic device combined with a home exercise program (HEP) designed to improve upper extremity function. The participant was a 54-year-old man, 22 weeks following right medullary pyramidal ischemic infarct. At baseline, he exhibited residual paresis of the left upper extremity, resulting in impaired motor control consistent with a flexion synergistic pattern, scoring 22 of 66 on the Fugl-Meyer Assessment. The participant completed 85 total hours of training (38 hours of robotic device and 47 hours of HEP) over the 8-week intervention period. The participant demonstrated an improvement of 26 points on the Action Research Arm Test, 5 points on the Functional Ability Scale portion of the Wolf Motor Function Test, and 20 points on the Fugl-Meyer Assessment, all of which surpassed the minimal clinically important difference. Of the 17 tasks of the Wolf Motor Function Test, he demonstrated improvement on 11 of the 15 time-based tasks and both strength measures. The participant reported an overall improvement in his recovery from stroke on the Stroke Impact Scale quality-of-life questionnaire from 40 of 100 to 65 of 100. His score on the Center for Epidemiologic Studies Depression Scale improved by 19 points. This case demonstrates that robotic-assisted therapy paired with an HEP can be successfully delivered within a home environment to a person with stroke. Robotic-assisted therapy may be a feasible and efficacious adjunct to an HEP program to elicit substantial improvements in upper extremity motor function, especially in those persons with stroke who lack access to stroke rehabilitation centers.

  16. Effectiveness and experiences of families and support workers participating in peer-led parenting support programs delivered as home visiting programs: a comprehensive systematic review.

    Science.gov (United States)

    Munns, Ailsa; Watts, Robin; Hegney, Desley; Walker, Roz

    2016-10-01

    Designing child and family health services to meet the diverse needs of contemporary families is intended to minimize impacts of early disadvantage and subsequent lifelong health and social issues. Innovative programs to engage families with child and family support services have led to interest in the potential value of peer-led home visiting from parents in local communities. There is a range of benefits and challenges identified in a limited number of studies associated with home visiting peer support. The objective of the review is to identify: INCLUSION CRITERIA PARTICIPANTS: Families/parents with one or more children aged zero to four years, peer support workers and their supervisors. Peer-led home visiting parenting support programs that use volunteer or paraprofessional home visitors from the local community compared to standard community maternal-child care. The phenomenon of interest will be the relationships between participants in the program. Quantitative studies: randomized control trials (RCTs). Qualitative studies: grounded theory and qualitative descriptive studies. Parental attitudes and beliefs, coping skills and confidence in parenting, parental stress, compliance with child health checks/links with primary healthcare services, satisfaction with peer support and services and the nature of the relationship between parents and home visitors. The search strategy will include both published and unpublished studies. Seven journal databases and five other sources will be searched. Only studies published in the English language from 2000 to 2015 will be considered. Studies were assessed by two independent reviewers using standardized critical appraisal tools from the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) and the Joanna Briggs Institute Qualitative Assessment and Review Instrument (JBI-QARI) as appropriate. Both quantitative and qualitative data were independently extracted by two reviewers

  17. The effects of public reporting on physical restraints and antipsychotic use in nursing home residents with severe cognitive impairment.

    Science.gov (United States)

    Konetzka, R Tamara; Brauner, Daniel J; Shega, Joseph; Werner, Rachel M

    2014-03-01

    To assess whether reductions in physical restraint use associated with quality reporting may have had the unintended consequence of increasing antipsychotic use in nursing home (NH) residents with severe cognitive impairment. Retrospective analysis of NH clinical assessment data from 1999 to 2008 comparing NHs subject to public reporting of physical restraints with nonreporting NHs. Medicare- and Medicaid-certified NHs in the United States. Observations (N = 3.9 million) on 809,645 residents with severe cognitive impairment in 4,258 NHs in six states. Public reporting of physical restraint use rates. Use of physical restraints and antipsychotic medications. Physical restraint use declined significantly from 1999 to 2008 in NH residents with severe cognitive impairment. The decline was larger in NHs that were subject to reporting of restraints than in those that were not (-8.3 vs -3.3 percentage points, P < .001). Correspondingly, antipsychotic use in the same residents increased more in NHs that were subject to public reporting (4.5 vs 2.9 percentage points, P < .001). Approximately 36% of the increase in antipsychotic use may be attributable to public reporting of physical restraints. This analysis suggests that public reporting of physical restraint use had the unintended consequence of increasing use of antipsychotics in NH residents with severe cognitive impairment. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  18. Developing Leaders: Implementation of a Peer Advising Program for a Public Health Sciences Undergraduate Program

    Directory of Open Access Journals (Sweden)

    Megan eGriffin

    2015-01-01

    Full Text Available Peer advising is an integral part of our undergraduate advising system in the Public Health Sciences major at the University of Massachusetts Amherst. The program was developed in 2009 to address the advising needs of a rapidly growing major that went from 25 to over 530 majors between 2007 and 2014. Each year, 9-12 top performing upper-level students are chosen through an intensive application process. A major goal of the program is to provide curriculum and career guidance to students in the major and empower students in their academic and professional pursuits. The year-long program involves several components, including: staffing the drop-in advising center, attending training seminars, developing and presenting workshops for students, meeting prospective students and families, evaluating ways to improve the program, and collaborating on self-directed projects. The peer advisors also provide program staff insight into the needs and perspectives of students in the major. In turn, peer advisors gain valuable leadership and communication skills, and learn strategies for improving student success. The Peer Advising Program builds community and fosters personal and professional development for the peer advisors. In this paper, we will discuss the undergraduate peer advising model, the benefits and challenges of the program, and lessons learned. Several methods were used to understand the perceived benefits and challenges of the program and experiences of students who utilized the Peer Advising Center. The data for this evaluation were drawn from three sources: 1 archival records from the Peer Advising Center; 2 feedback from peer advisors who completed the year-long internship; and 3 a survey of students who utilized the Peer Advising Center. Results of this preliminary evaluation indicate that peer advisors gain valuable skills that they can carry into their professional world. The program is also a way to engage students in building community

  19. Paraprofessional home visitation program to prevent childhood unintentional injuries in low-income communities: a cluster randomized controlled trial.

    Science.gov (United States)

    Swart, L; van Niekerk, A; Seedat, M; Jordaan, E

    2008-06-01

    To investigate the effectiveness of a paraprofessional home visitation program (HVP) to improve home safety and prevent injuries among children living in low-income settings. The HVP was implemented in two low-income communities in South Africa. In each community, approximately 200 households were randomly selected for the trial. Eligible households were those with children aged < or = 10 years. Intervention households received four visits, one every two weeks, by trained paraprofessionals that focused on a specific injury topic and consisted of: information dissemination about specific injury prevention practices; home inspection accompanied by information about home hazards; and the supply of safety devices. The key outcomes to measure the presence of home hazards were scores for burns (safety practices, paraffin, and electrical), poisoning, and falls. Significant reductions were found for injury risks related to burn safety practices. For injury risks related to electrical burns, paraffin burns, and poisoning, a decline was also noted although this was not statistically significant. No decline was noted for fall-related risks. Subject to further replication and evaluation, home visits by paraprofessionals providing safety education, home inspection, and safety devices be considered for integration into a comprehensive child injury prevention strategy in low-income communities.

  20. New Whole-House Solutions Case Study: Northwest Energy Efficient Manufactured Housing Program High-Performance Test Homes - Pacific Northwest

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-05-01

    This project represents the third phase of a multi-year effort to develop and bring to market a High Performance Manufactured Home (HPMH). In this project, the Northwest Energy Efficient Manufactured Housing Program worked with Building America Partnership for Improved Residential Construction and Bonneville Power Administration to help four factory homebuilders build prototype zero energy ready manufactured homes, resulting in what is expected to be a 30% savings relative to the Building America Benchmark. (The actual % savings varies depending on choice of heating equipment and climate zone). Previous phases of this project created a HPMH specification and prototyped individual measures from the package to obtain engineering approvals and develop preliminary factory construction processes. This case study describes the project team's work during 2014 to build prototype homes to the HPMH specifications and to monitor the homes for energy performance and durability. Monitoring is expected to continue into 2016.

  1. Out of hospital cardiac arrest outside home in Sweden, change in characteristics, outcome and availability for public access defibrillation

    Directory of Open Access Journals (Sweden)

    Rosenqvist Mårten

    2009-04-01

    Full Text Available Abstract Background A large proportion of patients who suffer from out of hospital cardiac arrest (OHCA outside home are theoretically candidates for public access defibrillation (PAD. We describe the change in characteristics and outcome among these candidates in a 14 years perspective in Sweden. Methods All patients who suffered an OHCA in whom cardiopulmonary resuscitation (CPR was attempted between 1992 and 2005 and who were included in the Swedish Cardiac Arrest Register (SCAR. We included patients in the survey if OHCA took place outside home excluding crew witnessed cases and those taken place in a nursing home. Results 26% of all OHCAs (10133 patients out of 38710 patients fulfilled the inclusion criteria. Within this group, the number of patients each year varied between 530 and 896 and the median age decreased from 68 years in 1992 to 64 years in 2005 (p for trend = 0.003. The proportion of patients who received bystander CPR increased from 47% in 1992 to 58% in 2005 (p for trend The median time from cardiac arrest to defibrillation among witnessed cases was 12 min in 1992 and 10 min in 2005 (p for trend = 0.029. Survival to one month among all patients increased from 8.1% to 14.0% (p for trend = 0.01. Among patients found in a shockable rhythm survival increased from 15.3% in 1992 to 27.0% in 2005 (p for trend Conclusion In Sweden, there was a change in characteristics and outcome among patients who suffer OHCA outside home. Among these patients, bystander CPR increased, but the occurrence of VF decreased. One-month survival increased moderately overall and highly significantly among patients found in VF, even though the time to defibrillation changed only moderately.

  2. [Development of a web-based education program for nurses working in nursing homes on human rights of older adults].

    Science.gov (United States)

    Kim, Ki-Kyong

    2010-08-01

    This study was done to develop a web-based education program for nurses working in nursing homes. The focus was on the rights of older adults. The program was designed based on the Network-Based Instructional System Design (NBISD) model and was operated and evaluated between July 2007 and June 2008. Out of nursing records of 40 residents from a nursing home, the final 7 cases were deducted through classification using the Resource Utilization Group (RUG)-III. The data on needs for education was collected from 28 nurses working in 15 nursing homes located in Seoul and Gyeonggi Province, who agreed to complete a self-report questionnaire. A comprehensive review of the literature and two focus groups interviews were used to search for risk factors and guidelines for protection of human rights. The education program was developed based on Kolb's experiential learning model and composed of 5 units, which included content on types of human rights and rights to death with dignity, elder abuse, physical liberty, and self-determination. The program was positively evaluated showing a score of 3.35 (SD=0.37) out of 4. The educational program developed in this study should promote nurses' sensitivity to the rights of elders and improve nurses' behaviors in protecting the rights of elders residing in nursing homes.

  3. Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2017-11-07

    This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

  4. More than Just a Lack of Uniformity: Exploring the Evolution of Public Relations Master's Programs

    Science.gov (United States)

    Briones, Rowena L.; Shen, Hongmei; Parrish, Candace; Toth, Elizabeth L.; Russell, Maria

    2017-01-01

    Public relations is well known for its adaptability through continual change, and as a result, public relations master's programs have been re-conceptualized to remain rigorous and competitive. To further assess both the state and changes of these programs, 20 in-depth interviews were conducted with administrators of public relations master's…

  5. 75 FR 26269 - Draft Programmatic Environmental Assessment for the Integrated Public Alert and Warning Program's...

    Science.gov (United States)

    2010-05-11

    ... Public Alert and Warning Program's Construction Projects AGENCY: Federal Emergency Management Agency, DHS... Public Alert and Warning Program (IPAWS). The construction actions will be taken to ensure that FEMA meets its responsibilities under Executive Order 13407, Public Alert and Warning System, by providing...

  6. 49 CFR 37.61 - Public transportation programs and activities in existing facilities.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 1 2010-10-01 2010-10-01 false Public transportation programs and activities in... TRANSPORTATION SERVICES FOR INDIVIDUALS WITH DISABILITIES (ADA) Transportation Facilities § 37.61 Public transportation programs and activities in existing facilities. (a) A public entity shall operate a designated...

  7. The NuSTAR Education and Public Outreach Program

    Science.gov (United States)

    Cominsky, Lynn R.; McLin, K. M.; Boggs, S. E.; Christensen, F.; Hailey, C. J.; Harrison, F.; Stern, D.; Zhang, W.; NuSTAR Team

    2013-04-01

    NuSTAR is a NASA Small Explorer mission led by Caltech, managed by JPL, and implemented by an international team of scientists and engineers, under the direction of CalTech Professor Fiona Harrison, principal investigator. NuSTAR is a pathfinder mission that is opening the high-energy X-ray sky for sensitive study for the first time. By focusing X-rays at higher energies (up to 79 keV) NuSTAR will answer fundamental questions about the Universe: How are black holes distributed through the cosmos? How were the elements that compose our bodies and the Earth forged in the explosions of massive stars? What powers the most extreme active galaxies? Perhaps most exciting is the opportunity to fill a blank map with wonders we have not yet dreamed of: NuSTAR offers the opportunity to explore our Universe in an entirely new way. The purpose of the NuSTAR E/PO program is to increase understanding of the science of the high-energy Universe, by capitalizing on the synergy of existing high-energy astrophysics E/PO programs to support the mission’s objectives. Our goals are to: facilitate understanding of the nature of collapsed objects, develop awareness of the role of supernovae in creating the chemical elements and to facilitate understanding of the physical properties of the extreme Universe. We will do this through a program that includes educator workshops through NASA's Astrophysics Educator Ambassador program, a technology education unit for formal educators, articles for Physics Teacher and/or Science Scope magazines, and work with informal educators on a museum exhibit that includes a model of NuSTAR and describes the mission’s science objectives. Extensive outreach is also underway by members of the Science Team, who are working with high school students, undergraduates and graduate students. We are also developing printed materials that describe the mission and special workshops for girls at public libraries in order to improve the STEM pipeline.

  8. The Technology Acceptance of a TV Platform for the Elderly Living Alone or in Public Nursing Homes.

    Science.gov (United States)

    Santana-Mancilla, Pedro C; Anido-Rifón, Luis E

    2017-06-08

    In Mexico, many seniors are alone for most of the day or live in public nursing homes. Simple interaction with computer systems is required for older people. This is why we propose the exploration of a medium well known by seniors, such as the television (TV). The primary objective of this study is to improve the quality of life of seniors through an easier reminder system, using the television set. A technological platform was designed based on interactive television, through which seniors and their caregivers can have a better way to track their daily activities. Finally, an evaluation of the technology adoption was performed with 50 seniors living in two public nursing homes. The evaluation found that the elderly perceived the system as useful, easy to use, and they had a positive attitude and good intention to use it. This helped to generate initial evidence that the system supported them in achieving a better quality of life, by reminding them to take their medications and increasing their rate of attendance to their medical appointments.

  9. Exploring shared risks through public-private partnerships in public health programs: a mixed method.

    Science.gov (United States)

    Alonazi, Wadi B

    2017-06-12

    The natural assimilation of the process through which health partners sustain long-term relationships is a key issue in maintaining social well-being, reducing health risk factors, and sustaining public health programs. One global initiative in building effective healthcare systems is public-private partnerships (PPPs). This study elucidates the proposed key performance indicators initiated by the Ministry of Health of Saudi Arabia based on the projections of the government, known as Vision 2030, from the perspective of health risk factors. Through an inductive content analysis, this study assessed primary and secondary data in relation to the Saudi National Transformation Program (NTP). To identify the institutions that played a role in formulating the new Saudi Healthcare System, health policies, regulations, and reports published between 1996 and 2016 were categorized. After ranking the risk factors, the investigator selected 13 healthcare professionals in four focus group interviews to insightfully explore the challenges that the NTP faces from a health risk perspective. Thus, the study employed qualitative data gathered through focus group interviews with key figures as well as data extracted from written sources to identify distinct but interrelated partnerships practiced within risk management. A methodological overview of NTP priority and implementation offered practical guidance in the healthcare context. The five critical factors in maintaining successful and sustainable PPPs were (1) trustworthiness, (2) technological capability, (3) patient-centeredness, (4) competence, and (5) flexibility. Concession on primary and secondary healthcare services might be a good option based on the literature review and considering its popularity in other countries. A high outcome-based risk of PPPs was found as the most commonly shared perspective in risk management. Although the impact of the NTP rise has yet to be explored, its potential for challenging health

  10. Better Duct Systems for Home Heating and Cooling; Building Technologies Program (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2004-11-01

    Duct systems used in forced-air space-conditioning systems are a vital element in home energy efficiency. How well a system works makes a big difference in the cost and the effectiveness of heating and cooling a home.

  11. Denmark's Master of Public Governance Program: Assessment and Lessons Learned

    Science.gov (United States)

    Greve, Carsten; Pedersen, Anne Reff

    2017-01-01

    This paper focuses on Denmark's Master of Public Governance and its assessments and lessons learned. Denmark is seen to have an efficient economy and public sector, a digitalized public service delivery system, and an advanced work-life balance. The Danish government invested substantial resources into developing a Master of Public Governance…

  12. Academic Executive Programs in Public Administration and Management: Some Variety across Europe

    Science.gov (United States)

    Reichard, Christoph

    2017-01-01

    Universities and other higher education institutions in Europe offer a vast and increasing number of academic degree programs in the broad field of Public Administration. A subset of these programs is those offering postgraduate degrees to experienced students being already employed by public or private organisations. These executive programs are…

  13. The efficacy of a volunteer-administered cognitive stimulation program in long-term care homes.

    Science.gov (United States)

    van Zon, Lorraine; Kirby, John R; Anderson, Nicole

    2016-06-01

    Cognitive impairment (CI) that arises in some older adults limits independence and decreases quality of life. Cognitive stimulation programs delivered by professional therapists have been shown to help maintain cognitive abilities, but the costs of such programming are prohibitive. The present study explored the feasibility and efficacy of using long-term care homes' volunteers to administer a cognitive stimulation program to residents. Thirty-six resident participants and 16 volunteers were alternately assigned to one of two parallel groups: a control group (CG) or stimulation group (SG). For eight weeks, three times each week, CG participants met for standard "friendly visits" (casual conversation between a resident and volunteer) and SG participants met to work through a variety of exercises to stimulate residents' reasoning, attention, and memory abilities. Resident participants were pre- and post-tested using the Weschler Abbreviated Scale of Intelligence-Second Edition, Test of Memory, and Learning-Senior Edition, a modified Letter Sorting test (LS), Clock Drawing Test (CDT), and the Action Word Verbal Fluency Test. Two-way analyses of covariance (ANCOVA) controlling for dementia diagnosis indicated statistically greater improvements in the stimulation participants than in the control participants in Immediate Verbal Memory, p = 0.011; Non-Verbal Memory, p = 0.012; Learning, p = 0.016; and Verbal Fluency, p = 0.024. The feasibility and efficiency of a volunteer-administered cognitive stimulation program was demonstrated. Longitudinal studies with larger sample sizes are recommended in order to continue investigating the breadth and depth volunteer roles in the maintenance of the cognitive abilities of older adults.

  14. Structures, processes and outcomes of the Aussie Heart Guide Program: A nurse mentor supported, home based cardiac rehabilitation program for rural patients with acute coronary syndrome.

    Science.gov (United States)

    Frohmader, Terence J; Lin, Frances; Chaboyer, Wendy P

    2018-03-01

    Cardiac rehabilitation has a number of benefits for patients, yet participation in it is sub-optimal, especially in regional Australia. Innovative models of cardiac rehabilitation are needed to improve participation. Providing nurse mentors to support patients transitioning from hospital to home represents a new model of service delivery in Australia. To explore the impact of a home-based cardiac rehabilitation program in assisting patients to recover from Acute Coronary Syndrome and meeting the expectations of nurse mentors delivering the program. This case study was underpinned by the structure, process and outcomes model and occurred in three Australian hospitals 2008-2011. Thirteen patients recovering from acute coronary syndrome were interviewed by telephone and seven nurse mentors completed a survey after completing the program. Mentor perceptions concerning the structures of the home-based CR program included the timely recruitment of patients, mentor training to operationalise the program, commitment to development of the mentor role, and the acquisition of knowledge and skills about cognitive behavioural therapy and patient centred care. Processes included the therapeutic relationship between mentors and patients, suitability of the program and the promotion of healthier lifestyle behaviours. Outcomes identified that patients were satisfied with the program's audiovisual resources, and the level of support and guidance provided by their nurse mentors. Mentors believed that the program was easy to use in terms of its delivery. Patients believed the program assisted their recovery and were satisfied with the information, guidance and support received from mentors. There were positive signs that the program influenced patients' decisions to change unhealthy lifestyle behaviours. Outcomes highlighted both rewards and barriers associated with mentoring patients in their homes by telephone. Experience gained from developing a therapeutic relationship with

  15. Assessment of CEPH accredited institutions offering Public Health programs in the United States: A Short Report

    Directory of Open Access Journals (Sweden)

    Ashish eJoshi

    2016-01-01

    Full Text Available Aims: Examine the distribution of the CEPH accredited institutions offering public health educational programs in the United States, and characterize their various attributes.Methods: A search was conducted during the period of June 2014, using the Association of Schools and Programs of Public Health database (ASPPH, and individual university websites to obtain a complete list of CEPH accredited institutions offering programs in Public Health at the Certificate, Masters, and Doctoral levels in the United States. Detailed information were abstracted from the various programs offerings including: school/program information, school type, geographic location, admission cycle, education delivery format, public health concentration, number of credits, presence of a global component, joint programs and tuition. The data was analyzed in August 2014. Results: A total of 85 CEPH accredited institutions designated as either Schools of Public Health, or individual Programs of Public Health were present in the ASPPH database at the time of this data collection (2014. These institutions offer programs in public health at the Certificate (61%, n=52, Masters (100%, n=85 and Doctoral (44%, n=37 levels in the US. More than half of the programs offered were provided by schools of public health (58%, N=49, which were mostly public universities (75%, n=64, concentrated in the Northeast (22%, n=19 and mainly admitted students during the fall semester. Ninety three concentrations of Public Health currently exist, of which 25 concentrations are predominant. Conclusion: To the best of our knowledge, this is the first study which examines the distribution of existing CEPH accredited Public Health educational programs offered by US institutions. We suggest future areas of research to assess existing Public Health workforce demands, and map them to the curriculums and competencies provided by institutions offering Public Health educational programs in the United States

  16. Enriching preschool classrooms and home visits with evidence-based programming: sustained benefits for low-income children.

    Science.gov (United States)

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

    2017-02-01

    Growing up in poverty undermines healthy development, producing disparities in the cognitive and social-emotional skills that support early learning and mental health. Preschool and home-visiting interventions for low-income children have the potential to build early cognitive and social-emotional skills, reducing the disparities in school readiness that perpetuate the cycle of poverty. However, longitudinal research suggests that the gains low-income children make during preschool interventions often fade at school entry and disappear by early elementary school. In an effort to improve the benefits for low-income children, the REDI program enriched Head Start preschool classrooms (study one) and home visits (study two) with evidence-based programming, documenting positive intervention effects in two randomized trials. In this study, REDI participants were followed longitudinally, to evaluate the sustained impact of the classroom and home-visiting enrichments 3 years later, when children were in second grade. The combined sample included 556 children (55% European American, 25% African American, 19% Latino; 49% male): 288 children received the classroom intervention, 105 children received the classroom intervention plus the home-visiting intervention, and 173 children received usual practice Head Start. The classroom intervention led to sustained benefits in social-emotional skills, improving second grade classroom participation, student-teacher relationships, social competence, and peer relations. The coordinated home-visiting intervention produced additional benefits in child mental health (perceived social competence and peer relations) and cognitive skills (reading skills, academic performance). Significant effects ranged from 25% to 48% of a standard deviation, representing important effects of small to moderate magnitude relative to usual practice Head Start. Preschool classroom and home-visiting programs for low-income children can be improved with the use

  17. Connecting the learners: improving uptake of a nursing home educational program by focusing on staff interactions.

    Science.gov (United States)

    Colón-Emeric, Cathleen S; Pinheiro, Sandro O; Anderson, Ruth A; Porter, Kristie; McConnell, Eleanor; Corazzini, Kirsten; Hancock, Kathryn; Lipscomb, Jeffery; Beales, Julie; Simpson, Kelly M

    2014-06-01

    The CONNECT intervention is designed to improve staff connections, communication, and use of multiple perspectives for problem solving. This analysis compared staff descriptions of the learning climate, use of social constructivist learning processes, and outcomes in nursing facilities receiving CONNECT with facilities receiving a falls education program alone. Qualitative evaluation of a randomized controlled trial was done using a focus group design. Facilities (n = 8) were randomized to a falls education program alone (control) or CONNECT followed by FALLS (intervention). A total of 77 staff participated in 16 focus groups using a structured interview protocol. Transcripts were analyzed using framework analysis, and summaries for each domain were compared between intervention and control facilities. Notable differences in descriptions of the learning climate included greater learner empowerment, appreciation of the role of all disciplines, and seeking diverse viewpoints in the intervention group. Greater use of social constructivist learning processes was evidenced by the intervention group as they described greater identification of communication weaknesses, improvement in communication frequency and quality, and use of sense-making by seeking out multiple perspectives to better understand and act on information. Intervention group participants reported outcomes including more creative fall prevention plans, a more respectful work environment, and improved relationships with coworkers. No substantial difference between groups was identified in safety culture, shared responsibility, and self-reported knowledge about falls. CONNECT appears to enhance the use of social constructivist learning processes among nursing home staff. The impact of CONNECT on clinical outcomes requires further study.

  18. Engaging military parents in a home-based reintegration program: a consideration of strategies.

    Science.gov (United States)

    Ross, Abigail M; DeVoe, Ellen R

    2014-02-01

    For more than a decade, the long wars in Afghanistan and Iraq have placed tremendous and cumulative strain on U.S. military personnel and their families. The high operational tempo, length, and number of deployments-and greater in-theater exposure to threat-have resulted in well-documented psychological health concerns among service members and veterans. In addition, there is increasing and compelling evidence describing the significant deleterious impact of the deployment cycle on family members, including children, in military-connected families. However, rates of engagement and service utilization in prevention and intervention services continue to lag far below apparent need among service members and their families, because of both practical and psychological barriers. The authors describe the dynamic and ultimately successful process of engaging military families with young children in a home-based reintegration program designed to support parenting and strengthen parent-child relationships as service member parents move back into family life. In addition to the integration of existing evidence-based engagement strategies, the authors applied a strengths-based approach to working with military families and worked from a community-based participatory foundation to enhance family engagement and program completion. Implications for engagement of military personnel and their loved ones are discussed.

  19. Individual and collective considerations in public health: influenza vaccination in nursing homes.

    Science.gov (United States)

    Verweij, M

    2001-10-01

    Many nursing homes have an influenza vaccination policy in which it is assumed that express (proxy) consent is not necessary. Tacit consent procedures are more efficient if one aims at high vaccination rates. In this paper I focus on incompetent residents and proxy consent. Tacit proxy consent for vaccination implies a deviance of standard proxy consent requirements. I analyse several arguments that may possibly support such a deviance. The primary reason to offer influenza vaccination is that vaccinated persons have a significantly reduced risk of getting the flu. This reason however cannot support the assumption that each nursing home resident is 'better off' if she is vaccinated. Neither can it support tacit proxy consent policies. More promising are arguments that take the collective nature of infectious diseases into account. A potentially strong, but ultimately insufficient, argument for non-express consent is that vaccination contributes to prevention of harm to others. Other arguments emphasize the importance of group protection: herd immunity. I discuss three collective reasons for aiming at herd immunity: solidarity, a common interest in reducing the risk of illness, and a common interest in the prevention of an influenza outbreak. The latter argument appears to be most important. An outbreak is not just detrimental to the health of residents; it is detrimental to their everyday social life as well. Outbreaks can be seen as collective evil. My analysis shows that there are valid (though not necessarily sufficient) moral arguments for a tacit proxy consent policy.

  20. 78 FR 63747 - Public Housing Capital Fund Program

    Science.gov (United States)

    2013-10-24

    ... Housing Development Program (which encompasses mixed-finance development), into the Capital Fund Program... that promote energy conservation and efficiency, including green construction and retrofits, which... Housing Development Program (which encompasses mixed-finance development). In 2008, the Housing and...