Home Care Providers to the Rescue: A Novel First-Responder Programme

Science.gov (United States)

Hansen, Steen M.; Brøndum, Stig; Thomas, Grethe; Rasmussen, Susanne R.; Kvist, Birgitte; Christensen, Anette; Lyng, Charlotte; Lindberg, Jan; Lauritsen, Torsten L. B.; Lippert, Freddy K.; Torp-Pedersen, Christian; Hansen, Poul A.

2015-01-01

Aim To describe the implementation of a novel first-responder programme in which home care providers equipped with automated external defibrillators (AEDs) were dispatched in parallel with existing emergency medical services in the event of a suspected out-of-hospital cardiac arrest (OHCA). Methods We evaluated a one-year prospective study that trained home care providers in performing cardiopulmonary resuscitation (CPR) and using an AED in cases of suspected OHCA. Data were collected from cardiac arrest case files, case files from each provider dispatch and a survey among dispatched providers. The study was conducted in a rural district in Denmark. Results Home care providers were dispatched to 28 of the 60 OHCAs that occurred in the study period. In ten cases the providers arrived before the ambulance service and subsequently performed CPR. AED analysis was executed in three cases and shock was delivered in one case. For 26 of the 28 cases, the cardiac arrest occurred in a private home. Ninety-five per cent of the providers who had been dispatched to a cardiac arrest reported feeling prepared for managing the initial resuscitation, including use of AED. Conclusion Home care providers are suited to act as first-responders in predominantly rural and residential districts. Future follow-up will allow further evaluation of home care provider arrivals and patient survival. PMID:26509532

Formulating evidence-based guidelines for certified nurse-midwives and certified midwives attending home births.

Science.gov (United States)

Cook, Elizabeth; Avery, Melissa; Frisvold, Melissa

2014-01-01

Implementing national home birth guidelines for certified nurse-midwives (CNMs) and certified midwives (CMs) in the United States may facilitate a common approach to safe home birth practices. Guidelines are evidence-based care recommendations for specified clinical situations that can be modified by individual providers to meet specific client needs. Following a review of home birth guidelines from multiple countries, a set of home birth practices guidelines for US CNMs/CMs was drafted. Fifteen American Midwifery Certification Board, Inc. (AMCB)-certified home birth midwives who participate in the American College of Nurse-Midwives (ACNM) home birth electronic mailing list considered the use of such a document in their practices and reviewed and commented on the guidelines. The proposed guidelines addressed client screening, informed consent, antepartum care, routine intrapartum care, obstetric complications and hospital transports, postpartum care, neonatal care, gynecologic care, primary care, peer reviews, recordkeeping, and physician collaboration. The reviewers had varying assessments as to whether the guidelines reflected international standards and current best evidence. The primary concern expressed was that an adoption of national guidelines could compromise provider autonomy. Incorporation of evidence-based guidelines is an ACNM standard and was recommended by the Home Birth Consensus Summit. Clinical practice guidelines are informed by current evidence and supported by experts in a given discipline. Implementation of guidelines ensures optimal patient care and is becoming increasingly central to reimbursement and to medicolegal support. A set of practice guidelines based on current best evidence and internationally accepted standards was developed and reviewed by an interested group of US CNMs/CMs. Further discussion with home birth midwives and other stakeholders about the development and implementation of home birth guidelines is needed, especially in

41 CFR 102-5.75 - What circumstances do not establish a basis for authorizing home-to-work transportation for field...

Science.gov (United States)

2010-07-01

... not establish a basis for authorizing home-to-work transportation for field work? 102-5.75 Section 102... (Continued) FEDERAL MANAGEMENT REGULATION GENERAL 5-HOME-TO-WORK TRANSPORTATION Authorizing Home-to-Work Transportation § 102-5.75 What circumstances do not establish a basis for authorizing home-to-work transportation...

Automated Clinical Assessment from Smart home-based Behavior Data

Science.gov (United States)

Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

2016-01-01

Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behaviour in the home and predicting standard clinical assessment scores of the residents. To accomplish this goal, we propose a Clinical Assessment using Activity Behavior (CAAB) approach to model a smart home resident’s daily behavior and predict the corresponding standard clinical assessment scores. CAAB uses statistical features that describe characteristics of a resident’s daily activity performance to train machine learning algorithms that predict the clinical assessment scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years using prediction and classification-based experiments. In the prediction-based experiments, we obtain a statistically significant correlation (r = 0.72) between CAAB-predicted and clinician-provided cognitive assessment scores and a statistically significant correlation (r = 0.45) between CAAB-predicted and clinician-provided mobility scores. Similarly, for the classification-based experiments, we find CAAB has a classification accuracy of 72% while classifying cognitive assessment scores and 76% while classifying mobility scores. These prediction and classification results suggest that it is feasible to predict standard clinical scores using smart home sensor data and learning-based data analysis. PMID:26292348

An Ontology-based Context-aware System for Smart Homes: E-care@home

Directory of Open Access Journals (Sweden)

Marjan Alirezaie

2017-07-01

Full Text Available Smart home environments have a significant potential to provide for long-term monitoring of users with special needs in order to promote the possibility to age at home. Such environments are typically equipped with a number of heterogeneous sensors that monitor both health and environmental parameters. This paper presents a framework called E-care@home, consisting of an IoT infrastructure, which provides information with an unambiguous, shared meaning across IoT devices, end-users, relatives, health and care professionals and organizations. We focus on integrating measurements gathered from heterogeneous sources by using ontologies in order to enable semantic interpretation of events and context awareness. Activities are deduced using an incremental answer set solver for stream reasoning. The paper demonstrates the proposed framework using an instantiation of a smart environment that is able to perform context recognition based on the activities and the events occurring in the home.

An Ontology-based Context-aware System for Smart Homes: E-care@home.

Science.gov (United States)

Alirezaie, Marjan; Renoux, Jennifer; Köckemann, Uwe; Kristoffersson, Annica; Karlsson, Lars; Blomqvist, Eva; Tsiftes, Nicolas; Voigt, Thiemo; Loutfi, Amy

2017-07-06

Smart home environments have a significant potential to provide for long-term monitoring of users with special needs in order to promote the possibility to age at home. Such environments are typically equipped with a number of heterogeneous sensors that monitor both health and environmental parameters. This paper presents a framework called E-care@home, consisting of an IoT infrastructure, which provides information with an unambiguous, shared meaning across IoT devices, end-users, relatives, health and care professionals and organizations. We focus on integrating measurements gathered from heterogeneous sources by using ontologies in order to enable semantic interpretation of events and context awareness. Activities are deduced using an incremental answer set solver for stream reasoning. The paper demonstrates the proposed framework using an instantiation of a smart environment that is able to perform context recognition based on the activities and the events occurring in the home.

Home-based Healthcare Technology

DEFF Research Database (Denmark)

Verdezoto, Nervo

of these systems target a specific treatment or condition and might not be sufficient to support the care management work at home. Based on a case study approach, my research investigates home-based healthcare practices and how they can inform future design of home-based healthcare technology that better account......Sustaining daily, unsupervised healthcare activities in non-clinical settings such as the private home can challenge, among others, older adults. To support such unsupervised care activities, an increasingly number of reminders and monitoring systems are being designed. However, most...

Research on the model of home networking

Science.gov (United States)

Yun, Xiang; Feng, Xiancheng

2007-11-01

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

A HOME-BASED MASSED PRACTICE SYSTEM FOR PEDIATRIC NEUROREHABILITATION

Directory of Open Access Journals (Sweden)

Yi-Ning Wu

2013-11-01

Full Text Available The objective of this paper is to introduce a novel low-cost human-computer interface (HCI system for home-based massed practice for children with upper limb impairment due to brain injury. Successful massed practice, a type of neurorehabilitation, may be of value for children with brain injury because it facilitates impaired limb use. Use of automated, home-based systems could provide a practical means for massed practice. However, the optimal strategy to deliver and monitor home-based massed practice is still unclear. We integrated motion sensor, video game, and HCI software technologies to create a useful home-based massed practice at targeted joints. The system records joint angle and number of movements using a low-cost custom hand-held sensor. The sensor acts as an input device to play video games. We demonstrated the system’s functionality and provided preliminary observations on usage by children with brain injury, including joint motion and muscle activation.

National Survey of Emergency Physicians Concerning Home-Based Care Options as Alternatives to Emergency Department-Based Hospital Admissions.

Science.gov (United States)

Stuck, Amy R; Crowley, Christopher; Killeen, James; Castillo, Edward M

2017-11-01

Emergency departments (EDs) in the United States play a prominent role in hospital admissions, especially for the growing population of older adults. Home-based care, rather than hospital admission from the ED, provides an important alternative, especially for older adults who have a greater risk of adverse events, such as hospital-acquired infections, falls, and delirium. The objective of the survey was to understand emergency physicians' (EPs) perspectives on home-based care alternatives to hospitalization from the ED. Specific goals included determining how often EPs ordered home-based care, what they perceive as the barriers and motivators for more extensive ordering of home-based care, and the specific conditions and response times most appropriate for such care. A group of 1200 EPs nationwide were e-mailed a six-question survey. Participant response was 57%. Of these, 55% reported ordering home-based care from the ED within the past year as an alternative to hospital admission or observation, with most doing so less than once per month. The most common barrier was an "unsafe or unstable home environment" (73%). Home-based care as a "better setting to care for low-acuity chronic or acute disease exacerbation" was the top motivator (79%). Medical conditions EPs most commonly considered for home-based care were cellulitis, urinary tract infection, diabetes, and community-acquired pneumonia. Results suggest that EPs recognize there is a benefit to providing home-based care as an alternative to hospitalization, provided they felt the home was safe and a process was in place for dispositioning the patient to this setting. Better understanding of when and why EPs use home-based care pathways from the ED may provide suggestions for ways to promote wider adoption. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Maximizing federal Medicaid dollars: nursing home provider tax adoption, 2000-2004.

Science.gov (United States)

Miller, Edward Alan; Wang, Lili

2009-12-01

Since Medicaid is jointly financed by the federal and state governments, state officials have sought to offset state expenditures by maximizing federal contributions. One such strategy is to adopt a provider tax, which enables states to collect revenues from providers; those revenues are then used to pay for services rendered to Medicaid recipients, thereby leveraging federal matching dollars without concomitant increases in state expenditures. The number of states adopting a nursing home tax increased from thirteen to thirty-one between 2000 and 2004. This study seeks to identify the factors that spurred the rapid increase in nursing home provider taxes following implementation of the Balanced Budget Act of 1997. Results indicate that states with more powerful nursing home lobbies, lower proportions of private pay nursing home residents, worse fiscal health, weaker fiscal capacity, broader Medicaid eligibility, and nursing home supply restrictions were more likely to adopt. This implies that state officials react rationally to prevailing fiscal and programmatic circumstances when formulating policy under Medicaid and that providers seek relief, in part, from the adverse fiscal consequences of federal policy changes by promoting policy change at the state level.

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

Science.gov (United States)

Vik, Kjersti; Eide, Arne H

2012-09-01

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

A comparison of home care clients and nursing home residents: can community based care keep the elderly and disabled at home?

Science.gov (United States)

Shugarman, L R; Fries, B E; James, M

1999-01-01

Admission cohorts from the Michigan Medicaid Home and Community-Based Waiver program and Ohio nursing homes were compared on measures of resource utilization including a modified Resource Utilization Groups (RUG-III) system, Activities of Daily Living (ADLs), and overall case mix. We found that, contrary to previous research, the two samples were remarkably similar across RUG-III categories. However, the nursing home sample was more functionally impaired on measures of ADL functioning and overall case mix. Results of this study may inform policymakers and providers of the potential for maintaining the appropriate population in the home with government-funded home care.

Comparison of home and away-from-home physical activity using accelerometers and cellular network-based tracking devices.

Science.gov (United States)

Ramulu, Pradeep Y; Chan, Emilie S; Loyd, Tara L; Ferrucci, Luigi; Friedman, David S

2012-08-01

Measuring physical at home and away from home is essential for assessing health and well-being, and could help design interventions to increase physical activity. Here, we describe how physical activity at home and away from home can be quantified by combining information from cellular network-based tracking devices and accelerometers. Thirty-five working adults wore a cellular network-based tracking device and an accelerometer for 6 consecutive days and logged their travel away from home. Performance of the tracking device was determined using the travel log for reference. Tracking device and accelerometer data were merged to compare physical activity at home and away from home. The tracking device detected 98.6% of all away-from-home excursions, accurately measured time away from home and demonstrated few prolonged signal drop-out periods. Most physical activity took place away from home on weekdays, but not on weekends. Subjects were more physically active per unit of time while away from home, particularly on weekends. Cellular network-based tracking devices represent an alternative to global positioning systems for tracking location, and provide information easily integrated with accelerometers to determine where physical activity takes place. Promoting greater time spent away from home may increase physical activity.

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

Science.gov (United States)

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

2015-01-01

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

Role of informal care providers in home based long term care in diabetes mellitus at Kaiwara Primary Health Center area, Karnataka, India

Directory of Open Access Journals (Sweden)

Arjunan Isaac

2011-06-01

Full Text Available Objective: To find the prevalence of diabetics, identify informal care providers for them in Kaiwara Primary Health Center (PHC area, assess the level of knowledge and skills of an informal care provider in home based long term care and improve the level of knowledge and skill of the informal care provider through a structured training capsule. Methods: A cross sectional and an interventional study was conducted on diabetics and their informal care providers in Kaiwara PHC area. Data were collected using pre-tested, structured questionnaire by an interview method. A structured training capsule was developed and implemented. Evaluation of the knowledge and skills was assessed at the beginning and at the end of the training. Student ’s paired/unpaired ‘t ’ tests and correlation analysis were done. Results: Improvement scores were calculated by subtracting the pre-evaluation scores from the post-evaluation scores. The mean improvement scores was (2.66暲0.32 and was statistically significant (P<0.001. No significant difference in mean values was found in the knowledge and skills scores in relation to the socio-demographic variables in the study. Conclusions: Knowledge and skills component of the informal care provider in home based care of diabetes could be perceived as a “felt need ”.

Automated Cognitive Health Assessment From Smart Home-Based Behavior Data.

Science.gov (United States)

Dawadi, Prafulla Nath; Cook, Diane Joyce; Schmitter-Edgecombe, Maureen

2016-07-01

Smart home technologies offer potential benefits for assisting clinicians by automating health monitoring and well-being assessment. In this paper, we examine the actual benefits of smart home-based analysis by monitoring daily behavior in the home and predicting clinical scores of the residents. To accomplish this goal, we propose a clinical assessment using activity behavior (CAAB) approach to model a smart home resident's daily behavior and predict the corresponding clinical scores. CAAB uses statistical features that describe characteristics of a resident's daily activity performance to train machine learning algorithms that predict the clinical scores. We evaluate the performance of CAAB utilizing smart home sensor data collected from 18 smart homes over two years. We obtain a statistically significant correlation ( r=0.72) between CAAB-predicted and clinician-provided cognitive scores and a statistically significant correlation ( r=0.45) between CAAB-predicted and clinician-provided mobility scores. These prediction results suggest that it is feasible to predict clinical scores using smart home sensor data and learning-based data analysis.

Caring for home-based care workers | de Saxe Zerden | Southern ...

African Journals Online (AJOL)

care workers provide critical services, which include physical, psychosocial, and palliative care activities.1 A quantitative and qualitative study of home-based care workers in South Africa was conducted in 2005 to better understand the needs, fears and motivations of front-line care workers at Thembalethu Home Based ...

[How can psychological help be provided for the patient/caregiver tandem home?].

Science.gov (United States)

Boucharlat, M; Montani, C; Myslinski, M; Franco, A

2006-01-01

Elderly people and their family helpers are often isolated at home and do not have access to the professional psychological help that they require. For an elderly population, the trips to consulting rooms are difficult, tedious and expensive. Besides, maintaining a patient at home is heavy to manage for close relatives because of the organization, financial issues and above all the risk of psychological burnout. The literature shows us that psychological assistance is more common at distance from home, in hospitals, in special institutions or specific organizations. However, there is a clear need of help at home. We propose to develop psychological assistance at home for the patient/helper tandem in cases of dementia. This prospective study reports three different cases. This study is a qualitative pilot study. Participants characteristics: patients were diagnosed with severe dementia, assistance showed deep fatigue of the helper, both members of the tandem lived at home, age above 69 years, the eed for nursing care at home. THERAPEUTIC ASSESSMENT: The psychological clinician acts after proposing his helpand not on a clear request from the patient. He will meet his patient 7 times during 4 months. The meetings always take place in the same place and last 45 minutes. Confidentiality during the meeting is explained and guaranteed so the patient can speak openly. An independent psychologist assessed the monitoring in the hospital. Our methodology included two assessments: the first, assessing the task of the helper before the evaluation and the second taking into account a new measurent of the task and the opinions of the participants following a semi-directed interview. The evaluation of the task was performed using Zarit's scale. The evaluation was also based on the clinical observation of the psychologist. Organization of the monitoring: one meeting per week was sufficient for all participants with a minimal duration of 45 minutes. The fact that the meetingsrook

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

Science.gov (United States)

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

2012-01-01

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

Nurse led home-based care for people with HIV/AIDS.

Science.gov (United States)

Wood, Elizabeth M; Zani, Babalwa; Esterhuizen, Tonya M; Young, Taryn

2018-03-27

Home-based care is used in many countries to increase quality of life and limit hospital stay, particularly where public health services are overburdened. Home-based care objectives for HIV/AIDS can include medical care, delivery of antiretroviral treatment and psychosocial support. This review assesses the effects of home-based nursing on morbidity in people infected with HIV/AIDS. The trials studied are in HIV positive adults and children, regardless of sex or setting and all randomised controlled. Home-based care provided by qualified nurses was compared with hospital or health-facility based treatment. The following electronic databases were searched from January 1980 to March 2015: AIDSearch, CINAHL, Cochrane Register of Controlled Trials, EMBASE, MEDLINE and PsycINFO/LIT, with an updated search in November 2016. Two authors independently screened titles and abstracts from the electronic search based on the study design, interventions and types of participant. For all selected abstracts, full text articles were obtained. The final study selection was determined with use of an eligibility form. Data extraction was performed independently from assessment of risk of bias. The results were analysed by narrative synthesis, in order to be able to obtain relevant effect measures plus 95% confidence intervals. Seven studies met the inclusion criteria. The trial size varied from 37 to 238 participants. Only one trial was conducted in children. Five studies were conducted in the USA and two in China. Four studies looked at home-based adherence support and the rest at providing home-based psychosocial support. Reported adherence to antiretroviral drugs improved with nurse-led home-based care but did not affect viral load. Psychiatric nurse support in those with existing mental health conditions improved mental health and depressive symptoms. Home-based psychological support impacted on HIV stigma, worry and physical functioning and in certain cases depressive symptoms

Home school student visit and introduction to rail transportation and engineering.

Science.gov (United States)

2016-06-22

This project consisted of hosting local Champaign-Urbana, Illinois home school students for a visit to : the Rail Transportation and Engineering Center (RailTEC) at the University of Illinois at Urbana- : Champaign (UIUC). Beyond visiting RailTEC, st...

Home-based care, technology, and the maintenance of selves.

Science.gov (United States)

Parks, Jennifer A

2015-06-01

In this paper, I will argue that there is a deep connection between home-based care, technology, and the self. Providing the means for persons (especially older persons) to receive care at home is not merely a kindness that respects their preference to be at home: it is an important means of extending their selfhood and respecting the unique selves that they are. Home-based technologies like telemedicine and robotic care may certainly be useful tools in providing care for persons at home, but they also have important implications for sustaining selfhood in ways that are of value to individuals and those who care for them. I will argue, by appealing to Hilde Lindemann's notion of "holding" persons' identities in place, that technological interventions are not only useful tools for improving and sustaining health and good care at home, but that they may also help to extend our personal identities and relational capacities in ways that are practically and ethically good. Because of these important goods, I will claim that there is a prima facie moral duty to do this "holding" work and that it is best done by family members and loved ones who are well suited to the job because of their history and relationship with the individual that needs to be "held" in place.

Home and Community-Based Service Use by Vulnerable Older Adults.

Science.gov (United States)

Weaver, Raven H; Roberto, Karen A

2017-06-01

The purpose of this study was to identify different types of clients who use home and community-based services. Enrollment characteristics of 76 clients at risk of nursing home placement and Medicaid spend-down who were enrolled in the Virginia Community Living Program were analyzed. Two-step cluster analysis identified 4 groups of service users. Enabling resources (caregiver relationship to participant, participant living arrangement, and length of time caregiver provided assistance to participant) and disability type (physical, cognitive, traumatic brain injury, or other) differentiated the client groups. Groups differed on average service cost per day and likelihood of nursing home placement if services were not provided. Findings point to the value of having practitioners assist vulnerable clients in tailoring services to meet different care needs and the need for refining policies guiding home and community-based care. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Home Delivery and the Impacts on Urban Freight Transport : A Review

NARCIS (Netherlands)

Visser, J.G.S.N.; Nemoto, T.; Browne, M.

2014-01-01

This review paper discusses the latest developments in internet shopping, home delivery and the potential impacts on city logistics and alternative vehicle use. The review has illustrated the rapid changes during the past few years and the potentially important impacts on patterns of transport

Home-based COPD psychoeducation

DEFF Research Database (Denmark)

Bove, D G; Midtgaard, J; Kaldan, G

2017-01-01

in reducing symptoms of anxiety and increasing mastery of dyspnoea in patients with advanced chronic obstructive pulmonary disease (COPD). However, we do not know if the intervention is perceived as meaningful and applicable in the everyday life of patients with advanced COPD. METHODS: We conducted a nested......OBJECTIVE: To explore the patients' experiences of a minimal home-based psychoeducative intervention aimed at reducing symptoms of anxiety. BACKGROUND: In a randomised controlled trial (RCT) we have shown that a minimal home-based and nurse-led psychoeducative intervention has a significant effect...... post-trial qualitative study. The study methodology was Interpretive Description as described by Thorne. The study was based on semi-structured interviews with twenty patients from the RCT intervention group i.g. home-living people with a diagnosis of advanced COPD and symptoms of anxiety. RESULTS...

Smart Home System Based on GSM Network

Directory of Open Access Journals (Sweden)

Bakhtiar Ali Karim

2018-04-01

Full Text Available Due to increasing robbery and intrusion, establishing home-security system has become a correlated part of the modern houses, buildings, and offices. As the family members are not at home all the time, the traditional home security system, which makes alarm sound only, may not be efficient enough. Alternatively, Global System for Mobile communications (GSM based security system can provide higher level of security and convenience compared to the traditionally used systems. The main objective of the current paper is to design and implement cost-efficient and reliable security, safety and home automation system for protection and occupants’ convenience. If any undesired events, such as intrusion, gas leakage and fire occurs in the house, our system warns the homeowner in real-time using Short Message Service (SMS. With the proposed system home appliances can also be controlled in three ways, namely sending SMS from the authorized numbers to the system through GSM network, smartphone app using Bluetooth module and infrared (IR control using IR module

Sodium-glucose co-transporter type 2 inhibitors reduce evening home blood pressure in type 2 diabetes with nephropathy.

Science.gov (United States)

Takenaka, Tsuneo; Kishimoto, Miyako; Ohta, Mari; Tomonaga, Osamu; Suzuki, Hiromichi

2017-05-01

The effects of sodium-glucose co-transporter type 2 inhibitors on home blood pressure were examined in type 2 diabetes with nephropathy. The patients with diabetic nephropathy were screened from medical records in our hospitals. Among them, 52 patients who measured home blood pressure and started to take sodium-glucose co-transporter type 2 inhibitors were selected. Clinical parameters including estimated glomerular filtration rate, albuminuria and home blood pressure for 6 months were analysed. Sodium-glucose co-transporter type 2 inhibitors (luseogliflozin 5 mg/day or canagliflozin 100 mg/day) reduced body weight, HbA1c, albuminuria, estimated glomerular filtration rate and office blood pressure. Although sodium-glucose co-transporter type 2 inhibitors did not alter morning blood pressure, it reduced evening systolic blood pressure. Regression analyses revealed that decreases in evening blood pressure predicted decrements in albuminuria. The present data suggest that sodium-glucose co-transporter type 2 inhibitors suppress sodium overload during daytime to reduce evening blood pressure and albuminuria.

Providing High-Quality Support Services to Home-Based Child Care: A Conceptual Model and Literature Review

Science.gov (United States)

Bromer, Juliet; Korfmacher, Jon

2017-01-01

Research Findings: Home-based child care accounts for a significant proportion of nonparental child care arrangements for young children in the United States. Yet the early care and education field lacks clear models or pathways for how to improve quality in these settings. The conceptual model presented here articulates the components of…

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

Science.gov (United States)

Daley, Andrea; MacDonnell, Judith A

2015-05-01

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

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

Science.gov (United States)

2011-11-21

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

The functions of hospital-based home care for people with severe mental illness in Taiwan.

Science.gov (United States)

Huang, Xuan-Yi; Lin, Mei-Jue; Yang, Tuz-Ching; Hsu, Yuan-Shan

2010-02-01

The purposes of this study were to understand the functions of hospital-based home care for people with severe mental illness in Taiwan, and the factors that affect functions of professionals who provide hospital-based home care. Hospital-based home care is a service which provides those people with serious mental illnesses who are in crisis and who are candidates for admission to hospital. Home care has been shown to have several advantages over inpatient treatment. However, there is a lack of knowledge about the functions of hospital-based home care for people with severe mental illness in Taiwan. This qualitative study was based on the grounded theory method of Strauss and Corbin. The study was conducted in six different hospital areas in central Taiwan in 2007-2008. Data were collected using semi-structured face-to-face interviews. Constant comparative analysis continued during the open, axial and selective coding processes until data saturation occurred. Participants were selected by theoretical sampling. When theoretical saturation was achieved, 21 clients with mental illness, 19 carers and 25 professionals were interviewed. Several functions were found when these professionals provided hospital-based home care services for people with severe mental illness in Taiwan, including stabilising the clients illness, supplying emergency care services, improving life-coping abilities, employment and welfare assistance, emotional support for both clients and carers, assistance with future and long-term arrangements and assistance with communication between carers and clients. Hospital-based home care provides several important services for helping clients and their families to live in the community. The recommendations based on the findings of this study can be used as a guide to improve the delivery of hospital-based home care services to community-dwelling clients with severe mental illness and their carers.

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

Science.gov (United States)

2010-10-01

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

Primary care providers and medical homes for individuals with spina bifida.

Science.gov (United States)

Walker, William O

2008-01-01

The contributions of primary care providers to the successful care of children with spina bifida cannot be underestimated. Overcoming systemic barriers to their integration into a comprehensive care system is essential. By providing routine and disability specific care through the structure of a Medical Home, they are often the first line resource and support for individuals and their families. The Medical Home model encourages primary care providers to facilitate discussions on topics as varied as education and employment. Knowledge of specific medical issues unique to this population allows the primary care provider to complement the efforts of other specialty clinics and providers in often neglected areas such as sexual health, obesity and latex sensitization. As individuals with spina bifida live into adulthood, and access to traditional multidisciplinary care models evolves, these skills will take on increasing importance within the scope of providing comprehensive and coordinated care.

Beyond Self-Monitoring: Understanding Non-functional Aspects of Home-based Healthcare Technology

DEFF Research Database (Denmark)

Grönvall, Erik; Verdezoto, Nervo

2013-01-01

the appropriation of healthcare technologies and people with comorbidity may have diverse but co-existing monitoring needs. In this paper, we seek to understand home-based health monitoring practices to better design and integrate them into people’s everyday life. We perform an analysis of socio......-technical complexities in home-based healthcare technologies through three case studies of self-monitoring: 1) pre-eclampsia (i.e. pregnancy poisoning), 2) heart conditions, and 3) preventive care. Through the analysis seven themes emerged (people, resources, places, routines, knowledge, control and motivation) that can...... facilitate the understanding of home-based healthcare activities. We present three modes of self-monitoring use and provide a set of design recommendations for future Ubicomp designs of home-based healthcare technology....

Active home-based cancer treatment

Directory of Open Access Journals (Sweden)

Bordonaro S

2012-06-01

Full Text Available Sebastiano Bordonaro Fabio Raiti, Annamaria Di Mari, Calogera Lopiano, Fabrizio Romano, Vitalinda Pumo, Sebastiano Rametta Giuliano, Margherita Iacono, Eleonora Lanteri, Elena Puzzo, Sebastiano Spada, Paolo TralongoUOC Medical Oncology, RAO, ASP 8 Siracusa, ItalyBackground: Active home-based treatment represents a new model of health care. Chronic treatment requires continuous access to facilities that provide cancer care, with considerable effort, particularly economic, on the part of patients and caregivers. Oral chemotherapy could be limited as a consequence of poor compliance and adherence, especially by elderly patients.Methods: We selected 30 cancer patients referred to our department and treated with oral therapy (capecitabine, vinorelbine, imatinib, sunitinib, sorafenib, temozolomide, ibandronate. This pilot study of oral therapy in the patient’s home was undertaken by a doctor and two nurses with experience in clinical oncology. The instruments used were clinical diaries recording home visits, hospital visits, need for caregiver support, and a questionnaire specially developed by the European Organization for Research and Treatment of Cancer (EORTC, known as the QLQ-C30 version 2.0, concerning the acceptability of oral treatment from the patient’s perspective.Results: This program decreased the need to access cancer facilities by 98.1%, promoted better quality of life for patients, as reflected in increased EORTC QLQ-C30 scores over time, allowing for greater adherence to oral treatment as a result of control of drug administration outside the hospital. This model has allowed treatment of patients with difficult access to care (elderly, disabled or otherwise needed caregivers that in the project represent the majority (78% of these.Conclusions: This model of active home care improves quality of life and adherence with oral therapy, reduces the need to visit the hospital, and consequently decreases the number of lost hours of work on

Appliance based control for Home Power Management Systems

International Nuclear Information System (INIS)

Özkan, Hanife Apaydın

2016-01-01

This study scrutinizes energy-friendly smart home appliances (hereafter ‘smart appliances’), control of these appliances and their effects on the efficient use of energy. To accomplish this, smart appliances and their operation principles are introduced and their energy savings compared to conventional appliances are analyzed using precise measurements. Then, a real-time Appliance-based Home Power Management System (Ab-HPMS) which manages power consumption of smart appliances and that of the house as a whole is proposed. For Ab-HPMS, an appliance control algorithm, called Appliance-based Rolling Wave Planning (Ab-RWP), is developed with the aim of reducing electricity cost and improving energy efficiency while maintaining user comfort. Ab-RWP algorithm interacts with appliances in a priority order based on user comfort which is determined by utilizing their smart operational characteristics. Operations of smart appliances and their integrations with Ab-HPMS are modeled with Petri nets to verify that they meet the requirements expressed in the specifications. Simulation results demonstrate that proposed Ab-HPMS provides improvements in terms of the energy consumption reduction of about 5%–16%, cost reduction of about 10%–24% and peak reduction at high demand period of about 38%–53% compared to conventional appliances usage. - Highlights: • The effects of smart home appliances on energy saving are investigated. • Petri nets models of smart appliances are developed to simulate their operations in smart home. • A real-time appliance-based home power management system (Ab-HPMS) is proposed. • Power density function is evaluated to interrupt the operation of smart washing machine.

41 CFR 302-10.200 - What costs are allowable when a commercial carrier transports my mobile home overland or over water?

Science.gov (United States)

2010-07-01

... when a commercial carrier transports my mobile home overland or over water? 302-10.200 Section 302-10... carrier transports my mobile home overland or over water? Your agency will allow the following costs for... State or local law. (b) When transporting over water cost must include, but not limited to the cost of...

The Incidence and Wage Consequences of Home-Based Work in the United States, 1980-2000

Science.gov (United States)

Oettinger, Gerald S.

2011-01-01

This study documents the rapid growth in home-based wage and salary employment and the sharp decline in the home-based wage penalty in the United States between 1980 and 2000. These twin patterns, observed for both men and women in most occupation groups, suggest that employer costs of providing home-based work arrangements have decreased.…

Evaluating the Implementation of Home-Based Videoconferencing for Providing Mental Health Services.

Science.gov (United States)

Interian, Alejandro; King, Arlene R; St Hill, Lauren M; Robinson, Claire H; Damschroder, Laura J

2018-01-01

The Veterans Health Administration (VHA) has recently implemented video-to-home (V2H) telehealth as part of a strategy to improve access to mental health treatment. Implementation research of this modality is needed, given that V2H telehealth transforms the traditional face-to-face delivery of mental health services. To address this need, V2H implementation was evaluated by examining barriers and facilitators that were associated with level of staff V2H experience and factors that differentiated facilities with various levels of V2H performance. Semistructured interviews with VHA personnel (N=33) from three facilities were conducted. The facilities were selected by overall number of mental health V2H visits during fiscal year (FY) 2015 as well as by growth in number of visits from FY 2014 through FY 2015. Factors influencing implementation were identified through qualitative analyses that contrasted responses by groups of participants with three different levels of V2H experience (no experience, limited experience, most experience) as well as three facilities that differed in V2H productivity (high visit count, high visit growth, and low visit count and low visit growth). Providers seemed to encounter different barriers and facilitators depending on their level of experience with V2H. Site-level analyses illustrated the importance of logistical support, especially for providers who are newly adopting the technology. Other factors that differentiated the facilities were also identified and described. Key factors related to implementation of V2H telehealth pertained to provider buy-in and logistical support. Facility-level strategies that address these factors may enhance provider progression from nonuse to sustained use.

Alert management for home healthcare based on home automation analysis.

Science.gov (United States)

Truong, T T; de Lamotte, F; Diguet, J-Ph; Said-Hocine, F

2010-01-01

Rising healthcare for elder and disabled people can be controlled by offering people autonomy at home by means of information technology. In this paper, we present an original and sensorless alert management solution which performs multimedia and home automation service discrimination and extracts highly regular home activities as sensors for alert management. The results of simulation data, based on real context, allow us to evaluate our approach before application to real data.

Smart Demand Response Based on Smart Homes

Directory of Open Access Journals (Sweden)

Jingang Lai

2015-01-01

Full Text Available Smart homes (SHs are crucial parts for demand response management (DRM of smart grid (SG. The aim of SHs based demand response (DR is to provide a flexible two-way energy feedback whilst (or shortly after the consumption occurs. It can potentially persuade end-users to achieve energy saving and cooperate with the electricity producer or supplier to maintain balance between the electricity supply and demand through the method of peak shaving and valley filling. However, existing solutions are challenged by the lack of consideration between the wide application of fiber power cable to the home (FPCTTH and related users’ behaviors. Based on the new network infrastructure, the design and development of smart DR systems based on SHs are related with not only functionalities as security, convenience, and comfort, but also energy savings. A new multirouting protocol based on Kruskal’s algorithm is designed for the reliability and safety of the SHs distribution network. The benefits of FPCTTH-based SHs are summarized at the end of the paper.

Differences and Agreement in Perception of Child Picky Eating Among Center- and Home-Based Childcare Providers and Parents and Its Impact on Utilized Mealtime Strategies

Directory of Open Access Journals (Sweden)

Virginia Luchini

2017-02-01

Full Text Available Picky eating is a problematic eating behavior caregivers may encounter with children under their care. A picky eater (PE is typically characterized as consuming a narrow range of food, as well as rejecting several food items. Much of the literature regarding PEs involves parents, although use of nonparental childcare arrangements in the United States has increased in the past several decades. Although data on parental mealtime strategies exist, little is known about how parent and childcare provider pickiness perceptions differ between types of childcare, such as center-based childcare (CBCC and home-based childcare (HBCC, or how these perceptions influence the mealtime strategies utilized. The objectives of this study were to (1 compare perceptions of child pickiness between parents and childcare providers, (2 compare percent agreement in pickiness perception between the dyads of CBCC parents and providers and HBCC parents and providers, and (3 identify mealtime strategy utilization based on pickiness perception. A total of 52 child, parent, and childcare provider triads participated in the study and completed the Mealtime Assessment Survey and the Parent/Teacher Mealtime Strategy Survey regarding the same child. Results showed that parents are 1.4 times more likely than childcare providers to perceive a child as being picky, HBCC parents and providers are 1.4 times more likely to perceive a child as being picky than CBCC parents and providers, CBCC parents and providers disagree more in their perception of child pickiness than HBCC parents and providers (41% vs 26%, and finally, perception of child pickiness has a greater influence on mealtime strategies utilized by parents. These results can be used to focus intervention efforts aimed at improving child eating habits across the home and childcare location.

Home-based versus centre-based cardiac rehabilitation.

Science.gov (United States)

Taylor, Rod S; Dalal, Hayes; Jolly, Kate; Moxham, Tiffany; Zawada, Anna

2010-01-20

The burden of cardiovascular disease world-wide is one of great concern to patients and health care agencies alike. Traditionally centre-based cardiac rehabilitation (CR) programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. To determine the effectiveness of home-based cardiac rehabilitation programmes compared with supervised centre-based cardiac rehabilitation on mortality and morbidity, health-related quality of life and modifiable cardiac risk factors in patients with coronary heart disease. We updated the search of a previous review by searching the Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library (2007, Issue 4), MEDLINE, EMBASE and CINAHL from 2001 to January 2008. We checked reference lists and sought advice from experts. No language restrictions were applied. Randomised controlled trials (RCTs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes, in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Studies were selected independently by two reviewers, and data extracted by a single reviewer and checked by a second one. Authors were contacted where possible to obtain missing information. Twelve studies (1,938 participants) met the inclusion criteria. The majority of studies recruited a lower risk patient following an acute myocardial infarction (MI) and revascularisation. There was no difference in outcomes of home- versus centre-based cardiac rehabilitation in mortality risk ratio (RR) was1.31 (95% confidence interval (C) 0.65 to 2.66), cardiac events, exercise capacity standardised mean difference (SMD) -0.11 (95% CI -0.35 to 0.13), as well as in modifiable risk factors (systolic blood pressure; diastolic blood pressure; total cholesterol

Region based Brain Computer Interface for a home control application.

Science.gov (United States)

Akman Aydin, Eda; Bay, Omer Faruk; Guler, Inan

2015-08-01

Environment control is one of the important challenges for disabled people who suffer from neuromuscular diseases. Brain Computer Interface (BCI) provides a communication channel between the human brain and the environment without requiring any muscular activation. The most important expectation for a home control application is high accuracy and reliable control. Region-based paradigm is a stimulus paradigm based on oddball principle and requires selection of a target at two levels. This paper presents an application of region based paradigm for a smart home control application for people with neuromuscular diseases. In this study, a region based stimulus interface containing 49 commands was designed. Five non-disabled subjects were attended to the experiments. Offline analysis results of the experiments yielded 95% accuracy for five flashes. This result showed that region based paradigm can be used to select commands of a smart home control application with high accuracy in the low number of repetitions successfully. Furthermore, a statistically significant difference was not observed between the level accuracies.

Comparing the nutrition environment and practices of home- and centre-based child-care facilities.

Science.gov (United States)

Martyniuk, Olivia J M; Vanderloo, Leigh M; Irwin, Jennifer D; Burke, Shauna M; Tucker, Patricia

2016-03-01

To assess and compare the nutrition environment and practices (as they relate to pre-schoolers) of centre- and home-based child-care facilities. Using a cross-sectional study design, nineteen child-care facilities (ten centre-based, nine home-based) were assessed for one full day using the Environment and Policy Assessment and Observation (EPAO) tool (consisting of a day-long observation/review of the nutrition environment, practices and related documents). Specifically, eight nutrition-related subscales were considered. Child-care facilities in London, Ontario, Canada. Child-care facilities were recruited through directors at centre-based programmes and the providers of home-based programmes. The mean total nutrition environment EPAO scores for centre- and home-based facilities were 12·3 (sd 1·94) and 10·8 (sd 0·78) out of 20 (where a higher score indicates a more supportive environment with regard to nutrition), respectively. The difference between the total nutrition environment EPAO score for centre- and home-based facilities was approaching significance (P=0·055). For both types of facilities, the highest nutrition subscale score (out of 20) was achieved in the staff behaviours domain (centre mean=17·4; home mean=17·0) and the lowest was in the nutrition training and education domain (centre mean=3·6; home mean=2·0). Additional research is needed to confirm these findings. In order to better support child-care staff and enhance the overall nutrition environment in child care, modifications to food practices could be adopted. Specifically, the nutritional quality of foods/beverages provided to pre-schoolers could be improved, nutrition-related training for child-care staff could be provided, and a nutrition curriculum could be created to educate pre-schoolers about healthy food choices.

41 CFR 102-5.70 - What considerations apply in making a determination to authorize home-to-work transportation for...

Science.gov (United States)

2010-07-01

... home-to-work transportation for field work: (a) The location of the employee's home in proximity to his/her work and to the locations where non-TDY travel is required; and (b) The use of home-to-work... increase the efficiency and economy of the Government. ...

Hand Motion-Based Remote Control Interface with Vibrotactile Feedback for Home Robots

Directory of Open Access Journals (Sweden)

Juan Wu

2013-06-01

Full Text Available This paper presents the design and implementation of a hand-held interface system for the locomotion control of home robots. A handheld controller is proposed to implement hand motion recognition and hand motion-based robot control. The handheld controller can provide a ‘connect-and-play’ service for the users to control the home robot with visual and vibrotactile feedback. Six natural hand gestures are defined for navigating the home robots. A three-axis accelerometer is used to detect the hand motions of the user. The recorded acceleration data are analysed and classified to corresponding control commands according to their characteristic curves. A vibration motor is used to provide vibrotactile feedback to the user when an improper operation is performed. The performances of the proposed hand motion-based interface and the traditional keyboard and mouse interface have been compared in robot navigation experiments. The experimental results of home robot navigation show that the success rate of the handheld controller is 13.33% higher than the PC based controller. The precision of the handheld controller is 15.4% more than that of the PC and the execution time is 24.7% less than the PC based controller. This means that the proposed hand motion-based interface is more efficient and flexible.

CULTURAL ADAPTATIONS OF EVIDENCE-BASED HOME-VISITATION MODELS IN TRIBAL COMMUNITIES.

Science.gov (United States)

Hiratsuka, Vanessa Y; Parker, Myra E; Sanchez, Jenae; Riley, Rebecca; Heath, Debra; Chomo, Julianna C; Beltangady, Moushumi; Sarche, Michelle

2018-05-01

The Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) Program provides federal grants to tribes, tribal consortia, tribal organizations, and urban Indian organizations to implement evidence-based home-visiting services for American Indian and Alaska Native (AI/AN) families. To date, only one evidence-based home-visiting program has been developed for use in AI/AN communities. The purpose of this article is to describe the steps that four Tribal MIECHV Programs took to assess community needs, select a home-visiting model, and culturally adapt the model for use in AI/AN communities. In these four unique Tribal MIECHV Program settings, each program employed a rigorous needs-assessment process and developed cultural modifications in accordance with community strengths and needs. Adaptations occurred in consultation with model developers, with consideration of the conceptual rationale for the program, while grounding new content in indigenous cultures. Research is needed to improve measurement of home-visiting outcomes in tribal and urban AI/AN settings, develop culturally grounded home-visiting interventions, and assess the effectiveness of home visiting in AI/AN communities. © 2018 Michigan Association for Infant Mental Health.

The frequency of outdoor play for preschool age children cared for at home-based child care settings.

Science.gov (United States)

Tandon, Pooja S; Zhou, Chuan; Christakis, Dimitri A

2012-01-01

Given that more than 34% of U.S. children are cared for in home-based child care settings and outdoor play is associated with physical activity and other health benefits, we sought to characterize the outdoor play frequency of preschoolers cared for at home-based child care settings and factors associated with outdoor play. Cross-sectional study of 1900 preschoolers (representing approximately 862,800 children) cared for in home-based child care settings (including relative and nonrelative care) using the nationally representative Early Childhood Longitudinal Study, Birth Cohort. Only 50% of home-based child care providers reported taking the child outside to walk or play at least once/day. More than one-third of all children did not go outside to play daily with either their parent(s) or home-based child care provider. There were increased odds of going outside daily for children cared for by nonrelatives in the child's home compared with care from a relative. Children with ≥3 regular playmates had greater odds of being taken outdoors by either the parents or child care provider. We did not find statistically significant associations between other child level (age, sex, screen-time), family level (highest education in household, mother's race, employment, exercise frequency), and child care level (hours in care, provider's educational attainment, perception of neighborhood safety) factors and frequency of outdoor play. At a national level, the frequency of outdoor play for preschoolers cared for in home-based child care settings is suboptimal. Further study and efforts to increase outdoor playtime for children in home-based child care settings are needed. Copyright © 2012 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

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

Science.gov (United States)

Freene, Nicole; Waddington, Gordon; Chesworth, Wendy; Davey, Rachel; Goss, John

2011-11-24

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

Personal computer based home automation system

OpenAIRE

Hellmuth, George F.

1993-01-01

The systems engineering process is applied in the development of the preliminary design of a home automation communication protocol. The objective of the communication protocol is to provide a means for a personal computer to communicate with adapted appliances in the home. A needs analysis is used to ascertain that a need exist for a home automation system. Numerous design alternatives are suggested and evaluated to determine the best possible protocol design. Coaxial cable...

Home-based intermediate care program vs hospitalization

Science.gov (United States)

Armstrong, Catherine Deri; Hogg, William E.; Lemelin, Jacques; Dahrouge, Simone; Martin, Carmel; Viner, Gary S.; Saginur, Raphael

2008-01-01

OBJECTIVE To explore whether a home-based intermediate care program in a large Canadian city lowers the cost of care and to look at whether such home-based programs could be a solution to the increasing demands on Canadian hospitals. DESIGN Single-arm study with historical controls. SETTING Department of Family Medicine at the Ottawa Hospital (Civic campus) in Ontario. PARTICIPANTS Patients requiring hospitalization for acute care. Participants were matched with historical controls based on case-mix, most responsible diagnosis, and level of complexity. INTERVENTIONS Placement in the home-based intermediate care program. Daily home visits from the nurse practitioner and 24-hour access to care by telephone. MAIN OUTCOME MEASURES Multivariate regression models were used to estimate the effect of the program on 5 outcomes: length of stay in hospital, cost of care substituted for hospitalization (Canadian dollars), readmission for a related diagnosis, readmission for any diagnosis, and costs incurred by community home-care services for patients following discharge from hospital. RESULTS The outcomes of 43 hospital admissions were matched with those of 363 controls. Patients enrolled in the program stayed longer in hospital (coefficient 3.3 days, P costs of home-based care were not significantly different from the costs of hospitalization (coefficient -$501, P = .11). CONCLUSION While estimated cost savings were not statistically significant, the limitations of our study suggest that we underestimated these savings. In particular, the economic inefficiencies of a small immature program and the inability to control for certain factors when selecting historical controls affected our results. Further research is needed to determine the economic effect of mature home-based programs. PMID:18208958

28 CFR 36.310 - Transportation provided by public accommodations.

Science.gov (United States)

2010-07-01

... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Transportation provided by public... BASIS OF DISABILITY BY PUBLIC ACCOMMODATIONS AND IN COMMERCIAL FACILITIES Specific Requirements § 36.310 Transportation provided by public accommodations. (a) General. (1) A public accommodation that provides...

38 CFR 52.220 - Transportation.

Science.gov (United States)

2010-07-01

... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Transportation. 52.220... FOR ADULT DAY HEALTH CARE OF VETERANS IN STATE HOMES Standards § 52.220 Transportation. Transportation... management must provide or contract for transportation to enable participants, including persons with...

Email based remote access and surveillance system for smart home infrastructure

Directory of Open Access Journals (Sweden)

Pooshkar Rajiv

2016-09-01

Full Text Available With the rapid rise of Internet of Things in public domain, people expect fast, reliable and on-demand home security via the Internet. However, existing remote home surveillance systems place a very rigid constraint on authentication and require customized hardware and software. In this paper we have proposed an ingenious and reliable internet based, home access system for smart homes that can be easily deployed on generic hardware. The proposed architecture uses popular email service providers to notify and update the user about the home access. It sends an email to the owner with the attached picture of the person who is at the door. It also incorporates a protected mechanism to give access of the door to a remote user by responding to that email. It essentially means that we can view and give access to the person at our door via sending and receiving an email. Furthermore, an image processing based mechanism has also been incorporated to provide access without email, to few selected personnel who are trusted by the owner. It works by capturing and comparing the visitor's image with the stored images in the database. Perceptual hashing or fingerprint matching algorithm is used for comparison purposes. Similarity percentage based on hamming distance was evaluated, and the similarity threshold for providing access was set. The simulations were performed in rigorous environment. The efficiency of the hashing algorithm was found to be 97% at the similarity threshold of 95%. The results validate that the average latency is only 155 ms with low standard deviation. The CPU utilization remained quite low with a minimum value of 10 MHz and a maximum value of 30 MHz when the payload size of the sent mail was increased to 1500 kB. Thus, the proposed system can be used for developing a larger low power infrastructure.

Research of home energy management system based on technology of PLC and ZigBee

Science.gov (United States)

Wei, Qi; Shen, Jiaojiao

2015-12-01

In view of the problem of saving effectively energy and energy management in home, this paper designs a home energy intelligent control system based on power line carrier communication and wireless ZigBee sensor networks. The system is based on ARM controller, power line carrier communication and wireless ZigBee sensor network as the terminal communication mode, and realizes the centralized and intelligent control of home appliances. Through the combination of these two technologies, the advantages of the two technologies complement each other, and provide a feasible plan for the construction of energy-efficient, intelligent home energy management system.

Focus on Dementia Care: Continuing Education Preferences, Challenges, and Catalysts among Rural Home Care Providers

Science.gov (United States)

Kosteniuk, Julie G.; Morgan, Debra G.; O'Connell, Megan E.; Dal Bello-Haas, Vanina; Stewart, Norma J.

2016-01-01

Home care staff who provide housekeeping and personal care to individuals with dementia generally have lower levels of dementia care training compared with other health care providers. The study's purposes were to determine whether the professional role of home care staff in a predominantly rural region was associated with preferences for delivery…

Home-based Constraint Induced Movement Therapy Poststroke

OpenAIRE

Stephen Isbel HScD; Christine Chapparo PhD; David McConnell PhD; Judy Ranka PhD

2014-01-01

Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy) protocol with eight poststroke survivors. Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT) and the Motor Activity L...

A model based message passing approach for flexible and scalable home automation controllers

Energy Technology Data Exchange (ETDEWEB)

Bienhaus, D. [INNIAS GmbH und Co. KG, Frankenberg (Germany); David, K.; Klein, N.; Kroll, D. [ComTec Kassel Univ., SE Kassel Univ. (Germany); Heerdegen, F.; Jubeh, R.; Zuendorf, A. [Kassel Univ. (Germany). FG Software Engineering; Hofmann, J. [BSC Computer GmbH, Allendorf (Germany)

2012-07-01

There is a large variety of home automation systems that are largely proprietary systems from different vendors. In addition, the configuration and administration of home automation systems is frequently a very complex task especially, if more complex functionality shall be achieved. Therefore, an open model for home automation was developed that is especially designed for easy integration of various home automation systems. This solution also provides a simple modeling approach that is inspired by typical home automation components like switches, timers, etc. In addition, a model based technology to achieve rich functionality and usability was implemented. (orig.)

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

OpenAIRE

Stosz, Laura

2008-01-01

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

The Utility of Home-Practice in Mindfulness-Based Group Interventions: A Systematic Review.

Science.gov (United States)

Lloyd, Annette; White, Ross; Eames, Catrin; Crane, Rebecca

2018-01-01

A growing body of research supports the efficacy of mindfulness-based interventions (MBIs). MBIs consider home-practice as essential to increasing the therapeutic effects of the treatment. To date however, the synthesis of the research conducted on the role of home-practice in controlled MBI studies has been a neglected area. This review aimed to conduct a narrative synthesis of published controlled studies, evaluating mindfulness-based group interventions, which have specifically measured home-practice. Empirical research literature published until June 2016 was searched using five databases. The search strategy focused on mindfulness-based stress reduction (MBSR), mindfulness-based cognitive therapy (MBCT), and home-practice. Included studies met the following criteria: controlled trials, participants 18 years and above, evaluations of MBSR or MBCT, utilised standardised quantitative outcome measures and monitored home-practice using a self-reported measure. Fourteen studies met the criteria and were included in the review. Across all studies, there was heterogeneity in the guidance and resources provided to participants and the approaches used for monitoring home-practice. In addition, the guidance on the length of home-practice was variable across studies, which indicates that research studies and teachers are not adhering to the published protocols. Finally, only seven studies examined the relationship between home-practice and clinical outcomes, of which four found that home-practice predicted improvements on clinical outcome measures. Future research should adopt a standardised approach for monitoring home-practice across MBIs. Additionally, studies should assess whether the amount of home-practice recommended to participants is in line with MBSR/MBCT manualised protocols. Finally, research should utilise experimental methodologies to explicitly explore the relationship between home-practice and clinical outcomes.

Wireless Android Based Home Automation System

Directory of Open Access Journals (Sweden)

Muhammad Tanveer Riaz

2017-01-01

Full Text Available This manuscript presents a prototype and design implementation of an advance home automation system that uses Wi-Fi technology as a network infrastructure connecting its parts. The proposed system consists of two main components; the first part is the server, which presents system core that manages and controls user’s home. Users and system administrator can locally (Local Area Network or remotely (internet manage and control the system. Second part is the hardware interface module, which provides appropriate interface to sensors and actuator of home automation system. Unlike most of the available home automation system in the market, the proposed system is scalable that one server can manage many hardware interface modules as long as it exists within network coverage. System supports a wide range of home automation devices like appliances, power management components, and security components. The proposed system is better in terms of the flexibility and scalability than the commercially available home automation systems

Providing Sources of Self-Efficacy Through Technology Enhanced Post-Stroke Rehabilitation in the Home.

Science.gov (United States)

Parker, Jack; Mawson, Susan

2017-01-01

This research explores the impact of receiving feedback through a Personalised Self-Managed Rehabilitation System (PSMrS) for home-based post-stroke rehabilitation on the users' self-efficacy; more specifically, mastery experiences and the interpretation of biomechanical data. Embedded within a realistic evaluation methodological approach, exploring the promotion of self-efficacy from the utilisation of computer-based technology to facilitate post-stroke upper-limb rehabilitation in the home included; semi-structured interviews, quantitative user data (activity and usage), observations and field notes. Data revealed that self-efficacy was linked with obtaining positive knowledge of results feedback. Encouragingly, this also transferred to functional activities such as, confidence to carry out kitchen tasks and bathroom personal activities. Findings suggest the PSMrS was able to provide key sources of self-efficacy by providing feedback which translated key biomechanical data to the users. Users could interpret and understand their performance, gain a sense of mastery and build their confidence which in some instances led to increased confidence to carry out functional activities. However, outcome expectations and socio-structural factors impacted on the self-efficacy associated with the use of the system. Increasing the understanding of how these factors promote or inhibit self-management and self-efficacy is therefore crucial to the successful adoption of technology solutions and promotion of self-efficacy.

Home-based radiology transcription and a productivity pay plan.

Science.gov (United States)

Kerr, K

1997-01-01

Shands Hospital in Gainesville, Fla., decided to evaluate the way it provided transcription services in its radiology department. It identified four goals: increased productivity, decreased operating expense, finding much needed space in the radiology department and increasing employee morale. The department performs 165,000 procedures annually, with 66 radiologists, 29 faculty, and 37 residents and fellows on staff. Six FTEs comprised the transcription pool in the radiology department, with transcription their only duty. Transcriptionists were paid an hourly rate based on their years of service, not their productivity. Evaluation and measurement studies were undertaken by the hospital's management systems engineering department. The transcriptionists' hours were then changed to provide coverage during the periods of heaviest dictation. The productivity level of the transcription staff was also measured and various methods of measurement reviewed. The goal was a pure incentive pay plan that would reward employees for every increase in productivity. The incentive pay plan was phased in over a three-month period. Transcriptionists were paid for work performed, with no base pay beyond minimum wage. The move to home-based transcription was planned. The necessary equipment was identified and various issues specific to working at home were addressed. Approximately six months later, the transcriptionists were set up to work at home. The astounding results achieved are presented: 28% increase in productivity, operational cost savings exceeding $25,000 and a space savings of 238 square feet.

Resource allocation in smart homes based on Banker's algorithm

NARCIS (Netherlands)

Virag, A.; Bogdan, S.

2011-01-01

This paper proposes a method for improved energy management in smart homes by means of resource allocation. For this purpose, a Banker's algorithm based strategy has been developed. It is used to control the system and decide which of the given processes should be provided with resources at the

Home-based care

African Journals Online (AJOL)

Mrs. Patience Edoho Samson-Akpan

study was to ascertain the relationship between home-based care and quality of life of PLWHA in support groups in. Calabar South Local Government Area. A correlational design was utilized and a purposive sample of 74 PLWHA participated in the study. A self developed and well validated questionnaire was used for data ...

Home-based Self-care: Understanding and Designing Pervasive Technology to Support Care Management Work at Home

DEFF Research Database (Denmark)

Verdezoto, Nervo

the self-care management work at home. People need to know which care activities to perform, when to perform them, how to proceed and why these are important. While at home, an active lifestyle and comorbidity not only challenge self-care activities but also the use of self-care technologies in non...... that fit into people’s everyday life. Through a design research approach applying user-centered design methods and prototyping, the main focus of this dissertation is on exploring and providing a holistic understanding of the self-care work practices in non-clinical settings. Several home-based care...... practices are investigated to (a) further understand the self-care management work in nonclinical settings, and (b) inform future design of pervasive healthcare technology that accounts for people’s perspectives on self-care and everyday life. First, we explore two selfcare practices of medication...

Experiences of HIV/AIDS home-based caregivers in Vhembe district of the Limpopo Province

Directory of Open Access Journals (Sweden)

N.S. Mashau

2009-09-01

Full Text Available The purpose of this study was to explore and describe the experiences of HIV and AIDS home-based caregivers in the Vhembe district of Limpopo Province. A qualitative research design which was exploratory, descriptive and contextual was executed with a sample of purposively selected participants who provided home-based care to people living with HIV and AIDS in the Vhembe district of Limpopo Province. Data saturation occurred after in-depth interviews with fifteen participants. In-depth individual interviews and field notes were also used during data collection. The findings reveal that HIV/AIDS home-based caregivers express pain and despair when caring for HIV/AIDS patients. The theme was supported by the following categories and subcategories: problems related to stigma when caring for patients at their homes; stress, burnout, frustration and feelings of helplessness when caring for patients. Recommendations that are described focus on building a working relationship between the home-based caregivers, community and the family.

Risk adjustment methods for Home Care Quality Indicators (HCQIs based on the minimum data set for home care

Directory of Open Access Journals (Sweden)

Hirdes John P

2005-01-01

Full Text Available Abstract Background There has been increasing interest in enhancing accountability in health care. As such, several methods have been developed to compare the quality of home care services. These comparisons can be problematic if client populations vary across providers and no adjustment is made to account for these differences. The current paper explores the effects of risk adjustment for a set of home care quality indicators (HCQIs based on the Minimum Data Set for Home Care (MDS-HC. Methods A total of 22 home care providers in Ontario and the Winnipeg Regional Health Authority (WRHA in Manitoba, Canada, gathered data on their clients using the MDS-HC. These assessment data were used to generate HCQIs for each agency and for the two regions. Three types of risk adjustment methods were contrasted: a client covariates only; b client covariates plus an "Agency Intake Profile" (AIP to adjust for ascertainment and selection bias by the agency; and c client covariates plus the intake Case Mix Index (CMI. Results The mean age and gender distribution in the two populations was very similar. Across the 19 risk-adjusted HCQIs, Ontario CCACs had a significantly higher AIP adjustment value for eight HCQIs, indicating a greater propensity to trigger on these quality issues on admission. On average, Ontario had unadjusted rates that were 0.3% higher than the WRHA. Following risk adjustment with the AIP covariate, Ontario rates were, on average, 1.5% lower than the WRHA. In the WRHA, individual agencies were likely to experience a decline in their standing, whereby they were more likely to be ranked among the worst performers following risk adjustment. The opposite was true for sites in Ontario. Conclusions Risk adjustment is essential when comparing quality of care across providers when home care agencies provide services to populations with different characteristics. While such adjustment had a relatively small effect for the two regions, it did

Risk adjustment methods for Home Care Quality Indicators (HCQIs) based on the minimum data set for home care

Science.gov (United States)

Dalby, Dawn M; Hirdes, John P; Fries, Brant E

2005-01-01

Background There has been increasing interest in enhancing accountability in health care. As such, several methods have been developed to compare the quality of home care services. These comparisons can be problematic if client populations vary across providers and no adjustment is made to account for these differences. The current paper explores the effects of risk adjustment for a set of home care quality indicators (HCQIs) based on the Minimum Data Set for Home Care (MDS-HC). Methods A total of 22 home care providers in Ontario and the Winnipeg Regional Health Authority (WRHA) in Manitoba, Canada, gathered data on their clients using the MDS-HC. These assessment data were used to generate HCQIs for each agency and for the two regions. Three types of risk adjustment methods were contrasted: a) client covariates only; b) client covariates plus an "Agency Intake Profile" (AIP) to adjust for ascertainment and selection bias by the agency; and c) client covariates plus the intake Case Mix Index (CMI). Results The mean age and gender distribution in the two populations was very similar. Across the 19 risk-adjusted HCQIs, Ontario CCACs had a significantly higher AIP adjustment value for eight HCQIs, indicating a greater propensity to trigger on these quality issues on admission. On average, Ontario had unadjusted rates that were 0.3% higher than the WRHA. Following risk adjustment with the AIP covariate, Ontario rates were, on average, 1.5% lower than the WRHA. In the WRHA, individual agencies were likely to experience a decline in their standing, whereby they were more likely to be ranked among the worst performers following risk adjustment. The opposite was true for sites in Ontario. Conclusions Risk adjustment is essential when comparing quality of care across providers when home care agencies provide services to populations with different characteristics. While such adjustment had a relatively small effect for the two regions, it did substantially affect the

Paramedics׳ involvement in planned home birth: A one-year case study.

Science.gov (United States)

McLelland, Gayle; McKenna, Lisa; Morgans, Amee; Smith, Karen

2016-07-01

to report findings from a study performed prior to the introduction of publicly funded home birth programmes in Victoria, Australia, that investigated the incidence of planned home births attended by paramedics and explored the clinical support they provided as well as the implications for education and practice. retrospective data previously collected via an in-field electronic patient care record (VACIS(®)) was provided by a state-wide ambulance service. Cases were identified via a comprehensive filter, manually screened and analysed using SPSS version 19. over a 12-month period paramedics attended 26 intended home births. Eight women were transported in labour, most for failure to progress. Three called the ambulance service and their pre-organised midwife simultaneously. Paramedics were required for a range of complications including post partum haemorrhage, perineal tears and neonatal resuscitation. Procedures performed for mothers included IV therapy and administering pain relief. For infants, paramedics performed intermittent positive pressure ventilation, endotracheal intubation and external cardiac compression. Of the 23 women transferred to hospital, 22 were transported to hospital within 32minutes. findings highlight that paramedics can provide clinical support, as well as efficient transportation, during perinatal emergencies at planned home births. Cooperative collaboration between ambulance services, privately practising midwives and maternity services to develop guidelines for emergency clinical support and transportation service may minimise risk associated with planned home births. This could also lead to opportunities for interprofessional education between midwives and paramedics. Copyright © 2016 Elsevier Ltd. All rights reserved.

Cognitive Radio-based Home Area Networks

NARCIS (Netherlands)

Sarijari, M.A.B.

2016-01-01

A future home area network (HAN) is envisaged to consist of a large number of devices that support various applications such as smart grid, security and safety systems, voice call, and video streaming. Most of these home devices are communicating based on various wireless networking technologies

Family Home Childcare Providers: A Comparison of Subsidized and Non-Subsidized Working Environments and Employee Issues

Science.gov (United States)

Shriner, Michael; Schlee, Bethanne M.; Mullis, Ronald L.; Cornille, Thomas A.; Mullis, Ann K.

2008-01-01

Federal and State Governments provide childcare subsidies for low-income working families. This study compares the encountered issues and working environments of family home providers of subsidized and non-subsidized childcare. Questionnaires were distributed throughout a southeastern state in the United States to 548 family home childcare…

Self-directed arm therapy at home after stroke with a sensor-based virtual reality training system.

Science.gov (United States)

Wittmann, Frieder; Held, Jeremia P; Lambercy, Olivier; Starkey, Michelle L; Curt, Armin; Höver, Raphael; Gassert, Roger; Luft, Andreas R; Gonzenbach, Roman R

2016-08-11

The effect of rehabilitative training after stroke is dose-dependent. Out-patient rehabilitation training is often limited by transport logistics, financial resources and a lack of motivation/compliance. We studied the feasibility of an unsupervised arm therapy for self-directed rehabilitation therapy in patients' homes. An open-label, single group study involving eleven patients with hemiparesis due to stroke (27 ± 31.5 months post-stroke) was conducted. The patients trained with an inertial measurement unit (IMU)-based virtual reality system (ArmeoSenso) in their homes for six weeks. The self-selected dose of training with ArmeoSenso was the principal outcome measure whereas the Fugl-Meyer Assessment of the upper extremity (FMA-UE), the Wolf Motor Function Test (WMFT) and IMU-derived kinematic metrics were used to assess arm function, training intensity and trunk movement. Repeated measures one-way ANOVAs were used to assess differences in training duration and clinical scores over time. All subjects were able to use the system independently in their homes and no safety issues were reported. Patients trained on 26.5 ± 11.5 days out of 42 days for a duration of 137 ± 120 min per week. The weekly training duration did not change over the course of six weeks (p = 0.146). The arm function of these patients improved significantly by 4.1 points (p = 0.003) in the FMA-UE. Changes in the WMFT were not significant (p = 0.552). ArmeoSenso based metrics showed an improvement in arm function, a high number of reaching movements (387 per session), and minimal compensatory movements of the trunk while training. Self-directed home therapy with an IMU-based home therapy system is safe and can provide a high dose of rehabilitative therapy. The assessments integrated into the system allow daily therapy monitoring, difficulty adaptation and detection of maladaptive motor patterns such as trunk movements during reaching. Unique identifier: NCT02098135 .

Characteristics of workplace violence prevention training and violent events among home health and hospice care providers.

Science.gov (United States)

Vladutiu, Catherine J; Casteel, Carri; Nocera, Maryalice; Harrison, Robert; Peek-Asa, Corinne

2016-01-01

In the rapidly growing home health and hospice industry, little is known about workplace violence prevention (WVP) training and violent events. We examined the characteristics of WVP training and estimated violent event rates among 191 home health and hospice care providers from six agencies in California. Training characteristics were identified from the Occupational Safety and Health Administration guidelines. Rates were estimated as the number of violent events divided by the total number of home visit hours. Between 2008 and 2009, 66.5% (n = 127) of providers reported receiving WVP training when newly hired or as recurrent training. On average, providers rated the quality of their training as 5.7 (1 = poor to 10 = excellent). Among all providers, there was an overall rate of 17.1 violent events per 1,000 visit-hours. Efforts to increase the number of home health care workers who receive WVP training and to improve training quality are needed. © 2015 Wiley Periodicals, Inc.

Using agent based modeling to assess the effect of increased Bus Rapid Transit system infrastructure on walking for transportation.

Science.gov (United States)

Lemoine, Pablo D; Cordovez, Juan Manuel; Zambrano, Juan Manuel; Sarmiento, Olga L; Meisel, Jose D; Valdivia, Juan Alejandro; Zarama, Roberto

2016-07-01

The effect of transport infrastructure on walking is of interest to researchers because it provides an opportunity, from the public policy point of view, to increase physical activity (PA). We use an agent based model (ABM) to examine the effect of transport infrastructure on walking. Particular relevance is given to assess the effect of the growth of the Bus Rapid Transit (BRT) system in Bogotá on walking. In the ABM agents are assigned a home, work location, and socioeconomic status (SES) based on which they are assigned income for transportation. Individuals must decide between the available modes of transport (i.e., car, taxi, bus, BRT, and walking) as the means of reaching their destination, based on resources and needed travel time. We calibrated the model based on Bogota's 2011 mobility survey. The ABM results are consistent with previous empirical findings, increasing BRT access does indeed increase the number of minutes that individuals walk for transportation, although this effect also depends on the availability of other transport modes. The model indicates a saturation process: as more BRT lanes are added, the increment in minutes walking becomes smaller, and eventually the walking time decreases. Our findings on the potential contribution of the expansion of the BRT system to walking for transportation suggest that ABMs may prove helpful in designing policies to continue promoting walking. Copyright © 2016 Elsevier Inc. All rights reserved.

Appearance-Based Multimodal Human Tracking and Identification for Healthcare in the Digital Home

Directory of Open Access Journals (Sweden)

Mau-Tsuen Yang

2014-08-01

Full Text Available There is an urgent need for intelligent home surveillance systems to provide home security, monitor health conditions, and detect emergencies of family members. One of the fundamental problems to realize the power of these intelligent services is how to detect, track, and identify people at home. Compared to RFID tags that need to be worn all the time, vision-based sensors provide a natural and nonintrusive solution. Observing that body appearance and body build, as well as face, provide valuable cues for human identification, we model and record multi-view faces, full-body colors and shapes of family members in an appearance database by using two Kinects located at a home’s entrance. Then the Kinects and another set of color cameras installed in other parts of the house are used to detect, track, and identify people by matching the captured color images with the registered templates in the appearance database. People are detected and tracked by multisensor fusion (Kinects and color cameras using a Kalman filter that can handle duplicate or partial measurements. People are identified by multimodal fusion (face, body appearance, and silhouette using a track-based majority voting. Moreover, the appearance-based human detection, tracking, and identification modules can cooperate seamlessly and benefit from each other. Experimental results show the effectiveness of the human tracking across multiple sensors and human identification considering the information of multi-view faces, full-body clothes, and silhouettes. The proposed home surveillance system can be applied to domestic applications in digital home security and intelligent healthcare.

Volume of Home and Community Based Services and...

Data.gov (United States)

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

A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway

OpenAIRE

Guan, Kai; Shao, Minggang; Wu, Shuicai

2017-01-01

This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) ...

Challenges for sustainability of home based economic activities in ...

African Journals Online (AJOL)

Factors accountable for successful and sustainable home based economic activities were determined. Impacts of home based economic activities were found to be significant in the education of the children, income security and social welfare of families. The study emphasized home economic entrepreneurial education, ...

The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey.

Science.gov (United States)

Forster, Della A; McKay, Heather; Powell, Rhonda; Wahlstedt, Emma; Farrell, Tanya; Ford, Rachel; McLachlan, Helen L

2016-04-01

There is limited evidence regarding the provision of home-based postnatal care, resulting in a weak evidence-base for policy formulation and the further development of home-based postnatal care services. To explore the structure and organisation of public hospital home-based postnatal care in Victoria, Australia. An online survey including mostly closed-ended questions was sent to representatives of all public maternity providers in July 2011. The response rate of 87% (67/77) included rural (70%; n=47), regional (15%; n=10) and metropolitan (15%; n=10) services. The majority (96%, 64/67) provided home-based postnatal care. The median number of visits for primiparous women was two and for multiparous women, one. The main reason for no visit was the woman declining. Two-thirds of services attempted to provide some continuity of carer for home-based postnatal care. Routine maternal and infant observations were broadly consistent across the services, and various systems were in place to protect the safety of staff members during home visits. Few services had a dedicated home-based postnatal care coordinator. This study demonstrates that the majority of women receive at least one home-based postnatal visit, and that service provision on the whole is similar across the state. Further work should explore the optimum number and timing of visits, what components of care are most valued by women, and what model best ensures the timely detection and prevention of postpartum complications, be they psychological or physiological. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Home-based Constraint Induced Movement Therapy Poststroke

Directory of Open Access Journals (Sweden)

Stephen Isbel HScD

2014-10-01

Full Text Available Background: This study examined the efficacy of a home-based Constraint Induced Movement Therapy (CI Therapy protocol with eight poststroke survivors. Method: Eight ABA, single case experiments were conducted in the homes of poststroke survivors. The intervention comprised restraint of the intact upper limb in a mitt for 21 days combined with a home-based and self-directed daily activity regime. Motor changes were measured using The Wolf Motor Function Test (WMFT and the Motor Activity Log (MAL. Results: Grouped results showed statistically and clinically significant differences on the WMFT (WMFT [timed items]: Mean 7.28 seconds, SEM 1.41, 95% CI 4.40 – 10.18, p = 0.000; WMFT (Functional Ability: z = -4.63, p = 0.000. Seven out of the eight participants exceeded the minimal detectable change on both subscales of the MAL. Conclusion: This study offers positive preliminary data regarding the feasibility of a home-based CI Therapy protocol. This requires further study through an appropriately powered control trial.

A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway

Directory of Open Access Journals (Sweden)

Kai Guan

2017-01-01

Full Text Available This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly’s electrocardiogram (ECG and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly.

A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway.

Science.gov (United States)

Guan, Kai; Shao, Minggang; Wu, Shuicai

2017-01-01

This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly.

A Remote Health Monitoring System for the Elderly Based on Smart Home Gateway

Science.gov (United States)

Shao, Minggang

2017-01-01

This paper proposed a remote health monitoring system for the elderly based on smart home gateway. The proposed system consists of three parts: the smart clothing, the smart home gateway, and the health care server. The smart clothing collects the elderly's electrocardiogram (ECG) and motion signals. The home gateway is used for data transmission. The health care server provides services of data storage and user information management; it is constructed on the Windows-Apache-MySQL-PHP (WAMP) platform and is tested on the Ali Cloud platform. To resolve the issues of data overload and network congestion of the home gateway, an ECG compression algorithm is applied. System demonstration shows that the ECG signals and motion signals of the elderly can be monitored. Evaluation of the compression algorithm shows that it has a high compression ratio and low distortion and consumes little time, which is suitable for home gateways. The proposed system has good scalability, and it is simple to operate. It has the potential to provide long-term and continuous home health monitoring services for the elderly. PMID:29204258

Hospital-based home care for children with cancer

DEFF Research Database (Denmark)

Hansson, Eva Helena; Kjaergaard, H; Schmiegelow, K

2012-01-01

, as it decreased the strain on the family and the ill child, maintained normality and an ordinary everyday life and fulfilled the need for safety and security. According to family members of children with cancer, hospital-based home care support enhanced their quality of life during the child's cancer trajectory......The study aims to describe the experiences of a hospital-based home care programme in the families of children with cancer. Fourteen parents, representing 10 families, were interviewed about their experiences of a hospital-based home care programme during a 4-month period in 2009 at a university...... hospital in Denmark. Five children participated in all or part of the interview. The interviews were transcribed verbatim and analysed using qualitative content analysis. The findings indicate that hospital-based home care enabled the families to remain intact throughout the course of treatment...

SMART HOME SECURITY SOLUTIONS BASED ON INTERNET OF THINGS (IOT) USING WIFI INTERFACE

OpenAIRE

Bhavna1, Dr. Neetu Sharma2

2018-01-01

Smart home system is very popular in modern days that give many kind of application that make everything is simple and easy to control. In modern day, home appliances are using wireless technology and can be accessed by internet that will make residents life easier and organized. IoT-based Home Automation System is designed to assist the people with physical disabilities and elderly to provide support as well as to control the electrical appliances and monitor the room temperature using mobil...

A Novel Web Service Based Home Energy Management System

DEFF Research Database (Denmark)

Rossello Busquet, Ana; Soler, José

2011-01-01

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

WIRELESS HOME AUTOMATION SYSTEM BASED ON MICROCONTROLLER

Directory of Open Access Journals (Sweden)

MUNA H. SALEH

2017-11-01

Full Text Available This paper presents the development of Global System Mobile (GSM-based control home air-conditioner for home automation system. The main aim of the prototype development is to reduce electricity wastage. GSM module was used for receiving Short Message Service (SMS from the user’s mobile phone that automatically enable the controller to take any further action such as to switch ON and OFF the home air-conditioner. The system controls the air-conditioner based on the temperature reading through the sensor. Every period temperature sensor sends the degree to Micro Controller Unit (MCU through ZigBee. Based on temperature degree MCU send ON or OFF signal to switch. Additionally, system allows user to operate or shut down the airconditioner remotely through SMS.

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.

The epidemiology of skin care provided by nurses at home: a multicentre prevalence study.

Science.gov (United States)

Kottner, Jan; Boronat, Xavier; Blume-Peytavi, Ulrike; Lahmann, Nils; Suhr, Ralf

2015-03-01

The aim of this study was to estimate the frequencies and patterns of skin care and applied skin care products in the home care nursing setting in Germany. Skin care belongs to the core activities of nursing practice. Especially in aged and long-term care settings, clients are vulnerable to various skin conditions. Dry skin is one of the most prevalent problems. Using mild skin cleansers and the regular application of moisturizing leave-on products is recommended. Until today, there are no quantitative empirical data about nursing skin care practice at home in the community. A multicentre cross-sectional study was conducted in July 2012. Home care clients from the German home care nursing setting were randomly selected. Instructed nurse raters performed the data collection using standardized forms. Variables included demographics, skin care needs and skin caring activities. Approximately 60% of home care clients received skin care interventions. The majority were washed and two-thirds received a leave-on product once daily. There was large heterogeneity in cleansing and skin care product use. Most often the product labels were unknown or product types were selected haphazardly. Skin care interventions play a significant role in home care and nurses have a considerable responsibility for skin health. Skin care provided does not meet recent recommendations. The importance of targeted skin cleansing and care might be underestimated. There are a confusing variety of skin care products available and often the labels provide little information regarding the ingredients or guidance about how they affect skin health. © 2014 John Wiley & Sons Ltd.

Using accelerometers and global positioning system devices to assess gender and age differences in children's school, transport, leisure and home based physical activity

DEFF Research Database (Denmark)

Klinker, Charlotte D; Schipperijn, Jasper; Christian, Hayley

2014-01-01

Knowledge on domain-specific physical activity (PA) has the potential to advance public health interventions and inform new policies promoting children's PA. The purpose of this study is to identify and assess domains (leisure, school, transport, home) and subdomains (e.g., recess, playgrounds, a......, and urban green space) for week day moderate to vigorous PA (MVPA) using objective measures and investigate gender and age differences....

Back home after an acquired brain injury: building a "low-cost" team to provide theory-driven cognitive rehabilitation after routine interventions.

Science.gov (United States)

Pierini, Davide; Hoerold, Doreen

2014-01-01

Individuals with Acquired Brain Injury (ABI) could benefit from further cognitive rehabilitation, after they have returned home. However, a lack of specialist services to provide such rehabilitation often prevents this. This leads to reduced reintegration of patients, increased social disadvantages and ultimately, higher economic costs. 10 months post-stroke, a 69 year-old woman was discharged from an inpatient rehabilitation program and returned home with severe cognitive impairments. We describe a pilot project which provided an individualised, low cost rehabilitation program, supervised and trained by a neuropsychologist. Progress was monitored every 3 months in order to decide on continuation of the program, based on the achieved results and predicted costs. Post intervention, despite severe initial impairment, cognitive and most notably daily functioning had improved. Although the financial investment was moderately high for the family, the intervention was still considered cost-effective when compared with the required costs of care in a local non-specialist care home. Moreover, the pilot experience was used to build a "local expert team" available for other individuals requiring rehabilitation. These results encourage the development of similar local "low cost" teams in the community, to provide scientifically-grounded cognitive rehabilitation for ABI patients returning home.

Home-Based Telepsychiatry in US Urban Area

Directory of Open Access Journals (Sweden)

Alireza Amirsadri

2017-01-01

Full Text Available Telepsychiatry expands access to psychiatric care. However, telepsychiatry for elderly adults is only reimbursed in the US if the patient is assessed while in a clinical setting. This case study presents a homebound older woman previously hospitalized for schizophrenia who had not seen a psychiatrist in over 20 years. Care was provided with hybrid telepsychiatry (team-based practice with social worker traveling to the home with electronic tablet for connection with psychiatrist. The intervention resulted in detecting unrecognized depression and complex trauma. The treatment plan included adding an antidepressant and therapy plan, eliminating one psychiatric medication, and reducing dosage of pain medication. The outcomes were improved function and quality of life. The patient and caregiver were both highly satisfied with the services. This hybrid telepsychiatry is a reasonable option for homebound elderly patients living in urban areas and less expensive than nursing home admission.

Long-term evaluation of home-based pulmonary rehabilitation in patients with COPD

Directory of Open Access Journals (Sweden)

Grosbois JM

2015-09-01

Full Text Available Jean Marie Grosbois,1,2 Alice Gicquello,3 Carole Langlois,4 Olivier Le Rouzic,3 Frédéric Bart,2 Benoit Wallaert,2,3 Cécile Chenivesse5 1FormAction Santé, rue Pietralunga, Pérenchies, 2Service de Pneumologie, CH Béthune, 3Service de Pneumologie et Immunoallergologie, Centre des Compétences des Maladies Pulmonaires Rares, Hôpital Calmette, CHRU Lille, 4Unité de Biostatistiques, CHRU Lille, 5AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale, Boulevard de l’Hôpital, Paris, France Introduction: Personalized, global pulmonary rehabilitation (PR management of patients with COPD is effective, regardless of the place in which this rehabilitation is provided. The objective of this retrospective observational study was to study the long-term outcome of exercise capacity and quality of life during management of patients with COPD treated by home-based PR.Methods: Home-based PR was administered to 211 patients with COPD (mean age, 62.3±11.1 years; mean forced expiratory volume in 1 second, 41.5%±17.7%. Home-based PR was chosen because of the distance of the patient’s home from the PR center and the patient’s preference. Each patient was individually managed by a team member once a week for 8 weeks with unsupervised continuation of physical exercises on the other days of the week according to an individual action plan. Exercise conditioning, therapeutic patient education, and self-management were included in the PR program. The home assessment comprised evaluation of the patient’s exercise capacity by a 6-minute stepper test, Timed Up and Go test, ten times sit-to-stand test, Hospital Anxiety and Depression score, and quality of life (Visual Simplified Respiratory Questionnaire, VQ11, Maugeri Respiratory Failure 28.Results: No incidents or accidents were observed during the course of home-based PR. The 6-minute stepper test was significantly improved after completion of the

Understanding the agency of home-based care volunteers ...

African Journals Online (AJOL)

In traditional Zulu communities, caregiving is rooted in compassionate and hardworking personal identity precepts and the traditional identity expectations of women. Home-based-care volunteerism in the community represents the performance of this identity. Data from a series of interviews with 15 home-based care ...

Sms-Based Home Management System

Directory of Open Access Journals (Sweden)

Paing Soe Oo

2015-08-01

Full Text Available Mobile phones are widely used nowadays for different application such as wireless control and monitoring due to its availability and ease of use. The implemented system is based on global system mobile GSM network by using short message service SMS. The design mainly contains a GSM modem and Arduino Uno. In this work the system will be described how to manage and control home appliances using mobile phone people can use this system to do things in their home from a far place before they reach home. For instance user may controlmanage hisher home lighting door or water pump which needed in daily life in different area House Office or factory etc. when they are away from home. The user can check the condition in the home that light is on or off door is locked or unlocked water pump is on or off and so on. If the time taken for this appliances to perform a task is known that can also be set so that if the time elapsed the appliance will automatically switch off itself. The control is done by sending a specific SMS messages from smart phone to a SIM900 and Arduino Uno which is connected to the appliance once the message is received the SIM 900 will send the command to a microcontroller in Arduino for controlling the appliance appropriately. Also feedback status of three devices can be requested in designed system.

Multimodal wireless sensor network-based ambient assisted living in real homes with multiple residents.

Science.gov (United States)

Tunca, Can; Alemdar, Hande; Ertan, Halil; Incel, Ozlem Durmaz; Ersoy, Cem

2014-05-30

Human activity recognition and behavior monitoring in a home setting using wireless sensor networks (WSNs) provide a great potential for ambient assisted living (AAL) applications, ranging from health and wellbeing monitoring to resource consumption monitoring. However, due to the limitations of the sensor devices, challenges in wireless communication and the challenges in processing large amounts of sensor data in order to recognize complex human activities, WSN-based AAL systems are not effectively integrated in the home environment. Additionally, given the variety of sensor types and activities, selecting the most suitable set of sensors in the deployment is an important task. In order to investigate and propose solutions to such challenges, we introduce a WSN-based multimodal AAL system compatible for homes with multiple residents. Particularly, we focus on the details of the system architecture, including the challenges of sensor selection, deployment, networking and data collection and provide guidelines for the design and deployment of an effective AAL system. We also present the details of the field study we conducted, using the systems deployed in two different real home environments with multiple residents. With these systems, we are able to collect ambient sensor data from multiple homes. This data can be used to assess the wellbeing of the residents and identify deviations from everyday routines, which may be indicators of health problems. Finally, in order to elaborate on the possible applications of the proposed AAL system and to exemplify directions for processing the collected data, we provide the results of several human activity inference experiments, along with examples on how such results could be interpreted. We believe that the experiences shared in this work will contribute towards accelerating the acceptance of WSN-based AAL systems in the home setting.

Multimodal Wireless Sensor Network-Based Ambient Assisted Living in Real Homes with Multiple Residents

Directory of Open Access Journals (Sweden)

Can Tunca

2014-05-01

Full Text Available Human activity recognition and behavior monitoring in a home setting using wireless sensor networks (WSNs provide a great potential for ambient assisted living (AAL applications, ranging from health and wellbeing monitoring to resource consumption monitoring. However, due to the limitations of the sensor devices, challenges in wireless communication and the challenges in processing large amounts of sensor data in order to recognize complex human activities, WSN-based AAL systems are not effectively integrated in the home environment. Additionally, given the variety of sensor types and activities, selecting the most suitable set of sensors in the deployment is an important task. In order to investigate and propose solutions to such challenges, we introduce a WSN-based multimodal AAL system compatible for homes with multiple residents. Particularly, we focus on the details of the system architecture, including the challenges of sensor selection, deployment, networking and data collection and provide guidelines for the design and deployment of an effective AAL system. We also present the details of the field study we conducted, using the systems deployed in two different real home environments with multiple residents. With these systems, we are able to collect ambient sensor data from multiple homes. This data can be used to assess the wellbeing of the residents and identify deviations from everyday routines, which may be indicators of health problems. Finally, in order to elaborate on the possible applications of the proposed AAL system and to exemplify directions for processing the collected data, we provide the results of several human activity inference experiments, along with examples on how such results could be interpreted. We believe that the experiences shared in this work will contribute towards accelerating the acceptance of WSN-based AAL systems in the home setting.

A Role Model Mother/caregiver Programme to Expand Home-based ...

African Journals Online (AJOL)

In Nigeria, a Role Model Mother/Caregiver (RMM/C) programme was initiated by the National Malaria Control Programme (NMCP) to provide home-based management of malaria. Criteria for RMM/C selection were developed centrally by the Nigerian NMCP for community use. RMM/Cs were identified and recruited by the ...

Enabling Composition-Based Video-Conferencing for the Home

NARCIS (Netherlands)

A.J. Jansen (Jack); P.S. Cesar Garcia (Pablo Santiago); T. Stevens; I. Kegel; J. Issing

2011-01-01

htmlabstractThis paper describes a videoconferencing system that meets performance constraints and functional requirements for use in consumer homes. Our system improves existing home technologies (such as video chat) by providing high-quality audiovisual communication, efficient encoding

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

Science.gov (United States)

2013-11-14

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

The home-based maternal record: a tool for family involvement in health care.

Science.gov (United States)

Shah, P M; Shah, K P; Belsey, M A

1988-04-01

The home-based maternal record offers an opportunity for family involvement in health care. Home-based records of maternal health have been used in several developing countries, and have led to increased detection and monitoring of women at high risk for complications during pregnancy. Home-based cards that include menstrual information remind health workers to educate and motivate women for family planning, and serve as a source of health statistics. Records that use pictures and symbols have been used by illiterate traditional birth attendants, and had an accurate completion rate of over 90%. The WHO has prepared a prototype record and guidelines for local adaptation. The objectives were to provide continuity of care throughout pregnancy, ensure recognition of at-risk women, encourage family participation in health care, an provide data on maternal health, breastfeeding, and family planning. The guidelines have been evaluated and results show that the records have improved the coverage, acceptability, and quality of MCH/FP care. The records have also led to an increase in diagnosis and referral of at-risk women and newborns, and the use of family planning and tetanus toxoid immunization has increased in the 13 centers where the reports are being used. Focus group discussions have shown that mothers, community members, primary health workers, and doctors and nurses liked the records. It is important to adapt criteria for high-risk conditions to the local areas where the records will be used to ensure the relevance of risk diagnosis. The evidence shows that home-based maternal and child records can be an important tool in the promotion of self-reliance and family participation in health care. In addition, home-based records can be used for the implementation of primary health care at the local level, and serve as a resource for data collection.

Environmental Health and Safety Hazards Experienced by Home Health Care Providers: A Room-by-Room Analysis.

Science.gov (United States)

Polivka, Barbara J; Wills, Celia E; Darragh, Amy; Lavender, Steven; Sommerich, Carolyn; Stredney, Donald

2015-11-01

The number of personnel providing in-home health care services is increasing substantially. The unique configuration of environmental hazards in individual client homes has a significant impact on the safety and health of home health care providers (HHPs). This mixed-methods study used data from a standardized questionnaire, focus groups, and individual interviews to explore environmental health and safety hazards encountered by HHPs in client homes. The participant sample (N = 68) included nurses, aides, therapists, and owners/managers from a variety of geographic locations. The most often-reported hazards were trip/slip/lift hazards, biohazards, and hazards from poor air quality, allergens, pests and rodents, and fire and burns. Frequency of identified key hazards varied by room, that is, kitchen (e.g., throw rugs, water on floor), bathroom (e.g., tight spaces for client handling), bedroom (e.g., bed too low), living room (e.g., animal waste), and hallway (e.g., clutter). Findings indicate the need for broader training to enable HHPs to identify and address hazards they encounter in client homes. © 2015 The Author(s).

Mapping a Research Agenda for Home Care Safety: Perspectives from Researchers, Providers, and Decision Makers

Science.gov (United States)

Macdonald, Marilyn; Lang, Ariella; MacDonald, Jo-Anne

2011-01-01

The purpose of this qualitative interpretive design was to explore the perspectives of researchers, health care providers, policy makers, and decision makers on key risks, concerns, and emerging issues related to home care safety that would inform a line of research inquiry. Defining safety specifically in this home care context has yet to be…

A Home-Based Palliative Care Consult Service for Veterans.

Science.gov (United States)

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

2016-11-01

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

49 CFR 236.806 - Signal, home.

Science.gov (United States)

2010-10-01

... 49 Transportation 4 2010-10-01 2010-10-01 false Signal, home. 236.806 Section 236.806 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Signal, home. A roadway signal at the entrance to a route or block to govern trains in entering and using...

The Home as Workplace: Investigating Home Based Enterprises in ...

African Journals Online (AJOL)

The research revealed the importance of home based enterprises as a major source of income generation and socialization in urban areas. Recommendations include the adoption of case-specific planning models, consideration of cultural contexts in planning and the adoption of local economic development strategies in ...

Associations of Caregiver Stress with Working Conditions, Caregiving Practices, and Child Behaviour in Home-Based Child Care

Science.gov (United States)

Rusby, Julie C.; Jones, Laura Backen; Crowley, Ryann; Smolkowski, Keith

2013-01-01

Home-based child caregivers face unique stressors related to the nature of their work. One hundred and fifty-five home-based child care providers in Oregon, USA, participated in this cross-sectional correlational study. We investigated associations between indicators of caregiver stress and child care working conditions, the quality of caregiver…

Comparison of home- and gymnasium-based resistance training on ...

African Journals Online (AJOL)

Comparison of home- and gymnasium-based resistance training on flexibility in the ... which is especially essential in the maintenance of functional abilities of the ... the effects of a home- and gymnasium-based resistance training programme ...

Recommendations for providing protection during the transport of uranium hexafluoride

International Nuclear Information System (INIS)

1987-06-01

In July 1986 a group of consultants was convened by the IAEA to provide initial guidance on the transport of UF 6 and the regulations for it considering the hazards posed by this material. A Technical Committee meeting was held in November 1986 to finalize the development of the recommendations for providing protection during the transport of UF 6 . This report provides the recommendations resulting from the meetings of these experts. The IAEA recommends that national competent authorities and other relevant national regulatory and standards-related organizations, and appropriate international organizations seriously consider all of the information provided in this report especially the additional requirements set forth in Section III.3 concerning design, manufacturing and testing requirements, design approval requirements, requirements on loading for transport, and requirements for quality assurance and maintenance. This report also deals with United Nations' Recommendations of the Transport of Dangerous Goods, International Modal Regulatory Documents, ANSIN14.1-1982 and ISO/DIS/7195 Standards

Medicare Provider Payment Data - Home Health Agencies

Data.gov (United States)

U.S. Department of Health & Human Services — The Home Health Agency PUF contains information on utilization, payment (Medicare payment and standard payment), and submitted charges organized by CMS Certification...

A Systematic Review of Home-Based Childhood Obesity Prevention Studies

Science.gov (United States)

Fawole, Oluwakemi; Segal, Jodi; Wilson, Renee F.; Cheskin, Lawrence J.; Bleich, Sara N.; Wu, Yang; Lau, Brandyn; Wang, Youfa

2013-01-01

BACKGROUND AND OBJECTIVES: Childhood obesity is a global epidemic. Despite emerging research about the role of the family and home on obesity risk behaviors, the evidence base for the effectiveness of home-based interventions on obesity prevention remains uncertain. The objective was to systematically review the effectiveness of home-based interventions on weight, intermediate (eg, diet and physical activity [PA]), and clinical outcomes. METHODS: We searched Medline, Embase, PsychInfo, CINAHL, clinicaltrials.gov, and the Cochrane Library from inception through August 11, 2012. We included experimental and natural experimental studies with ≥1-year follow-up reporting weight-related outcomes and targeting children at home. Two independent reviewers screened studies and extracted data. We graded the strength of the evidence supporting interventions targeting diet, PA, or both for obesity prevention. RESULTS: We identified 6 studies; 3 tested combined interventions (diet and PA), 1 used diet intervention, 1 combined intervention with primary care and consumer health informatics components, and 1 combined intervention with school and community components. Select combined interventions had beneficial effects on fruit/vegetable intake and sedentary behaviors. However, none of the 6 studies reported a significant effect on weight outcomes. Overall, the strength of evidence is low that combined home-based interventions effectively prevent obesity. The evidence is insufficient for conclusions about home-based diet interventions or interventions implemented at home in association with other settings. CONCLUSIONS: The strength of evidence is low to support the effectiveness of home-based child obesity prevention programs. Additional research is needed to test interventions in the home setting, particularly those incorporating parenting strategies and addressing environmental influences. PMID:23753095

One-Class Classification-Based Real-Time Activity Error Detection in Smart Homes.

Science.gov (United States)

Das, Barnan; Cook, Diane J; Krishnan, Narayanan C; Schmitter-Edgecombe, Maureen

2016-08-01

Caring for individuals with dementia is frequently associated with extreme physical and emotional stress, which often leads to depression. Smart home technology and advances in machine learning techniques can provide innovative solutions to reduce caregiver burden. One key service that caregivers provide is prompting individuals with memory limitations to initiate and complete daily activities. We hypothesize that sensor technologies combined with machine learning techniques can automate the process of providing reminder-based interventions. The first step towards automated interventions is to detect when an individual faces difficulty with activities. We propose machine learning approaches based on one-class classification that learn normal activity patterns. When we apply these classifiers to activity patterns that were not seen before, the classifiers are able to detect activity errors, which represent potential prompt situations. We validate our approaches on smart home sensor data obtained from older adult participants, some of whom faced difficulties performing routine activities and thus committed errors.

Balance of power shifts when providing care in patients' homes.

Science.gov (United States)

Sander, Ruth

2011-06-01

Nursing practice at home involves entering a place where the patient's and family's values and habits predominate. In hospital, nurses work in safe territory with the aid of conferred authority but this manner might not be suitable in a patient's own home. When people need nursing care, the meaning of home is at risk of changing.

Home Features and Assistive Technology for the Home-Bound Elderly in a Thai Suburban Community by Applying the International Classification of Functioning, Disability, and Health

Directory of Open Access Journals (Sweden)

Supawadee Putthinoi

2017-01-01

Full Text Available The ageing population is having an impact worldwide and has created a serious challenge in Thailand’s healthcare systems, whereby healthcare practitioners play a major role in promoting independent interaction of their client’s abilities, as well as environmental factors. The purpose of this study was to survey features of the home and assistive technology (AT for the home-bound elderly in the community of Chiang Mai, Thailand. Home evaluation included features inside and outside the home, and AT was based on the International Classification of Functioning, Disability, and Health (ICF concept. Methods included observation and an interview that were used by the researcher for evaluation. The study found that every home had at least one hazardous home feature such as inappropriate width of the door, high door threshold, tall stair steps, no bedside rail, and inappropriate height of the toilet pan. AT was found in houses as general products and technology for personal use in daily living and for personal indoor and outdoor mobility as well as transportation. Therefore, home features and AT can afford the home-bound elderly independent living within the community. Perspective AT according to the ICF concept could provide a common language for ageing in place benefits.

Remember the Drive Home? An Assessment of Emergency Providers' Sleep Deficit.

Science.gov (United States)

Ferguson, Brian A; Shoff, Hugh W; McGowan, Jennifer E; Huecker, Martin R

2018-01-01

Sleep deprivation decreases work performance and predisposes workers to deleterious health outcomes. We sought to evaluate sleep hygiene and fatigue among emergency physicians. In March-June 2016, physicians and residents at an academic emergency medicine program were invited to complete a survey evaluating sleep and alertness. Six attending physicians and 26 residents completed the survey. Among six personal priorities, sleep ranked fourth behind family, work, and leisure. 75% stated poor sleep impedes effectiveness as a physician while 53% noted difficulty falling asleep before a night shift. In the last three months, 39% of subjects forgot driving home from a shift, and 34% had fallen asleep while driving. 34% used medications to assist with sleep (including melatonin (36%), alcohol (27%), and prescription drugs (9%)). Most providers attested to phone (88%) and television exposure (69%) immediately prior to goal sleep onset. Despite sleep being identified as a priority among EM physicians, deleterious habits remain. Poor sleep affects perceived effectiveness and personal safety, as evidenced by a significant portion of providers falling asleep on the commute home. Night shift is the chief obstacle to optimal sleep hygiene.

Weathering the storm: challenges to nurses providing care to nursing home residents during hurricanes.

Science.gov (United States)

Hyer, Kathryn; Brown, Lisa M; Christensen, Janelle J; Thomas, Kali S

2009-11-01

This article documents the experience of 291 Florida nursing homes during the 2004 hurricane season. Using quantitative and qualitative methods, the authors described and compared the challenges nurses encountered when evacuating residents with their experiences assisting residents of facilities that sheltered in place. The primary concerns for evacuating facilities were accessing appropriate evacuation sites for residents and having ambulance transportation contracts honored. The main issue for facilities that sheltered in place was the length of time it took for power to be restored. Barriers to maintaining resident health during disasters for those who evacuated or sheltered in place are identified.

Bandwidth Reservations in Home Networks

DEFF Research Database (Denmark)

Nelis, Jelle; Verslype, Dieter; Develder, Chris

2010-01-01

In order for service providers to provide their users high quality services in the home network, Quality of Service (QoS) provisioning is needed to protect premium services. In this paper, we describe how a Universal Plug-and-Play (UPnP) based home network architecture solves this problem...... in a heterogeneous home network. We outline how it both relieves the end user from troublesome configuration and still offers control to the service provider. We particularly present performance assessment results for UPnP-QoS v3, based on a fully operational experimental implementation. The quantitative measurement...

Diabetes knowledge in nursing homes and home-based care services: a validation study of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel.

Science.gov (United States)

Haugstvedt, Anne; Aarflot, Morten; Igland, Jannicke; Landbakk, Tilla; Graue, Marit

2016-01-01

Providing high-quality diabetes care in nursing homes and home-based care facilities requires suitable instruments to evaluate the level of diabetes knowledge among the health-care providers. Thus, the aim of this study was to examine the psychometric properties of the Michigan Diabetes Knowledge Test adapted for use among nursing personnel. The study included 127 nursing personnel (32 registered nurses, 69 nursing aides and 26 nursing assistants) at three nursing homes and one home-based care facility in Norway. We examined the reliability and content and construct validity of the Michigan Diabetes Knowledge Test. The items in both the general diabetes subscale and the insulin-use subscale were considered relevant and appropriate. The instrument showed satisfactory properties for distinguishing between groups. Item response theory-based measurements and item information curves indicate maximum information at average or lower knowledge scores. Internal consistency and the item-total correlations were quite weak, indicating that the Michigan Diabetes Knowledge Test measures a set of items related to various relevant knowledge topics but not necessarily related to each other. The Michigan Diabetes Knowledge Test measures a broad range of topics relevant to diabetes care. It is an appropriate instrument for identifying individual and distinct needs for diabetes education among nursing personnel. The knowledge gaps identified by the Michigan Diabetes Knowledge Test could also provide useful input for the content of educational activities. However, some revision of the test should be considered.

Nutrition and Physical Activity Environments of Home-Based Child Care: What Hispanic Providers Have to Say.

Science.gov (United States)

Tovar, Alison; Mena, Noereem Z; Risica, Patricia; Gorham, Gemma; Gans, Kim M

2015-10-01

It is important to understand the perceptions and beliefs of family child care providers (FCCPs) regarding which factors influence children's physical activity (PA), screen-time (ST), and dietary behaviors in order to develop and implement appropriate obesity prevention interventions. The aim of this qualitative study was to explore the aforementioned perceptions and beliefs of FCCPs in Rhode Island. Four focus groups (n = 30) were held with FCCPs. Providers were female, Hispanic, and Spanish speaking. Providers were asked about different aspects of feeding, PA, and ST behaviors. Themes were coded using NVivo10 (QSR International Pty Ltd, Doncaster, Victoria, Australia). Content analysis was used to analyze final themes. Providers understood the importance of providing opportunities for healthy eating and PA for the children they cared for, but there was room for improvement, especially with regard to certain feeding and ST practices. Several barriers were evident, including the lack of physical infrastructure for PA, cultural beliefs and practices related to child feeding, and difficulties working with parents to provide consistent messages across environments. Given that FCCPs are aware of the importance of healthy eating and PA, there is a need to address the specific barriers they face, and operationalize some of their knowledge into practical everyday actions. This formative work will inform the development of a culturally relevant, multicomponent intervention for ethnically diverse FCCPs to improve the food and PA environments of their homes, which should, in turn, improve the dietary, PA, and ST behaviors of the 2- to 5-year-old children they care for.

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

Science.gov (United States)

2010-10-01

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

Study protocol: home-based telehealth stroke care: a randomized trial for veterans

Directory of Open Access Journals (Sweden)

McGee-Hernandez Nancy

2010-06-01

Full Text Available Abstract Background Stroke is one of the most disabling and costly impairments of adulthood in the United States. Stroke patients clearly benefit from intensive inpatient care, but due to the high cost, there is considerable interest in implementing interventions to reduce hospital lengths of stay. Early discharge rehabilitation programs require coordinated, well-organized home-based rehabilitation, yet lack of sufficient information about the home setting impedes successful rehabilitation. This trial examines a multifaceted telerehabilitation (TR intervention that uses telehealth technology to simultaneously evaluate the home environment, assess the patient's mobility skills, initiate rehabilitative treatment, prescribe exercises tailored for stroke patients and provide periodic goal oriented reassessment, feedback and encouragement. Methods We describe an ongoing Phase II, 2-arm, 3-site randomized controlled trial (RCT that determines primarily the effect of TR on physical function and secondarily the effect on disability, falls-related self-efficacy, and patient satisfaction. Fifty participants with a diagnosis of ischemic or hemorrhagic stroke will be randomly assigned to one of two groups: (a TR; or (b Usual Care. The TR intervention uses a combination of three videotaped visits and five telephone calls, an in-home messaging device, and additional telephonic contact as needed over a 3-month study period, to provide a progressive rehabilitative intervention with a treatment goal of safe functional mobility of the individual within an accessible home environment. Dependent variables will be measured at baseline, 3-, and 6-months and analyzed with a linear mixed-effects model across all time points. Discussion For patients recovering from stroke, the use of TR to provide home assessments and follow-up training in prescribed equipment has the potential to effectively supplement existing home health services, assist transition to home and

Analysis Of Provided Service Quality In Flowers And Living Plants Transport

Science.gov (United States)

Poliaková, Adela

2015-06-01

This paper analyses quality of the living flowers and plants transportation. A part of this paper compares the demands for a particular transport mode and a practical demonstration of these transport modes within a specific transport mode. The paper presents a survey of quality of services provided by individual transport modes.

Utilization and costs of home-based and community-based care within a social HMO: trends over an 18-year period

Directory of Open Access Journals (Sweden)

Walter Leutz

2005-10-01

Full Text Available Purpose: Our objective was to describe the utilization and costs of services from 1985 to 2002 of a Social Health Maintenance Organization (SHMO demonstration project providing a benefit for home-based and community-based as well as short-term institutional (HCB care at Kaiser Permanente Northwest (KPNW, serving the Portland, Oregon area. The HCB care benefit was offered by KPNW as a supplement to Medicare's acute care medical benefits, which KPNW provides in an HMO model. KPNW receives a monthly per capita payment from Medicare to provide medical benefits, and Medicare beneficiaries who choose to join pay a supplemental premium that covers prescription drugs, HCB care benefits, and other services. A HCB care benefit of up to $12,000 per year in services was available to SHMO members meeting requirement for nursing home certification (NHC. Methods: We used aggregate data to track temporal changes in the period 1985 to 2002 on member eligibility, enrollment in HCB care plans, age, service utilization and co-payments. Trends in the overall costs and financing of the HCB care benefit were extracted from quarterly reports, management data, and finance data. Results: During the time period, 14,815 members enrolled in the SHMO and membership averaged 4,531. The proportion of SHMO members aged 85 or older grew from 12 to 25%; proportion meeting requirements for NHC rose from 4 to 27%; and proportion with HCB care plans rose from 4 to 18%. Costs for the HCB care benefit rose from $21 per SHMO member per month in 1985 to $95 in 2002. The HCB care costs were equivalent to 12% to 16% of Medicare reimbursement. The HCB program costs were covered by member premiums (which rose from $49 to $180 and co-payments from members with care plans. Over the 18-year period, spending shifted from nursing homes to a range of community services, e.g. personal care, homemaking, member reimbursement, lifeline, equipment, transportation, shift care, home nursing, adult day

A novel method for designing and optimizing the layout of facilities in bathroom for the elderly in home-based rehabilitation.

Science.gov (United States)

Wang, Duojin; Wu, Jing; Lin, Qinglian

2018-05-01

The home-based rehabilitation of elderly patients improves their autonomy, independence and reintegration into society. Hence, a suitable environment plays an important role in rehabilitation, as do different assistance technologies. The majority of accidents at home involving elderly people occur in the bathroom. Therefore, the planning of the layout of facilities is important in this potentially dangerous area. This paper proposes an approach towards designing and optimizing the layout of facilities in the bathroom, based on logistical and nonlogistical relationships. A fuzzy-based analytical hierarchical process (fuzzy-AHP) is then proposed for a comprehensive evaluation of the alternatives for this layout plan. This approach was applied to the home of a 71 years old female patient, who was experiencing home-based rehabilitation. After the initial designing and optimizing of the layout of the facilities in her bathroom, a plan could then be created for her particular needs. The results of this research could then enable the home-based rehabilitation of elderly patients to be more effective. Value: This paper develops a new approach to design and optimize the layout of facilities in bathroom for the elderly. Implications for Rehabilitation Develop a new approach to design and optimize the layout of facilities in bathroom. Provide a mathematical and more scientific approach to home layout design for home-based rehabilitation. Provide new opportunities for research, for both the therapist and the patient to analyse the home facility layout.

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

Science.gov (United States)

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

2010-06-01

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

A fuzzy-based particle swarm optimisation approach for task assignment in home healthcare

Directory of Open Access Journals (Sweden)

Mutingi, Michael

2014-11-01

Full Text Available Home healthcare (HHC organisations provide coordinated healthcare services to patients at their homes. Motivated by the ever-increasing need for home-based care, the assignment of tasks to available healthcare staff is a common and complex problem in homecare organisations. Designing high quality task schedules is critical for improving worker morale, job satisfaction, service efficiency, service quality, and competitiveness over the long term. The desire is to provide high quality task assignment schedules that satisfy the patient, the care worker, and the management. This translates to maximising schedule fairness in terms of workload assignments, avoiding task time window violation, and meeting management goals as much as possible. However, in practice, these desires are often subjective as they involve imprecise human perceptions. This paper develops a fuzzy multi-criteria particle swarm optimisation (FPSO approach for task assignment in a home healthcare setting in a fuzzy environment. The proposed approach uses a fuzzy evaluation method from a multi-criteria point of view. Results from illustrative computational experiments show that the approach is promising.

Providing Home-Based HIV Testing and Counseling for Transgender Youth (Project Moxie): Protocol for a Pilot Randomized Controlled Trial.

Science.gov (United States)

Stephenson, Rob; Metheny, Nicholas; Sharma, Akshay; Sullivan, Stephen; Riley, Erin

2017-11-28

Transgender and gender nonconforming people experience some of the highest human immunodeficiency virus (HIV) rates in the United States, and experience many structural and behavioral barriers that may limit their engagement in HIV testing, prevention, and care. Evidence suggests that transgender and gender nonconforming youth (TY) are especially vulnerable to acquiring HIV, yet there is little research on TY and few services are targeted towards HIV testing, prevention, and care for this population. Telehealth presents an opportunity to mitigate some structural barriers that TY experience in accessing HIV testing, allowing TY to engage in HIV testing and counseling in a safe and nonjudgmental space of their choosing. Project Moxie is an HIV prevention intervention that pairs the use of HIV self-testing with remote video-based counseling and support from a trained, gender-affirming counselor. This study aims to offer a more positive HIV testing and counseling experience, with the goal of improving HIV testing frequency. Project Moxie involves a pilot randomized controlled trial (RCT) of 200 TY aged 15-24 years, who are randomized on a 1:1 basis to control or intervention arms. The aim is to examine whether the addition of counseling provided via telehealth, coupled with home-based HIV testing, can create gains in routine HIV testing among TY over a six-month follow-up period. This study implements a prospective pilot RCT of 200 TY recruited online. Participants in the control arm will receive one HIV self-testing kit and will be asked to report their results via the study's website. Participants in the experimental arm will receive one HIV self-testing kit and will test with a remotely-located counselor during a prescheduled video-counseling session. Participants are assessed at baseline, and at three and six months posttesting. Project Moxie was launched in June 2017 and recruitment is ongoing. As of August 21, 2017, the study had enrolled 130 eligible

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

Science.gov (United States)

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

2017-11-01

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

Implementation of an Embedded Web Server Application for Wireless Control of Brain Computer Interface Based Home Environments.

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Aydın, Eda Akman; Bay, Ömer Faruk; Güler, İnan

2016-01-01

Brain Computer Interface (BCI) based environment control systems could facilitate life of people with neuromuscular diseases, reduces dependence on their caregivers, and improves their quality of life. As well as easy usage, low-cost, and robust system performance, mobility is an important functionality expected from a practical BCI system in real life. In this study, in order to enhance users' mobility, we propose internet based wireless communication between BCI system and home environment. We designed and implemented a prototype of an embedded low-cost, low power, easy to use web server which is employed in internet based wireless control of a BCI based home environment. The embedded web server provides remote access to the environmental control module through BCI and web interfaces. While the proposed system offers to BCI users enhanced mobility, it also provides remote control of the home environment by caregivers as well as the individuals in initial stages of neuromuscular disease. The input of BCI system is P300 potentials. We used Region Based Paradigm (RBP) as stimulus interface. Performance of the BCI system is evaluated on data recorded from 8 non-disabled subjects. The experimental results indicate that the proposed web server enables internet based wireless control of electrical home appliances successfully through BCIs.

The Future of Home Health project: developing the framework for health care at home.

Science.gov (United States)

Lee, Teresa; Schiller, Jennifer

2015-02-01

In addition to providing high-quality care to vulnerable patient populations, home healthcare offers the least costly option for patients and the healthcare system, particularly in postacute care. As the baby boom generation ages, policymakers are expressing concerns about rising costs, variation in home healthcare service use, and program integrity. The Alliance for Home Health Quality and Innovation seeks to develop a research-based strategic framework for the future of home healthcare for older Americans and those with disabilities. This article describes the initiative and invites readers to provide comments and suggestions.

Personal vulnerability and work-home interaction: the effect of job performance-based self-esteem on work/home conflict and facilitation.

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Innstrand, Siw Tone; Langballe, Ellen Melbye; Espnes, Geir Arild; Aasland, Olaf Gjerløw; Falkum, Erik

2010-12-01

The aim of the present study was to examine the longitudinal relationship between job performance-based self-esteem (JPB-SE) and work-home interaction (WHI) in terms of the direction of the interaction (work-to-home vs. home-to-work) and the effect (conflict vs. facilitation). A sample of 3,475 respondents from eight different occupational groups (lawyers, physicians, nurses, teachers, church ministers, bus drivers, and people working in advertising and information technology) supplied data at two points of time with a two-year time interval. The two-wave, cross-lagged structural equations modeling (SEM) analysis demonstrated reciprocal relationships between these variables, i.e., job performance-based self-esteem may act as a precursor as well as an outcome of work-home interaction. The strongest association was between job performance-based self-esteem and work-to-home conflict. Previous research on work-home interaction has mainly focused on situational factors. This longitudinal study expands the work-home literature by demonstrating how individual vulnerability (job performance-based self-esteem) contributes to the explanation of work-home interactions. © 2010 The Authors. Scandinavian Journal of Psychology © 2010 The Scandinavian Psychological Associations.

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

Science.gov (United States)

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

2018-05-01

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

Developing suitable buffers to capture transport cycling behavior

DEFF Research Database (Denmark)

Madsen, Thomas; Schipperijn, Jasper; Christiansen, Lars Breum

2014-01-01

units (e.g., home-buffer-based neighborhoods) are not necessarily representative for environmental exposure. An increased understanding of appropriate neighborhoods is needed. GPS cycling tracks from 78 participants for 7 days form the basis for the development and testing of different neighborhood...... buffers for transport cycling. The percentage of GPS points per square meter was used as indicator of the effectiveness of a series of different buffer types, including home-based network buffers, shortest route to city center buffers, and city center-directed ellipse-shaped buffers. The results show...... center-directed ellipse-shaped buffers yielded better results than traditional home-based network buffer types. The ellipse-shaped buffer types could therefore be considered an alternative to more traditional buffers or administrative units in future studies of transport cycling behavior....

Employees' views on home-based, after-hours telephone triage by Dutch GP cooperatives.

Science.gov (United States)

Backhaus, Ramona; van Exel, Job; de Bont, Antoinette

2013-11-04

Dutch out-of-hours (OOH) centers find it difficult to attract sufficient triage staff. They regard home-based triage as an option that might attract employees. Specially trained nurses are supposed to conduct triage by telephone from home for after-hours medical care. The central aim of this research is to investigate the views of employees of OOH centers in The Netherlands on home-based telephone triage in after-hours care. The study is a Q methodology study. Triage nurses, general practitioners (GPs) and managers of OOH centers ranked 36 opinion statements on home-based triage. We interviewed 10 participants to help develop and validate the statements for the Q sort, and 77 participants did the Q sort. We identified four views on home-based telephone triage. Two generally favor home-based triage, one highlights some concerns and conditions, and one opposes it out of concern for quality. The four views perceive different sources of credibility for nurse triagists working from home. Home-based telephone triage is a controversial issue among triage nurses, GPs and managers of OOH centers. By identifying consensus and dissension among GPs, triagists, managers and regulators, this study generates four perspectives on home-based triage. In addition, it reveals the conditions considered important for home-based triage.

Home telemonitoring for type 2 diabetes: an evidence-based analysis.

Science.gov (United States)

2009-01-01

In June 2008, the Medical Advisory Secretariat began work on the Diabetes Strategy Evidence Project, an evidence-based review of the literature surrounding strategies for successful management and treatment of diabetes. This project came about when the Health System Strategy Division at the Ministry of Health and Long-Term Care subsequently asked the secretariat to provide an evidentiary platform for the Ministry's newly released Diabetes Strategy.After an initial review of the strategy and consultation with experts, the secretariat identified five key areas in which evidence was needed. Evidence-based analyses have been prepared for each of these five areas: insulin pumps, behavioural interventions, bariatric surgery, home telemonitoring, and community based care. For each area, an economic analysis was completed where appropriate and is described in a separate report.To review these titles within the Diabetes Strategy Evidence series, please visit the Medical Advisory Secretariat Web site, http://www.health.gov.on.ca/english/providers/program/mas/mas_about.html,DIABETES STRATEGY EVIDENCE PLATFORM: Summary of Evidence-Based AnalysesContinuous Subcutaneous Insulin Infusion Pumps for Type 1 and Type 2 Adult Diabetics: An Evidence-Based AnalysisBehavioural Interventions for Type 2 Diabetes: An Evidence-Based AnalysisBARIATRIC SURGERY FOR PEOPLE WITH DIABETES AND MORBID OBESITY: An Evidence-Based SummaryCommunity-Based Care for the Management of Type 2 Diabetes: An Evidence-Based AnalysisHome Telemonitoring for Type 2 Diabetes: An Evidence-Based AnalysisApplication of the Ontario Diabetes Economic Model (ODEM) to Determine the Cost-effectiveness and Budget Impact of Selected Type 2 Diabetes Interventions in Ontario The objective of this report is to determine whether home telemonitoring and management of blood glucose is effective for improving glycemic control in adults with type 2 diabetes. An aging population coupled with a shortage of nurses and physicians in

Treating Emotionally Disturbed Youth: Home-Based Family Focused Intervention.

Science.gov (United States)

Anders-Cibik, Pamela; And Others

Home-based intervention services for emotionally disturbed youth are also commonly known as in-home services, family-centered services, family-based services, intensive family services, or family preservation services. They have developed as a way to deal with serious family problems that often result in the removal of a child or adolescent from…

Entrepreneurial Checklist Tool for Beginning Farm and Home-Based Businesses

Science.gov (United States)

Rafie, A. R.; Nartea, Theresa

2012-01-01

Extension educators entertain frequent questions on beginning a farm or starting a home-based business. Retired, unemployed, and displaced workers consider starting a small farm or home-based business. Determining educational needs or individual business aptitude is time consuming. Lengthy and comprehensive skill-based checklists exist for…

Home Learning, Technology, and Tomorrow's Workplace.

Science.gov (United States)

Rieseberg, Rhonda L.

1995-01-01

Discusses characteristics and trends of home schools and workplaces. Use of computers and computer applications (CD-ROMS, interactive software, and networking) in home schooling provides a compatible environment for future home-based businesses and telecommuting trends. Sidebars include information on home schools on line; standardized test…

Internet protocol television for personalized home-based health information: design-based research on a diabetes education system.

Science.gov (United States)

Gray, Kathleen Mary; Clarke, Ken; Alzougool, Basil; Hines, Carolyn; Tidhar, Gil; Frukhtman, Feodor

2014-03-10

The use of Internet protocol television (IPTV) as a channel for consumer health information is a relatively under-explored area of medical Internet research. IPTV may afford new opportunities for health care service providers to provide health information and for consumers, patients, and caretakers to access health information. The technologies of Web 2.0 add a new and even less explored dimension to IPTV's potential. Our research explored an application of Web 2.0 integrated with IPTV for personalized home-based health information in diabetes education, particularly for people with diabetes who are not strong computer and Internet users, and thus may miss out on Web-based resources. We wanted to establish whether this system could enable diabetes educators to deliver personalized health information directly to people with diabetes in their homes; and whether this system could encourage people with diabetes who make little use of Web-based health information to build their health literacy via the interface of a home television screen and remote control. This project was undertaken as design-based research in two stages. Stage 1 comprised a feasibility study into the technical work required to integrate an existing Web 2.0 platform with an existing IPTV system, populated with content and implemented for user trials in a laboratory setting. Stage 2 comprised an evaluation of the system by consumers and providers of diabetes information. The project succeeded in developing a Web 2.0 IPTV system for people with diabetes and low literacies and their diabetes educators. The performance of the system in the laboratory setting gave them the confidence to engage seriously in thinking about the actual and potential features and benefits of a more widely-implemented system. In their feedback they pointed out a range of critical usability and usefulness issues related to Web 2.0 affordances and learning fundamentals. They also described their experiences with the system in

Design of smart home gateway based on Wi-Fi and ZigBee

Science.gov (United States)

Li, Yang

2018-04-01

With the increasing demand for home lifestyle, the traditional smart home products have been unable to meet the needs of users. Aim at the complex wiring, high cost and difficult operation problems of traditional smart home system, this paper designs a home gateway for smart home system based on Wi-Fi and ZigBee. This paper first gives a smart home system architecture base on cloud server, Wi-Fi and ZigBee. This architecture enables users to access the smart home system remotely from Internet through the cloud server or through Wi-Fi at home. It also offers the flexibility and low cost of ZigBee wireless networking for home equipment. This paper analyzes the functional requirements of the home gateway, and designs a modular hardware architecture based on the RT5350 wireless gateway module and the CC2530 ZigBee coordinator module. Also designs the software of the home gateway, including the gateway master program and the ZigBee coordinator program. Finally, the smart home system and home gateway are tested in two kinds of network environments, internal network and external network. The test results show that the designed home gateway can meet the requirements, support remote and local access, support multi-user, support information security technology, and can timely report equipment status information.

On participatory design of home-based healthcare

DEFF Research Database (Denmark)

Grönvall, Erik; Kyng, Morten

2013-01-01

Participatory design (PD) activities in private homes challenge how we relate to the PD process, compared to PD in professional settings. Grounded in a project related to chronic dizziness among older people, we identified four challenges when performing PD with ill, weak users in their private...... homes. The challenges are (1) designing for, and negotiating knowledge about, the home, (2) ill, weak users and their participation in PD, (3) divergent interests of participants and (4) usable and sustainable post-project solutions. These challenges have to be carefully addressed, and we use them...... to reflect upon differences between a home-based PD process with non-workers, such as ours, and work-place projects, such as Utopia. Through this reflection, the paper contributes to a more general discussion on PD in non-work settings with weak users. Indeed, differences do exist between traditional PD...

Nursing staff competence, work strain, stress and satisfaction in elderly care: a comparison of home-based care and nursing homes.

Science.gov (United States)

Hasson, Henna; Arnetz, Judith E

2008-02-01

The aims of this study were to: (1) compare older people care nursing staff's perceptions of their competence, work strain and work satisfaction in nursing homes and home-based care; and (2) to examine determinants of work satisfaction in both care settings. The shift in older people care from hospitals to community-based facilities and home care has had implications for nursing practice. Lack of competence development, high levels of work strain and low levels of work satisfaction among nursing staff in both care settings have been associated with high turnover. Few studies have compared staff perceptions of their competence and work in nursing homes as opposed to home-based care. A cross-sectional questionnaire survey. Nursing staff perceptions of their competence, work strain, stress and satisfaction were measured by questionnaire in 2003 in two older people care organizations in Sweden. Comparisons of all outcome variables were made between care settings both within and between the two organizations. Multiple regression analysis was used to determine predictors of work satisfaction in home care and nursing homes respectively. In general, staff in home-based care reported significantly less sufficient knowledge compared with staff in nursing homes. However, home care staff experienced significantly less physical and emotional strain compared with staff in nursing homes. Ratings of work-related exhaustion, mental energy and overall work satisfaction did not differ significantly between care settings. In both care settings, work-related exhaustion was the strongest (inverse) predictor of work satisfaction. Future interventions should focus on counteracting work-related exhaustion and improving competence development to improve work satisfaction among older people care nursing staff in both care settings. Relevance to clinical practice. Work-related exhaustion and lack of competence development may have significant negative implications for work satisfaction among

Home-based specialized palliative care in patients with advanced cancer

DEFF Research Database (Denmark)

Nordly, Mie; Vadstrup, Eva Soelberg; Sjøgren, Per

2016-01-01

OBJECTIVE: Due to an urgent need for specialized palliative care (SPC) for patients with advanced cancer, an overview of available information on organization and outcomes of home-based SPC would be valuable. Our systematic review aims to give an overview of available information...... on the organization and outcomes of home-based SPC for patients with advanced cancer. Outcomes related to place of death, survival time, quality of life, performance status, and symptom management are included. METHOD: A PICO process search strategy consisting of terms related to cancer, palliation, and home care...... for patients with advanced cancer, resulting in poor information and a lack of evidence. Generally, home-based SPC seems to have some positive effect on pain and dyspnea, but more high-quality studies are required....

Stem cell homing-based tissue engineering using bioactive materials

Science.gov (United States)

Yu, Yinxian; Sun, Binbin; Yi, Chengqing; Mo, Xiumei

2017-06-01

Tissue engineering focuses on repairing tissue and restoring tissue functions by employing three elements: scaffolds, cells and biochemical signals. In tissue engineering, bioactive material scaffolds have been used to cure tissue and organ defects with stem cell-based therapies being one of the best documented approaches. In the review, different biomaterials which are used in several methods to fabricate tissue engineering scaffolds were explained and show good properties (biocompatibility, biodegradability, and mechanical properties etc.) for cell migration and infiltration. Stem cell homing is a recruitment process for inducing the migration of the systemically transplanted cells, or host cells, to defect sites. The mechanisms and modes of stem cell homing-based tissue engineering can be divided into two types depending on the source of the stem cells: endogenous and exogenous. Exogenous stem cell-based bioactive scaffolds have the challenge of long-term culturing in vitro and for endogenous stem cells the biochemical signal homing recruitment mechanism is not clear yet. Although the stem cell homing-based bioactive scaffolds are attractive candidates for tissue defect therapies, based on in vitro studies and animal tests, there is still a long way before clinical application.

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

Directory of Open Access Journals (Sweden)

Zamane Vafaei

2015-06-01

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

IMPLEMENTING AN ATTACHMENT-BASED PARENTING INTERVENTION WITHIN HOME-BASED EARLY HEAD START: HOME-VISITORS' PERCEPTIONS AND EXPERIENCES.

Science.gov (United States)

West, Allison L; Aparicio, Elizabeth M; Berlin, Lisa J; Jones Harden, Brenda

2017-07-01

Implementation of evidence-based interventions in "real-world" settings is enhanced when front-line staff view the intervention as acceptable, appropriate, and feasible. This qualitative study addresses Early Head Start (EHS) home visitors' perceptions and experiences of an evidence-based parenting intervention, the Attachment and Biobehavioral Catch-up program (M. Dozier, O. Lindhiem, & J. Ackerman, 2005), when added to EHS services as usual within the context of a research-practice partnership. Thematic analysis of in-depth, qualitative interviews indicates that home visitors experienced the intervention as positive and helpful for EHS families. Some challenges included scheduling and uncertainty regarding the goals of the intervention. Concerns over participation in the research centered on information exchange, confidentiality, and time limitations. © 2017 Michigan Association for Infant Mental Health.

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

Science.gov (United States)

Smith-Stoner, Marilyn

2011-06-01

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

End use energy consumption data base: transportation sector

Energy Technology Data Exchange (ETDEWEB)

Hooker, J.N.; Rose, A.B.; Greene, D.L.

1980-02-01

The transportation fuel and energy use estimates developed a Oak Ridge National Laboratory (ORNL) for the End Use Energy Consumption Data Base are documented. The total data base contains estimates of energy use in the United States broken down into many categories within all sectors of the economy: agriculture, mining, construction, manufacturing, commerce, the household, electric utilities, and transportation. The transportation data provided by ORNL generally cover each of the 10 years from 1967 through 1976 (occasionally 1977 and 1978), with omissions in some models. The estimtes are broken down by mode of transport, fuel, region and State, sector of the economy providing transportation, and by the use to which it is put, and, in the case of automobile and bus travel, by the income of the traveler. Fuel types include natural gas, motor and aviation gasoline, residual and diesel oil, liuqefied propane, liquefied butane, and naphtha- and kerosene-type jet engine fuels. Electricity use is also estimated. The mode, fuel, sector, and use categories themselves subsume one, two, or three levels of subcategories, resulting in a very detailed categorization and definitive accounting.

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

Directory of Open Access Journals (Sweden)

Heidi H. Ewen

2017-03-01

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

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

Science.gov (United States)

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

2017-01-01

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

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

Science.gov (United States)

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

2013-06-15

children. Home care was reported as more costly for service providers with substantial cost savings for the family in two studies, while one study revealed no significant cost benefits for the family. Current research does not provide supporting evidence for a reduction in access to hospital services or a reduction in hospital readmission rate for children with acute and chronic illnesses using specialist home-based nursing services; however, the only summary finding across a few studies was that there is a significant decrease in length of hospitalisation. The preliminary results show no adverse impact on physical health outcomes and a number of papers reported improved satisfaction with home-based care. Further trials are required, measuring health, satisfaction, service utilisation and long-term costs.

Home-Based Computer Gaming in Vestibular Rehabilitation of Gaze and Balance Impairment.

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Szturm, Tony; Reimer, Karen M; Hochman, Jordan

2015-06-01

Disease or damage of the vestibular sense organs cause a range of distressing symptoms and functional problems that could include loss of balance, gaze instability, disorientation, and dizziness. A novel computer-based rehabilitation system with therapeutic gaming application has been developed. This method allows different gaze and head movement exercises to be coupled to a wide range of inexpensive, commercial computer games. It can be used in standing, and thus graded balance demands using a sponge pad can be incorporated into the program. A case series pre- and postintervention study was conducted of nine adults diagnosed with peripheral vestibular dysfunction who received a 12-week home rehabilitation program. The feasibility and usability of the home computer-based therapeutic program were established. Study findings revealed that using head rotation to interact with computer games, when coupled to demanding balance conditions, resulted in significant improvements in standing balance, dynamic visual acuity, gaze control, and walking performance. Perception of dizziness as measured by the Dizziness Handicap Inventory also decreased significantly. These preliminary findings provide support that a low-cost home game-based exercise program is well suited to train standing balance and gaze control (with active and passive head motion).

A Novel Secure IoT-Based Smart Home Automation System Using a Wireless Sensor Network

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Pirbhulal, Sandeep; Zhang, Heye; E Alahi, Md Eshrat; Ghayvat, Hemant; Mukhopadhyay, Subhas Chandra; Zhang, Yuan-Ting; Wu, Wanqing

2016-01-01

Wireless sensor networks (WSNs) provide noteworthy benefits over traditional approaches for several applications, including smart homes, healthcare, environmental monitoring, and homeland security. WSNs are integrated with the Internet Protocol (IP) to develop the Internet of Things (IoT) for connecting everyday life objects to the internet. Hence, major challenges of WSNs include: (i) how to efficiently utilize small size and low-power nodes to implement security during data transmission among several sensor nodes; (ii) how to resolve security issues associated with the harsh and complex environmental conditions during data transmission over a long coverage range. In this study, a secure IoT-based smart home automation system was developed. To facilitate energy-efficient data encryption, a method namely Triangle Based Security Algorithm (TBSA) based on efficient key generation mechanism was proposed. The proposed TBSA in integration of the low power Wi-Fi were included in WSNs with the Internet to develop a novel IoT-based smart home which could provide secure data transmission among several associated sensor nodes in the network over a long converge range. The developed IoT based system has outstanding performance by fulfilling all the necessary security requirements. The experimental results showed that the proposed TBSA algorithm consumed less energy in comparison with some existing methods. PMID:28042831

A Novel Secure IoT-Based Smart Home Automation System Using a Wireless Sensor Network.

Science.gov (United States)

Pirbhulal, Sandeep; Zhang, Heye; E Alahi, Md Eshrat; Ghayvat, Hemant; Mukhopadhyay, Subhas Chandra; Zhang, Yuan-Ting; Wu, Wanqing

2016-12-30

Wireless sensor networks (WSNs) provide noteworthy benefits over traditional approaches for several applications, including smart homes, healthcare, environmental monitoring, and homeland security. WSNs are integrated with the Internet Protocol (IP) to develop the Internet of Things (IoT) for connecting everyday life objects to the internet. Hence, major challenges of WSNs include: (i) how to efficiently utilize small size and low-power nodes to implement security during data transmission among several sensor nodes; (ii) how to resolve security issues associated with the harsh and complex environmental conditions during data transmission over a long coverage range. In this study, a secure IoT-based smart home automation system was developed. To facilitate energy-efficient data encryption, a method namely Triangle Based Security Algorithm (TBSA) based on efficient key generation mechanism was proposed. The proposed TBSA in integration of the low power Wi-Fi were included in WSNs with the Internet to develop a novel IoT-based smart home which could provide secure data transmission among several associated sensor nodes in the network over a long converge range. The developed IoT based system has outstanding performance by fulfilling all the necessary security requirements. The experimental results showed that the proposed TBSA algorithm consumed less energy in comparison with some existing methods.

A Novel Secure IoT-Based Smart Home Automation System Using a Wireless Sensor Network

Directory of Open Access Journals (Sweden)

Sandeep Pirbhulal

2016-12-01

Full Text Available Wireless sensor networks (WSNs provide noteworthy benefits over traditional approaches for several applications, including smart homes, healthcare, environmental monitoring, and homeland security. WSNs are integrated with the Internet Protocol (IP to develop the Internet of Things (IoT for connecting everyday life objects to the internet. Hence, major challenges of WSNs include: (i how to efficiently utilize small size and low-power nodes to implement security during data transmission among several sensor nodes; (ii how to resolve security issues associated with the harsh and complex environmental conditions during data transmission over a long coverage range. In this study, a secure IoT-based smart home automation system was developed. To facilitate energy-efficient data encryption, a method namely Triangle Based Security Algorithm (TBSA based on efficient key generation mechanism was proposed. The proposed TBSA in integration of the low power Wi-Fi were included in WSNs with the Internet to develop a novel IoT-based smart home which could provide secure data transmission among several associated sensor nodes in the network over a long converge range. The developed IoT based system has outstanding performance by fulfilling all the necessary security requirements. The experimental results showed that the proposed TBSA algorithm consumed less energy in comparison with some existing methods.

Preferences for Home-Based HIV Testing Among Heterosexuals at Increased Risk for HIV/AIDS: New Orleans, Louisiana, 2013.

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Robinson, William T; Zarwell, Meagan; Gruber, DeAnn

2017-07-01

Participants in the New Orleans arm of the National HIV Behavioral Surveillance of Heterosexuals at Increased Risk for HIV were asked about potential utilization of self-administered home-based tests for HIV. The majority (86%) would use a free home-based test if provided by mail and 99% would seek treatment based on a positive result. In addition, more than half of respondents would return test results in some format to the test provider, whereas most of the remaining participants preferred to discuss results only with their doctor. These findings point toward a potential method for advancing the National HIV/AIDS Strategy.

An Efficient Secure Scheme Based on Hierarchical Topology in the Smart Home Environment

Directory of Open Access Journals (Sweden)

Mansik Kim

2017-08-01

Full Text Available As the Internet of Things (IoT has developed, the emerging sensor network (ESN that integrates emerging technologies, such as autonomous driving, cyber-physical systems, mobile nodes, and existing sensor networks has been in the limelight. Smart homes have been researched and developed by various companies and organizations. Emerging sensor networks have some issues of providing secure service according to a new environment, such as a smart home, and the problems of low power and low-computing capacity for the sensor that previous sensor networks were equipped with. This study classifies various sensors used in smart homes into three classes and contains the hierarchical topology for efficient communication. In addition, a scheme for establishing secure communication among sensors based on physical unclonable functions (PUFs that cannot be physically cloned is suggested in regard to the sensor’s low performance. In addition, we analyzed this scheme by conducting security and performance evaluations proving to constitute secure channels while consuming fewer resources. We believe that our scheme can provide secure communication by using fewer resources in a smart home environment in the future.

Factors related to the provision of home-based end-of-life care among home-care nursing, home help, and care management agencies in Japan.

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Igarashi, Ayumi; Kurinobu, Takeshi; Ko, Ayako; Okamoto, Yuko; Matsuura, Shino; Feng, Mei; Yamamoto-Mitani, Noriko

2015-09-12

To promote home death, it is necessary to clarify the institutional barriers to conducting end-of-life (EOL) care and consider strategies to deal with this process. This study aims to clarify institution-related factors associated with the provision of home-based EOL care cases, and to compare them among three different types of home-care agencies. We administered a cross-sectional survey throughout Japan to investigate the number and characteristics of EOL cases of home-care nursing (HN), home-help (HH) and care management (CM) agencies. Bivariate and multivariate analyses were performed for each type of agency to examine factors related to the provision of EOL care. 378 HN agencies, 274 HH agencies, and 452 CM agencies responded to the distributed questionnaire. HN agencies had on average 2.1 (SD = 4.0; range 0-60) home-based EOL cases in the last 3 months, while HH agencies had 0.9 (SD = 1.3; range 0-7) and CM agencies had 1.5 (SD = 2.2; range 0-18) in the last 6 months. In a multivariable analysis of HN agencies, a large number of staff (OR: 1.52; p EOL care; in HH agencies, accepting EOL clients in the agency (OR: 3.29; p EOL care; in CM agencies, the number of staff (OR: 1.21; p = 0.037), the number of collaborating HH agencies (OR: 1.07; p = 0.032), and whether home-care nurses and home helpers visit clients together (OR: 1.89; p = 0.007) were positively associated with the provision of EOL care. The agency's size and the inter-agency collaborative system seemed most important among HN agencies and CM agencies, while institutional preparedness for EOL was most important for HH agencies. These findings represent important new information for targeting different effective strategies in the promotion of home-based EOL care, depending on the agency type.

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

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

2018-07-01

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

Self-Administered, Home-Based SMART (Sensorimotor Active Rehabilitation Training) Arm Training: A Single-Case Report.

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Hayward, Kathryn S; Neibling, Bridee A; Barker, Ruth N

2015-01-01

This single-case, mixed-method study explored the feasibility of self-administered, home-based SMART (sensorimotor active rehabilitation training) Arm training for a 57-yr-old man with severe upper-limb disability after a right frontoparietal hemorrhagic stroke 9 mo earlier. Over 4 wk of self-administered, home-based SMART Arm training, the participant completed 2,100 repetitions unassisted. His wife provided support for equipment set-up and training progressions. Clinically meaningful improvements in arm impairment (strength), activity (arm and hand tasks), and participation (use of arm in everyday tasks) occurred after training (at 4 wk) and at follow-up (at 16 wk). Areas for refinement of SMART Arm training derived from thematic analysis of the participant's and researchers' journals focused on enabling independence, ensuring home and user friendliness, maintaining the motivation to persevere, progressing toward everyday tasks, and integrating practice into daily routine. These findings suggest that further investigation of self-administered, home-based SMART Arm training is warranted for people with stroke who have severe upper-limb disability. Copyright © 2015 by the American Occupational Therapy Association, Inc.

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

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

2018-01-01

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

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

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

2014-11-01

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

"Willing but unwilling": attitudinal barriers to adoption of home-based health information technology among older adults.

Science.gov (United States)

Young, Rachel; Willis, Erin; Cameron, Glen; Geana, Mugur

2014-06-01

While much research focuses on adoption of electronic health-care records and other information technology among health-care providers, less research explores patient attitudes. This qualitative study examines barriers to adoption of home-based health information technology, particularly personal electronic health records, among older adults. We conducted in-depth interviews (30-90 min duration) with 35 American adults, aged 46-72 years, to determine their perceptions of and attitudes toward home-based health information technology. Analysis of interview data revealed that most barriers to adoption fell under four themes: technological discomfort, privacy or security concerns, lack of relative advantage, and perceived distance from the user representation. Based on our findings, systems to promote home-based health information technology should incorporate familiar computer applications, alleviate privacy and security concerns, and align with older adults' active and engaged self-image.

Exploration of digital entrepreneurship – online home based businesses through empirical analysis

OpenAIRE

Anwar, Naveed

2015-01-01

Digital entrepreneurship is a broad domain and includes businesses predominantly operating online, such as online retailers, portals, community sites and also businesses providing services to enable other businesses to operate online, such as web designers, platform providers and operators. This research focused online home based businesses on any stage of business development, for example start-up or grown, and focus on any aspect, such as raising finance, establishing networks or developing...

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

Science.gov (United States)

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

2015-10-01

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

Latino Parent Home-Based Practices that Bolster Student Academic Persistence

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Mena, Jasmine A.

2011-01-01

Home-based parental involvement practices (i.e., educational encouragement, monitoring, and support) and their impact on students' academic persistence were investigated with a sample of 137, ninth-grade Latino students in a northeast high school. Structural Equation Modeling results indicate that the relationship between home-based parental…

Work and Home Neighborhood Design and Physical Activity.

Science.gov (United States)

Carlson, Jordan A; Frank, Lawrence D; Ulmer, Jared; Conway, Terry L; Saelens, Brian E; Cain, Kelli L; Sallis, James F

2018-01-01

To investigate relations of perceived worksite neighborhood environments to total physical activity and active transportation, over and above home neighborhood built environments. Observational epidemiologic study. Baltimore, Maryland-Washington, DC, and Seattle-King County, Washington metropolitan areas. One thousand eighty-five adults (mean age = 45.0 [10.2]; 46% women) recruited from 32 neighborhoods stratified by high/low neighborhood income and walkability. The Neighborhood Environment Walkability Survey assessed perceptions of worksite and home neighborhood environments. Accelerometers assessed total moderate-to-vigorous physical activity (MVPA). The International Physical Activity Questionnaire assessed total active transportation and active transportation to and around work. Mixed-effects regression tested relations of home and worksite neighborhood environments to each physical activity outcome, adjusted for demographics. Home and worksite mixed land use and street connectivity had the most consistent positive associations with physical activity outcomes. Worksite traffic and pedestrian safety were also associated with multiple physical activity outcomes. The worksite neighborhood explained additional variance in physical activity outcomes than explained by the home neighborhood. Worksite and home neighborhood environments interacted in explaining active transportation to work, with the greatest impacts occurring when both neighborhoods were activity supportive. Both worksite and home neighborhood environments were independently related to total MVPA and active transportation. Community design policies should target improving the physical activity supportiveness of worksite neighborhood environments and integrating commercial and residential development.

Palliative home-based technology from a practitioner's perspective: benefits and disadvantages

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Johnston BM

2014-11-01

Full Text Available Bridget M Johnston Sue Ryder Care Centre for the Study of Supportive, Palliative, and End of Life Care, School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK Abstract: This critical review paper explores the concept of palliative home-based technology from a practitioner's perspective. The aim of the critical review was to scope information available from published and unpublished research on the current state of palliative home-based technology, practitioner-focused perspectives, patient-focused perspectives, quality of life, and the implications for clinical practice. Published and unpublished studies were included. An example of one UK patient-centered home-based technology is explored as an exemplar. The evidence suggests that despite the challenges, there are numerous examples of good practice in relation to palliative home-based technology. Improvements in technology mean that telehealth has much to offer people being cared for at home with palliative needs. However, some of the evaluative evidence is limited, and further rigor is needed when evaluating future technology-based solutions innovations. Keywords: technology, telehealth, telemedicine, information technology, palliative care, hospice, terminal illness

Developing Home-Based Virtual Reality Therapy Interventions.

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Lin, Janice; Kelleher, Caitlin L; Engsberg, Jack R

2013-02-01

Stroke is one of the leading causes of serious long-term disability. However, home exercise programs given at rehabilitation often lack in motivational aspects. The purposes of this pilot study were (1) create individualized virtual reality (VR) games and (2) determine the effectiveness of VR games for improving movement in upper extremities in a 6-week home therapy intervention for persons with stroke. Participants were two individuals with upper extremity hemiparesis following a stroke. VR games were created using the Looking Glass programming language and modified based on personal interests, goals, and abilities. Participants were asked to play 1 hour each day for 6 weeks. Assessments measured upper extremity movement (range of motion and Action Research Arm Test [ARAT]) and performance in functional skills (Canadian Occupational Performance Measure [COPM] and Motor Activity Log [MAL]). Three VR games were created by a supervised occupational therapist student. The participants played approximately four to six times a week and performed over 100 repetitions of movements each day. Participants showed improvement in upper extremity movement and participation in functional tasks based on results from the COPM, ARAT, and MAL. Further development in the programming environment is needed to be plausible in a rehabilitation setting. Suggestions include graded-level support and continuation of creating a natural programming language, which will increase the ability to use the program in a rehabilitation setting. However, the VR games were shown to be effective as a home therapy intervention for persons with stroke. VR has the potential to advance therapy services by creating a more motivating home-based therapy service.

Home-based carers’ perceptions of health promotion on sexual health communication in Vhembe District

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Dorah U. Ramathuba

2015-05-01

Full Text Available Background: The introduction of home-based care in rural communities in the 1980s contributed immensely toward the upliftment of the personal and environmental health of communities. Women’s groups provided health promotion skills and health education to communities and made a difference in health-related behaviour change. Objective: The purpose of the study was to explore and describe the home-based carers’ perception regarding health promotion concerning sexual health communication in Vhembe district, in the context of HIV, amongst communities still rooted in their culture. Method: A qualitative, explorative and descriptive design was used in order to understand home-based carers’ perceptions regarding health promotion on sexual health communication amongst rural communities which may adversely impact on health promotion practices. The population were home-based organisations in Vhembe. The sample was purposive and randomly selected and data were gathered through semi-structured face-to-face interviews and focus groups which determined data saturation. Open coding was used for analysis of data. Results: The results indicated that sexual communication was absent in most relationships and was not seen as necessary amongst married couples. Socioeconomic conditions, power inequity and emotional dependence had a negative impact on decision making and sexual communication. Conclusion: This study, therefore, recommends that educational and outreach efforts should focus on motivating change by improving the knowledge base of home-based carers. Since they are health promoters, they should be able to change the perceptions of the communities toward sexually-transmitted infections and HIV by promoting sexual health communication.

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

Science.gov (United States)

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

2000-04-01

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

Home Based Training: Main Strategy in Community Based Rehabilitation in Iran

Directory of Open Access Journals (Sweden)

Peiman Salamati

2006-10-01

Full Text Available Objective: Study of effectiveness of “home based training” in community based rehabilitation program on disabled people, under supervised of 21 pilot cities health and medical networks, who were trained and evaluated at the end of the course. Materials & Methods: In a cross-sectional study, 614 disabled people who had participated in “home based training” were selected with stratified random sampling method. They were evaluated according to function progress level variables by community based rehabilitation programme experts. Age, sex, disability groups, employment state and teacher’s relation variables were studied from their files and recording datas. Statistical analysis was performed with Chi-square test. Results: There was a relationship between age group and disability group with functional progress level (P = 0.014 & P <0.001. Low age groups, visional disabled group, epileptic patients and individuals with learning problems had the best results. High age groups, mixed disability group and individuals with verbal and hearing problems had the least results. There was a relationship between teacher’s relation with progress or nonprogress state (P = 0.038. Individuals that they were own teachers had the best results and individuals with teachers other than first or second relation or health worker had the least results. Conclusion: Home based training in community based rehabilitation programme is an effective method for improving disabled people in some selected groups.

Home-based bimanual training based on motor learning principles in children with unilateral cerebral palsy and their parents (the COAD-study): rationale and protocols.

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Schnackers, Marlous; Beckers, Laura; Janssen-Potten, Yvonne; Aarts, Pauline; Rameckers, Eugène; van der Burg, Jan; de Groot, Imelda; Smeets, Rob; Geurts, Sander; Steenbergen, Bert

2018-04-18

Home-based training is considered an important intervention in rehabilitation of children with unilateral cerebral palsy. Despite consensus on the value of home-based upper limb training, no evidence-based best practice exists. Promoting compliance of children to adhere to an intensive program while keeping parental stress levels low is an important challenge when designing home-based training programs. Incorporating implicit motor learning principles emerges to be a promising method to resolve this challenge. Here we describe two protocols for home-based bimanual training programs, one based on implicit motor learning principles and one based on explicit motor learning principles, for children with unilateral spastic cerebral palsy aged 2 through 7 years. Children receive goal-oriented, task-specific bimanual training in their home environment from their parents for 3.5 h/week for 12 weeks according to an individualized program. Parents will be intensively coached by a multidisciplinary team, consisting of a pediatric therapist and remedial educationalist. Both programs consist of a preparation phase (goal setting, introductory meetings with coaching professionals, design of individualized program, instruction of parents, home visit) and home-based training phase (training, video-recordings, registrations, and telecoaching and home visits by the coaching team). The programs contrast with respect to the teaching strategy, i.e. how the parents support their child during training. In both programs parents provide their child with instructions and feedback that focus on the activity (i.e. task-oriented) or the result of the activity (i.e. result-oriented). However, in the explicit program parents are in addition instructed to give exact instructions and feedback on the motor performance of the bimanual activities, whereas in the implicit program the use of both hands and the appropriate motor performance of the activity are elicited via manipulation of the

Increased Classroom Consumption of Home-Provided Fruits and Vegetables for Normal and Overweight Children: Results of the Food Dudes Program in Italy.

Science.gov (United States)

Presti, Giovambattista; Cau, Silvia; Oppo, Annalisa; Moderato, Paolo

2015-01-01

To increase classroom consumption of home-provided fruits (F) and vegetables (V) in obese, overweight, and normal weight children. Consumption evaluated within and across the baseline phase and the end of the intervention and maintenance phases. Three Italian primary schools. The study involved 672 children (321 male and 329 female) aged 5-11 years. Body mass index measures were available for 461 children. Intervention schools received the Food Dudes (FD) program: 16 days of repeated taste exposure (40 g of F and 40 g of V), video modeling, and rewards-based techniques. The comparison school was only repeatedly exposed to FV. Grams of FV brought from home and eaten. Chi-square, independent t test, repeated-measures ANOVA, and generalized estimating equation model. Intervention schools show a significant increase in home-provided F (P < .001) and V (P < .001) consumption both in overweight and non-overweight children. Approximately half of children in the intervention schools ate at least 1 portion of FV at the end of the intervention and maintenance phases. The increase in home-provided FV intake was similar in overweight and non-overweight children in the FD intervention schools compared with the comparison school. The effect of the FD program was higher at the end of the intervention phase than the end of the maintenance phase. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.

Android based security and home automation system

OpenAIRE

Khan, Sadeque Reza; Dristy, Farzana Sultana

2015-01-01

The smart mobile terminal operator platform Android is getting popular all over the world with its wide variety of applications and enormous use in numerous spheres of our daily life. Considering the fact of increasing demand of home security and automation, an Android based control system is presented in this paper where the proposed system can maintain the security of home main entrance and also the car door lock. Another important feature of the designed system is that it can control the o...

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

Science.gov (United States)

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

2018-06-18

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

Home Care Quality Indicators (HCQIS) Based on the MDS-HC

Science.gov (United States)

Hirdes, John P.; Fries, Brant E.; Morris, John N.; Ikegami, Naoki; Zimmerman, David; Dalby, Dawn M.; Aliaga, Pablo; Hammer, Suzanne; Jones, Richard

2004-01-01

Purpose: This study aimed to develop home care quality indicators (HCQIs) to be used by a variety of audiences including consumers, agencies, regulators, and policy makers to support evidence-based decision making related to the quality of home care services. Design and Methods: Data from 3,041 Canadian and 11,252 U.S. home care clients assessed…

Smart home-based health platform for behavioral monitoring and alteration of diabetes patients.

Science.gov (United States)

Helal, Abdelsalam; Cook, Diane J; Schmalz, Mark

2009-01-01

Researchers and medical practitioners have long sought the ability to continuously and automatically monitor patients beyond the confines of a doctor's office. We describe a smart home monitoring and analysis platform that facilitates the automatic gathering of rich databases of behavioral information in a manner that is transparent to the patient. Collected information will be automatically or manually analyzed and reported to the caregivers and may be interpreted for behavioral modification in the patient. Our health platform consists of five technology layers. The architecture is designed to be flexible, extensible, and transparent, to support plug-and-play operation of new devices and components, and to provide remote monitoring and programming opportunities. The smart home-based health platform technologies have been tested in two physical smart environments. Data that are collected in these implemented physical layers are processed and analyzed by our activity recognition and chewing classification algorithms. All of these components have yielded accurate analyses for subjects in the smart environment test beds. This work represents an important first step in the field of smart environment-based health monitoring and assistance. The architecture can be used to monitor the activity, diet, and exercise compliance of diabetes patients and evaluate the effects of alternative medicine and behavior regimens. We believe these technologies are essential for providing accessible, low-cost health assistance in an individual's own home and for providing the best possible quality of life for individuals with diabetes. © Diabetes Technology Society

Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement

Directory of Open Access Journals (Sweden)

Remedios López-Liria

2015-01-01

Full Text Available Objectives. To compare home-based rehabilitation with the standard hospital rehabilitation in terms of improving knee joint mobility and recovery of muscle strength and function in patients after a total knee replacement. Materials and Methods. A non-randomised controlled trial was conducted. Seventy-eight patients with a prosthetic knee were included in the study and allocated to either a home-based or hospital-based rehabilitation programme. Treatment included various exercises to restore strength and joint mobility and to improve patients’ functional capacity. The primary outcome of the trial was the treatment effectiveness measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC. Results. The groups did not significantly differ in the leg side (right/left or clinical characteristics (P>0.05. After the intervention, both groups showed significant improvements (P<0.001 from the baseline values in the level of pain (visual analogue scale, the range of flexion-extension motion and muscle strength, disability (Barthel and WOMAC indices, balance, and walking. Conclusions. This study reveals that the rehabilitation treatments offered either at home or in hospital settings are equally effective.

Quality Improvement in Home-Based Child Care Settings: Research Resources to Inform Policy

Science.gov (United States)

Lawrence, Sharmila; Stephens, Samuel A.

2016-01-01

This "Topic of Interest" provides a comprehensive list of research in the Research Connections collection that was published in 2005 or later addressing issues related to quality improvement specifically in home-based child care. The resources are grouped under the following headings: Overviews, Summaries, and Reviews of Quality…

Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single-Family Homes

Energy Technology Data Exchange (ETDEWEB)

Cummings, James [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Withers, Charles [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Martin, Eric [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States); Moyer, Neil [Building America Partnership for Improved Residential Construction (BA-PIRC), Cocoa, FL (United States)

2012-10-01

This report is a revision of an earlier report titled: Measure Guideline: Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single-Family Homes. Revisions include: Information in the text box on page 1 was revised to reflect the most accurate information regarding classifications as referenced in the 2012 International Residential Code. “Measure Guideline” was dropped from the title of the report. An addition was made to the reference list.

Methodical approaches to providing sustainable development of the transport industry management system based on self-organization

Science.gov (United States)

Belyantseva, Oksana; Panenkov, Andrey; Safonova, Nataliya

2017-10-01

Current conditions of the cognitive economy formation demand to take into account the leading role of information, knowledge and human capital in the development of the transport industry management system. The article substantiates the conceptual approach to the self-organization of a management system on the basis of innovative changes. Human capital is the key aspect of self-organization, so the directions of improving the workforce quality are justified. Basing on the information-innovative genesis of the process of self-organization, the authors justified the necessity of preventing asymmetric information. For this pupose the actions against the resistance to innovations were proposed. The implementation of certain measures contributes to the effective development of the transport management system.

Designing of smart home automation system based on Raspberry Pi

Science.gov (United States)

Saini, Ravi Prakash; Singh, Bhanu Pratap; Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn

2016-03-01

Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning "on" and "off" of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

A Study on Home Based Enterprises in Kampoeng Pandean as Supporting Sustainable Architecture

Directory of Open Access Journals (Sweden)

Safeyah Muchlisiniyati

2016-01-01

Full Text Available Home Based Enterprises (HBEs provide an enormous impact on the lives of the citizens and the environment. The impacts include: increase income and welfare of the family, provide job opportunities, improve the quality of homes and the environment, and ensure life sustainability. The existence of the business leads changes to the house. Those changes that made to the house are often ignore the comfort of home space and the environment as living space. This study aims to look at the development of HBEs performed by community in Kampoeng Pandean. The measurement items used are architectural sustainability factors, ie economical sustainability, social sustainability, and enviromental sustainability. The study is located in Kampoeng Pandean Sidoarjo. The method used is a combination of qualitative and quantitative method. The results show that HBEs in Kampoeng Pandean have not fully supported the sustainable architecture. Environmental sustainability has not been met, due to the density of the environment, the high percentage of building area to land area, and the construction of business space does not consider the comfort factor.

Analyzing the Interprofessional Working of a Home-Based Primary Care Team.

Science.gov (United States)

Smith-Carrier, Tracy; Neysmith, Sheila

2014-09-01

Increasingly, interprofessional teams are responsible for providing integrated health care services. Effective teams, however, are not the result of chance but require careful planning and ongoing attention to team processes. Based on a case study involving interviews, participant observation, and a survey, we identified key attributes for effective interprofessional working (IPW) within a home-based primary care (HBPC) setting. Recognizing the importance of a theoretical model that reflects the multidimensional nature of team effectiveness research, we employed the integrated team effectiveness model to analyze our findings. The results indicated that a shared vision, common goals, respect, and trust among team members – as well as processes for ongoing communication, effective leadership, and mechanisms for conflict resolution – are vital in the development of a high-functioning IPW team. The ambiguity and uncertainty surrounding the context of service provision (clients' homes), as well the negotiation of external relationships in the HBPC field, require further investigation.

Gendered home-based care in South Africa: more trouble for the troubled.

Science.gov (United States)

Akintola, Olagoke

2006-11-01

This study investigates the experiences of informal caregivers of people living with HIV in two semi-rural communities in South Africa. Ethnographic methods were used to collect and analyse data on the gendered nature and consequences of home-based care from 21 primary caregivers and 20 volunteer caregivers as well as 10 key informants. It was generally women who were poor, unemployed and unmarried who combined the care-giving role with their traditional role as homemaker and that of being the household head and breadwinner. The caregivers experienced physical strains and emotional problems, and were at elevated risk of being infected with HIV and TB. Men were largely absent in HIV/AIDS-affected homes and usually did not assist because of rigid gendered divisions of labour. Home-based care, by creating a disproportionate burden on women, is exacerbating existing gender inequities. It is argued that a thorough understanding of how home-based care undermines the physical health and psychological wellbeing of already vulnerable women is crucial for informing policies on home-based care. Thus, there is a need to incorporate gender perspectives when planning and implementing home-based care programmes.

Guidelines on the safety of light-based home-use hair removal devices from the European Society for Laser Dermatology

DEFF Research Database (Denmark)

Town, Graham; Ash, C; Dierickx, C

2012-01-01

. These guidelines provide a definition of light-based home-use technology, to inform healthcare professionals about home-use light-based technology and encourage manufacturers wishing to sell in Europe to adopt 'best practice'. The review presents the current status on standards and regulation issues and considers...... home-use safety issues, encompassing human, device and electrical safety, given risks to the eyes and skin from optical radiation both to the consumer and persons in the vicinity. Proposed technical measurement methodology is considered with focus on recognized critical parameters for the safe use...... of light-based hair removal technology including recording the technical performance and safety claims of a range of home-use hair removal devices. The literature review emphasizes potential adverse incidents and safety aspects of treating cosmetic conditions, such as unwanted hair growth. Although some...

The Impact of Certificate-of-Need Laws on Nursing Home and Home Health Care Expenditures.

Science.gov (United States)

Rahman, Momotazur; Galarraga, Omar; Zinn, Jacqueline S; Grabowski, David C; Mor, Vincent

2016-02-01

Over the past two decades, nursing homes and home health care agencies have been influenced by several Medicare and Medicaid policy changes including the adoption of prospective payment for Medicare-paid postacute care and Medicaid-paid long-term home and community-based care reforms. This article examines how spending growth in these sectors was affected by state certificate-of-need (CON) laws, which were designed to limit the growth of providers and have remained unchanged for several decades. Compared with states without CON laws, Medicare and Medicaid spending in states with CON laws grew faster for nursing home care and more slowly for home health care. In particular, we observed the slowest growth in community-based care in states with CON for both the nursing home and home health industries. Thus, controlling for other factors, public postacute and long-term care expenditures in CON states have become dominated by nursing homes. © The Author(s) 2015.

Design and development of a mobile exercise application for home care aides and older adult medicaid home and community-based clients.

Science.gov (United States)

Danilovich, Margaret K; Diaz, Laura; Saberbein, Gustavo; Healey, William E; Huber, Gail; Corcos, Daniel M

2017-01-01

We describe a community-engaged approach with Medicaid home and community-based services (HCBS), home care aide (HCA), client, and physical therapist stakeholders to develop a mobile application (app) exercise intervention through focus groups and interviews. Participants desired a short exercise program with modification capabilities, goal setting, and mechanisms to track progress. Concerns regarding participation were training needs and feasibility within usual care services. Technological preferences were for simple, easy-to-use, and engaging content. The app was piloted with HCA-client dyads (n = 5) to refine the intervention and evaluate content. Engaging stakeholders in intervention development provides valuable user-feedback on both desired exercise program contents and mobile technology preferences for HCBS recipients.

A low cost, adaptive mixed reality system for home-based stroke rehabilitation.

Science.gov (United States)

Chen, Yinpeng; Baran, Michael; Sundaram, Hari; Rikakis, Thanassis

2011-01-01

This paper presents a novel, low-cost, real-time adaptive multimedia environment for home-based upper extremity rehabilitation of stroke survivors. The primary goal of this system is to provide an interactive tool with which the stroke survivor can sustain gains achieved within the clinical phase of therapy and increase the opportunity for functional recovery. This home-based mediated system has low cost sensing, off the shelf components for the auditory and visual feedback, and remote monitoring capability. The system is designed to continue active learning by reducing dependency on real-time feedback and focusing on summary feedback after a single task and sequences of tasks. To increase system effectiveness through customization, we use data from the training strategy developed by the therapist at the clinic for each stroke survivor to drive automated system adaptation at the home. The adaptation includes changing training focus, selecting proper feedback coupling both in real-time and in summary, and constructing appropriate dialogues with the stroke survivor to promote more efficient use of the system. This system also allows the therapist to review participant's progress and adjust the training strategy weekly.

Personalized Home-Networks

DEFF Research Database (Denmark)

Soler, José; Gandy, Michael

2007-01-01

The paper provides details of a home-networking architecture based on an enhanced residential gateway. Initially the need for mechanisms allowing user-dependent network behavior is described and afterwards details of an initial implementation are provided in terms of architectural description...

A home-based clothing manufacturing: the owner and the business

African Journals Online (AJOL)

S Blignaut

home life. Women in home-based businesses are more flexible in managing ... and balancing their work and families (Alderman & .... business are important in determining its overall .... purpose of the study, to inspire a trusting relationship,.

Impact on postpartum hemorrhage of prophylactic administration of oxytocin 10 IU via Uniject™ by peripheral health care providers at home births: design of a community-based cluster-randomized trial.

Science.gov (United States)

Stanton, Cynthia K; Newton, Samuel; Mullany, Luke C; Cofie, Patience; Agyemang, Charlotte Tawiah; Adiibokah, Edward; Darcy, Niamh; Khan, Sadaf; Levisay, Alice; Gyapong, John; Armbruster, Deborah; Owusu-Agyei, Seth

2012-06-07

Hemorrhage is the leading direct cause of maternal death globally. While oxytocin is the drug of choice for postpartum hemorrhage prevention, its use has generally been limited to health facilities. This trial assesses the effectiveness, safety, and feasibility of expanding the use of prophylactic intramuscular oxytocin to peripheral health care providers at home births in four predominantly rural districts in central Ghana. This study is designed as a community-based cluster-randomized trial in which Community Health Officers are randomized to provide (or not provide) an injection of oxytocin 10 IU via the Uniject™ injection system within one minute of delivery of the baby to women who request their presence at home at the onset of labor. The primary aim is to determine if administration of prophylactic oxytocin via Uniject™ by this cadre will reduce the risk of postpartum hemorrhage by 50 % relative to deliveries which do not receive the prophylactic intervention. Postpartum hemorrhage is examined under three sequential definitions: 1) blood loss ≥500 ml (BL); 2) treatment for bleeding (TX) and/or BL; 3) hospital referral for bleeding and/or TX and/or BL. Secondary outcomes address safety and feasibility of the intervention and include adverse maternal and fetal outcomes and logistical concerns regarding assistance at home births and the storage and handling of oxytocin, respectively. Results from this trial will build evidence for the effectiveness of expanding the delivery of this established prophylactic intervention to peripheral settings. Complementary data on safety and logistical issues related to this intervention will assist policymakers in low-income countries in selecting both the best uterotonic and service delivery strategy for postpartum hemorrhage prevention. Results of this trial are expected in mid-2013. The trial is registered at ClinicalTrials.gov: NCT01108289.

Registered nurses' perceptions of their professional work in nursing homes and home-based care: a focus group study.

Science.gov (United States)

Carlson, Elisabeth; Rämgård, Margareta; Bolmsjö, Ingrid; Bengtsson, Mariette

2014-05-01

In Sweden, as well as in most industrialised countries, an increasing older population is expected to create a growing demand for health care staff. Previous studies have pointed to lack of proficient medical and nursing staff specialised in geriatric care, which poses serious threats to the care of a vulnerable population. At the same time, there are studies describing elderly care as a low-status career choice, attracting neither nurses nor student nurses. Judging from previous research it was deemed important to explore how nurses in elderly care perceive their work, thus possibly provide vital knowledge that can guide nurse educators and unit managers as a means to promote a career in elderly care. The aim of the present study was to illuminate how nurses, working in nursing homes and home-based care, perceived their professional work. This was a qualitative study using focus groups. 30 registered nurses in seven focus groups were interviewed. The participants worked in nursing homes and home-based care for the elderly in rural areas and in a larger city in southern Sweden. The interviews were analysed in line with the tradition of naturalistic inquiry. Our findings illustrate how nurses working in elderly care perceived their professional work as holistic and respectful nursing. Three categories of professional work emerged during analysis: (1) establishing long-term relationships, (2) nursing beyond technical skills, and (3) balancing independence and a sense of loneliness. The findings are important as they represent positive alternatives to the somewhat prevailing view on elderly care as depressing and undemanding. Nurse educators might use the key aspects as good examples, thus influencing student nurses' attitudes towards elderly care in a positive way. Elderly care agencies might find them helpful when recruiting and retaining nurses to a much needed area. Copyright © 2013 Elsevier Ltd. All rights reserved.

VOLTTRON-Based System for Providing Ancillary Services with Residential Building Loads

Energy Technology Data Exchange (ETDEWEB)

Jin, Xin

2016-07-01

interfaces, manufacturer-provided application programming interfaces, and proprietary communication interfaces. We document the ability to manage nine appliances, using four different standards or proprietary communication methods. A hardware-in-the-loop test was performed in a laboratory environment where the loads of a laboratory home and a large number of simulated homes are controlled by an aggregator. Upon receipt of an AGC signal, the VOLTTRON home energy management system (HEMS) of the laboratory home adjusts the end-device controls based on the comfort criteria set by the end users and sends telemetry to the aggregator to verify response. The aggregator then sends the AGC signal to other simulated homes in attempts to match the utility request as closely as possible. Frequency regulation is generally considered a higher value service than other ancillary services but it is also more challenging due to the constraint of short response time. A frequency regulation use case has been implemented with the regulation signals sent every 10 seconds. Experimental results indicate that the VOLTTRON-controlled residential loads are able to be controlled with sufficient fidelity to enable an aggregator to meet frequency regulation requirements. Future work is warranted, such as understanding the impact of this type of control on equipment life, and market requirements needed to open up residential loads to ancillary service aggregators.

Activity-Based Costing Application in an Urban Mass Transport Company

Directory of Open Access Journals (Sweden)

Popesko Boris

2011-12-01

Full Text Available The purpose of this paper is to provide a basic overview of the application of Activity-Based Costing in an urban mass transport company which operates land public transport via buses and trolleys within the city. The case study was conducted using the Activity-Based Methodology in order to calculate the true cost of individual operations and to measure the profitability of particular transport lines. The case study analysis showed the possible effects of the application of the Activity-Based Costing for an urban mass transport company as well as the limitations of using the ABC methodology in the service industry. With regards to the application of the ABC methodology, the primary limitation of the accuracy of the conclusions is the quality of the non-financial information which had to be gathered throughout the implementation process. A basic limitation of the accurate data acquisition is the nature of the fare system of the transport company which does not allow the identification of the route that is taken by an individual passenger. The study illustrates the technique of ABC in urban mass transport and provides a real company example of information outputs of the ABC system. The users indicated that, the ABC model is very useful for profitability reporting and profit management. Also, the paper shows specific application of the Activity-Based Methodology in conditions of urban mass transport companies with regional specifics.

Health economic evaluation of home and hospital-based care in ...

African Journals Online (AJOL)

... diabetes treatment satisfaction, diabetes knowledge and costs during three months ... Results: The cost of home-based care in insulin therapy diabetes was 61% ... Conclusions: The care at home approach for type 2 diabetic patients can be ...

Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes.

Science.gov (United States)

Ali, Bako; Awad, Ali Ismail

2018-03-08

The Internet of Things (IoT) is an emerging paradigm focusing on the connection of devices, objects, or "things" to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE) methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes.

Hospital-based home care for children with cancer

DEFF Research Database (Denmark)

Hansson, Eva Helena; Kjaergaard, Hanne; Johansen, Christoffer

2013-01-01

BACKGROUND: To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. PROCEDURE: A HBHC program was carried out with 51 children (0-18 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety...... children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care. RESULTS: All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age......, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P = 0.04; 95% confidence interval (CI): -0.2-19.5) and worry (P = 0.04; 95% CI: -0.4-20.6) in the home-care group indicating better physical health and less worry for children...

Privacy and information security risks in a technology platform for home-based chronic disease rehabilitation and education.

Science.gov (United States)

Henriksen, Eva; Burkow, Tatjana M; Johnsen, Elin; Vognild, Lars K

2013-08-09

Privacy and information security are important for all healthcare services, including home-based services. We have designed and implemented a prototype technology platform for providing home-based healthcare services. It supports a personal electronic health diary and enables secure and reliable communication and interaction with peers and healthcare personnel. The platform runs on a small computer with a dedicated remote control. It is connected to the patient's TV and to a broadband Internet. The platform has been tested with home-based rehabilitation and education programs for chronic obstructive pulmonary disease and diabetes. As part of our work, a risk assessment of privacy and security aspects has been performed, to reveal actual risks and to ensure adequate information security in this technical platform. Risk assessment was performed in an iterative manner during the development process. Thus, security solutions have been incorporated into the design from an early stage instead of being included as an add-on to a nearly completed system. We have adapted existing risk management methods to our own environment, thus creating our own method. Our method conforms to ISO's standard for information security risk management. A total of approximately 50 threats and possible unwanted incidents were identified and analysed. Among the threats to the four information security aspects: confidentiality, integrity, availability, and quality; confidentiality threats were identified as most serious, with one threat given an unacceptable level of High risk. This is because health-related personal information is regarded as sensitive. Availability threats were analysed as low risk, as the aim of the home programmes is to provide education and rehabilitation services; not for use in acute situations or for continuous health monitoring. Most of the identified threats are applicable for healthcare services intended for patients or citizens in their own homes. Confidentiality

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

Directory of Open Access Journals (Sweden)

Peng Qingchao

2016-01-01

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

Home-Explorer: Ontology-Based Physical Artifact Search and Hidden Object Detection System

Directory of Open Access Journals (Sweden)

Bin Guo

2008-01-01

Full Text Available A new system named Home-Explorer that searches and finds physical artifacts in a smart indoor environment is proposed. The view on which it is based is artifact-centered and uses sensors attached to the everyday artifacts (called smart objects in the real world. This paper makes two main contributions: First, it addresses, the robustness of the embedded sensors, which is seldom discussed in previous smart artifact research. Because sensors may sometimes be broken or fail to work under certain conditions, smart objects become hidden ones. However, current systems provide no mechanism to detect and manage objects when this problem occurs. Second, there is no common context infrastructure for building smart artifact systems, which makes it difficult for separately developed applications to interact with each other and uneasy for them to share and reuse knowledge. Unlike previous systems, Home-Explorer builds on an ontology-based knowledge infrastructure named Sixth-Sense, which makes it easy for the system to interact with other applications or agents also based on this ontology. The hidden object problem is also reflected in our ontology, which enables Home-Explorer to deal with both smart objects and hidden objects. A set of rules for deducing an object's status or location information and for locating hidden objects are described and evaluated.

Packaging and transportation occurrence reporting

International Nuclear Information System (INIS)

Needels, T.S.

1996-01-01

The US Department of Energy (DOE) Order 231.1 calls for the maintenance of a database for all unclassified occurrence reports (ORs). ORS provide DOE with notice of incidents and accidents that endanger the public, workers, or DOE facility operations. To fulfill this policy, the DOE Occurrence Reporting and Processing System (ORPS) was established to require DOE facilities to report and process information concerning such events. The Oak Ridge National Laboratory (ORNL) provides DOE with data and analysis of occurrence related to packaging and transportation (P and T) safety. This program produces annual reports, lessons learned bulletins, and information for the packaging and transportation home page on the Internet. The analysis and reports provided can be used as a tool for oversight and a means for DOE sites to be proactive and anticipate problems through shared knowledge and lessons learned. To illustrate, some observable trends based on 3 years of the program are given. In summary, this program shows potential problem areas that need correcting, and possible breakdowns of safety

Designing of smart home automation system based on Raspberry Pi

International Nuclear Information System (INIS)

Saini, Ravi Prakash; Singh, Bhanu Pratap; Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn

2016-01-01

Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning “on” and “off” of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

Designing of smart home automation system based on Raspberry Pi

Energy Technology Data Exchange (ETDEWEB)

Saini, Ravi Prakash; Singh, Bhanu Pratap [B K Birla Institute of Engineering & Technology, Pilani, Rajasthan (India); Sharma, Mahesh Kumar; Wattanawisuth, Nattapol; Leeprechanon, Nopbhorn, E-mail: Dr.N.L@ieee.org [Thammasat University, Rangsit Campus, Pathum Thani (Thailand)

2016-03-09

Locally networked or remotely controlled home automation system becomes a popular paradigm because of the numerous advantages and is suitable for academic research. This paper proposes a method for an implementation of Raspberry Pi based home automation system presented with an android phone access interface. The power consumption profile across the connected load is measured accurately through programming. Users can access the graph of total power consumption with respect to time worldwide using their Dropbox account. An android application has been developed to channelize the monitoring and controlling operation of home appliances remotely. This application facilitates controlling of operating pins of Raspberry Pi by pressing the corresponding key for turning “on” and “off” of any desired appliance. Systems can range from the simple room lighting control to smart microcontroller based hybrid systems incorporating several other additional features. Smart home automation systems are being adopted to achieve flexibility, scalability, security in the sense of data protection through the cloud-based data storage protocol, reliability, energy efficiency, etc.

Performance Improvement Strategic Home Based Manufacturer Tahu And Tempe Groups Based In The District Of Jember

Directory of Open Access Journals (Sweden)

Istatuk Budi Yuswanto

2017-04-01

Full Text Available Tahu dan tempe is a product of the soybean meal that has been known since long in Indonesia. Tahu is a Chinese food products in contrast to tempe an authentic Indonesian food . As tempe tahu also favored by the people of Indonesia because it has a taste that delicious nutritious and affordable price.Industries that produce tahu dan tempe are generally small-scale home-based businesses with the number of workers a little less than 2-6 people and investments that are not too large. The use of technology in small business home-based producer of tahu dan tempe quite simple and easy to learn so it can be run by anyone. The success of small business home-based manufacturers to survive and evolve toward more advanced by knowing their strengths weaknesses opportunities that can be taken by small business home-based and threat or better known as the SWOT Strength Weakness Opportunity Threath that can be retrieved strategies that affect the success and development of small business home-based manufacturer of tahu dan tempe.Constraints faced by small businesses and home-based manufacturers know that the soybean Tepe that include budget constraints limited access to banking limited human resources marketing only the scope of Jember and lack of good management. No group or cooperative does not have a good recording making it difficult to make financial reports manufacturing planning and operational supervision and finances into this industry employers group lemah.Pembentukan help solve problems and maximize its potential.

Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes

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Bako Ali

2018-03-01

Full Text Available The Internet of Things (IoT is an emerging paradigm focusing on the connection of devices, objects, or “things” to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes.

Cyber and Physical Security Vulnerability Assessment for IoT-Based Smart Homes

Science.gov (United States)

2018-01-01

The Internet of Things (IoT) is an emerging paradigm focusing on the connection of devices, objects, or “things” to each other, to the Internet, and to users. IoT technology is anticipated to become an essential requirement in the development of smart homes, as it offers convenience and efficiency to home residents so that they can achieve better quality of life. Application of the IoT model to smart homes, by connecting objects to the Internet, poses new security and privacy challenges in terms of the confidentiality, authenticity, and integrity of the data sensed, collected, and exchanged by the IoT objects. These challenges make smart homes extremely vulnerable to different types of security attacks, resulting in IoT-based smart homes being insecure. Therefore, it is necessary to identify the possible security risks to develop a complete picture of the security status of smart homes. This article applies the operationally critical threat, asset, and vulnerability evaluation (OCTAVE) methodology, known as OCTAVE Allegro, to assess the security risks of smart homes. The OCTAVE Allegro method focuses on information assets and considers different information containers such as databases, physical papers, and humans. The key goals of this study are to highlight the various security vulnerabilities of IoT-based smart homes, to present the risks on home inhabitants, and to propose approaches to mitigating the identified risks. The research findings can be used as a foundation for improving the security requirements of IoT-based smart homes. PMID:29518023

A Process-Based Transport-Distance Model of Aeolian Transport

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Naylor, A. K.; Okin, G.; Wainwright, J.; Parsons, A. J.

2017-12-01

We present a new approach to modeling aeolian transport based on transport distance. Particle fluxes are based on statistical probabilities of particle detachment and distributions of transport lengths, which are functions of particle size classes. A computational saltation model is used to simulate transport distances over a variety of sizes. These are fit to an exponential distribution, which has the advantages of computational economy, concordance with current field measurements, and a meaningful relationship to theoretical assumptions about mean and median particle transport distance. This novel approach includes particle-particle interactions, which are important for sustaining aeolian transport and dust emission. Results from this model are compared with results from both bulk- and particle-sized-specific transport equations as well as empirical wind tunnel studies. The transport-distance approach has been successfully used for hydraulic processes, and extending this methodology from hydraulic to aeolian transport opens up the possibility of modeling joint transport by wind and water using consistent physics. Particularly in nutrient-limited environments, modeling the joint action of aeolian and hydraulic transport is essential for understanding the spatial distribution of biomass across landscapes and how it responds to climatic variability and change.

Hospital-at-home Integrated Care Program for Older Patients With Orthopedic Processes: An Efficient Alternative to Usual Hospital-Based Care.

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Closa, Conxita; Mas, Miquel À; Santaeugènia, Sebastià J; Inzitari, Marco; Ribera, Aida; Gallofré, Miquel

2017-09-01

To compare outcomes and costs for patients with orthogeriatric conditions in a home-based integrated care program versus conventional hospital-based care. Quasi-experimental longitudinal study. An acute care hospital, an intermediate care hospital, and the community of an urban area in the North of Barcelona, in Southern Europe. In a 2-year period, we recruited 367 older patients attended at an orthopedic/traumatology unit in an acute hospital for fractures and/or arthroplasty. Patients were referred to a hospital-at-home integrated care unit or to standard hospital-based postacute orthogeriatric unit, based on their social support and availability of the resource. We compared home-based care versus hospital-based care for Relative Functional Gain (gain/loss of function measured by the Barthel Index), mean direct costs, and potential savings in terms of reduction of stay in the acute care hospital. No differences were found in Relative Functional Gain, median (Q25-Q75) = 0.92 (0.64-1.09) in the home-based group versus 0.93 (0.59-1) in the hospital-based group, P =.333. Total health service direct cost [mean (standard deviation)] was significantly lower for patients receiving home-based care: €7120 (3381) versus €12,149 (6322), P home-based care [10.1 (7)] than in patients discharged to the postacute orthogeriatric hospital-based unit [15.3 (12) days, P home integrated care program was suitable for managing older patients with orthopedic conditions who have good social support for home care. It provided clinical care comparable to the hospital-based model, and it seems to enable earlier acute hospital discharge and lower direct costs. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Vgi Based Urban Public Transport

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Teymurian, F.; Alesheikh, A. A.; Alimohammadi, A.; Sadeghi-Niaraki, A.

2013-09-01

in constant contact with the system can have detailed and updated information about the problems, solutions and they are affected by the related implemented policies. Thus user involvement is an essential part in public transport decision making process. Although GIS in transportation (GIS-T) has been used for data collection, spatial analysis, and spatial modeling, due to recent promotions, GIS-T is moving towards the use of capabilities of VGI to user-centric services. The main goals of this paper are two as follows: First is to survey and review the key concepts of the geo-collaboration, to introduce and present fields to utilizing the VGI in the public transportation system to improve the performance of that system. The Second goal is to propose a VGI-based public transport conceptual framework. in this paper in the first part capabilities of VGI is explored, and areas of public transport that can utilize the public involvement is assessed and classified. Then, by surveying the related works in this context, a classification based on the models of participation is provided. Finally, a VGI-based conceptual framework for organizing a public participation for performance measurement of urban public transport for Tehran city is proposed. Results of this paper show that utilizing VGI presents an efficient solution for public transport problems.

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

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Walus, Ashley N; Woloschuk, Donna M M

2017-01-01

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

Home care decision support using an Arden engine--merging smart home and vital signs data.

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Marschollek, Michael; Bott, Oliver J; Wolf, Klaus-H; Gietzelt, Matthias; Plischke, Maik; Madiesh, Moaaz; Song, Bianying; Haux, Reinhold

2009-01-01

The demographic change with a rising proportion of very old people and diminishing resources leads to an intensification of the use of telemedicine and home care concepts. To provide individualized decision support, data from different sources, e.g. vital signs sensors and home environmental sensors, need to be combined and analyzed together. Furthermore, a standardized decision support approach is necessary. The aim of our research work is to present a laboratory prototype home care architecture that integrates data from different sources and uses a decision support system based on the HL7 standard Arden Syntax for Medical Logical Modules. Data from environmental sensors connected to a home bus system are stored in a data base along with data from wireless medical sensors. All data are analyzed using an Arden engine with the medical knowledge represented in Medical Logic Modules. Multi-modal data from four different sensors in the home environment are stored in a single data base and are analyzed using an HL7 standard conformant decision support system. Individualized home care decision support must be based on all data available, including context data from smart home systems and medical data from electronic health records. Our prototype implementation shows the feasibility of using an Arden engine for decision support in a home setting. Our future work will include the utilization of medical background knowledge for individualized decision support, as there is no one-size-fits-all knowledge base in medicine.

WiSPH: a wireless sensor network-based home care monitoring system.

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Magaña-Espinoza, Pedro; Aquino-Santos, Raúl; Cárdenas-Benítez, Néstor; Aguilar-Velasco, José; Buenrostro-Segura, César; Edwards-Block, Arthur; Medina-Cass, Aldo

2014-04-22

This paper presents a system based on WSN technology capable of monitoring heart rate and the rate of motion of seniors within their homes. The system is capable of remotely alerting specialists, caretakers or family members via a smartphone of rapid physiological changes due to falls, tachycardia or bradycardia. This work was carried out using our workgroup's WiSe platform, which we previously developed for use in WSNs. The proposed WSN architecture is flexible, allowing for greater scalability to better allow event-based monitoring. The architecture also provides security mechanisms to assure that the monitored and/or stored data can only be accessed by authorized individuals or devices. The aforementioned characteristics provide the network versatility and solidity required for use in health applications.

WiSPH: A Wireless Sensor Network-Based Home Care Monitoring System

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Pedro Magaña-Espinoza

2014-04-01

Full Text Available This paper presents a system based on WSN technology capable of monitoring heart rate and the rate of motion of seniors within their homes. The system is capable of remotely alerting specialists, caretakers or family members via a smartphone of rapid physiological changes due to falls, tachycardia or bradycardia. This work was carried out using our workgroup’s WiSe platform, which we previously developed for use in WSNs. The proposed WSN architecture is flexible, allowing for greater scalability to better allow event-based monitoring. The architecture also provides security mechanisms to assure that the monitored and/or stored data can only be accessed by authorized individuals or devices. The aforementioned characteristics provide the network versatility and solidity required for use in health applications.

Design and Implementation of GSM Based Automated Home Security System

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Love Aggarwal

2014-05-01

Full Text Available The Automated Home Security System aims at building a security system for common households using GSM modem, sensors and microcontroller. Since many years, impeccable security system has been the prime need of every man who owns a house. The increasing crime rate has further pressed the need for it. Our system is an initiative in this direction. The system provides security function by monitoring the surroundings at home for intruders, fire, gas leakages etc. using sensors and issue alerts to the owners and local authorities by using GSM via SMS. It provides the automation function as it can control (On/Off the various home appliances while the owners are away via SMS. Thus the Automated Home Security System is self-sufficient and can be relied upon undoubtedly. Also, it is capable of establishing two way communication with its owner so that he/she can keep a watch on his/her home via sensor information or live video streaming. A camera can be installed for continuous monitoring of the system and its surroundings. The system consists of two main parts: hardware and software. Hardware consists of Microcontroller, Sensors, Buzzer and GSM modem while software is implemented by tools using Embedded ‘C’.

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

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Josu Etxaniz

2017-04-01

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

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

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Etxaniz, Josu; Aranguren, Gerardo

2017-01-01

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

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

Science.gov (United States)

Etxaniz, Josu; Aranguren, Gerardo

2017-04-30

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

Nursing perception of patient transitions from hospitals to home with home health.

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Smith, Shannon Bright; Alexander, Judith W

2012-01-01

The study's purpose was to determine nurses' opinions of sending patients from the hospital to home with home health services. The study occurred in the Charleston, South Carolina, Tricounty area (Berkeley, Charleston, and Dorchester counties). Home health agencies and hospitals were invited to participate. The study used a survey design to gather information on nursing perceptions of current practices and needed changes to improve transition of patients. The population was nurses (licensed practical nurses (LPNs) and registered nurses (RNs)) employed at inpatient hospitals or home health agencies in the area. Thirty-four RNs responded with no LPNs respondents. Agency administrators/chief nursing officers agreed for their agencies to participate and distributed the survey using a Research Electronic Data Capture (REDCap) Internet-based survey tool. Using the survey results and information from a literature review, the study developed a list of propositions, which participating administrators reviewed, for improving transitions to home. Both home health and hospital nurses reported a need to improve the process of sending patients from hospital to home with home health services. This study provides hospitals and home health agencies with propositions to facilitate the establishment of a process to communicate effectively patients care needs and streamline the discharging patients from the hospital to home health care; thus, improving patient transition. Case managers and discharge planners will need interagency collaboration along with evidence-based interventions to transition patients from the hospital to home with home health services with various populations. Direct patient care nurses in both hospital and home health settings should share the same accountability as case managers to ensure successful transitions.

A Solution Based on Bluetooth Low Energy for Smart Home Energy Management

Directory of Open Access Journals (Sweden)

Mario Collotta

2015-10-01

Full Text Available The research and the implementation of home automation are getting more popular because the Internet of Things holds promise for making homes smarter through wireless technologies. The installation of systems based on wireless networks can play a key role also in the extension of the smart grid towards smart homes, that can be deemed as one of the most important components of smart grids. This paper proposes a fuzzy-based solution for smart energy management in a home automation wireless network. The approach, by using Bluetooth Low Energy (BLE, introduces a Fuzzy Logic Controller (FLC in order to improve a Home Energy Management (HEM scheme, addressing the power load of standby appliances and their loads in different hours of the day. Since the consumer is involved in the choice of switching on/off of home appliances, the approach introduced in this work proposes a fuzzy-based solution in order to manage the consumer feedbacks. Simulation results show that the proposed solution is efficient in terms of reducing peak load demand, electricity consumption charges with an increase comfort level of consumers. The performance of the proposed BLE-based wireless network scenario are validated in terms of packet delivery ratio, delay, and jitter and are compared to IEEE 802.15.4 technology.

The application of autostereoscopic display in smart home system based on mobile devices

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Zhang, Yongjun; Ling, Zhi

2015-03-01

Smart home is a system to control home devices which are more and more popular in our daily life. Mobile intelligent terminals based on smart homes have been developed, make remote controlling and monitoring possible with smartphones or tablets. On the other hand, 3D stereo display technology developed rapidly in recent years. Therefore, a iPad-based smart home system adopts autostereoscopic display as the control interface is proposed to improve the userfriendliness of using experiences. In consideration of iPad's limited hardware capabilities, we introduced a 3D image synthesizing method based on parallel processing with Graphic Processing Unit (GPU) implemented it with OpenGL ES Application Programming Interface (API) library on IOS platforms for real-time autostereoscopic displaying. Compared to the traditional smart home system, the proposed system applied autostereoscopic display into smart home system's control interface enhanced the reality, user-friendliness and visual comfort of interface.

Home Automation System Based on Intelligent Transducer Enablers

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Suárez-Albela, Manuel; Fraga-Lamas, Paula; Fernández-Caramés, Tiago M.; Dapena, Adriana; González-López, Miguel

2016-01-01

This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers), which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet. PMID:27690031

Home Automation System Based on Intelligent Transducer Enablers.

Science.gov (United States)

Suárez-Albela, Manuel; Fraga-Lamas, Paula; Fernández-Caramés, Tiago M; Dapena, Adriana; González-López, Miguel

2016-09-28

This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers), which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet.

Home Automation System Based on Intelligent Transducer Enablers

Directory of Open Access Journals (Sweden)

Manuel Suárez-Albela

2016-09-01

Full Text Available This paper presents a novel home automation system named HASITE (Home Automation System based on Intelligent Transducer Enablers, which has been specifically designed to identify and configure transducers easily and quickly. These features are especially useful in situations where many transducers are deployed, since their setup becomes a cumbersome task that consumes a significant amount of time and human resources. HASITE simplifies the deployment of a home automation system by using wireless networks and both self-configuration and self-registration protocols. Thanks to the application of these three elements, HASITE is able to add new transducers by just powering them up. According to the tests performed in different realistic scenarios, a transducer is ready to be used in less than 13 s. Moreover, all HASITE functionalities can be accessed through an API, which also allows for the integration of third-party systems. As an example, an Android application based on the API is presented. Remote users can use it to interact with transducers by just using a regular smartphone or a tablet.

Toward a More Usable Home-Based Video Telemedicine System: A Heuristic Evaluation of the Clinician User Interfaces of Home-Based Video Telemedicine Systems.

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Agnisarman, Sruthy; Narasimha, Shraddhaa; Chalil Madathil, Kapil; Welch, Brandon; Brinda, Fnu; Ashok, Aparna; McElligott, James

2017-04-24

Telemedicine is the use of technology to provide and support health care when distance separates the clinical service and the patient. Home-based telemedicine systems involve the use of such technology for medical support and care connecting the patient from the comfort of their homes with the clinician. In order for such a system to be used extensively, it is necessary to understand not only the issues faced by the patients in using them but also the clinician. The aim of this study was to conduct a heuristic evaluation of 4 telemedicine software platforms-Doxy.me, Polycom, Vidyo, and VSee-to assess possible problems and limitations that could affect the usability of the system from the clinician's perspective. It was found that 5 experts individually evaluated all four systems using Nielsen's list of heuristics, classifying the issues based on a severity rating scale. A total of 46 unique problems were identified by the experts. The heuristics most frequently violated were visibility of system status and Error prevention amounting to 24% (11/46 issues) each. Esthetic and minimalist design was second contributing to 13% (6/46 issues) of the total errors. Heuristic evaluation coupled with a severity rating scale was found to be an effective method for identifying problems with the systems. Prioritization of these problems based on the rating provides a good starting point for resolving the issues affecting these platforms. There is a need for better transparency and a more streamlined approach for how physicians use telemedicine systems. Visibility of the system status and speaking the users' language are keys for achieving this. ©Sruthy Agnisarman, Shraddhaa Narasimha, Kapil Chalil Madathil, Brandon Welch, FNU Brinda, Aparna Ashok, James McElligott. Originally published in JMIR Human Factors (http://humanfactors.jmir.org), 24.04.2017.

The Sweet-Home project: audio processing and decision making in smart home to improve well-being and reliance.

Science.gov (United States)

Vacher, Michel; Chahuara, Pedro; Lecouteux, Benjamin; Istrate, Dan; Portet, Francois; Joubert, Thierry; Sehili, Mohamed; Meillon, Brigitte; Bonnefond, Nicolas; Fabre, Sébastien; Roux, Camille; Caffiau, Sybille

2013-01-01

The Sweet-Home project aims at providing audio-based interaction technology that lets the user have full control over their home environment, at detecting distress situations and at easing the social inclusion of the elderly and frail population. This paper presents an overview of the project focusing on the implemented techniques for speech and sound recognition as context-aware decision making with uncertainty. A user experiment in a smart home demonstrates the interest of this audio-based technology.

Outcome prediction in home- and community-based brain injury rehabilitation using the Mayo-Portland Adaptability Inventory.

Science.gov (United States)

Malec, James F; Parrot, Devan; Altman, Irwin M; Swick, Shannon

2015-01-01

The objective of the study was to develop statistical formulas to predict levels of community participation on discharge from post-hospital brain injury rehabilitation using retrospective data analysis. Data were collected from seven geographically distinct programmes in a home- and community-based brain injury rehabilitation provider network. Participants were 642 individuals with post-traumatic brain injury. Interventions consisted of home- and community-based brain injury rehabilitation. The main outcome measure was the Mayo-Portland Adaptability Inventory (MPAI-4) Participation Index. Linear discriminant models using admission MPAI-4 Participation Index score and log chronicity correctly predicted excellent (no to minimal participation limitations), very good (very mild participation limitations), good (mild participation limitations), and limited (significant participation limitations) outcome levels at discharge. Predicting broad outcome categories for post-hospital rehabilitation programmes based on admission assessment data appears feasible and valid. Equations to provide patients and families with probability statements on admission about expected levels of outcome are provided. It is unknown to what degree these prediction equations can be reliably applied and valid in other settings.

Meeting psychosocial needs for persons with dementia in home care services - a qualitative study of different perceptions and practices among health care providers.

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Hansen, Anette; Hauge, Solveig; Bergland, Ådel

2017-09-11

The majority of persons with dementia are home-dwelling. To enable these persons to stay in their own homes as long as possible, a holistic, individual and flexible care is recommended. Despite a requirement for meeting psychological, social and physical needs, home care services seem to focus on patients' physical needs. Accordingly, the aim of this study was to explore how the psychosocial needs of home-dwelling, older persons with dementia were perceived, emphasized and met by home care services. A descriptive, qualitative approach was used. Data were collected through semi-structured focus group interviews with 24 health care providers in home care services from four municipalities. Data were analysed using systematic text condensation. This study showed major differences in how health care providers perceived the psychosocial needs of older home-dwelling persons with dementia and how they perceived their responsibilities for meeting those psychosocial needs. The differences in the health care providers' perceptions seemed to significantly influence the provided care. Three co-existing logics of care were identified: the physical need-oriented logic, the renouncement logic and the integrated logic. The differences in how health care providers perceived the psychosocial needs of persons with dementia and their responsibilities for meeting those needs, influenced how the psychosocial needs were met. These differences indicates a need for a clarification of how psychosocial needs should be conceptualized and who should be responsible for meeting these needs. Further, increased competence and increased consciousness of psychosocial needs and how those needs can be met, are essential for delivering high-quality holistic care that enables persons with dementia to live in their own home for as long as possible.

Comparative economic evaluation of home-based and hospital-based palliative care for terminal cancer patients.

Science.gov (United States)

Kato, Koki; Fukuda, Haruhisa

2017-11-01

To quantify the difference between adjusted costs for home-based palliative care and hospital-based palliative care in terminally ill cancer patients. We carried out a case-control study of home-care patients (cases) who had died at home between January 2009 and December 2013, and hospital-care patients (controls) who had died at a hospital between April 2008 and December 2013. Data on patient characteristics were obtained from insurance claims data and medical records. We identified the determinants of home care using a multivariate logistic regression analysis. Cox proportional hazards analysis was used to examine treatment duration in both types of care, and a generalized linear model was used to estimate the reduction in treatment costs associated with home care. The case and control groups comprised 48 and 99 patients, respectively. Home care was associated with one or more person(s) living with the patient (adjusted OR 6.54, 95% CI 1.18-36.05), required assistance for activities of daily living (adjusted OR 3.61, 95% CI 1.12-10.51), non-use of oxygen inhalation therapy (adjusted OR 12.75, 95% CI 3.53-46.02), oral or suppository opioid use (adjusted OR 5.74, 95% CI 1.11-29.54) and transdermal patch opioid use (adjusted OR 8.30, 95% CI 1.97-34.93). The adjusted hazard ratio of home care for treatment duration was not significant (adjusted OR 0.95, 95% CI 0.59-1.53). However, home care was significantly associated with a reduction of $7523 (95% CI $7093-7991, P = 0.015) in treatment costs. Despite similar treatment durations between the groups, treatment costs were substantially lower in the home-care group. These findings might inform the policymaking process for improving the home-care support system. Geriatr Gerontol Int 2017; 17: 2247-2254. © 2017 Japan Geriatrics Society.

Facility and home based HIV Counseling and Testing: a comparative analysis of uptake of services by rural communities in southwestern Uganda

Directory of Open Access Journals (Sweden)

Guerra Ranieri

2011-03-01

Full Text Available Abstract Background In Uganda, public human immunodeficiency virus (HIV Voluntary Counseling and Testing (VCT services are mainly provided through the facility based model, although the home based approach is being promoted as a strategy for improving access to VCT. However the uptake of VCT varies according to service delivery model and is influenced by a number of factors. The aim of this study therefore, was to compare predictors for uptake of facility and home based VCT in a rural context. Methods A longitudinal study with cross-sectional investigative phases was conducted at two sites (Rugando and Kabingo in southwestern Uganda between November 2007 (baseline and March 2008 (follow up. During the baseline visit, facility based VCT was offered at the main health centre in Rugando while home based VCT was offered at the household level in Kabingo and a mixed survey questionnaire administered to the respondents. The results presented in this paper are derived from only the baseline data. Results Nine hundred ninety four (994 respondents were interviewed, of whom 500 received facility based VCT in Rugando and 494 home based VCT in Kabingo during the baseline visit. The respondents had a mean age of 32.2 years (SD 10.9 and were mainly female (68 percent. Clients who received facility based VCT were less likely to be residents of the more rural households (adjusted Odds Ratio (aOR = 0.14, 95% CI 0.07, 0.22. The clients who received home based VCT were less likely to report having an STI symptom (aOR = 0.63, 95% CI 0.46, 0.86, and more likely to be worried about discrimination if they contracted AIDS (aOR = 1.78, 95% CI 1.22, 2.61. Conclusion The uptake of VCT provided through either the facility or home based models is influenced by client characteristics such as proximity to service delivery points, HIV related symptoms, and fear of discrimination in rural Uganda. Interventions that seek to improve uptake of VCT should provide potential clients

Quality management in home care: models for today's practice.

Science.gov (United States)

Verhey, M P

1996-01-01

In less than a decade, home care providers have been a part of two major transitions in health care delivery. First, because of the advent of managed care and a shift from inpatient to community-based services, home care service delivery systems have experienced tremendous growth. Second, the principles and practices of total quality management and continuous quality improvement have permeated the organization, administration, and practice of home health care. Based on the work of Deming, Juran, and Crosby, the basic tenets of the new quality management philosophy involve a focus on the following five key areas: (1) systems and processes rather than individual performance; (2) involvement, collaboration, and empowerment; (3) internal and external "customers"; (4) data and measurement; and (5) standards, guidelines, and outcomes of care. Home care providers are among those in the forefront who are developing and implementing programs that integrate these foci into the delivery of quality home care services. This article provides a summary of current home care programs that address these five key areas of quality management philosophy and provide models for innovative quality management practice in home care. For further information about each program, readers are referred to the original reports in the home care and quality management journal literature, as cited herein.

Intelligent Home Control System Based on Single Chip Microcomputer

Science.gov (United States)

Yang, Libo

2017-12-01

Intelligent home as a way to achieve the realization of the family information has become an important part of the development of social information, Internet of Things because of its huge application prospects, will be smart home industry in the development process of a more realistic breakthrough in the smart home industry development has great significance. This article is based on easy to implement, easy to operate, close to the use of the design concept, the use of STC89C52 microcontroller as the control core for the control terminal, and including infrared remote control, buttons, Web interface, including multiple control sources to control household appliances. The second chapter of this paper describes the design of the hardware and software part of the specific implementation, the fifth chapter is based on the design of a good function to build a specific example of the environment.

The efficacy of unsupervised home-based exercise regimens in comparison to supervised laboratory-based exercise training upon cardio-respiratory health facets.

Science.gov (United States)

Blackwell, James; Atherton, Philip J; Smith, Kenneth; Doleman, Brett; Williams, John P; Lund, Jonathan N; Phillips, Bethan E

2017-09-01

Supervised high-intensity interval training (HIIT) can rapidly improve cardiorespiratory fitness (CRF). However, the effectiveness of time-efficient unsupervised home-based interventions is unknown. Eighteen volunteers completed either: laboratory-HIIT (L-HIIT); home-HIIT (H-HIIT) or home-isometric hand-grip training (H-IHGT). CRF improved significantly in L-HIIT and H-HIIT groups, with blood pressure improvements in the H-IHGT group only. H-HIIT offers a practical, time-efficient exercise mode to improve CRF, away from the laboratory environment. H-IHGT potentially provides a viable alternative to modify blood pressure in those unable to participate in whole-body exercise. © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

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

Science.gov (United States)

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

2018-04-06

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

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

Science.gov (United States)

Kralik, Debbie; Anderson, Barbara

2008-11-01

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

What is a 'secure base' when death is approaching? A study applying attachment theory to adult patients' and family members' experiences of palliative home care.

Science.gov (United States)

Milberg, A; Wåhlberg, R; Jakobsson, M; Olsson, E-C; Olsson, M; Friedrichsen, M

2012-08-01

Attachment theory has received much interest lately in relation to how adults cope with stress and severe illness. The aim of this study was using the experiences of patients and family members to explore palliative home care as a 'secure base' (a central concept within the theory). Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed with deductive qualitative content analysis. Informants expressed the relevance of sensing security during palliative home care because death and dying were threats that contributed to vulnerability. Palliative home care could foster a feeling of security and provide a secure base. This was facilitated when informants had trust in staff (e.g. due to availability and competence in providing symptom relief), felt recognised as individuals and welcomed to contact the team in times of needs. Being comfortable, informed and having an everyday life also contributed to a perception of palliative home care as a secure base. Family members stressed the importance of being relieved from responsibilities that were too heavy. The underlying meanings of experiencing palliative home care as a secure base involved gaining a sense of control and of inner peace, perceiving that despite a demanding and changed life situation, one could continue partially being oneself and having something to hope for, even if this no longer concerned cure for the ill person. Important aspects of palliative home care as providing a secure base were identified and these have implications for clinical practice. Copyright © 2011 John Wiley & Sons, Ltd.

Smart-Home Architecture Based on Bluetooth mesh Technology

Science.gov (United States)

Wan, Qing; Liu, Jianghua

2018-03-01

This paper describes the smart home network system based on Nordic nrf52832 device. Nrf52832 is new generation RF SOC device focus on sensor monitor and low power Bluetooth connection applications. In this smart home system, we set up a self-organizing network system which consists of one control node and a lot of monitor nodes. The control node manages the whole network works; the monitor nodes collect the sensor information such as light intensity, temperature, humidity, PM2.5, etc. Then update to the control node by Bluetooth mesh network. The design results show that the Bluetooth mesh wireless network system is flexible and construction cost is low, which is suitable for the communication characteristics of a smart home network. We believe it will be wildly used in the future.

Back disorders and lumbar load in nursing staff in geriatric care: a comparison of home-based care and nursing homes

Directory of Open Access Journals (Sweden)

Beck Barbara-Beate

2009-12-01

Full Text Available Abstract Background Back pain is one of the most frequent complaints in the nursing profession. Thus, the 12-month prevalence of pain in the lumbar spine in nursing staff is as high as 76%. Only a few representative studies have assessed the prevalence rates of back pain and its risk factors among nursing staff in nursing homes in comparison to staff in home-based care facilities. The present study accordingly investigates the prevalence in the lumbar and cervical spine and determines the physical workload to lifting and caring in geriatric care. Methods 1390 health care workers in nursing homes and home care participated in this cross sectional survey. The nursing staff members were examined by occupational physicians according to the principals of the multistep diagnosis of musculoskeletal disorders. Occupational exposure to daily care activities with patient transfers was measured by a standardised questionnaire. The lumbar load was calculated with the Mainz-Dortmund dose model. Information on ergonomic conditions were recorded from the management of the nursing homes. Comparisons of all outcome variables were made between both care settings. Results Complete documentation, including the findings from the occupational physicians and the questionnaire, was available for 41%. Staff in nursing homes had more often positive orthopaedic findings than staff in home care. At the same time the values calculated for lumbar load were found to be significant higher in staff in nursing homes than in home-based care: 45% vs. 6% were above the reference value. Nursing homes were well equipped with technical lifting aids, though their provision with assistive advices is unsatisfactory. Situation in home care seems worse, especially as the staff often has to get by without assistance. Conclusions Future interventions should focus on counteracting work-related lumbar load among staff in nursing homes. Equipment and training in handling of assistive devices

Managing the Drivers of Air Flow and Water Vapor Transport in Existing Single Family Homes (Revised)

Energy Technology Data Exchange (ETDEWEB)

Cummings, J.; Withers, C.; Martin, E.; Moyer, N.

2012-10-01

This document focuses on managing the driving forces which move air and moisture across the building envelope. While other previously published Measure Guidelines focus on elimination of air pathways, the ultimate goal of this Measure Guideline is to manage drivers which cause air flow and water vapor transport across the building envelope (and also within the home), control air infiltration, keep relative humidity (RH) within acceptable limits, avoid combustion safety problems, improve occupant comfort, and reduce house energy use.

The Judaic-Christian origin of nursing homes.

Science.gov (United States)

Brandeis, Gary H; Oates, Daniel J

2007-06-01

Many nursing homes today have a religious heritage. While governmental regulations control how much of the care is delivered, the foundations and goals of many homes predate governmental rules and payment policies. This paper explores the basis of Jewish and Christian thought in providing groundwork for religiously based nursing homes. Although the underlying principles are similar, differences in approach and execution for the formation of these homes exist.

Intelligent Control of Home Appliances via Network

DEFF Research Database (Denmark)

Rossello Busquet, Ana

platform which guaranties interoperability, as well as scalability and flexibility. Therefore, a home gateway prototype has been developed in JAVA. This implementation offers the required capabilities for a Home Energy Management System, i.e. it enables the user to monitor and control the home devices......, in addition to providing energy management strategies to reduce electricity consumption. Reducing energy consumption in home environments has become crucial to meet the "20-20-20" targets set by European Commission Climate Action. However, reducing energy in home environments is not sufficient. The power grid......This thesis addresses selected topics of energy management in home environments and ICT for the Smart Grid. However, those two topics are vast and only a few aspects of them have been discussed. This thesis focuses on providing a home energy management solution based on a technology independent...

Just-in-Time Evidence-Based E-mail “Reminders” in Home Health Care: Impact on Nurse Practices

Science.gov (United States)

Murtaugh, Christopher M; Pezzin, Liliana E; McDonald, Margaret V; Feldman, Penny H; Peng, Timothy R

2005-01-01

Objective To test the effectiveness of two interventions designed to improve the adoption of evidence-based practices by home health nurses caring for heart failure (HF) patients. Data Sources/Study Setting Information on nurse practices was abstracted from the clinical records of patients admitted between June 2000 and November 2001 to the care of 354 study nurses at a large, urban, nonprofit home care agency. Study Design The study employed a randomized design with nurses assigned to usual care or one of two intervention groups upon identification of an eligible patient. The basic intervention was a one-time e-mail reminder highlighting six HF-specific clinical recommendations. The augmented intervention consisted of the initial e-mail reminder supplemented by provider prompts, patient education material, and clinical nurse specialist outreach. Data Collection At each home health visit provided by a study nurse to an eligible HF patient during the 45-day follow-up period, a structured chart abstraction tool was used to collect information on whether the nurse provided the care practices highlighted in the e-mail reminder. Principal Findings Both the basic and the augmented interventions greatly increased the practice of evidence-based care, according to patient records, in the areas of patient assessment and instructions about HF disease management. While not all results were statistically significant at conventional levels, intervention effects were positive in virtually all cases and effect magnitudes frequently were large. Conclusions The results of this randomized trial strongly support the efficacy of just-in-time evidence-based reminders as a means of changing clinical practice among home health nurses who are geographically dispersed and spend much of their time in the field. PMID:15960694

Assessment of Home-Based Nigerian Engineers on Risk ...

African Journals Online (AJOL)

Assessment of Home-Based Nigerian Engineers on Risk Management Approach ... Journal of Applied Sciences and Environmental Management ... The Analysis of Variance (ANOVA) and Correlation methods were adopted for statistical ...

Current-based detection of nonlocal spin transport in graphene for spin-based logic applications

Science.gov (United States)

Wen, Hua; Zhu, Tiancong; Luo, Yunqiu Kelly; Amamou, Walid; Kawakami, Roland K.

2014-05-01

Graphene has been proposed for novel spintronic devices due to its robust and efficient spin transport properties at room temperature. Some of the most promising proposals require current-based readout for integration purposes, but the current-based detection of spin accumulation has not yet been developed. In this work, we demonstrate current-based detection of spin transport in graphene using a modified nonlocal geometry. By adding a variable shunt resistor in parallel to the nonlocal voltmeter, we are able to systematically cross over from the conventional voltage-based detection to current-based detection. As the shunt resistor is reduced, the output current from the spin accumulation increases as the shunt resistance drops below a characteristic value R*. We analyze this behavior using a one-dimensional drift-diffusion model, which accounts well for the observed behavior. These results provide the experimental and theoretical foundation for current-based detection of nonlocal spin transport.

Home-based mobile cardio-pulmonary rehabilitation consultant system.

Science.gov (United States)

Lee, Hsu-En; Wang, Wen-Chih; Lu, Shao-Wei; Wu, Bo-Yuan; Ko, Li-Wei

2011-01-01

Cardiovascular diseases are the most popular cause of death in the world recently. For postoperatives, cardiac rehabilitation is still asked to maintain at home (phase II) to improve cardiac function. However, only one third of outpatients do the exercise regularly, reflecting the difficulty for home-based healthcare: lacking of monitoring and motivation. Hence, a cardio-pulmonary rehabilitation system was proposed in this research to improve rehabilitation efficiency for better prognosis. The proposed system was built on mobile phone and receiving electrocardiograph (ECG) signal from a wireless ECG holter via Bluetooth connection. Apart from heart rate (HR) monitor, an ECG derived respiration (EDR) technique is also included to provide respiration rate (RR). Both HR and RR are the most important vital signs during exercise but only used one physiological signal recorder in this system. In clinical test, there were 15 subjects affording Bruce Task (treadmill) to simulate rehabilitation procedure. Correlation between this system and commercial product (Custo-Med) was up to 98% in HR and 81% in RR. Considering the prevention of sudden heart attack, an arrhythmia detection expert system and healthcare server at the backend were also integrated to this system for comprehensive cardio-pulmonary monitoring whenever and wherever doing the exercise.

Future Directions of Applying Healthcare Cloud for Home-based Chronic Disease Care

OpenAIRE

Hu, Yan; Eriksén, Sara; Lundberg, Jenny

2017-01-01

The care of chronic disease has become the main challenge for healthcare institutions around the world. To meet the growing needs of patients, moving the front desk of healthcare from hospital to home is essential. Recently, cloud computing has been applied to healthcare domain; however, adapting to and using this technology effectively for home-based care is still in its initial phase. We have proposed a conceptual hybrid cloud model for home-based chronic disease care, and have evaluated it...

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

Science.gov (United States)

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

2017-02-01

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

Flux-based transport enhancement as a plausible unifying mechanism for auxin transport in meristem development.

Directory of Open Access Journals (Sweden)

Szymon Stoma

2008-10-01

Full Text Available Plants continuously generate new organs through the activity of populations of stem cells called meristems. The shoot apical meristem initiates leaves, flowers, and lateral meristems in highly ordered, spiralled, or whorled patterns via a process called phyllotaxis. It is commonly accepted that the active transport of the plant hormone auxin plays a major role in this process. Current hypotheses propose that cellular hormone transporters of the PIN family would create local auxin maxima at precise positions, which in turn would lead to organ initiation. To explain how auxin transporters could create hormone fluxes to distinct regions within the plant, different concepts have been proposed. A major hypothesis, canalization, proposes that the auxin transporters act by amplifying and stabilizing existing fluxes, which could be initiated, for example, by local diffusion. This convincingly explains the organised auxin fluxes during vein formation, but for the shoot apical meristem a second hypothesis was proposed, where the hormone would be systematically transported towards the areas with the highest concentrations. This implies the coexistence of two radically different mechanisms for PIN allocation in the membrane, one based on flux sensing and the other on local concentration sensing. Because these patterning processes require the interaction of hundreds of cells, it is impossible to estimate on a purely intuitive basis if a particular scenario is plausible or not. Therefore, computational modelling provides a powerful means to test this type of complex hypothesis. Here, using a dedicated computer simulation tool, we show that a flux-based polarization hypothesis is able to explain auxin transport at the shoot meristem as well, thus providing a unifying concept for the control of auxin distribution in the plant. Further experiments are now required to distinguish between flux-based polarization and other hypotheses.

Small and Home-Based Businesses: Measures of Success and the Contribution of Local Development Services

Science.gov (United States)

Brooks, Lara; Whitacre, Brian; Shideler, Dave; Muske, Glenn; Woods, Mike

2012-01-01

Small and home-based businesses have long been identified by Extension educators as an important component of economic development, particularly in rural areas. The services available to these businesses can take many forms, including management training, accessibility of local funding, providing incubation facilities, or setting up mentoring…

Effectiveness of an Internet-based learning program on venous leg ulcer nursing care in home health care--study protocol.

Science.gov (United States)

Ylönen, Minna; Viljamaa, Jaakko; Isoaho, Hannu; Junttila, Kristiina; Leino-Kilpi, Helena; Suhonen, Riitta

2015-10-01

To describe the study protocol for a study of the effectiveness of an internet-based learning program on venous leg ulcer nursing care (eVLU) in home health care. The prevalence of venous leg ulcers is increasing as population age. The majority of these patients are treated in a municipal home healthcare setting. However, studies show nurses' lack of knowledge of ulcer nursing care. Quasi-experimental study with pre- and postmeasurements and non-equivalent intervention and comparison groups. During the study, nurses taking care of patients with a chronic leg ulcer in home health care in one Finnish municipality will use the eVLU. Nurses working in home health care in another Finnish municipality will not use it providing standard care. Nurses will complete three questionnaires during the study and they will also be observed three times at patients' homes. Nurses' perceived and theoretical knowledge is the primary outcome of the study. Funding for this study was received from the Finnish Foundation for Nursing Education in 2014. Data from this study will provide information about the effectiveness of an internet-based educational program. After completing the program nurses will be accustomed to using internet-based resources that can aid them in the nursing care of patients with a VLU. Nurses will also have better knowledge of VLU nursing care. This study is registered with the International Clinical Trials Registry, identifier NCT02224300. © 2015 John Wiley & Sons Ltd.

The integrated evaluation of the macro environment of companies providing transport services

Directory of Open Access Journals (Sweden)

A. Žvirblis

2008-09-01

Full Text Available The article presents the main principles of the integrated evaluation of macro environment components and factors influencing the performance of transport companies as well as providing the validated quantitative evaluation models and results obtained in evaluating the macro environment of Lithuanian companies providing transport services. Since quantitative evaluation is growing in importance, the process of developing the principles and methods of business macro environment quantitative evaluation is becoming relevant from both theoretical and practical perspectives. The created methodology is based on the concept of macro environment as an integrated whole of components, formalization and the principle of three-stage quantitative evaluation. The methodology suggested involves the quantitative evaluation of primary factors and macro environment components as an integral dimension (expressed in points. On the basis of this principle, an integrated macro environment evaluation parameter is established as its level index. The methodology integrates the identification of significant factors, building scenarios, a primary analysis of factors, expert evaluation, the quantitative evaluation of macro environment components and their whole. The application of the multi-criteria Simple Additive Weighting (SAW method is validated. The integrated evaluation of the macro environment of Lithuanian freight transportation companies was conducted. As a result, the level indices of all components as well as the level index of macro environment considered as a whole of components were identified. The latter reflects the extent of deviation from an average level of a favourable macro environment. This is important for developing strategic marketing decisions and expanding a strategic area.

Design and methodology of a randomized clinical trial of home-based telemental health treatment for U.S. military personnel and veterans with depression.

Science.gov (United States)

Luxton, David D; Pruitt, Larry D; O'Brien, Karen; Stanfill, Katherine; Jenkins-Guarnieri, Michael A; Johnson, Kristine; Wagner, Amy; Thomas, Elissa; Gahm, Gregory A

2014-05-01

Home-based telemental health (TMH) treatments have the potential to address current and future health needs of military service members, veterans, and their families, especially for those who live in rural or underserved areas. The use of home-based TMH treatments to address the behavioral health care needs of U.S. military healthcare beneficiaries is not presently considered standard of care in the Military Health System. The feasibility, safety, and clinical efficacy of home-based TMH treatments must be established before broad dissemination of home-based treatment programs can be implemented. This paper describes the design, methodology, and protocol of a clinical trial that compares in-office to home-based Behavioral Activation for Depression (BATD) treatment delivered via web-based video technology for service members and veterans with depression. This grant funded three-year randomized clinical trial is being conducted at the National Center for Telehealth and Technology at Joint-base Lewis-McChord and at the Portland VA Medical Center. Best practice recommendations regarding the implementation of in-home telehealth in the military setting as well as the cultural and contextual factors of providing in-home care to active duty and veteran military populations are also discussed. Published by Elsevier Inc.

76 FR 16354 - Per Diem Payments for the Care Provided to Eligible Veterans Evacuated From a State Home as a...

Science.gov (United States)

2011-03-23

... Payments for the Care Provided to Eligible Veterans Evacuated from a State Home as a Result of an Emergency..., Office of Patient Care Services (114), Veterans Health Administration, Department of Veterans Affairs... for each eligible veteran receiving nursing home care, domiciliary care, and adult day health care in...

Montessori-based training makes a difference for home health workers & their clients.

Science.gov (United States)

Gorzelle, Gregg J; Kaiser, Kathy; Camp, Cameron J

2003-01-01

Home care visits can last several hours. Home care workers are often at a loss on how to fill time spent in homes of clients. The challenge is how to use this time in ways that are productive and engaging for both clients and home health workers. The authors trained home health aides to implement Montessori-based activities while interacting with clients who have dementia. The results were amazing. Among other positive results, the authors found a statistically significant increase in the amount of pleasure displayed by clients after health workers received training.

Effect of Caffeine on Attention and Alertness Measured in a Home-Setting, Using Web-Based Cognition Tests.

Science.gov (United States)

Pasman, Wilrike J; Boessen, Ruud; Donner, Yoni; Clabbers, Nard; Boorsma, André

2017-09-07

There is an increasing interest among nutritional researchers to perform lifestyle and nutritional intervention studies in a home setting instead of testing subjects in a clinical unit. The term used in other disciplines is 'ecological validity' stressing a realistic situation. This becomes more and more feasible because devices and self-tests that enable such studies are more commonly available. Here, we present such a study in which we reproduced the effect of caffeine on attention and alertness in an at-home setting. The study was aimed to reproduce the effect of caffeine on attention and alertness using a Web-based study environment of subjects, at home, performing different Web-based cognition tests. The study was designed as a randomized, placebo-controlled, double-blind, crossover study. Subjects were provided with coffee sachets (2 with and 2 without caffeine). They were also provided with a written instruction of the test days. Healthy volunteers consumed a cup of coffee after an overnight fast. Each intervention was repeated once. Before and 1 hour after coffee consumption subjects performed Web-based cognitive performance tests at home, which measured alertness and attention, established by 3 computerized tests provided by QuantifiedMind. Each test was performed for 5 minutes. Web-based recruitment was fast and efficient. Within 2 weeks, 102 subjects applied, of whom 70 were eligible. Of the 66 subjects who started the study, 53 completed all 4 test sessions (80%), indicating that they were able to perform the do it yourself tests, at home, correctly. The Go-No Go cognition test performed at home showed the same significant improvement in reaction time with caffeine as found in controlled studies in a metabolic ward (P=.02). For coding and N-back the second block was performed approximately 10% faster. No effect was seen on correctness. The study showed that the effects of caffeine consumption on a cognition test in an at-home setting revealed similar

Impact on postpartum hemorrhage of prophylactic administration of oxytocin 10 IU via UnijectTM by peripheral health care providers at home births: design of a community-based cluster-randomized trial

Directory of Open Access Journals (Sweden)

Stanton Cynthia K

2012-06-01

Full Text Available Abstract Background Hemorrhage is the leading direct cause of maternal death globally. While oxytocin is the drug of choice for postpartum hemorrhage prevention, its use has generally been limited to health facilities. This trial assesses the effectiveness, safety, and feasibility of expanding the use of prophylactic intramuscular oxytocin to peripheral health care providers at home births in four predominantly rural districts in central Ghana. Methods This study is designed as a community-based cluster-randomized trial in which Community Health Officers are randomized to provide (or not provide an injection of oxytocin 10 IU via the UnijectTM injection system within one minute of delivery of the baby to women who request their presence at home at the onset of labor. The primary aim is to determine if administration of prophylactic oxytocin via Uniject™ by this cadre will reduce the risk of postpartum hemorrhage by 50 % relative to deliveries which do not receive the prophylactic intervention. Postpartum hemorrhage is examined under three sequential definitions: 1 blood loss ≥500 ml (BL; 2 treatment for bleeding (TX and/or BL; 3 hospital referral for bleeding and/or TX and/or BL. Secondary outcomes address safety and feasibility of the intervention and include adverse maternal and fetal outcomes and logistical concerns regarding assistance at home births and the storage and handling of oxytocin, respectively. Discussion Results from this trial will build evidence for the effectiveness of expanding the delivery of this established prophylactic intervention to peripheral settings. Complementary data on safety and logistical issues related to this intervention will assist policymakers in low-income countries in selecting both the best uterotonic and service delivery strategy for postpartum hemorrhage prevention. Results of this trial are expected in mid-2013. The trial is registered at ClinicalTrials.gov: NCT01108289.

WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings

OpenAIRE

Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

2015-01-01

Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home...

Newborn care practices and home-based postnatal newborn care programme – Mewat, Haryana, India, 2013

Directory of Open Access Journals (Sweden)

Latika Nath Sinha

2014-09-01

Full Text Available Background: In India, the Home Based Postnatal Newborn Care programme by Accredited Social Health Activists (ASHAs under the National Rural Health Mission was initiated in 2011 to reduce neonatal mortality rates (NMRs. ASHAs get cash incentives for six postnatal home visits for newborn care. We studied newborn care practices among mothers in Mewat, Haryana, having a high NMR and determined risk factors for unsafe practices and described the knowledge and skills of ASHAs during home visits. Methods: A cross-sectional survey was conducted among mothers who had delivered a child during the previous seven months using cluster sampling. We interviewed mothers and ASHAs in the selected subcentres using semi–structured questionnaires on the six safe newborn care practices, namely safe breastfeeding, keeping cord and eyes clean, wrapping baby, kangaroo care, delayed bathing and hand washing. Results: We interviewed 320 mothers, 61 ASHAs and observed 19 home visits. Overall, 60% of mothers adopted less than three safe practices. Wrapping newborns (96% and delayed bathing (64% were better adopted than cord care (49%, safe breastfeeding (48%, hand washing (30%, kangaroo care (20% and eye care (9%. Cultural beliefs and traditional birth attendants influenced the mother’s practices. The lack of supervision by auxiliary nurse midwives (ANM, delayed referral and transportation were the other challenges. Conclusion: Knowledge–practice gaps existed among mothers counselled by ASHAs. Poor utilization of reproductive and child health services decreased opportunities for ASHA–mother dialogue on safe practices. Recommendations included training ANMs, training TBAs as ASHAs, innovative communication strategies for ASHAs and improved referral system.

Rural Alberta Home-Based Businesses: A Profile of Workshop Participants.

Science.gov (United States)

Capjack, M. Linda; Fetterman, Nelma I.

1992-01-01

Of 252 rural Alberta attendees of home-based business workshops, 60 were in business. Of these, 65 percent produced sewing, textile, or food-related products; 73 percent contributed less than 5 percent of family income; 72 percent worked at home because a hobby became profitable; and the majority were married women over 40. (SK)

Transportation optimization with fuzzy trapezoidal numbers based on possibility theory.

Science.gov (United States)

He, Dayi; Li, Ran; Huang, Qi; Lei, Ping

2014-01-01

In this paper, a parametric method is introduced to solve fuzzy transportation problem. Considering that parameters of transportation problem have uncertainties, this paper develops a generalized fuzzy transportation problem with fuzzy supply, demand and cost. For simplicity, these parameters are assumed to be fuzzy trapezoidal numbers. Based on possibility theory and consistent with decision-makers' subjectiveness and practical requirements, the fuzzy transportation problem is transformed to a crisp linear transportation problem by defuzzifying fuzzy constraints and objectives with application of fractile and modality approach. Finally, a numerical example is provided to exemplify the application of fuzzy transportation programming and to verify the validity of the proposed methods.

Distance-Based Access Modifiers Applied to Safety in Home Networks

DEFF Research Database (Denmark)

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

2004-01-01

Home networks and the interconnection of home appliances is a classical theme in ubiquitous computing research. Security is a recurring concern, but there is a lack of awareness of safety: preventing the computerized house from harming the inhabitants, even in a worst-case scenario where...... be performed within a physical proximity that ensures safety. We use a declarative approach integrated with an IDL language to express location-based restrictions on operations. This model has been implemented in a middleware for home audio-video devices, using infrared communication and a local-area network...

Enabling affordable and efficiently deployed location based smart home systems.

Science.gov (United States)

Kelly, Damian; McLoone, Sean; Dishongh, Terry

2009-01-01

With the obvious eldercare capabilities of smart environments it is a question of "when", rather than "if", these technologies will be routinely integrated into the design of future houses. In the meantime, health monitoring applications must be integrated into already complete home environments. However, there is significant effort involved in installing the hardware necessary to monitor the movements of an elder throughout an environment. Our work seeks to address the high infrastructure requirements of traditional location-based smart home systems by developing an extremely low infrastructure localisation technique. A study of the most efficient method of obtaining calibration data for an environment is conducted and different mobile devices are compared for localisation accuracy and cost trade-off. It is believed that these developments will contribute towards more efficiently deployed location-based smart home systems.

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

OpenAIRE

Peng Qingchao

2016-01-01

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

Home safe home: Evaluation of a childhood home safety program.

Science.gov (United States)

Stewart, Tanya Charyk; Clark, Andrew; Gilliland, Jason; Miller, Michael R; Edwards, Jane; Haidar, Tania; Batey, Brandon; Vogt, Kelly N; Parry, Neil G; Fraser, Douglas D; Merritt, Neil

2016-09-01

The London Health Sciences Centre Home Safety Program (HSP) provides safety devices, education, a safety video, and home safety checklist to all first-time parents for the reduction of childhood home injuries. The objective of this study was to evaluate the HSP for the prevention of home injuries in children up to 2 years of age. A program evaluation was performed with follow-up survey, along with an interrupted time series analysis of emergency department (ED) visits for home injuries 5 years before (2007-2013) and 2 years after (2013-2015) implementation. Spatial analysis of ED visits was undertaken to assess differences in home injury rates by dissemination areas controlling differences in socioeconomic status (i.e., income, education, and lone-parent status) at the neighborhood level. A total of 3,458 first-time parents participated in the HSP (a 74% compliance rate). Of these, 20% (n = 696) of parents responded to our questionnaire, with 94% reporting the program to be useful (median, 6; interquartile range, 2 on a 7-point Likert scale) and 81% learning new strategies for preventing home injuries. The median age of the respondent's babies were 12 months (interquartile range, 1). The home safety check list was used by 87% of respondents to identify hazards in their home, with 95% taking action to minimize the risk. The time series analysis demonstrated a significant decline in ED visits for home injuries in toddlers younger than2 years of age after HSP implementation. The declines in ED visits for home injuries remained significant over and above each socioeconomic status covariate. Removing hazards, supervision, and installing safety devices are key facilitators in the reduction of home injuries. Parents found the HSP useful to identify hazards, learn new strategies, build confidence, and provide safety products. Initial finding suggests that the program is effective in reducing home injuries in children up to 2 years of age. Therapeutic/care management study

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

Science.gov (United States)

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

2008-08-01

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

Home or hospital? Midwife or physician? Preferences for maternity care provider and place of birth among Western Australian students.

Science.gov (United States)

Stoll, Kathrin H; Hauck, Yvonne L; Hall, Wendy A

2016-02-01

Australian caesarean birth rates have exceeded 30% in most states and are approaching 45%, on average, in private hospitals. Australian midwifery practice occurs almost exclusively in hospitals; less than 3% of women deliver at home or in birthing centres. It is unclear whether the trend towards hospital-based, high interventionist birth reflects preferences of the next generation of maternity care consumers. We conducted a descriptive cross-sectional online survey of 760 Western Australian (WA) university students in 2014, to examine their preferences for place of birth, type of maternity care, mode of birth and attitudes towards birth. More students who preferred midwives (35.8%) had vaginal birth intentions, contested statements that birth is unpredictable and risky, and valued patient-provider relationships. More students who preferred obstetricians (21.8%) expressed concerns about childbirth safety, feared birth, held favourable views towards obstetric technology, and expressed concerns about the impact of pregnancy and birth on the female body. One in 8 students preferred out-of-hospital birth settings, supporting consumer demand for midwife-attended births at home and in birthing centres. Stories and experiences of friends and family shaped students' care provider preferences, rather than the media or information learned at school. Students who express preferences for midwives have significantly different views about birth compared to students who prefer obstetricians. Increasing access to midwifery care in all settings (hospital, birthing centre and home) is a cost effective strategy to decrease obstetric interventions for low risk women and a desirable option for the next generation. Copyright © 2015 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

Co-creative design developments for accessibility and home automation

OpenAIRE

Taib, SM; De Coster, R; Sabri Tekantape, E

2017-01-01

The term “Home Automation” can be referred to a networked home, which provides electronically controlled security and convenience for its users. Home automation is also defined as the integration of home-based technology and services for a better quality of living (Quynh, et al., 2012). The main purpose of home automation technologies is to enhance home comfort for everyone through the automation of higher security, domestic tasks and easy communication. Home automation should be able to enha...

Policy-based Network Management in Home Area Networks: Interim Test Results

OpenAIRE

Ibrahim Rana, Annie; Ó Foghlú, Mícheál

2009-01-01

This paper argues that Home Area Networks (HANs) are a good candidate for advanced network management automation techniques, such as Policy-Based Network Management (PBNM). What is proposed is a simple use of policy based network management to introduce some level of Quality of Service (QoS) and Security management in the HAN, whilst hiding this complexity from the home user. In this paper we have presented the interim test results of our research experiments (based on a scenario) using the H...

Comparative effectiveness and acceptability of home-based and clinic-based sampling methods for sexually transmissible infections screening in females aged 14-50 years: a systematic review and meta-analysis.

Science.gov (United States)

Odesanmi, Tolulope Y; Wasti, Sharada P; Odesanmi, Omolola S; Adegbola, Omololu; Oguntuase, Olubukola O; Mahmood, Sajid

2013-12-01

Home-based sampling is a strategy to enhance uptake of sexually transmissible infection (STI) screening. This review aimed to compare the screening uptake levels of home-based self-sampling and clinic-based specimen collection for STIs (chlamydia (Chlamydia trachomatis), gonorrhoea (Neisseria gonorrhoeae) and trichomoniasis) in females aged 14-50 years. Acceptability and effect on specimen quality were determined. Sixteen electronic databases were searched from inception to September 2012. Randomised controlled trials (RCTs) comparing the uptake levels of home-based self-sampling and clinic-based sampling for chlamydia, gonorrhoea and trichomoniasis in females aged 14-50 years were eligible for inclusion. The risk of bias in the trials was assessed. Risk ratios (RRs) for dichotomous outcomes were meta-analysed. Of 3065 papers, six studies with seven RCTs contributed to the final review. Compared with clinic-based methods, home-based screening increased uptake significantly (P=0.001-0.05) in five trials and was substantiated in a meta-analysis (RR: 1.55; 95% confidence interval: 1.30-1.85; P=0.00001) of two trials. In three trials, a significant preference for home-based testing (P=0.001-0.05) was expressed. No significant difference was observed in specimen quality. Sampling was rated as easy by a significantly higher number of women (P=0.01) in the clinic group in one trial. The review provides evidence that home-based testing results in greater uptake of STI screening in females (14-50 years) than clinic-based testing without compromising quality in the developed world. Home collection strategies should be added to clinic-based screening programs to enhance uptake.

Individualized, home-based interactive training of cerebral palsy children delivered through the Internet

DEFF Research Database (Denmark)

Bilde, Peder E; Kliim-Due, Mette; Rasmussen, Betina

2011-01-01

The available health resources limit the amount of therapy that may be offered to children with cerebral palsy and the amount of training in each session may be insufficient to drive the neuroplastic changes, which are necessary for functional improvements to take place. The aim of this pilot study...... was to provide proof of concept that individualized and supervised interactive home-based training delivered through the internet may provide an efficient way of maintaining intensive training of children with cerebral palsy over prolonged periods....

Smart GSM Based Home Automation System

OpenAIRE

Teymourzadeh, Rozita

2013-01-01

This research work investigates the potential of ‘Full Home Control’, which is the aim of the Home Automation Systems in near future. The analysis and implementation of the home automation technology using Global System for Mobile Communication (GSM) modem to control home appliances such as light, conditional system, and security system via Short Message Service (SMS) text messages is presented in this paper. The proposed research work is focused on the functionality of the GSM protocol, whic...

Costing of three feeding regimens for home-based management of children with uncomplicated severe acute malnutrition from a randomised trial in India.

Science.gov (United States)

Garg, Charu C; Mazumder, Sarmila; Taneja, Sunita; Shekhar, Medha; Mohan, Sanjana Brahmawar; Bose, Anuradha; Iyengar, Sharad D; Bahl, Rajiv; Martines, Jose; Bhandari, Nita

2018-01-01

Three feeding regimens-centrally produced ready-to-use therapeutic food, locally produced ready-to-use therapeutic food, and augmented, energy-dense, home-prepared food-were provided in a community setting for children with severe acute malnutrition (SAM) in the age group of 6-59 months in an individually randomised multicentre trial that enrolled 906 children. Foods, counselling, feeding support and treatment for mild illnesses were provided until recovery or 16 weeks. Costs were estimated for 371 children enrolled in Delhi in a semiurban location after active survey and identification, enrolment, diagnosis and treatment for mild illnesses, and finally treatment with one of the three regimens, both under the research and government setting. Direct costs were estimated for human resources using a price times quantity approach, based on their salaries and average time taken for each activity. The cost per week per child for food, medicines and other consumables was estimated based on the total expenditure over the period and children covered. Indirect costs for programme management including training, transport, non-consumables, infrastructure and equipment were estimated per week per child based on total expenditures for research study and making suitable adjustments for estimations under government setting. No significant difference in costs was found across the three regimens per covered or per treated child. The average cost per treated child in the government setting was estimated at US$56 (based management of SAM with a locally produced ready-to-use therapeutic food is feasible, acceptable, affordable and very cost-effective in terms of the disability-adjusted life years saved and gross national income per capita of the country. The treatment of SAM at home needs serious attention and integration into the existing health system, along with actions to prevent SAM. NCT01705769; Pre-results.

The unique experience of home for parents and carers of children with disabilities.

Science.gov (United States)

Aplin, Tammy; Thornton, Heloise; Gustafsson, Louise

2017-01-24

The aim of this paper was to investigate the experience of home for parents and carers of children with disabilities in Australia. Data for this qualitative study were gathered using semi-structured interviews with four families living in their own homes. An inductive thematic analysis revealed two main themes. The first was titled 'Aspects making everyday life easier' explored the aspects of the home environment that facilitated home life for the child, including access to transport, services, family and home modifications. The second theme 'Decisions and efforts to create opportunities for the child' emphasized the efforts made by parents and carers to promote their child's independence and participation including a strong consideration for their children's future needs. The study indicated that the location of home, appropriate home modifications and planning for the future defined the experience of home for parents and carers. These findings identify some important considerations for occupational therapists when providing services in the homes of families with children who have a disability.

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

Science.gov (United States)

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

2017-10-23

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

Behaviour change techniques in home-based cardiac rehabilitation: a systematic review

OpenAIRE

Heron, Neil; Kee, Frank; Donnelly, Michael; Cardwell, Christopher; Tully, Mark A; Cupples, Margaret E

2016-01-01

BACKGROUND: Cardiac rehabilitation (CR) programmes offering secondary prevention for cardiovascular disease (CVD) advise healthy lifestyle behaviours, with the behaviour change techniques (BCTs) of goals and planning, feedback and monitoring, and social support recommended. More information is needed about BCT use in home-based CR to support these programmes in practice.AIM: To identify and describe the use of BCTs in home-based CR programmes.DESIGN AND SETTING: Randomised controlled trials o...

A Smart Home Center Platform Solution Based on Smart Mirror

Directory of Open Access Journals (Sweden)

Deng Xibo

2017-01-01

Full Text Available With the popularization of the concept of smart home, people have raised requirements on the experience of smart living. A smart home platform center solution is put forward in order to solve the intelligent interoperability and information integration of smart home, which enable people to have a more intelligent and convenient life experience. This platform center is achieved through the Smart Mirror. The Smart Mirror refers to a smart furniture, on the basis of the traditional concept of mirror, combining Raspberry Pi, the application of one-way mirror imaging principle, the touch－enabled design, voice and video interaction. Smart Mirror can provide a series of intelligent experience for the residents, such as controlling all the intelligent furniture through Smart Mirror; accessing and displaying the weather, time, news and other life information; monitoring the home environment; remote interconnection operation.

Exploring new health markets: experiences from informal providers of transport for maternal health services in Eastern Uganda

Directory of Open Access Journals (Sweden)

Bloom Gerald

2011-03-01

Full Text Available Abstract Background Although a number of intermediate transport initiatives have been used in some developing countries, available evidence reveals a dearth of local knowledge on the effect of these rural informal transport mechanisms on access to maternal health care services, the cost of implementing such schemes and their scalability. This paper, attempts to provide insights into the functioning of the informal transport markets in facilitating access to maternal health care. It also demonstrates the role that higher institutions of learning can play in designing projects that can increase the utilization of maternal health services. Objectives To explore the use of intermediate transport mechanisms to improve access to maternal health services, with emphasis on the benefits and unintended consequences of the transport scheme, as well as challenges in the implementation of the scheme. Methods This paper is based on the pilot phase to inform a quasi experimental study aimed at increasing access to maternal health services using demand and supply side incentives. The data collection for this paper included qualitative and quantitative methods that included focus group interviews, review of project documents and facility level data. Results There was a marked increase in attendance of antenatal, and delivery care services, with the contracted transporters playing a leading role in mobilizing mothers to attend services. The project also had economic spill-over effects to the transport providers, their families and community generally. However, some challenges were faced including difficulty in setting prices for paying transporters, and poor enforcement of existing traffic regulations. Conclusions and implications The findings indicate that locally existing resources such as motorcycle riders, also known as “boda boda” can be used innovatively to reduce challenges caused by geographical inaccessibility and a poor transport network with

Effectiveness of a home-based pulmonary rehabilitation programme ...

African Journals Online (AJOL)

week home-based pulmonary rehabilitation programme (PRP) improved the baseline measurements of lung function, exercise tolerance and health-related quality of life (HRQoL) in patients receiving out-patient treatment for PTB. Method: A single ...

76 FR 55570 - Per Diem Payments for the Care Provided to Eligible Veterans Evacuated From a State Home as a...

Science.gov (United States)

2011-09-08

... relocated due to emergency. (a) Definition of emergency. For the purposes of this section, emergency means... Provided to Eligible Veterans Evacuated From a State Home as a Result of an Emergency AGENCY: Department of... for veterans who have been evacuated from a State home as a result of an emergency. Per diem is the...

Wildcat wellness coaching feasibility trial: protocol for home-based health behavior mentoring in girls.

Science.gov (United States)

Cull, Brooke J; Rosenkranz, Sara K; Dzewaltowski, David A; Teeman, Colby S; Knutson, Cassandra K; Rosenkranz, Richard R

2016-01-01

Childhood obesity is a major public health problem, with one third of America's children classified as either overweight or obese. Obesity prevention and health promotion programs using components such as wellness coaching and home-based interventions have shown promise, but there is a lack of published research evaluating the impact of a combined home-based and wellness coaching intervention for obesity prevention and health promotion in young girls. The main objective of this study is to test the feasibility of such an intervention on metrics related to recruitment, intervention delivery, and health-related outcome assessments. The secondary outcome is to evaluate the possibility of change in health-related psychosocial, behavioral, and biomedical outcomes in our sample of participants. Forty girls who are overweight or obese (aged 8-13 years) will be recruited from a Midwestern college town. Participants will be recruited through posted flyers, newspaper advertisements, email, and social media. The volunteer convenience sample of girls will be randomized to one of two home-based wellness coaching interventions: a general health education condition or a healthy eating physical activity skills condition. Trained female wellness coaches will conduct weekly hour-long home visits for 12 consecutive weeks. Assessments will occur at baseline, post-intervention (3 months after baseline), and follow-up (6 months after baseline) and will include height, weight, waist circumference, body composition, pulmonary function, blood pressure, systemic inflammation, physical activity (Actical accelerometer), and self-reported survey measures (relevant to fruit and vegetable consumption, physical activity, and quality of life). This study will evaluate the feasibility of home-based wellness coaching interventions for overweight and obese girls and secondarily assess the preliminary impact on health-related psychosocial, behavioral, and biomedical outcomes. Results will provide

Subjective Response to Simulated Sonic Booms in Homes

Science.gov (United States)

McCurdy, David A.; Brown, Sherilyn A.

1996-01-01

One of the environmental issues affecting the development of a second-generation supersonic commercial transport is the impact of sonic booms on people. Aircraft designers are attempting to design the transport to produce sonic boom signatures that will have minimum impact on the public. Current supersonic commercial aircraft produce an 'N-wave' sonic boom pressure signature that is considered unacceptable by the public. This has resulted in first-generation supersonic transports being banned from flying supersonic over land in the United States, a severe economic constraint. By tailoring aircraft volume and lift distributions, designers hope to produce sonic boom signatures having specific shapes other than 'N-wave' that may be more acceptable to the public. As part of the effort to develop a second-generation supersonic commercial transport, Langley Research Center is conducting research to study people's subjective response to sonic booms. As part of that research, a system was developed for performing studies of the subjective response of people to the occurrence of simulated sonic booms in their homes. The In-Home Noise Generation/Response System (IHONORS) provides a degree of situational realism not available in the laboratory and a degree of control over the noise exposure not found in community surveys. The computer-controlled audio system generates the simulated sonic booms, measures the noise levels, and records the subjects' ratings and can be placed and operated in individual homes for extended periods of time. The system was used to conduct an in-home study of subjective response to simulated sonic booms. The primary objective of the study was to determine the effect on annoyance of the number of sonic boom occurrences in a realistic environment. The effects on annoyance of several other parameters were also examined. Initially, data analyses were based on all the data collected. However, further analyser found that test subjects adapted to the sonic

Sensor-Based Optimization Model for Air Quality Improvement in Home IoT.

Science.gov (United States)

Kim, Jonghyuk; Hwangbo, Hyunwoo

2018-03-23

We introduce current home Internet of Things (IoT) technology and present research on its various forms and applications in real life. In addition, we describe IoT marketing strategies as well as specific modeling techniques for improving air quality, a key home IoT service. To this end, we summarize the latest research on sensor-based home IoT, studies on indoor air quality, and technical studies on random data generation. In addition, we develop an air quality improvement model that can be readily applied to the market by acquiring initial analytical data and building infrastructures using spectrum/density analysis and the natural cubic spline method. Accordingly, we generate related data based on user behavioral values. We integrate the logic into the existing home IoT system to enable users to easily access the system through the Web or mobile applications. We expect that the present introduction of a practical marketing application method will contribute to enhancing the expansion of the home IoT market.

Data base of accident and agricultural statistics for transportation risk assessment

Energy Technology Data Exchange (ETDEWEB)

Saricks, C.L.; Williams, R.G.; Hopf, M.R.

1989-11-01

A state-level data base of accident and agricultural statistics has been developed to support risk assessment for transportation of spent nuclear fuels and high-level radioactive wastes. This data base will enhance the modeling capabilities for more route-specific analyses of potential risks associated with transportation of these wastes to a disposal site. The data base and methodology used to develop state-specific accident and agricultural data bases are described, and summaries of accident and agricultural statistics are provided. 27 refs., 9 tabs.

Data base of accident and agricultural statistics for transportation risk assessment

International Nuclear Information System (INIS)

Saricks, C.L.; Williams, R.G.; Hopf, M.R.

1989-11-01

A state-level data base of accident and agricultural statistics has been developed to support risk assessment for transportation of spent nuclear fuels and high-level radioactive wastes. This data base will enhance the modeling capabilities for more route-specific analyses of potential risks associated with transportation of these wastes to a disposal site. The data base and methodology used to develop state-specific accident and agricultural data bases are described, and summaries of accident and agricultural statistics are provided. 27 refs., 9 tabs

"No place like home": Gender, family, and the politics of home care in post-world war II Ontario.

Science.gov (United States)

Struthers, James

2003-01-01

Since the early 1990s home care increasingly has emerged as a favoured policy response to the growing costs which an aging population poses for our health care system. This paper explores the early history of home care for the elderly in Ontario during the first three decades after World War II. It demonstrates that policy debates over the merits of home versus institutional care for the elderly, and community-based over hospital-based approaches to home care are not recent phenomenon but have been on going since the 1940s within the public health and social services sector. The paper examines why home care failed for so long to develop beyond the margins of Ontario's highly institutionalized health care system. It also explores how earlier visions of community-based home care, designed to help the elderly age in place, increasingly were obscured by an exclusive preoccupation with home care's "cost effectiveness" as an alternative to hospital or residential care, a rationale which discounted home care's costs to unpaid and principally female care givers. The paper concludes that the Ontario health ministry's systematic devaluing of caregiving and home maker skills, the fear of undermining the family's willingness to provide care, as well as the failure to develop effective mechanisms for integrated regional health care planning, also impeded the progress of home care's development before the 1980s.

Unmet home healthcare needs and quality of life in cancer patients: a hospital-based Turkish sample.

Science.gov (United States)

Ataman, Gülsen; Erbaydar, Tugrul

2017-07-01

Home healthcare services in Turkey are provided primarily to patients that are bedridden or seriously disabled. There are no such services integrated with hospital services that are specifically designed for cancer patients. The present study aimed to explore the home healthcare needs of cancer patients and their experiences related to unmet home healthcare needs. The study included 394 adult cancer patients who were followed up at the surgical oncology department of a university hospital. A 37-item, study-specific questionnaire and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire for cancer patients (EORTC-QLQ-C30) were administered, and patient clinical records were evaluated. Home healthcare was provided primarily by the patients' immediate family members; the professional home healthcare usage rate was only 2.8%. Patient quality of life (QoL) was negatively affected by cancer, especially those with stage three and four disease. The frequency of the need for home healthcare services due to disease-related health problems during the 30 days prior to administration of the questionnaires was as follows: pain (62.9%), surgical wound care (44.9%), injection of therapeutics (52.3%), gastrointestinal complaints (51.8%), anxiety (87.1%), psychosocial assistance (77.2%) and information about cancer (94.4%). In the absence of home healthcare services, the patients primarily used institutional healthcare services to meet their needs; otherwise, their needs were not met. The physical and psychosocial problems that cancer patients experience could be solved in most cases by professional home healthcare services. Hospital-integrated home healthcare services might not only improve cancer patient QoL but might also increase the effectiveness of hospital-based healthcare services. © 2017 John Wiley & Sons Ltd.

Palliative home-based technology from a practitioner's perspective: benefits and disadvantages

OpenAIRE

Johnston, Bridget

2014-01-01

Bridget M Johnston Sue Ryder Care Centre for the Study of Supportive, Palliative, and End of Life Care, School of Health Sciences, University of Nottingham, Queen's Medical Centre, Nottingham, UK Abstract: This critical review paper explores the concept of palliative home-based technology from a practitioner's perspective. The aim of the critical review was to scope information available from published and unpublished research on the current state of palliative home-based tec...

Modelling home equity conversion loans with life insurance models

Directory of Open Access Journals (Sweden)

Baškot Bojan

2013-01-01

Full Text Available Home equity represents a reserve that can be used for providing additional money for its owners during their retirement. Life insurance models can be successfully applied to model home equity conversion loans. The home equity conversion loan is a financial product that provides a certain flexibility by using home equity as a resource for a quality life during retirement. Home equity conversion loans do not have a predetermined maturity date, as do conventional loans. But, like every loan, it must be repaid. One potential advantage of using a home equity conversion loan during tough financial times instead of some types of need-based assistance is that eligibility is straightforward. Home equity conversion loans can be useful tools in the process of pension system reform.

Behavior Drift Detection Based on Anomalies Identification in Home Living Quantitative Indicators

OpenAIRE

Fabio Veronese; Andrea Masciadri; Sara Comai; Matteo Matteucci; Fabio Salice

2018-01-01

Home Automation and Smart Homes diffusion are providing an interesting opportunity to implement elderly monitoring. This is a new valid technological support to allow in-place aging of seniors by means of a detection system to notify potential anomalies. Monitoring has been implemented by means of Complex Event Processing on live streams of home automation data: this allows the analysis of the behavior of the house inhabitant through quantitative indicators. Different kinds of quantitative in...

Patient-centered medical home implementation and primary care provider turnover.

Science.gov (United States)

Sylling, Philip W; Wong, Edwin S; Liu, Chuan-Fen; Hernandez, Susan E; Batten, Adam J; Helfrich, Christian D; Nelson, Karin; Fihn, Stephan D; Hebert, Paul L

2014-12-01

The Veterans Health Administration (VHA) began implementing a patient-centered medical home (PCMH) model of care delivery in April 2010 through its Patient Aligned Care Team (PACT) initiative. PACT represents a substantial system reengineering of VHA primary care and its potential effect on primary care provider (PCP) turnover is an important but unexplored relationship. This study examined the association between a system-wide PCMH implementation and PCP turnover. This was a retrospective, longitudinal study of VHA-employed PCPs spanning 29 calendar quarters before PACT and eight quarters of PACT implementation. PCP employment periods were identified from administrative data and turnover was defined by an indicator on the last quarter of each uncensored period. An interrupted time series model was used to estimate the association between PACT and turnover, adjusting for secular trend and seasonality, provider and job characteristics, and local unemployment. We calculated average marginal effects (AME), which reflected the change in turnover probability associated with PACT implementation. The quarterly rate of PCP turnover was 3.06% before PACT and 3.38% after initiation of PACT. In adjusted analysis, PACT was associated with a modest increase in turnover (AME=4.0 additional PCPs per 1000 PCPs per quarter, P=0.004). Models with interaction terms suggested that the PACT-related change in turnover was increasing in provider age and experience. PACT was associated with a modest increase in PCP turnover, concentrated among older and more experienced providers, during initial implementation. Our findings suggest that policymakers should evaluate potential workforce effects when implementing PCMH.

Parental Perceptions of Child Care Quality in Centre-Based and Home-Based Settings: Associations with External Quality Ratings

Science.gov (United States)

Lehrer, Joanne S.; Lemay, Lise; Bigras, Nathalie

2015-01-01

The current study examined how parental perceptions of child care quality were related to external quality ratings and considered how parental perceptions of quality varied according to child care context (home-based or centre-based settings). Parents of 179 4-year-old children who attended child care centres (n = 141) and home-based settings…

Cross-Platform Android/iOS-Based Smart Switch Control Middleware in a Digital Home

Directory of Open Access Journals (Sweden)

Guo Jie

2015-01-01

Full Text Available With technological and economic development, people’s lives have been improved substantially, especially their home environments. One of the key aspects of these improvements is home intellectualization, whose core is the smart home control system. Furthermore, as smart phones have become increasingly popular, we can use them to control the home system through Wi-Fi, Bluetooth, and GSM. This means that control with phones is more convenient and fast and now becomes the primary terminal controller in the smart home. In this paper, we propose middleware for developing a cross-platform Android/iOS-based solution for smart switch control software, focus on the Wi-Fi based communication protocols between the cellphone and the smart switch, achieved a plugin-based smart switch function, defined and implemented the JavaScript interface, and then implemented the cross-platform Android/iOS-based smart switch control software; also the scenarios are illustrated. Finally, tests were performed after the completed realization of the smart switch control system.

Effectiveness of a home-based pulmonary rehabilitation programme ...

African Journals Online (AJOL)

AZ-505), exercise tolerance using the 6-min-walk test (6MWT), the Borg exercise exertion scale and ... determine whether a six week home-based Pulmonary. Rehabilitation ..... the study was consistent with the scenario relating to the historical ...

Home-based exercise may not decrease the insulin resistance in individuals with metabolic syndrome.

Science.gov (United States)

Chen, Chiao-Nan; Chuang, Lee-Ming; Korivi, Mallikarjuna; Wu, Ying-Tai

2015-01-01

This study investigated the differences in exercise self-efficacy, compliance, and effectiveness of home-based exercise in individuals with and without metabolic syndrome (MetS). One hundred and ten individuals at risk for diabetes participated in this study. Subjects were categorized into individuals with MetS and individuals without MetS. Metabolic risk factors and exercise self-efficacy were evaluated for all subjects before and after 3 months of home-based exercise. Univariate analysis of variance was used to compare the effectiveness of a home-based exercise program between individuals with and without MetS. The home-based exercise program improved body mass index and lipid profile in individuals at risk for diabetes, regardless of MetS status at baseline. Individuals without MetS had higher exercise self-efficacy at baseline and performed greater exercise volume compared with individuals with MetS during the intervention. The increased exercise volume in individuals without MetS may contribute to their better control of insulin resistance than individuals with MetS. Furthermore, baseline exercise self-efficacy was correlated with exercise volume executed by subjects at home. We conclude that home-based exercise programs are beneficial for individuals at risk for diabetes. However, more intensive and/or supervised exercise intervention may be needed for those with MetS.

Home-based versus hospital-based cardiac rehabilitation after myocardial infarction or revascularisation: design and rationale of the Birmingham Rehabilitation Uptake Maximisation Study (BRUM: a randomised controlled trial [ISRCTN72884263

Directory of Open Access Journals (Sweden)

Lane Deirdre

2003-09-01

Full Text Available Abstract Background Cardiac rehabilitation following myocardial infarction reduces subsequent mortality, but uptake and adherence to rehabilitation programmes remains poor, particularly among women, the elderly and ethnic minority groups. Evidence of the effectiveness of home-based cardiac rehabilitation remains limited. This trial evaluates the effectiveness and cost-effectiveness of home-based compared to hospital-based cardiac rehabilitation. Methods/design A pragmatic randomised controlled trial of home-based compared with hospital-based cardiac rehabilitation in four hospitals serving a multi-ethnic inner city population in the United Kingdom was designed. The home programme is nurse-facilitated, manual-based using the Heart Manual. The hospital programmes offer comprehensive cardiac rehabilitation in an out-patient setting. Patients We will randomise 650 adult, English or Punjabi-speaking patients of low-medium risk following myocardial infarction, coronary angioplasty or coronary artery bypass graft who have been referred for cardiac rehabilitation. Main outcome measures Serum cholesterol, smoking cessation, blood pressure, Hospital Anxiety and Depression Score, distance walked on Shuttle walk-test measured at 6, 12 and 24 months. Adherence to the programmes will be estimated using patient self-reports of activity. In-depth interviews with non-attendees and non-adherers will ascertain patient views and the acceptability of the programmes and provide insights about non-attendance and aims to generate a theory of attendance at cardiac rehabilitation. The economic analysis will measure National Health Service costs using resource inputs. Patient costs will be established from the qualitative research, in particular how they affect adherence. Discussion More data are needed on the role of home-based versus hospital-based cardiac rehabilitation for patients following myocardial infarction and revascularisation, which would be provided by the

Development of Home-Based Sleep Monitoring System for Obstructive Sleep Apnea.

Science.gov (United States)

Wu, Peirong; Chen, Guan-Ting; Cui, Yanyan; Li, Jin-Wei; Kuo, Terry B J; Chang, Polun

2017-01-01

Obstructive Sleep Apnea (OSA) has been proven to increase the risk of high blood pressure, heart attack, stroke, obesity, and diabetes. If people would like to know whether they are suffering from this sleep disorder, they need to go to particular hospital with which a sleep center that could perform polysomnography (PSG); however, for most people, this is not convenient. Consequently, the goal of this study is to develop a convenient, lower priced, and easy-to-use home-based sleep monitoring system. The researchers have developed the "Sleep Healthcare Management System" for OSA patients and healthcare providers. It combines smartphone and wearable devices that can perform real-time sleep monitoring. Healthcare providers could apply their professional knowledge to provide customized feedback via a web application. When the patient is diagnosed with an abnormal sleep health condition, healthcare providers may be able to provide appropriate and timely care.

The uniqueness of elderly care: registered nurses' experience as preceptors during clinical practice in nursing homes and home-based care.

Science.gov (United States)

Carlson, Elisabeth; Bengtsson, Mariette

2014-04-01

The expected shortage of registered nurses with an advanced degree as specialists in geriatric care or gerontology is imminent. Previous studies report that clinical practice where student nurses are supervised by registered nurses has a direct impact on how students perceive nursing as a profession and future career choice. Considering the anticipated need for well-educated and specialised nurses it is therefore, relevant as well as necessary to describe clinical learning with a focus on preceptorship in geriatric nursing care. This paper is a report of a study describing registered nurses' experience of precepting undergraduate student nurses during clinical practice in nursing homes and home-based care. A qualitative design, based on seven focus group interviews, was employed with 30 registered nurses with preceptor experience from nursing homes and home-based care for the elderly. Our findings present three precepting strategies that are unique to elderly care: preparing students for end of life care, facilitating a respectful approach to the older person and promoting creativity and independent work. The findings are discussed using a socio-cultural perspective and illustrate how communities of elderly practice can be valuable learning environments. © 2013.

Integrating Parenting Support Within and Beyond the Pediatric Medical Home.

Science.gov (United States)

Linton, Julie M; Stockton, Maria Paz; Andrade, Berta; Daniel, Stephanie

2018-01-01

Positive parenting programs, developmental support services, and evidence-based home visiting programs can effectively provide parenting support and improve health and developmental outcomes for at-risk children. Few models, however, have integrated referrals for on-site support and home visiting programs into the provision of routine pediatric care within a medical home. This article describes an innovative approach, through partnership with a community-based organization, to deliver on-site and home visiting support services for children and families within and beyond the medical home. Our model offers a system of on-site services, including parenting, behavior, and/or development support, with optional intensive home visiting services. Assessment included description of the population served, delineation of services provided, and qualitative identification of key themes of the impact of services, illustrated by case examples. This replicable model describes untapped potential of the pediatric medical home as a springboard to mitigate risk and optimize children's health and development.

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

Science.gov (United States)

Luke, Josh

2016-01-01

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

Home-Based Comprehensive Assessment of Rural Elderly Persons: The CARE Project

Science.gov (United States)

Cravens, David D.; Mehr, David R.; Campbell, James D.; Armer, Jane; Kruse, Robin L.; Rubenstein, Laurence Z.

2005-01-01

Context: Home-based comprehensive geriatric assessment (CGA) has been effective in urban areas but has had little study in rural areas. CGA involves medical history taking, a physical exam, and evaluation of functional status, mental status, cognitive status, gait and balance, medications, vision, extent of social supports, and home safety. We…

Cost-effectiveness implications based on a comparison of nursing home and home health case mix.

OpenAIRE

Kramer, A M; Shaughnessy, P W; Pettigrew, M L

1985-01-01

Case-mix differences between 653 home health care patients and 650 nursing home patients, and between 455 Medicare home health patients and 447 Medicare nursing home patients were assessed using random samples selected from 20 home health agencies and 46 nursing homes in 12 states in 1982 and 1983. Home health patients were younger, had shorter lengths of stay, and were less functionally disabled than nursing home patients. Traditional long-term care problems requiring personal care were more...

Kinect based physiotherapy system for home use

Directory of Open Access Journals (Sweden)

Haas Dominik

2015-09-01

Full Text Available In physiotherapy, rehabilitation outcome is majorly dependent on the patient continuing exercises at home. To support a continuous and correct execution of exercises composed by the physiotherapist it is important that the patient stays motivated. With the emergence of game consoles such as Nintendo Wii, Sony PlayStation or Microsoft Xbox360 that employ special controllers or camera based motion recognition as means of user input those technologies have also been found to be interesting for other real-life applications. We present a concept to employ the Microsoft Kinect system as means to support patients during physiotherapy exercises at home. The system is intended to allow a physiotherapist to compose an individual set of exercises and to control the correct execution of those exercises through tracking the patient’s motions.

77 FR 72738 - Contracts and Provider Agreements for State Home Nursing Home Care

Science.gov (United States)

2012-12-06

..., to implement VA's authority under the Act to enter into provider agreements and contracts to pay for... these veterans using either contracts or provider agreements. Because the Act makes no further.... Paragraph (b) of revised Sec. 51.41 discusses contracts. The Act requires that rates of payments be ``based...

Home-based cardiac rehabilitation for people with heart failure

DEFF Research Database (Denmark)

Zwisler, Ann Dorthe Olsen; Norten, RJ; Dean, SG

2016-01-01

AIMS: To assess the effectiveness of home-based cardiac rehabilitation (CR) for heart failure compared to either usual medical care (i.e. no CR) or centre-based CR on mortality, morbidity, exercise capacity, health-related quality of life, drop out, adherence rates, and costs. METHODS: Randomised...

Dignity of older people in a nursing home: narratives of care providers.

Science.gov (United States)

Jakobsen, Rita; Sørlie, Venke

2010-05-01

The purpose of this study was to illuminate the ethically difficult situations experienced by care providers working in a nursing home. Individual interviews using a narrative approach were conducted. A phenomenological-hermeneutic method developed for researching life experience was applied in the analysis. The findings showed that care providers experience ethical challenges in their everyday work. The informants in this study found the balance between the ideal, autonomy and dignity to be a daily problem. They defined the culture they work in as not supportive. They also thought they were not being seen and heard in situations where they disagree with the basic values of the organization. The results are discussed in terms of Habermas's understanding of modern society. Care settings for elderly people obviously present ethical challenges, particularly in the case of those suffering from dementia. The care provider participants in this study expressed frustration and feelings of powerlessness. It is possible to understand their experiences in terms of Habermas's theory of modern society and the concept of the system's colonization of the life world.

HIV/aids related home based care practices among primary health care workers in Ogun state, Nigeria

Directory of Open Access Journals (Sweden)

E Amoran

2012-05-01

Full Text Available Abstract Background HIV/AIDS is fast becoming a chronic disease with the advent of antiretroviral drugs, therefore making home based care key in the management of chronically ill HIV/AIDS patient. The objective of this study was to determine the perception and practice of health care workers on HIV/AIDS related home based care in the health facilities in Ogun state, Nigeria. Methods This study is an analytical cross-sectional study. A multistage cluster sampling technique was used to obtain a representative sample of the primary health care workers in Ogun state. An interviewer administered structured questionnaire was administered by trained health workers to elicit the required information. Result A total of 350 health care workers were interviewed, 70% of the respondents could adequately describe the components of home based care. Only 38.7% were aware of the National guideline on home based care practices and 17.1% believe that home based care will not significantly improve the prognosis of PLWAs. Few 19.1% had ever been trained or ever involved 16.6% in home based care practices. Only 20 [5.7%] are involved on a weekly basis, 16 [4.6%] monthly and 22 [6.3%] quarterly. Reasons given for non implementation of home based care are inadequate number of healthcare workers 45%, lack of political will 24.4%, lack of implementation by facility managers 14% and inadequate funds 16.6%. Factors that were significantly associated with the practice of home based care were perception of its relevance in improving prognosis [OR = 54.21, C.I = 23.22-129.52] and presence of a support group in the facility [OR = 4.80, C.I = 2.40-9.57]. There was however no statistically significant relationship between adequate knowledge of home based care [OR = 0.78, C.I = 0.39-1.54] and previous training on home based care (OR = 1.43, C.I = 0.66-3.06]. Conclusion The practice of home based care for HIV/AIDS among the study population is low

MDS 3.0 for Nursing Homes and Swing Bed Providers

Data.gov (United States)

U.S. Department of Health & Human Services — The MDS is a powerful tool for implementing standardized assessment and for facilitating care management in nursing homes (NHs) and non-critical access hospital...

Improved Collaborative Transport Planning at Dutch Logistics Service Provider Fritom

NARCIS (Netherlands)

Buijs, Paul; Lopez Alvarez, Jose Alejandro; Veenstra, Marjolein; Roodbergen, Kees Jan

2016-01-01

We study the collaborative transport planning for two autonomous business units of Fritom, a Dutch logistics service provider. This difficult planning problem does not fit any existing type of vehicle routing problem proposed in the academic literature; therefore, we define a new problem class, the

Web-based home rehabilitation gaming system for balance training

Directory of Open Access Journals (Sweden)

Oleh Kachmar

2014-06-01

Full Text Available Currently, most systems for virtual rehabilitation and motor training require quite complex and expensive hardware and can be used only in clinical settings. Now, a low-cost rehabilitation game training system has been developed for patients with movement disorders; it is suitable for home use under the distant supervision of a therapist. It consists of a patient-side application installed on a home computer and the virtual rehabilitation Game Server in the Internet. System can work with different input gaming devices connected through USB or Bluetooth, such as a Nintendo Wii balance board, a Nintendo Wii remote, a MS Kinect sensor, and custom made rehabilitation gaming devices based on a joystick. The same games can be used with all training devices. Assessment of the Home Rehabilitation Gaming System for balance training was performed on six patients with Cerebral Palsy, who went through daily training sessions for two weeks. Preliminary results showed balance improvement in patients with Cerebral Palsy after they had completed home training courses. Further studies are needed to establish medical requirements and evidence length.

Sensor-Based Optimization Model for Air Quality Improvement in Home IoT

Directory of Open Access Journals (Sweden)

Jonghyuk Kim

2018-03-01

Full Text Available We introduce current home Internet of Things (IoT technology and present research on its various forms and applications in real life. In addition, we describe IoT marketing strategies as well as specific modeling techniques for improving air quality, a key home IoT service. To this end, we summarize the latest research on sensor-based home IoT, studies on indoor air quality, and technical studies on random data generation. In addition, we develop an air quality improvement model that can be readily applied to the market by acquiring initial analytical data and building infrastructures using spectrum/density analysis and the natural cubic spline method. Accordingly, we generate related data based on user behavioral values. We integrate the logic into the existing home IoT system to enable users to easily access the system through the Web or mobile applications. We expect that the present introduction of a practical marketing application method will contribute to enhancing the expansion of the home IoT market.

Next Generation Reliable Transport Networks

DEFF Research Database (Denmark)

Zhang, Jiang

the wavelength and fiber assignment problem is proposed and implemented for avionic optical transport networks. Simulation results give out resource consumptions and prove the efficiency of the proposed mechanisms. Finally, a Home Environment Service Knowledge Management system is proposed. Through ontology...... technologies, a knowledge base is constructed to represent the whole information of a home environment. By applying the reasoner tool, the proposed system manages to keep the consistency in a home environment and helps all software configure and update procedures across multiple vendors....... of criticality and security, there are certain physical or logical segregation requirements between the avionic systems. Such segregations can be implemented on the proposed avionic networks with different hierarchies. In order to fulfill the segregation requirements, a tailored heuristic approach for solving...

Access Control in Smart Homes by Android-Based Liveness Detection

Directory of Open Access Journals (Sweden)

Susanna Spinsante

2017-05-01

Full Text Available Technologies for personal safety and security play an increasing role in modern life, and are among the most valuable features expected to be supported by so-called smart homes. This paper presents a low-complexity Android application designed for both mobile and embedded devices, that exploits the available on-board camera to easily capture two images of a subject, and processes them to discriminate a true 3D and live face, from a fake or printed 2D one. The liveness detection based on such a discrimination provides anti-spoofing capabilities to secure access control based on face recognition. The limited computational complexity of the developed application makes it suitable for practical implementation in video-entry phones based on embedded Android platforms. The results obtained are satisfactory even in different ambient light conditions, and further improvements are being developed to deal with low precision image acquisition.

Measuring and Assuring the Quality of Home Health Care

Science.gov (United States)

Shaughnessy, Peter W.; Crisler, Kathryn S.; Schlenker, Robert E.; Arnold, Angela G.; Kramer, Andrew M.; Powell, Martha C.; Hittle, David F.

1994-01-01

The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assurance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basis in a partnership between the home health industry and payers or regulators. PMID:10140157

Quality and use of consumer information provided with home test kits: room for improvement.

Science.gov (United States)

Grispen, Janaica E J; Ickenroth, Martine H P; de Vries, Nanne K; van der Weijden, Trudy; Ronda, Gaby

2014-10-01

Diagnostic self-tests (tests on body materials that are initiated by consumers with the aim of diagnosing a disorder or risk factor) are becoming increasingly available. Although the pros and cons of self-testing are currently not clear, it is an existing phenomenon that is likely to gain further popularity. To examine consumers' use of and needs for information about self-testing, and to assess the quality of consumer information provided with home test kits, as perceived by consumers and as assessed using a checklist of quality criteria. A cross-sectional Internet survey among 305 self-testers assessed their use of and needs for information and their perception of the quality of consumer information provided with self-test kits. A meta-search engine was used to identify Dutch and English consumer information for home diagnostic tests available online at the time of the study. The quality of this consumer information was evaluated using a checklist of quality criteria. The consumers' information needs were in line with the most frequently used information, and the information was perceived as being of moderate to good quality. The information was mostly in agreement with clinical practice guidelines, although information on reliability and follow-up behaviour was limited. Approximately half of the instruction leaflets did not include information on the target group of the test. Although generally of moderate to good quality, some aspects of the information provided were in many cases insufficient. European legislation concerning self-tests and accompanying information needs to be adapted and adhered to more closely. © 2012 John Wiley & Sons Ltd.

Home based care practices by caregivers of under five children with ...

African Journals Online (AJOL)

Background: Home treatment for childhood febrile illness is a common practice among caregivers in Nigeria as well as some other countries in sub- Saharan Africa. The aim of the study was to assess the home based care practices of caregivers of under- five children with febrile illnesses as seen in the general paediatric ...

Music Therapy Clinical Practice in Hospice: Differences Between Home and Nursing Home Delivery.

Science.gov (United States)

Liu, Xiaodi; Burns, Debra S; Hilliard, Russell E; Stump, Timothy E; Unroe, Kathleen T

2015-01-01

Hospice music therapy is delivered in both homes and nursing homes (NH). No studies to date have explored differences in music therapy delivery between home and NH hospice patients. To compare music therapy referral reasons and delivery for hospice patients living in NH versus home. A retrospective, electronic medical record review was conducted from a large U.S. hospice of patients receiving music therapy between January 1, 2006, and December 31, 2010. Among the 4,804 patients, 2,930 lived in an NH and 1,847 patients lived at home. Compared to home, NH hospice patients were more likely to be female, older, unmarried, and Caucasian. For home hospice patients, the top referral reasons were patient/family emotional and spiritual support, quality of life, and isolation. The most frequent referral reasons for NH hospice patients were isolation, quality of life, and patient/family emotional and spiritual support. Differences in music therapy delivery depended mainly on patients' primary diagnosis and location of care. Results suggest differences in referral reasons and delivery based on an interaction between location of care and patient characteristics. Delivery differences are likely a result of individualized assessment and care plans developed by the music therapist and other interdisciplinary team members to address the unique needs of the patient. Thus, it is important to have professionally trained music therapists assess and provide tailored music-based interventions for patients with different referral reasons and personal characteristics. This study also supports staffing decisions based on patient need rather than average daily census. © the American Music Therapy Association 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Fallout radiation protection provided by transportation vehicles

Energy Technology Data Exchange (ETDEWEB)

Burson, Z.G.

1972-10-20

Fallout radiation protection factors (PF's) were estimated for a variety of civilian transportation vehicles using measurements of the natural terrain radiation as a source. The PF values are below 2 in light vehicles, truck beds, or trailers; from 2.5 to 3 in the cabs of heavy trucks and in a railway guard car; and from 3.0 to 3.5 in the engineer's seat of heavy locomotives. This information can be useful in planning the possible movement of personnel from or through areas contaminated either by a wartime incident or a peacetime accident. The information may also be useful for studying the reduction of exposure to the natural terrestrial radiation environment provided by vehicles.

Sensor Network-Based and User-Friendly User Location Discovery for Future Smart Homes.

Science.gov (United States)

Ahvar, Ehsan; Lee, Gyu Myoung; Han, Son N; Crespi, Noel; Khan, Imran

2016-06-27

User location is crucial context information for future smart homes where many location based services will be proposed. This location necessarily means that User Location Discovery (ULD) will play an important role in future smart homes. Concerns about privacy and the need to carry a mobile or a tag device within a smart home currently make conventional ULD systems uncomfortable for users. Future smart homes will need a ULD system to consider these challenges. This paper addresses the design of such a ULD system for context-aware services in future smart homes stressing the following challenges: (i) users' privacy; (ii) device-/tag-free; and (iii) fault tolerance and accuracy. On the other hand, emerging new technologies, such as the Internet of Things, embedded systems, intelligent devices and machine-to-machine communication, are penetrating into our daily life with more and more sensors available for use in our homes. Considering this opportunity, we propose a ULD system that is capitalizing on the prevalence of sensors for the home while satisfying the aforementioned challenges. The proposed sensor network-based and user-friendly ULD system relies on different types of inexpensive sensors, as well as a context broker with a fuzzy-based decision-maker. The context broker receives context information from different types of sensors and evaluates that data using the fuzzy set theory. We demonstrate the performance of the proposed system by illustrating a use case, utilizing both an analytical model and simulation.

Sensor Network-Based and User-Friendly User Location Discovery for Future Smart Homes

Directory of Open Access Journals (Sweden)

Ehsan Ahvar

2016-06-01

Full Text Available User location is crucial context information for future smart homes where many location based services will be proposed. This location necessarily means that User Location Discovery (ULD will play an important role in future smart homes. Concerns about privacy and the need to carry a mobile or a tag device within a smart home currently make conventional ULD systems uncomfortable for users. Future smart homes will need a ULD system to consider these challenges. This paper addresses the design of such a ULD system for context-aware services in future smart homes stressing the following challenges: (i users’ privacy; (ii device-/tag-free; and (iii fault tolerance and accuracy. On the other hand, emerging new technologies, such as the Internet of Things, embedded systems, intelligent devices and machine-to-machine communication, are penetrating into our daily life with more and more sensors available for use in our homes. Considering this opportunity, we propose a ULD system that is capitalizing on the prevalence of sensors for the home while satisfying the aforementioned challenges. The proposed sensor network-based and user-friendly ULD system relies on different types of inexpensive sensors, as well as a context broker with a fuzzy-based decision-maker. The context broker receives context information from different types of sensors and evaluates that data using the fuzzy set theory. We demonstrate the performance of the proposed system by illustrating a use case, utilizing both an analytical model and simulation.

Home-based music therapy--a systematic overview of settings and conditions for an innovative service in healthcare.

Science.gov (United States)

Schmid, Wolfgang; Ostermann, Thomas

2010-10-14

Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from music therapists, patients and their

Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

Directory of Open Access Journals (Sweden)

Ostermann Thomas

2010-10-01

Full Text Available Abstract Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8, were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely

Home-based music therapy - a systematic overview of settings and conditions for an innovative service in healthcare

Science.gov (United States)

2010-01-01

Background Almost every Western healthcare system is changing to make their services more centered around out-patient care. In particular, long-term or geriatric patients who have been discharged from the hospital often require home-based care and therapy. Therefore, several programs have been developed to continue the therapeutic process and manage the special needs of patients after discharge from hospital. Music therapy has also moved into this field of healthcare service by providing home-based music therapy (HBMT) programs. This article reviews and summarizes the settings and conditions of HBMT for the first time. Methods The following databases were used to find articles on home-based music therapy: AMED, CAIRSS, EMBASE, MEDLINE, PsychINFO, and PSYNDEX. The search terms were "home-based music therapy" and "mobile music therapy". Included articles were analyzed with respect to participants as well as conditions and settings of HBMT. Furthermore, the date of publication, main outcomes, and the design and quality of the studies were investigated. Results A total of 20 international publications, 11 clinical studies and nine reports from practice, mainly from the United States (n = 8), were finally included in the qualitative synthesis. Six studies had a randomized controlled design and included a total of 507 patients. The vast majority of clients of HBMT are elderly patients living at home and people who need hospice and palliative care. Although settings were heterogeneous, music listening programs played a predominant role with the aim to reduce symptoms like depression and pain, or to improve quality of life and the relationship between patients and caregivers as primary endpoints. Conclusions We were able to show that HBMT is an innovative service for future healthcare delivery. It fits with the changing healthcare system and its conditions but also meets the therapeutic needs of the increasing number of elderly and severely impaired people. Apart from

Intelligent Transportation and Evacuation Planning A Modeling-Based Approach

CERN Document Server

Naser, Arab

2012-01-01

Intelligent Transportation and Evacuation Planning: A Modeling-Based Approach provides a new paradigm for evacuation planning strategies and techniques. Recently, evacuation planning and modeling have increasingly attracted interest among researchers as well as government officials. This interest stems from the recent catastrophic hurricanes and weather-related events that occurred in the southeastern United States (Hurricane Katrina and Rita). The evacuation methods that were in place before and during the hurricanes did not work well and resulted in thousands of deaths. This book offers insights into the methods and techniques that allow for implementing mathematical-based, simulation-based, and integrated optimization and simulation-based engineering approaches for evacuation planning. This book also: Comprehensively discusses the application of mathematical models for evacuation and intelligent transportation modeling Covers advanced methodologies in evacuation modeling and planning Discusses principles a...

Women's experiences of mistreatment during childbirth: A comparative view of home- and facility-based births in Pakistan.

Science.gov (United States)

Hameed, Waqas; Avan, Bilal Iqbal

2018-01-01

.75). Sub-group analyses for home-based births identified the same significant associations with mistreatment, with ethnicity included. In facility-based births, there was a significant relationship between women's employment and empowerment status and mistreatment. Women with prior education on birth preparedness were less likely to experience mistreatment compared to those who had received no previous birth preparedness education. In order to promote care that is woman-centred and provided in a respectful and culturally appropriate manner, service providers should be cognisant of the current situation and ensure provision of quality antenatal care. At the community level, women should seek antenatal care for improved birth preparedness, while at the interpersonal level strategies should be devised to leverage women's ability to participate in key household decisions.

Bayesian Spatial NBDA for Diffusion Data with Home-Base Coordinates.

Directory of Open Access Journals (Sweden)

Glenna F Nightingale

Full Text Available Network-based diffusion analysis (NBDA is a statistical method that allows the researcher to identify and quantify a social influence on the spread of behaviour through a population. Hitherto, NBDA analyses have not directly modelled spatial population structure. Here we present a spatial extension of NBDA, applicable to diffusion data where the spatial locations of individuals in the population, or of their home bases or nest sites, are available. The method is based on the estimation of inter-individual associations (for association matrix construction from the mean inter-point distances as represented on a spatial point pattern of individuals, nests or home bases. We illustrate the method using a simulated dataset, and show how environmental covariates (such as that obtained from a satellite image, or from direct observations in the study area can also be included in the analysis. The analysis is conducted in a Bayesian framework, which has the advantage that prior knowledge of the rate at which the individuals acquire a given task can be incorporated into the analysis. This method is especially valuable for studies for which detailed spatially structured data, but no other association data, is available. Technological advances are making the collection of such data in the wild more feasible: for example, bio-logging facilitates the collection of a wide range of variables from animal populations in the wild. We provide an R package, spatialnbda, which is hosted on the Comprehensive R Archive Network (CRAN. This package facilitates the construction of association matrices with the spatial x and y coordinates as the input arguments, and spatial NBDA analyses.

Cycling in multimodal transport behaviours: Exploring modality styles in the Danish population

DEFF Research Database (Denmark)

Olafsson, Anton Stahl; Nielsen, Thomas Alexander Sick; Carstensen, Trine Agervig

2016-01-01

and small towns. Thus, the way in which travel modes relate to the urban environment and variations in modality styles must serve as the starting point for policies aiming to fulfil the potential of multimodal transport behaviour and promote cycling. (C) 2016 Elsevier Ltd. All rights reserved....... explores how cycling forms part of multimodal transport behaviour based on survey data on transport modes and travel purposes and the weekly frequency of out-of-home activities and travel mode use in a representative sample of adult Danes (n = 1957). The following five distinct multimodal travel segments...... or 'modality styles' are identified: 'education transport'; 'public-based transport'; 'limited transport'; 'bicycle-based transport'; and 'car-based transport'. Travel behaviour is predominantly multimodal with few unimodal car-drivers being identified. Substantial cycling takes place in all modality styles...

Economic evaluation of home-based telebehavioural health care compared to in-person treatment delivery for depression.

Science.gov (United States)

Bounthavong, Mark; Pruitt, Larry D; Smolenski, Derek J; Gahm, Gregory A; Bansal, Aasthaa; Hansen, Ryan N

2018-02-01

Introduction Home-based telebehavioural healthcare improves access to mental health care for patients restricted by travel burden. However, there is limited evidence assessing the economic value of home-based telebehavioural health care compared to in-person care. We sought to compare the economic impact of home-based telebehavioural health care and in-person care for depression among current and former US service members. Methods We performed trial-based cost-minimisation and cost-utility analyses to assess the economic impact of home-based telebehavioural health care versus in-person behavioural care for depression. Our analyses focused on the payer perspective (Department of Defense and Department of Veterans Affairs) at three months. We also performed a scenario analysis where all patients possessed video-conferencing technology that was approved by these agencies. The cost-utility analysis evaluated the impact of different depression categories on the incremental cost-effectiveness ratio. One-way and probabilistic sensitivity analyses were performed to test the robustness of the model assumptions. Results In the base case analysis the total direct cost of home-based telebehavioural health care was higher than in-person care (US$71,974 versus US$20,322). Assuming that patients possessed government-approved video-conferencing technology, home-based telebehavioural health care was less costly compared to in-person care (US$19,177 versus US$20,322). In one-way sensitivity analyses, the proportion of patients possessing personal computers was a major driver of direct costs. In the cost-utility analysis, home-based telebehavioural health care was dominant when patients possessed video-conferencing technology. Results from probabilistic sensitivity analyses did not differ substantially from base case results. Discussion Home-based telebehavioural health care is dependent on the cost of supplying video-conferencing technology to patients but offers the opportunity to

The global classroom model simultaneous campus- and home-based education using videoconferencing

DEFF Research Database (Denmark)

Weitze, Charlotte Lærke; Ørngreen, Rikke

2014-01-01

This paper presents and discusses findings about how students, teachers, and the organization experience a start-up-project applying videoconferences between campus and home. This is new territory for adult learning centers. The research is based on the Global Classroom Model as it is implemented...... experiences and on the organizational issues related to the transition to the Global Classroom Model as well as provide outlines to the consequences these findings may have, for example in relation to the continued development of the teachers' educational designs....

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

Science.gov (United States)

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

2017-05-01

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

Cost effectiveness of facility and home based HIV voluntary ...

African Journals Online (AJOL)

Cost effectiveness of facility and home based HIV voluntary counseling and ... Background: In Uganda, the main stay for provision of human immunodeficiency virus (HIV) voluntary counseling and testing (VCT) ... AJOL African Journals Online.

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

Science.gov (United States)

Friedman, Carli; VanPuymbrouck, Laura

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

Occupational Therapy in Medicaid Home and Community-Based Services Waivers

Science.gov (United States)

VanPuymbrouck, Laura

2018-01-01

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

Provider category and quality of care in the Norwegian nursing home industry

Directory of Open Access Journals (Sweden)

Astri Drange Hole

2016-02-01

Full Text Available This paper examines empirically if there is a link between quality of care in the Norwegian nursing home industry and exposure of the industry to competition. Exposing public care to competition implies that the responsibility for providing care services is shared between public authorities and private actors. In Norway, exposure to competition means tender competition. Suppliers bid for a contract issued by the Norwegian authorities for a limited number of years. Quality of care in an institution is the major competitive factor. The provider categories of elderly care are: 1 care provided by institutions run by municipalities, 2 care provided by institutions run by private companies, which have won a tender competition, 3 care provided by institutions run by private companies owned by private families, voluntary religious or idealistic organizations. Nurse-to-patient ratio is used as a proxy for quality of care. The regression analysis indicates a relationship between quality of care and exposure to competition. The quality of care in provider category 2 is significantly lower than in provider category 1, but there are more variations in the quality of care in provider category 1 than in provider category 2. We find the lowest quality of care in provider category 1. There is also a relationship between the quality of care in an institution and the educational level of the staff, the location, the workforce, and the size of an institution. Finally, there is a relationship between the quality of care in an institution and the real and the required capacity, and the financial status in a region.

Biomass-based energy carriers in the transportation sector

International Nuclear Information System (INIS)

Johansson, Bengt.

1995-03-01

The purpose of this report is to study the technical and economic prerequisites to attain reduced carbon dioxide emissions through the use of biomass-based energy carriers in the transportation sector, and to study other environmental impacts resulting from an increased use of biomass-based energy carriers. CO 2 emission reduction per unit arable and forest land used for biomass production (kg CO 2 /ha,year) and costs for CO 2 emission reduction (SEK/kg CO 2 ) are estimated for the substitution of gasoline and diesel with rape methyl ester, biogas from lucerne, ethanol from wheat and ethanol, methanol, hydrogen and electricity from Salix and logging residues. Of the studied energy carriers, those based on Salix provide the largest CO 2 emission reduction. In a medium long perspective, the costs for CO 2 emission reduction seem to be lowest for methanol from Salix and logging residues. The use of fuel cell vehicles, using methanol or hydrogen as energy carriers, can in a longer perspective provide more energy efficient utilization of biomass for transportation than the use of internal combustion engine vehicles. 136 refs, 12 figs, 25 tabs

Hospital-based home care for children with cancer

DEFF Research Database (Denmark)

Hansson, Helena; Hallström, Inger; Kjaergaard, Hanne

2011-01-01

Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL...

Home/community-based services: a two-tier approach.

Science.gov (United States)

Aponte, H J; Zarski, J J; Bixenstine, C; Cibik, P

1991-07-01

A two-tier model for work with high-risk families is presented. It combines multiple-family groups in the community with home-based family therapy for individual families. The ecostructural conceptual framework of the model is discussed, and its application is illustrated by a case vignette.

Prospective study on cost-effectiveness of home-based motor assessment in Parkinson's disease.

Science.gov (United States)

Cubo, E; Mariscal, N; Solano, B; Becerra, V; Armesto, D; Calvo, S; Arribas, J; Seco, J; Martinez, A; Zorrilla, L; Heldman, D

2017-02-01

Introduction Treatment adjustments in Parkinson's disease (PD) are in part dependent on motor assessments. The aim of this study was to evaluate the cost-effectiveness of home-based motor monitoring plus standard in-office visits versus in-office visits alone in patients with advanced PD. Methods The procedures consisted of a prospective, one-year follow-up, randomized, case-control study. A total of 40 patients with advanced PD were randomized into two groups: 20 patients underwent home-based motor monitoring by using wireless motion sensor technology, while the other 20 patients had in-office visits. Motor and non-motor symptom severities, quality of life, neuropsychiatric symptoms, and comorbidities were assessed every four months. Direct costs were assessed using a standardized questionnaire. Cost-effectiveness was assessed using the incremental cost-effectiveness ratio (ICER). Results Both groups of PD patients were largely comparable in their clinical and demographic variables at baseline; however, there were more participants using levodopa-carbidopa intestinal gel in the home-based motor monitoring group. There was a trend for lower Unified Parkinson's Disease Rating Scale functional status (UPDRS II) scores in the patients monitored at home compared to the standard clinical follow-up ( p = 0.06). However, UPDRS parts I, III, IV and quality-adjusted life-years scores were similar between both groups. Home-based motor monitoring was cost-effective in terms of improvement of functional status, motor severity, and motor complications (UPDRS II, III; IV subscales), with an ICER/UPDRS ranging from €126.72 to €701.31, respectively. Discussion Home-based motor monitoring is a tool which collects cost-effective clinical information and helps augment health care for patients with advanced PD.

Mobile and Home-based Vendors’ Contributions to the Retail Food Environment in Rural South Texas Mexican-origin Settlements

Science.gov (United States)

Valdez, Zulema; Dean, Wesley R; Sharkey, Joseph R

2012-01-01

A growing concern with high rates of obesity and overweight among immigrant minority populations in the U.S. has focused attention on the availability and accessibility to healthy foods in such communities. Small-scale vending in rural, impoverished and underserved areas, however, is generally overlooked; yet, this type of informal activity and source for food is particularly important in such environs, or “food desserts,” where traditional forms of work and mainstream food outlets are limited or even absent. This exploratory study investigates two types of small-scale food vending that take place in rural colonias, or Mexican-origin settlements along the South Texas border with Mexico: mobile and home-based. Using a convenience sample of 23 vendors who live and work in Texas colonias, this study identifies the characteristics associated with mobile and home-based food vendors and their businesses and its contributions to the rural food environment. Findings reveal that mobile and home-based vending provides a variety of food and beverage options to colonia residents, and suggests that home-based vendors contribute a greater assortment of food options, including some healthier food items, than mobile food vendors, which offer and sell a limited range of products. Findings may contribute to the development of innovative policy solutions and interventions aimed at increasing healthy food options or reducing health disparities in immigrant communities. PMID:22531289

Representing in-home and out-of-home energy consumption behavior in Beijing

International Nuclear Information System (INIS)

Yu Biying; Zhang Junyi; Fujiwara, Akimasa

2011-01-01

It is expected that in-home and out-of-home energy consumption behavior in a household might be correlated with each other, probably due to the existence of household budget constraints. Ownership and usage of energy-saving technologies for in-home appliances (or vehicles) might lead to the increase in out-of-home (or in-home) energy consumption. It is therefore necessary to jointly represent in-home and out-of-home energy consumption in the same modeling framework. With this consideration, we first build a new type of energy consumption model based on the Multiple Discrete-Continuous Extreme Value (MDCEV) modeling framework. Next, we conducted a questionnaire survey in Beijing in 2009 and successfully collected the information about households' energy consumption, ownership/usage of in-home appliances and vehicles, and households' and their members' attributes from 1014 households. Throughout an empirical analysis, it is confirmed that the MDCEV model is effective to simultaneously describe the in-home and out-of-home energy consumption behavior. In addition, it is revealed that a set of household and personal attributes affect the ownership and usage of in-home appliances and vehicles. Furthermore, it is shown that the unobserved factors play a much more important role in explaining energy consumption behavior than the observed attributes of households and their members. - Highlights: → Representing in-home and out-of-home energy consumption behavior jointly. → MDCEV model is built to describe household energy consumption behavior. → Log-linear competitive relationships are found among expenditures of end-uses. → Model results provide some insights about the influence of varied observed factors. → Unobserved factors are more important in explaining energy consumption behavior.

Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training at Home randomised, controlled trial

Directory of Open Access Journals (Sweden)

Amanda Bates

2018-04-01

Full Text Available Introduction: Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. Research questions: This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Design: Randomised, controlled trial. Participants and setting: A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Intervention: Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. Outcome measures: The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated

Trial Protocol: Home-based exercise programs to prevent falls and upper limb dysfunction among community-dwelling older people: study protocol for the BEST (Balance Exercise Strength Training) at Home randomised, controlled trial.

Science.gov (United States)

Bates, Amanda; Furber, Susan; Tiedemann, Anne; Ginn, Karen; van den Dolder, Paul; Howard, Kirsten; Bauman, Adrian; Chittenden, Catherine; Franco, Lisa; Kershaw, Michelle; Sherrington, Catherine

2018-04-01

Falling when older is a major public health issue. There is compelling evidence to show that specific exercise programs can reduce the risk and rate of falls in community-dwelling older people. Another major health issue for older people living in the community is upper limb dysfunction, including shoulder pain. Home-based exercise programs appeal to some older people, due to their convenience. This trial aims to determine the effectiveness and cost-effectiveness of a home-based lower limb exercise program compared with a home-based upper limb exercise program to prevent falls and upper limb dysfunction among community-dwelling people aged 65+ years. Randomised, controlled trial. A total of 576 community-dwelling people will be recruited from the Illawarra and Shoalhaven regions of New South Wales, Australia. Participants will be randomised to either a home-based lower limb exercise intervention or a home-based upper limb exercise intervention. The lower limb program is designed to improve balance and strength in the lower limbs. The upper limb program is designed to improve upper limb strength and mobility. Participants will attend three group-based instruction sessions to learn and progress the exercises, and will be instructed to perform the exercises three times per week at home for 12 months. The two primary outcomes will be fall rates, recorded with monthly calendars for a 12-month period, and upper limb dysfunction, measured with the Disability of the Arm, Shoulder and Hand questionnaire. Secondary outcomes will include: lower limb strength and balance; shoulder strength and mobility; physical activity; quality of life; attitudes to exercise; proportion of fallers; fear of falling; and health and community service use. The cost-effectiveness of both exercise programs from a health and community service provider perspective will be evaluated. Negative binomial regression models will be used to estimate the between-group difference in fall rates. Modified

Smart Home Energy Management Based on Zigbee

OpenAIRE

E.Mallikarjuna

2015-01-01

Today organizations use IEEE 802.15&Zigbee to effectively deliver solutions for a variety of areas including consumer electronic device control, energy management and efficiency home and commercial building automation as well as industrial plant management. The smart home energy network has gained widespread attentions due to its flexible integrati- ion into everyday life. This next generation green home system transparently unifies various home appliances smart sensors &wireless communicati...

LHC@Home: a BOINC-based volunteer computing infrastructure for physics studies at CERN

Science.gov (United States)

Barranco, Javier; Cai, Yunhai; Cameron, David; Crouch, Matthew; Maria, Riccardo De; Field, Laurence; Giovannozzi, Massimo; Hermes, Pascal; Høimyr, Nils; Kaltchev, Dobrin; Karastathis, Nikos; Luzzi, Cinzia; Maclean, Ewen; McIntosh, Eric; Mereghetti, Alessio; Molson, James; Nosochkov, Yuri; Pieloni, Tatiana; Reid, Ivan D.; Rivkin, Lenny; Segal, Ben; Sjobak, Kyrre; Skands, Peter; Tambasco, Claudia; Veken, Frederik Van der; Zacharov, Igor

2017-12-01

The LHC@Home BOINC project has provided computing capacity for numerical simulations to researchers at CERN since 2004, and has since 2011 been expanded with a wider range of applications. The traditional CERN accelerator physics simulation code SixTrack enjoys continuing volunteers support, and thanks to virtualisation a number of applications from the LHC experiment collaborations and particle theory groups have joined the consolidated LHC@Home BOINC project. This paper addresses the challenges related to traditional and virtualized applications in the BOINC environment, and how volunteer computing has been integrated into the overall computing strategy of the laboratory through the consolidated LHC@Home service. Thanks to the computing power provided by volunteers joining LHC@Home, numerous accelerator beam physics studies have been carried out, yielding an improved understanding of charged particle dynamics in the CERN Large Hadron Collider (LHC) and its future upgrades. The main results are highlighted in this paper.

Using case-based reasoning to detect risk scenarios of elderly people living alone at home

OpenAIRE

Lupiani, Eduardo; Juarez, Jose M.; Palma, Jose; Sauer, Christian; Roth-Berghofer, Thomas

2014-01-01

In today’s ageing societies, the proportion of elderly people living alone in their own homes is dramatically increasing. Smart homes provide the appropriate environment for keeping them independent and, therefore, enhancing their quality of life. One of the most important requirements of these systems is that they have to provide a pervasive environment without disrupting elderly people’s daily activities. The present paper introduces a CBR agent used within a commercial Smart Home system, d...

Mountain Home Air Force Base, Idaho Geothermal Resource Assessment and Future Recommendations

Energy Technology Data Exchange (ETDEWEB)

Joseph C. Armstrong; Robert P. Breckenridge; Dennis L. Nielson; John W. Shervais; Thomas R. Wood

2013-03-01

The U.S. Air Force is facing a number of challenges as it moves into the future, one of the biggest being how to provide safe and secure energy to support base operations. A team of scientists and engineers met at Mountain Home Air Force Base in early 2011 near Boise, Idaho, to discuss the possibility of exploring for geothermal resources under the base. The team identified that there was a reasonable potential for geothermal resources based on data from an existing well. In addition, a regional gravity map helped identify several possible locations for drilling a new well. The team identified several possible sources of funding for this well—the most logical being to use U.S. Department of Energy funds to drill the upper half of the well and U.S. Air Force funds to drill the bottom half of the well. The well was designed as a slimhole well in accordance with State of Idaho Department of Water Resources rules and regulations. Drilling operations commenced at the Mountain Home site in July of 2011 and were completed in January of 2012. Temperatures increased gradually, especially below a depth of 2000 ft. Temperatures increased more rapidly below a depth of 5500 ft. The bottom of the well is at 5976 ft, where a temperature of about 140°C was recorded. The well flowed artesian from a depth below 5600 ft, until it was plugged off with drilling mud. Core samples were collected from the well and are being analyzed to help understand permeability at depth. Additional tests using a televiewer system will be run to evaluate orientation and directions at fractures, especially in the production zone. A final report on the well exploitation will be forthcoming later this year. The Air Force will use it to evaluate the geothermal resource potential for future private development options at Mountain Home Air Force Base. In conclusion, Recommendation for follow-up efforts include the following:

User-based representation of time-resolved multimodal public transportation networks.

Science.gov (United States)

Alessandretti, Laura; Karsai, Márton; Gauvin, Laetitia

2016-07-01

Multimodal transportation systems, with several coexisting services like bus, tram and metro, can be represented as time-resolved multilayer networks where the different transportation modes connecting the same set of nodes are associated with distinct network layers. Their quantitative description became possible recently due to openly accessible datasets describing the geo-localized transportation dynamics of large urban areas. Advancements call for novel analytics, which combines earlier established methods and exploits the inherent complexity of the data. Here, we provide a novel user-based representation of public transportation systems, which combines representations, accounting for the presence of multiple lines and reducing the effect of spatial embeddedness, while considering the total travel time, its variability across the schedule, and taking into account the number of transfers necessary. After the adjustment of earlier techniques to the novel representation framework, we analyse the public transportation systems of several French municipal areas and identify hidden patterns of privileged connections. Furthermore, we study their efficiency as compared to the commuting flow. The proposed representation could help to enhance resilience of local transportation systems to provide better design policies for future developments.

Precarious Situations of Care Workers in Home-Based Elder Care in Slovenia.

Science.gov (United States)

Hrženjak, Majda

2018-02-01

Based on policy analysis and individual interviews, the author analyzes the care workers' precarious situations in home-based elder care in Slovenia, a post-socialist, European Union country characterized by a rapidly aging population and delays in adapting a long-term care system to this new social risk. Employment and quasi-employment positions which coexist in home-based care can be sorted along two continuums: between public and market service; between formal and informal work. The author argues that working conditions in home-based care differ according to the position of the care worker on these two continuums, that is, being employed in public services, being self-employed, working in informal care markets, holding a status of family assistant, or being an informal family caregiver. Although the working conditions in public services are deteriorating, the analysis shows that precarity is more severe in market and informal care, while formalization and socialization of care bring about less precarious conditions.

Finding Home: Landmark Ambiguity in Human Navigation

Directory of Open Access Journals (Sweden)

Simon Jetzschke

2017-07-01

Full Text Available Memories of places often include landmark cues, i.e., information provided by the spatial arrangement of distinct objects with respect to the target location. To study how humans combine landmark information for navigation, we conducted two experiments: To this end, participants were either provided with auditory landmarks while walking in a large sports hall or with visual landmarks while walking on a virtual-reality treadmill setup. We found that participants cannot reliably locate their home position due to ambiguities in the spatial arrangement when only one or two uniform landmarks provide cues with respect to the target. With three visual landmarks that look alike, the task is solved without ambiguity, while audio landmarks need to play three unique sounds for a similar performance. This reduction in ambiguity through integration of landmark information from 1, 2, and 3 landmarks is well modeled using a probabilistic approach based on maximum likelihood estimation. Unlike any deterministic model of human navigation (based e.g., on distance or angle information, this probabilistic model predicted both the precision and accuracy of the human homing performance. To further examine how landmark cues are integrated we introduced systematic conflicts in the visual landmark configuration between training of the home position and tests of the homing performance. The participants integrated the spatial information from each landmark near-optimally to reduce spatial variability. When the conflict becomes big, this integration breaks down and precision is sacrificed for accuracy. That is, participants return again closer to the home position, because they start ignoring the deviant third landmark. Relying on two instead of three landmarks, however, goes along with responses that are scattered over a larger area, thus leading to higher variability. To model the breakdown of integration with increasing conflict, the probabilistic model based on a

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

Science.gov (United States)

Thomas, Neil; And Others

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

A web based tool for storing and visualising data generated within a smart home.

Science.gov (United States)

McDonald, H A; Nugent, C D; Moore, G; Finlay, D D; Hallberg, J

2011-01-01

There is a growing need to re-assess the current approaches available to researchers for storing and managing heterogeneous data generated within a smart home environment. In our current work we have developed the homeML Application; a web based tool to support researchers engaged in the area of smart home research as they perform experiments. Within this paper the homeML Application is presented which includes the fundamental components of the homeML Repository and the homeML Toolkit. Results from a usability study conducted by 10 computer science researchers are presented; the initial results of which have been positive.

Suicide among nursing home residents in Australia: A national population-based retrospective analysis of medico-legal death investigation information.

Science.gov (United States)

Murphy, Briony J; Bugeja, Lyndal C; Pilgrim, Jennifer L; Ibrahim, Joseph E

2018-05-01

Suicide among nursing home residents is a growing public health concern, currently lacking in empirical research. This study aims to describe the frequency and nature of suicide among nursing home residents in Australia. This research comprised a national population-based retrospective analysis of suicide deaths among nursing home residents in Australia reported to the Coroner between July 2000 and December 2013. Cases were identified using the National Coronial Information System, and data collected from paper-based coroners' records on individual, incident, and organizational factors, as well as details of the medico-legal death investigation. Data analysis comprised univariate and bivariate descriptive statistical techniques; ecological analysis of incidence rates using population denominators; and comparison of age and sex of suicide cases to deaths from other causes using logistic regression. The study identified 141 suicides among nursing home residents, occurring at a rate of 0.02 deaths per 100 000 resident bed days. The ratio of deaths from suicide to deaths from any other cause was higher in males than females (OR = 3.56, 95%CI = 2.48-5.12, P = home for less than 12 months (n = 71, 50.3%). Common major life stressors identified in suicide cases included the following: health deterioration (n = 112, 79.4%); isolation and loneliness (n = 60, 42.6%); and maladjustment to nursing home life (n = 42, 29.8%). This research provides a foundational understanding of suicide among nursing home residents in Australia and contributes important new information to the international knowledge base. Copyright © 2018 John Wiley & Sons, Ltd.

DC-based smart PV-powered home energy management system based on voltage matching and RF module

Science.gov (United States)

Hasan, W. Z. W.

2017-01-01

The main tool for measuring system efficiency in homes and offices is the energy monitoring of the household appliances’ consumption. With the help of GUI through a PC or smart phone, there are various applications that can be developed for energy saving. This work describes the design and prototype implementation of a wireless PV-powered home energy management system under a DC-distribution environment, which allows remote monitoring of appliances’ energy consumptions and power rate quality. The system can be managed by a central computer, which obtains the energy data based on XBee RF modules that access the sensor measurements of system components. The proposed integrated prototype framework is characterized by low power consumption due to the lack of components and consists of three layers: XBee-based circuit for processing and communication architecture, solar charge controller, and solar-battery-load matching layers. Six precise analogue channels for data monitoring are considered to cover the energy measurements. Voltage, current and temperature analogue signals were accessed directly from the remote XBee node to be sent in real time with a sampling frequency of 11–123 Hz to capture the possible surge power. The performance shows that the developed prototype proves the DC voltage matching concept and is able to provide accurate and precise results. PMID:28934271

DC-based smart PV-powered home energy management system based on voltage matching and RF module.

Directory of Open Access Journals (Sweden)

Ahmad H Sabry

Full Text Available The main tool for measuring system efficiency in homes and offices is the energy monitoring of the household appliances' consumption. With the help of GUI through a PC or smart phone, there are various applications that can be developed for energy saving. This work describes the design and prototype implementation of a wireless PV-powered home energy management system under a DC-distribution environment, which allows remote monitoring of appliances' energy consumptions and power rate quality. The system can be managed by a central computer, which obtains the energy data based on XBee RF modules that access the sensor measurements of system components. The proposed integrated prototype framework is characterized by low power consumption due to the lack of components and consists of three layers: XBee-based circuit for processing and communication architecture, solar charge controller, and solar-battery-load matching layers. Six precise analogue channels for data monitoring are considered to cover the energy measurements. Voltage, current and temperature analogue signals were accessed directly from the remote XBee node to be sent in real time with a sampling frequency of 11-123 Hz to capture the possible surge power. The performance shows that the developed prototype proves the DC voltage matching concept and is able to provide accurate and precise results.

DC-based smart PV-powered home energy management system based on voltage matching and RF module.

Science.gov (United States)

Sabry, Ahmad H; Hasan, W Z W; Ab Kadir, Mza; Radzi, M A M; Shafie, S

2017-01-01

The main tool for measuring system efficiency in homes and offices is the energy monitoring of the household appliances' consumption. With the help of GUI through a PC or smart phone, there are various applications that can be developed for energy saving. This work describes the design and prototype implementation of a wireless PV-powered home energy management system under a DC-distribution environment, which allows remote monitoring of appliances' energy consumptions and power rate quality. The system can be managed by a central computer, which obtains the energy data based on XBee RF modules that access the sensor measurements of system components. The proposed integrated prototype framework is characterized by low power consumption due to the lack of components and consists of three layers: XBee-based circuit for processing and communication architecture, solar charge controller, and solar-battery-load matching layers. Six precise analogue channels for data monitoring are considered to cover the energy measurements. Voltage, current and temperature analogue signals were accessed directly from the remote XBee node to be sent in real time with a sampling frequency of 11-123 Hz to capture the possible surge power. The performance shows that the developed prototype proves the DC voltage matching concept and is able to provide accurate and precise results.

Exploration and design of smart home circuit based on ZigBee

Science.gov (United States)

Luo, Huirong

2018-05-01

To apply ZigBee technique in smart home circuit design, in the hardware design link of ZigBee node, TI Company's ZigBee wireless communication chip CC2530 was used to complete the design of ZigBee RF module circuit and peripheral circuit. In addition, the function demand and the overall scheme of the intelligent system based on smart home furnishing were proposed. Finally, the smart home system was built by combining ZigBee network and intelligent gateway. The function realization, reliability and power consumption of ZigBee network were tested. The results showed that ZigBee technology was applied to smart home system, making it have some advantages in terms of flexibility, scalability, power consumption and indoor aesthetics. To sum up, the system has high application value.

WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings

Science.gov (United States)

Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

2015-01-01

Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home environment and performs his or her daily routine in order to live a long and healthy life. We initiate the research with the development of the smart home approach and implement it in different home conditions (different houses) to monitor the activity of an inhabitant for wellness detection. Additionally, our research extends the smart home system to smart buildings and models the design issues related to the smart building environment; these design issues are linked with system performance and reliability. This research paper also discusses and illustrates the possible mitigation to handle the ISM band interference and attenuation losses without compromising optimum system performance. PMID:25946630

WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings

Directory of Open Access Journals (Sweden)

Hemant Ghayvat

2015-05-01

Full Text Available Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home environment and performs his or her daily routine in order to live a long and healthy life. We initiate the research with the development of the smart home approach and implement it in different home conditions (different houses to monitor the activity of an inhabitant for wellness detection. Additionally, our research extends the smart home system to smart buildings and models the design issues related to the smart building environment; these design issues are linked with system performance and reliability. This research paper also discusses and illustrates the possible mitigation to handle the ISM band interference and attenuation losses without compromising optimum system performance.

WSN- and IOT-Based Smart Homes and Their Extension to Smart Buildings.

Science.gov (United States)

Ghayvat, Hemant; Mukhopadhyay, Subhas; Gui, Xiang; Suryadevara, Nagender

2015-05-04

Our research approach is to design and develop reliable, efficient, flexible, economical, real-time and realistic wellness sensor networks for smart home systems. The heterogeneous sensor and actuator nodes based on wireless networking technologies are deployed into the home environment. These nodes generate real-time data related to the object usage and movement inside the home, to forecast the wellness of an individual. Here, wellness stands for how efficiently someone stays fit in the home environment and performs his or her daily routine in order to live a long and healthy life. We initiate the research with the development of the smart home approach and implement it in different home conditions (different houses) to monitor the activity of an inhabitant for wellness detection. Additionally, our research extends the smart home system to smart buildings and models the design issues related to the smart building environment; these design issues are linked with system performance and reliability. This research paper also discusses and illustrates the possible mitigation to handle the ISM band interference and attenuation losses without compromising optimum system performance.

Development and Evaluation of a Home Enteral Nutrition Team

Directory of Open Access Journals (Sweden)

Sarah Dinenage

2015-03-01

Full Text Available The organisation of services to support the increasing number of people receiving enteral tube feeding (ETF at home varies across regions. There is evidence that multi-disciplinary primary care teams focussed on home enteral nutrition (HEN can provide cost-effective care. This paper describes the development and evaluation of a HEN Team in one UK city. A HEN Team comprising dietetians, nurses and a speech and language therapist was developed with the aim of delivering a quality service for people with gastrostomy tubes living at home. Team objectives were set and an underpinning framework of organisation developed including a care pathway and a schedule of training. Impact on patient outcomes was assessed in a pre-post test evaluation design. Patients and carers reported improved support in managing their ETF. Cost savings were realised through: (1 prevention of hospital admission and related transport for ETF related issues; (2 effective management and reduction of waste of feed and thickener; (3 balloon gastrostomy tube replacement by the HEN Team in the patient’s home, and optimisation of nutritional status. This service evaluation demonstrated that the establishment of a dedicated multi-professional HEN Team focussed on achievement of key objectives improved patient experience and, although calculation of cost savings were estimates, provided evidence of cost-effectiveness.

DOE Zero Energy Ready Home Case Study: Amaris Homes, Afton Model

Energy Technology Data Exchange (ETDEWEB)

Pacific Northwest National Laboratory

2017-09-01

Amaris Homes built this 3,734-ft2 home in Afton, Minnesota, to the performance criteria of the DOE Zero Energy Ready Home (ZERH) program. A high-efficiency gas boiler provides hot water for the zoned radiant floor system as well as for faucets and showers. A high-efficiency heat pump provides zoned cooling.

Eldercare at Home: Choosing a Nursing Home

Science.gov (United States)

... required, these services can be provided by a separate home health agency as directed by a doctor or ... complaints made by or on behalf of nursing home residents and work to resolve the problems. If they are unable ...

Foraging optimally for home ranges

Science.gov (United States)

Mitchell, Michael S.; Powell, Roger A.

2012-01-01

Economic models predict behavior of animals based on the presumption that natural selection has shaped behaviors important to an animal's fitness to maximize benefits over costs. Economic analyses have shown that territories of animals are structured by trade-offs between benefits gained from resources and costs of defending them. Intuitively, home ranges should be similarly structured, but trade-offs are difficult to assess because there are no costs of defense, thus economic models of home-range behavior are rare. We present economic models that predict how home ranges can be efficient with respect to spatially distributed resources, discounted for travel costs, under 2 strategies of optimization, resource maximization and area minimization. We show how constraints such as competitors can influence structure of homes ranges through resource depression, ultimately structuring density of animals within a population and their distribution on a landscape. We present simulations based on these models to show how they can be generally predictive of home-range behavior and the mechanisms that structure the spatial distribution of animals. We also show how contiguous home ranges estimated statistically from location data can be misleading for animals that optimize home ranges on landscapes with patchily distributed resources. We conclude with a summary of how we applied our models to nonterritorial black bears (Ursus americanus) living in the mountains of North Carolina, where we found their home ranges were best predicted by an area-minimization strategy constrained by intraspecific competition within a social hierarchy. Economic models can provide strong inference about home-range behavior and the resources that structure home ranges by offering falsifiable, a priori hypotheses that can be tested with field observations.

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

Science.gov (United States)

Fogler, Sarah

2009-11-01

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

Towards evidence-based palliative care in nursing homes in Sweden: a qualitative study informed by the organizational readiness to change theory.

Science.gov (United States)

Nilsen, Per; Wallerstedt, Birgitta; Behm, Lina; Ahlström, Gerd

2018-01-04

Sweden has a policy of supporting older people to live a normal life at home for as long as possible. Therefore, it is often the oldest, most frail people who move into nursing homes. Nursing home staff are expected to meet the existential needs of the residents, yet conversations about death and dying tend to cause emotional strain. This study explores organizational readiness to implement palliative care based on evidence-based guidelines in nursing homes in Sweden. The aim was to identify barriers and facilitators to implementing evidence-based palliative care in nursing homes. Interviews were carried out with 20 managers from 20 nursing homes in two municipalities who had participated along with staff members in seminars aimed at conveying knowledge and skills of relevance for providing evidence-based palliative care. Two managers responsible for all elderly care in each municipality were also interviewed. The questions were informed by the theory of Organizational Readiness for Change (ORC). ORC was also used as a framework to analyze the data by means of categorizing barriers and facilitators for implementing evidence-based palliative care. Analysis of the data yielded ten factors (i.e., sub-categories) acting as facilitators and/or barriers. Four factors constituted barriers: the staff's beliefs in their capabilities to face dying residents, their attitudes to changes at work as well as the resources and time required. Five factors functioned as either facilitators or barriers because there was considerable variation with regard to the staff's competence and confidence, motivation, and attitudes to work in general, as well as the managers' plans and decisional latitude concerning efforts to develop evidence-based palliative care. Leadership was a facilitator to implementing evidence-based palliative care. There is a limited organizational readiness to develop evidence-based palliative care as a result of variation in the nursing home staff's change efficacy

Quality in home-based childcare : Impact and improvement

NARCIS (Netherlands)

Groeneveld, Marilene Gerarda

2010-01-01

The thesis ‘Quality in home-based childcare: Impact and improvement’ consists of two studies. The general aim of the first study is to examine children’s stress levels and wellbeing, and the role of caregiver stress and childcare quality. This first study is described in chapters 2, 3, and 4.

Passive Infrared (PIR)-Based Indoor Position Tracking for Smart Homes Using Accessibility Maps and A-Star Algorithm.

Science.gov (United States)

Yang, Dan; Xu, Bin; Rao, Kaiyou; Sheng, Weihua

2018-01-24

Indoor occupants' positions are significant for smart home service systems, which usually consist of robot service(s), appliance control and other intelligent applications. In this paper, an innovative localization method is proposed for tracking humans' position in indoor environments based on passive infrared (PIR) sensors using an accessibility map and an A-star algorithm, aiming at providing intelligent services. First the accessibility map reflecting the visiting habits of the occupants is established through the integral training with indoor environments and other prior knowledge. Then the PIR sensors, which placement depends on the training results in the accessibility map, get the rough location information. For more precise positioning, the A-start algorithm is used to refine the localization, fused with the accessibility map and the PIR sensor data. Experiments were conducted in a mock apartment testbed. The ground truth data was obtained from an Opti-track system. The results demonstrate that the proposed method is able to track persons in a smart home environment and provide a solution for home robot localization.

Passive Infrared (PIR-Based Indoor Position Tracking for Smart Homes Using Accessibility Maps and A-Star Algorithm

Directory of Open Access Journals (Sweden)

Dan Yang

2018-01-01

Full Text Available Indoor occupants’ positions are significant for smart home service systems, which usually consist of robot service(s, appliance control and other intelligent applications. In this paper, an innovative localization method is proposed for tracking humans’ position in indoor environments based on passive infrared (PIR sensors using an accessibility map and an A-star algorithm, aiming at providing intelligent services. First the accessibility map reflecting the visiting habits of the occupants is established through the integral training with indoor environments and other prior knowledge. Then the PIR sensors, which placement depends on the training results in the accessibility map, get the rough location information. For more precise positioning, the A-start algorithm is used to refine the localization, fused with the accessibility map and the PIR sensor data. Experiments were conducted in a mock apartment testbed. The ground truth data was obtained from an Opti-track system. The results demonstrate that the proposed method is able to track persons in a smart home environment and provide a solution for home robot localization.

Feasibility and usability of a home monitoring concept based on mobile phones and near field communication (NFC) technology.

Science.gov (United States)

Morak, Jürgen; Kollmann, Alexander; Schreier, Günter

2007-01-01

Utilization of mobile information and communication technologies in home monitoring applications is becoming more and more common. The mobile phone, acting as a patient terminal for patients suffering from chronic diseases, provides an active link to the caregiver to transmit health status information and receive feedback. In such a concept the usability is still limited by the necessity of entering the values via the mobile phone's small keypad. The near field communication technology (NFC), a touch-based wireless interface that became available recently, may improve the usability level of such applications significantly. The focus of this paper is to describe the development of a prototype application based on this technology embedded in a home monitoring system. The feasibility and usability of this approach are evaluated and compared with concepts used in previous approaches. The high quantifier with respect to overall usability indicates that NFC may be the technology of choice for some tasks in home monitoring applications.

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

Science.gov (United States)

Dhiliwal, Sunil R; Muckaden, Maryann

2015-01-01

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

Transportation legislative data base : state radioactive materials transportation statute compilation, 1989-1993

Science.gov (United States)

1994-04-30

The Transportation Legislative Data Base (TLDB) is a computer-based information service containing summaries of federal, state and certain local government statutes and regulations relating to the transportation of radioactive materials in the United...

Cost-Effectiveness of a Home Based Intervention for Secondary Prevention of Readmission with Chronic Heart Disease.

Directory of Open Access Journals (Sweden)

Joshua Byrnes

Full Text Available The aim of this study is to consider the cost-effectiveness of a nurse-led, home-based intervention (HBI in cardiac patients with private health insurance compared to usual post-discharge care. A within trial analysis of the Young @ Heart multicentre, randomized controlled trial along with a micro-simulation decision analytical model was conducted to estimate the incremental costs and quality adjusted life years associated with the home based intervention compared to usual care. For the micro-simulation model, future costs, from the perspective of the funder, and effects are estimated over a twenty-year time horizon. An Incremental Cost-Effectiveness Ratio, along with Incremental Net Monetary Benefit, is evaluated using a willingness to pay threshold of $50,000 per quality adjusted life year. Sub-group analyses are conducted for men and women across three age groups separately. Costs and benefits that arise in the future are discounted at five percent per annum. Overall, home based intervention for secondary prevention in patients with chronic heart disease identified in the Australian private health care sector is not cost-effective. The estimated within trial incremental net monetary benefit is -$3,116 [95% CI: -11,145, $4,914]; indicating that the costs outweigh the benefits. However, for males and in particular males aged 75 years and above, home based intervention indicated a potential to reduce health care costs when compared to usual care (within trial: -$10,416 [95% CI: -$26,745, $5,913]; modelled analysis: -$1,980 [95% CI: -$22,843, $14,863]. This work provides a crucial impetus for future research to understand for whom disease management programs are likely to benefit most.

HOME Grantee Areas

Data.gov (United States)

Department of Housing and Urban Development — The HOME Investment Partnership Program (HOME) is authorized under Title II of the Cranston-Gonzalez National Affordable Housing Act. HOME provides formula grants to...

Organizational capacities for 'residential care homes for the elderly' to provide culturally appropriate end-of-life care for Chinese elders and their families.