WorldWideScience

Sample records for reported home address

  1. Addressing Maslow’s deficiency needs in smart homes

    NARCIS (Netherlands)

    Brink, M.; Bronswijk, van J.E.M.H.

    2013-01-01

    Modern smart homes contain elements from different technical disciplines, such as home automation, robotics, and tele-heath. We investigated to which extent smart-home systems address the different levels of deficiency needs of Maslow, and the corresponding level of integration of smart-home

  2. Key sectors of the home automation industry, topical report, January 1993

    International Nuclear Information System (INIS)

    White, K.L.

    1993-01-01

    This is one of a series of topical reports dealing with the strategic, technical, and market development of home automation. Particular emphasis is placed upon identifying those aspects of home automation that will impact the gas industry and gas products. Communication standards, market drivers, key organizations, technical implementation, product opportunities, and market growth projections will all be addressed in this or subsequent reports. These reports will also discuss how the gas industry and gas-fired equipment can use home automation technology to benefit the consumer

  3. Identifying risk factors for healthcare-associated infections from electronic medical record home address data

    Directory of Open Access Journals (Sweden)

    Rosenman Marc B

    2010-09-01

    Full Text Available Abstract Background Residential address is a common element in patient electronic medical records. Guidelines from the U.S. Centers for Disease Control and Prevention specify that residence in a nursing home, skilled nursing facility, or hospice within a year prior to a positive culture date is among the criteria for differentiating healthcare-acquired from community-acquired methicillin-resistant Staphylococcus aureus (MRSA infections. Residential addresses may be useful for identifying patients residing in healthcare-associated settings, but methods for categorizing residence type based on electronic medical records have not been widely documented. The aim of this study was to develop a process to assist in differentiating healthcare-associated from community-associated MRSA infections by analyzing patient addresses to determine if residence reported at the time of positive culture was associated with a healthcare facility or other institutional location. Results We identified 1,232 of the patients (8.24% of the sample with positive cultures as probable cases of healthcare-associated MRSA based on residential addresses contained in electronic medical records. Combining manual review with linking to institutional address databases improved geocoding rates from 11,870 records (79.37% to 12,549 records (83.91%. Standardization of patient home address through geocoding increased the number of matches to institutional facilities from 545 (3.64% to 1,379 (9.22%. Conclusions Linking patient home address data from electronic medical records to institutional residential databases provides useful information for epidemiologic researchers, infection control practitioners, and clinicians. This information, coupled with other clinical and laboratory data, can be used to inform differentiation of healthcare-acquired from community-acquired infections. The process presented should be extensible with little or no added data costs.

  4. Paraprofessional Home Visitors' Perspectives on Addressing Poor Mental Health, Substance Abuse, and Domestic Violence: A Qualitative Study

    Science.gov (United States)

    Tandon, S. Darius; Mercer, Constance D.; Saylor, Elizabeth L.; Duggan, Anne K.

    2008-01-01

    This research was conducted to understand paraprofessional home visitors' perceptions of their training in addressing poor mental health, substance abuse, and domestic violence, and their actions in working with families in addressing these issues. Five focus groups were conducted with a total of 28 paraprofessional home visitors. Three main…

  5. HOME Participating Jurisdictions Vacant Units Reports

    Data.gov (United States)

    Department of Housing and Urban Development — This report is an MS Excel spreadsheet broken up by state, similar to the HOME Participating Jurisdiction's Open Activities Reports. The purpose of the HOME...

  6. Helping Older Adults Improve Their Medication Experience (HOME) by Addressing Medication Regimen Complexity in Home Healthcare.

    Science.gov (United States)

    Sheehan, Orla C; Kharrazi, Hadi; Carl, Kimberly J; Leff, Bruce; Wolff, Jennifer L; Roth, David L; Gabbard, Jennifer; Boyd, Cynthia M

    In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules. We used human computer interaction design and evaluation principles, automated extraction from standardized forms, and modification of existing EHR fields to highlight key medication-related insights that had arisen during the SHHC visit. Separate versions of the tool were developed for physicians/nurses and patients/caregivers. A pilot of the tool was conducted using 20 SHHC encounters. Home care nurses and physicians found the tool useful for communication. Home care nurses were able to implement the HOME tool into their clinical workflow and reported improved communication with physicians about medications. This simple and largely automated tool improves understanding and communication around medications in SHHC.

  7. Understanding the Home Math Environment and Its Role in Predicting Parent Report of Children's Math Skills.

    Science.gov (United States)

    Hart, Sara A; Ganley, Colleen M; Purpura, David J

    2016-01-01

    There is a growing literature concerning the role of the home math environment in children's math development. In this study, we examined the relation between these constructs by specifically addressing three goals. The first goal was to identify the measurement structure of the home math environment through a series of confirmatory factor analyses. The second goal was to examine the role of the home math environment in predicting parent report of children's math skills. The third goal was to test a series of potential alternative explanations for the relation between the home math environment and parent report of children's skills, specifically the direct and indirect role of household income, parent math anxiety, and parent math ability as measured by their approximate number system performance. A final sample of 339 parents of children aged 3 through 8 drawn from Mechanical Turk answered a questionnaire online. The best fitting model of the home math environment was a bifactor model with a general factor representing the general home math environment, and three specific factors representing the direct numeracy environment, the indirect numeracy environment, and the spatial environment. When examining the association of the home math environment factors to parent report of child skills, the general home math environment factor and the spatial environment were the only significant predictors. Parents who reported doing more general math activities in the home reported having children with higher math skills, whereas parents who reported doing more spatial activities reported having children with lower math skills.

  8. Understanding the Home Math Environment and Its Role in Predicting Parent Report of Children's Math Skills.

    Directory of Open Access Journals (Sweden)

    Sara A Hart

    Full Text Available There is a growing literature concerning the role of the home math environment in children's math development. In this study, we examined the relation between these constructs by specifically addressing three goals. The first goal was to identify the measurement structure of the home math environment through a series of confirmatory factor analyses. The second goal was to examine the role of the home math environment in predicting parent report of children's math skills. The third goal was to test a series of potential alternative explanations for the relation between the home math environment and parent report of children's skills, specifically the direct and indirect role of household income, parent math anxiety, and parent math ability as measured by their approximate number system performance. A final sample of 339 parents of children aged 3 through 8 drawn from Mechanical Turk answered a questionnaire online. The best fitting model of the home math environment was a bifactor model with a general factor representing the general home math environment, and three specific factors representing the direct numeracy environment, the indirect numeracy environment, and the spatial environment. When examining the association of the home math environment factors to parent report of child skills, the general home math environment factor and the spatial environment were the only significant predictors. Parents who reported doing more general math activities in the home reported having children with higher math skills, whereas parents who reported doing more spatial activities reported having children with lower math skills.

  9. Understanding the Home Math Environment and Its Role in Predicting Parent Report of Children’s Math Skills

    Science.gov (United States)

    Ganley, Colleen M.; Purpura, David J.

    2016-01-01

    There is a growing literature concerning the role of the home math environment in children’s math development. In this study, we examined the relation between these constructs by specifically addressing three goals. The first goal was to identify the measurement structure of the home math environment through a series of confirmatory factor analyses. The second goal was to examine the role of the home math environment in predicting parent report of children’s math skills. The third goal was to test a series of potential alternative explanations for the relation between the home math environment and parent report of children’s skills, specifically the direct and indirect role of household income, parent math anxiety, and parent math ability as measured by their approximate number system performance. A final sample of 339 parents of children aged 3 through 8 drawn from Mechanical Turk answered a questionnaire online. The best fitting model of the home math environment was a bifactor model with a general factor representing the general home math environment, and three specific factors representing the direct numeracy environment, the indirect numeracy environment, and the spatial environment. When examining the association of the home math environment factors to parent report of child skills, the general home math environment factor and the spatial environment were the only significant predictors. Parents who reported doing more general math activities in the home reported having children with higher math skills, whereas parents who reported doing more spatial activities reported having children with lower math skills. PMID:28005925

  10. Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

    NARCIS (Netherlands)

    Chalmers, J. R.; Schmitt, J.; Apfelbacher, C.; Dohil, M.; Eichenfield, L. F.; Simpson, E. L.; Singh, J.; Spuls, P.; Thomas, K. S.; Admani, S.; Aoki, V.; Ardeleanu, M.; Barbarot, S.; Berger, T.; Bergman, J. N.; Block, J.; Borok, N.; Burton, T.; Chamlin, S. L.; Deckert, S.; DeKlotz, C. C.; Graff, L. B.; Hanifin, J. M.; Hebert, A. A.; Humphreys, R.; Katoh, N.; Kisa, R. M.; Margolis, D. J.; Merhand, S.; Minnillo, R.; Mizutani, H.; Nankervis, H.; Ohya, Y.; Rodgers, P.; Schram, M. E.; Stalder, J. F.; Svensson, A.; Takaoka, R.; Teper, A.; Tom, W. L.; von Kobyletzki, L.; Weisshaar, E.; Zelt, S.; Williams, H. C.

    2014-01-01

    This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6-7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial:

  11. Home Health PPS - Reports

    Data.gov (United States)

    U.S. Department of Health & Human Services — Abt Associates July 21, 2010 Analysis of 2000-2008 Home Health Case-mix Change Report estimates the extent to which the observed increases in average case-mix were...

  12. Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

    OpenAIRE

    Chalmers, JR; Schmitt, J; Apfelbacher, C; Dohil, M; Eichenfield, LF; Simpson, EL; Singh, J; Spuls, P; Thomas, KS; Admani, S; Aoki, V; Ardeleanu, M; Barbarot, S; Berger, T; Bergman, JN

    2014-01-01

    Summary This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6?7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting par...

  13. Smoke-Free Homes and Home Exposure to Secondhand Smoke in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Pinpin Zheng

    2014-11-01

    Full Text Available Few studies have examined home exposure to secondhand smoke (SHS in China. This study aimed to document: (1 the prevalence and correlates of exposure to SHS in homes (in adult non-smokers in Shanghai, and (2 enforcement of rules, harm reduction behaviors, and self-efficacy for maintaining smoke-free homes in Shanghai. A total of 500 participants were recruited using a multistage proportional random sampling design in an urban and suburban district to complete a survey. Among the total 355 nonsmokers, 127 (35.8% participants reported being exposed to SHS in the past 7 days. Participants living with smokers in the home, with no smoking restriction at home, and having children younger than 18 were more likely to be exposed to SHS at home. Higher self-efficacy in maintaining a smoke-free home was negatively associated with home SHS exposure. Having visitors who smoke was the greatest policy enforcement challenge. Ineffective measures such as opening windows were more commonly used in homes with partial bans. Educational initiatives to protect against SHS exposure in the home should promote smoke-free homes, address challenges to implementing such policies, and address misconceptions regarding the effectiveness of supposed harm reduction behaviors.

  14. Accuracy of Caregiver Proxy Reports of Home Care Service Use.

    Science.gov (United States)

    Chappell, Neena L; Kadlec, Helena

    2016-12-01

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

  15. Strategies for Addressing the Challenges of Patient-Centered Medical Home Implementation: Lessons from Oregon.

    Science.gov (United States)

    Gelmon, Sherril; Bouranis, Nicole; Sandberg, Billie; Petchel, Shauna

    2018-01-01

    Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics. Between 2015 and 2016, semistructured interviews and focus groups were completed with 85 key informants. Clinics reported similar challenges implementing the PCPCH model, including shifting patterns of care use, fidelity to the PCPCH model, and refining care processes. The following ten implementation strategies emerged: expanding access through care teams, preventing unnecessary emergency department visits through patient outreach, improved communication and referral tracking with outside providers, prioritization of selected program metrics, implementing patient-centered practices, developing continuous improvement capacity through committees and "champions," incorporating preventive services and chronic disease management, standardization of workflows, customizing electronic health records, and integration of mental health. Clinic leaders benefited from understanding the local context in which they were operating. Despite differences in size, ownership, geography, and population, all clinic leaders were observed to be proponents of strategies commonly associated with a "learning organization": systems thinking, personal mastery, mental models, shared vision, and team. Clinics can draw on their own characteristics, use state resources, and look to established PCMHs to build the evidence base for implementation in primary care. © Copyright 2018 by the American Board of Family Medicine.

  16. Washington State Nursing Home Administrator Model Curriculum. Final Report.

    Science.gov (United States)

    Cowan, Florence Kelly

    The course outlines presented in this final report comprise a proposed Fort Steilacoom Community College curriculum to be used as a statewide model two-year associate degree curriculum for nursing home administrators. The eight courses described are introduction to nursing, home administration, financial management of nursing homes, nursing home…

  17. Outcomes of a Randomized Trial of a Cognitive Behavioral Enhancement to Address Maternal Distress in Home Visited Mothers.

    Science.gov (United States)

    McFarlane, Elizabeth; Burrell, Lori; Duggan, Anne; Tandon, Darius

    2017-03-01

    Objectives To assess the effectiveness of a 6-week, cognitive behavioral therapy (CBT) group-based enhancement to home visiting to address stress and prevent depression as compared with home visiting as usual in low income mothers of young children. Methods We conducted a randomized controlled trial with 95 low-income mothers of young children to assess the effectiveness of a 6-week, cognitive behavioral group-based enhancement to Healthy Families America and Parents as Teachers home visiting (HV/CBT = 49) to address stress and prevent depression as compared with home visiting as usual (HV = 46). Booster sessions for the HV/CBT group were offered at 3 and 6 months. Participants completed measures of coping, stress and depression at three points: baseline prior to randomization, post-intervention, and 6 months post-intervention. Parent child interaction was also measured at 6 months. Results Intent-to-treat analyses found improved coping and reduced stress and depression post-intervention. While impacts on these outcomes were attenuated at 6 months, positive impacts were observed for selected aspects of mothers' interactions with their children. Maternal characteristics at baseline were associated with participation in the intervention and with post-intervention and 6-month outcomes. Mothers with lower levels of stress and those with fewer children were more likely to attend intervention sessions. Mothers with lower levels of stress had more favorable post intervention outcomes. Conclusions CBT group-based enhancement to home visiting improved maternal coping, reduced stress and depression immediately post intervention but not at 6 months, suggesting more work is needed to sustain positive gains in low-income mothers of young children.

  18. Measure Guideline: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, R. [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States)

    2014-02-01

    This report, developed by Building America research team CARB, addresses adding or improving mechanical ventilation systems to existing homes. The goal of this report is to assist decision makers and contractors in making informed decisions when selecting ventilation systems for homes. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including examination of relevant codes and standards. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors.

  19. Our winters of discontent : addressing the problem of rising home heating costs

    International Nuclear Information System (INIS)

    Hughes, L.; Wysocki, A.

    2006-03-01

    The cost of space heating may soon increase due to rising fuel prices in international energy markets and the absence of federal and provincial energy security policies. This report examined the benefits and disadvantages of 2 approaches to assist those with limited incomes to meet heating requirements: (1) offering Low Income Fuel Assistance (LIFA) as a one-time payment during the heating season; and (2) the elimination of taxes for home heating fuels. The cost of home heating fuels and their impacts on consumers and governments were considered. A review of the Nova Scotia government's Keep the Heat program noted that the program was not responsive to increases in the price of home heating fuel, particularly if increases in a year exceeded the level of assistance. It was suggested that the removal of heating sales taxes could provide unnecessary windfalls to households with large homes, as well as windfall profits for landlords if savings were not passed on to tenants. Using Nova Scotia as a case study, an alternative support system was considered that guaranteed a set price for heating fuel for those in need. It was suggested that this approach could cost less than a lump-sum payment or the elimination of taxes on home-heating fuel. In addition, the approach would provide low-income consumers with predictable and affordable prices. It was concluded that as space heating energy costs continue to rise, all government fuel assistance programs run the risk of becoming larger and more costly. Other solutions included reducing Canada's dependence on fossil fuels through the use of solar energy; the reduction of residential energy demand; and the promotion of district heating. 26 refs., 9 tabs., 3 figs

  20. Does information matter? Competition, quality, and the impact of nursing home report cards.

    Science.gov (United States)

    Grabowski, David C; Town, Robert J

    2011-12-01

    We evaluate the effects of the Nursing Home Quality Initiative (NHQI), which introduced quality measures to the Centers for Medicare and Medicaid Services' Nursing Home Compare website, on facility performance and consumer demand for services. The nursing home Minimum Data Set facility reports from 1999 to 2005 merged with facility-level data from the On-Line Survey, Certification, and Reporting System. We rely on the staggered rollout of the report cards across pilot and nonpilot states to examine the effect of report cards on market share and quality of care. We also exploit differences in nursing home market competition at baseline to identify the impacts of the new information on nursing home quality. The introduction of the NHQI was generally unrelated to facility quality and consumer demand. However, nursing homes facing greater competition improved their quality more than facilities in less competitive markets. The lack of competition in many nursing home markets may help to explain why the NHQI report card effort had a minimal effect on nursing home quality. With the introduction of market-based reforms such as report cards, this result suggests policy makers must also consider market structure in efforts to improve nursing home performance. © Health Research and Educational Trust.

  1. Frailty, pain and psychological variables among older adults living in Hong Kong nursing homes: can we do better to address multimorbidities?

    Science.gov (United States)

    Tse, M M Y; Lai, C; Lui, J Y W; Kwong, E; Yeung, S Y

    2016-06-01

    WHAT IS KNOWN ON THE SUBJECT?: Frailty and multimorbidity are common in later life. A higher level of frailty is associated with a higher risk of adverse physical and psychological health situations. Older adults with pain have been reported to be lonelier and more depressed, as well as less happy and less satisfied with their life as compared to those without pain. In view of the high prevalence of pain among older adults and the reversibility of frailty, it is important to explore the relationship between pain, frailty and psychological parameters in order to devise patient-centred interventions. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: Frailty index is positively correlated with the presence of pain, and associated with gender, functional mobility and loneliness. Among these significant variables, loneliness was the factor that contributed the most to the frailty index. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: It is essential to put the focus of healthcare on both the physical and psychological aspects of well-being. All nurses are advised to improve the management of pain in older people in order to lower the levels of pain, frailty and psychological distress among this population. Nursing care should address the loneliness level especially the problem of social loneliness among older adults particularly those living in nursing homes. Introduction In view of the high prevalence of pain among older adults and the reversibility of frailty, it is important to explore the relationship between pain, frailty and psychological parameters in order to devise patient-centred interventions. Aim To examine the levels of frailty, pain and psychological parameters among older adults living in Hong Kong nursing homes, and the cross-sectional relationships among these items. Methods A cross-sectional study was conducted among 178 residents from six nursing homes. Frailty, pain, mobility, happiness, loneliness and life satisfaction of participants were assessed using

  2. Development of eHOME, a Mobile Instrument for Reporting, Monitoring, and Consulting Drug-Related Problems in Home Care: Human-Centered Design Study.

    Science.gov (United States)

    Dijkstra, Nienke Elske; Sino, Carolina Geertruida Maria; Heerdink, Eibert Rob; Schuurmans, Marieke Joanna

    2018-03-07

    Home care patients often use many medications and are prone to drug-related problems (DRPs). For the management of problems related to drug use, home care could add to the multidisciplinary expertise of general practitioners (GPs) and pharmacists. The home care observation of medication-related problems by home care employees (HOME)-instrument is paper-based and assists home care workers in reporting potential DRPs. To facilitate the multiprofessional consultation, a digital report of DRPs from the HOME-instrument and digital monitoring and consulting of DRPs between home care and general practices and pharmacies is desired. The objective of this study was to develop an electronic HOME system (eHOME), a mobile version of the HOME-instrument that includes a monitoring and a consulting system for primary care. The development phase of the Medical Research Council (MRC) framework was followed in which an iterative human-centered design (HCD) approach was applied. The approach involved a Delphi round for the context of use and user requirements analysis of the digital HOME-instrument and the monitoring and consulting system followed by 2 series of pilots for testing the usability and redesign. By using an iterative design approach and by involving home care workers, GPs, and pharmacists throughout the process as informants, design partners, and testers, important aspects that were crucial for system realization and user acceptance were revealed. Through the report webpage interface, which includes the adjusted content of the HOME-instrument and added home care practice-based problems, home care workers can digitally report observed DRPs. Furthermore, it was found that the monitoring and consulting webpage interfaces enable digital consultation between home care and general practices and pharmacies. The webpages were considered convenient, clear, easy, and usable. By employing an HCD approach, the eHOME-instrument was found to be an easy-to-use system. The systematic

  3. Designing, testing, and implementing a sustainable nurse home visiting program: right@home.

    Science.gov (United States)

    Goldfeld, Sharon; Price, Anna; Kemp, Lynn

    2018-05-01

    Nurse home visiting (NHV) offers a potential platform to both address the factors that limit access to services for families experiencing adversity and provide effective interventions. Currently, the ability to examine program implementation is hampered by a lack of detailed description of actual, rather than expected, program development and delivery in published studies. Home visiting implementation remains a black box in relation to quality and sustainability. However, previous literature would suggest that efforts to both report and improve program implementation are vital for NHV to have population impact and policy sustainability. In this paper, we provide a case study of the design, testing, and implementation of the right@home program, an Australian NHV program and randomized controlled trial. We address existing gaps related to implementation of NHV programs by describing the processes used to develop the program to be trialed, summarizing its effectiveness, and detailing the quality processes and implementation evaluation. The weight of our evidence suggests that NHV can be a powerful and sustainable platform for addressing inequitable outcomes, particularly when the program focuses on parent engagement and partnership, delivers evidence-based strategies shown to improve outcomes, includes fidelity monitoring, and is adapted to and embedded within existing service delivery systems. © 2018 The Authors. Annals of the New York Academy of Sciences published by Wiley Periodicals, Inc. on behalf of The New York Academy of Sciences.

  4. Experiences of three states implementing the Medicaid health home model to address opioid use disorder-Case studies in Maryland, Rhode Island, and Vermont.

    Science.gov (United States)

    Clemans-Cope, Lisa; Wishner, Jane B; Allen, Eva H; Lallemand, Nicole; Epstein, Marni; Spillman, Brenda C

    2017-12-01

    The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health. This study examines state approaches to opioid health homes (OHH) and uses a retrospective analysis to identify facilitators and barriers to the program's implementation from the perspectives of multiple stakeholders. We conducted 28 semi-structured discussions with 70 discussants across the three states, including representatives from state agencies, OHH providers (OTPs and OBOTs), Medicaid health plans, and provider associations. Discussions were recorded, transcribed, and analyzed using NVivo. In addition, we reviewed state health home applications, policies, regulatory guidance, reporting, and other available OHH materials. We adapted the Exploration, Preparation, Implementation, and Sustainment (EPIS) model as a guiding framework to examine the collected data, helping us to identify key factors affecting each stage of the OHH implementation. Overall, discussants reported that the OHH model was implemented successfully and was responsible for substantial improvements in patient care. Contextual factors at both the state level (e.g., legislation, funding, state leadership, program design) and provider level (OHH provider characteristics, leadership, adaptability) affected each stage of implementation of the OHH model. States took a variety of approaches in

  5. Improving care in care homes: a qualitative evaluation of the Croydon care home support team.

    Science.gov (United States)

    Lawrence, Vanessa; Banerjee, Sube

    2010-05-01

    The Croydon care home support team (CHST) was developed in response to reports of patient abuse within long-term care. It presents a novel strategy for improving standards of care within care homes. A qualitative methodology was used to assess the perceived impact of the CHST. In-depth interviews were conducted with 14 care home managers and 24 members of care home staff across 14 care homes. Grounded theory principles guided the collection and analysis of the data. Reports of improved communication between staff, improved staff development and confidence, and improved quality of care point towards the effectiveness of the CHST model. The collaborative approach of the CHST was considered pivotal to its success and presented as an effective method of engaging care home managers and staff. The CHST adopted a systemic approach that placed an equal emphasis on the social, mental health and nursing needs of residents and aimed to address the whole culture of care within the individual homes. The data demonstrate the potential for specialist multi-disciplinary teams to raise standards of care across long-term care settings. Increased awareness of safeguarding issues, improved staff morale and communication and ongoing opportunities for discussion and problem solving promised to sustain improvements. Such services could be instrumental in meeting the government priority of preventing abuse among vulnerable adults.

  6. Volume 1: president's address, CNA committee reports

    International Nuclear Information System (INIS)

    The president's address summarizes the 1974-75 activities of the CNA and reports are given by CNA subcommittees on codes, standards and practices, economic development, education and manpower, international affairs, nuclear insurance, nuclear safety and environment, public relations, and technology. (E.C.B.)

  7. Eating Dinner Away from Home: Perspectives of Middle- to High-Income Parents

    Science.gov (United States)

    Robson, Shannon M.; Crosby, Lori E.; Stark, Lori J.

    2015-01-01

    This study sought to understand barriers and facilitators for preparing and eating dinner at home in families who report eating dinner away from home ≥3 per week. Cross-sectional, mixed methods (focus groups, questionnaires) study. Twenty-seven parents with a child 3–10 years-old who reported eating dinner away from home ≥3 times per week from a pediatric medical center in the Midwest participated. The key concepts analytic framework guided focus group analysis. Descriptive statistics were used to characterize parent demographics, anthropometrics, attitudes and confidence toward cooking, perceptions of dinner costs and portions, and parent and child dinners. Parents reported confidence in cooking a home prepared meal, but that eating away from home was reinforcing because it provided quality family time and diminished barriers such as picky eating and perceived costs. Home cooking was also hindered by early school lunch and after-school sports as children were not hungry or home at the typical dinner hour and parents did not want to cook after 8pm. Parents estimated preparing and eating a meal at home took significantly more time than driving and eating out (80.7 minutes vs. 30.3 minutes, peating out, interventions should address family factors (e.g., time management, quality time) and child behavior (e.g., picky eating). Innovative interventions that include experiential cooking opportunities that incorporate time management, address picky eating and enthusiasm for cooking with education on decreasing costs may be particularly beneficial for middle- to high-income families. PMID:26386299

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

    Science.gov (United States)

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

    2010-10-01

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

  9. Addressing Kitchen Contaminants for Healthy, Low-Energy Homes

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, J. Chris [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Singer, Brett C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2014-01-01

    Cooking and cooking burners emit pollutants that can adversely affect indoor air quality in residences and significantly impact occupant health. Effective kitchen exhaust ventilation can reduce exposure to cooking-related air pollutants as an enabling step to healthier, low-energy homes. This report by Lawrence Berkeley National Laboratory identifies barriers to the widespread adoption of kitchen exhaust ventilation technologies and practice and proposes a suite of strategies to overcome these barriers. The recommendations have been vetted by a group of industry, regulatory, health, and research experts and stakeholders who convened for two meetings and provided input and feedback to early drafts of this document. The most fundamental barriers are (1) the common misconception, based on a sensory perception of risk, that kitchen exhaust when cooking is unnecessary and (2) the lack of a code requirement for kitchen ventilation in most U.S. locations. Highest priority objectives include the following: (1) Raise awareness among the public and the building industry of the need to install and routinely use kitchen ventilation; (2) Incorporate kitchen exhaust ventilation as a requirement of building codes and improve the mechanisms for code enforcement; (3) Provide best practice product and use-behavior guidance to ventilation equipment purchasers and installers, and; (4) Develop test methods and performance targets to advance development of high performance products. A specific, urgent need is the development of an over-the-range microwave that meets the airflow and sound requirements of ASHRAE Standard 62.2.

  10. Addressing Kitchen Contaminants for Healthy, Low-Energy Homes

    Energy Technology Data Exchange (ETDEWEB)

    Stratton, J. Chris; Singer, Brett C.

    2014-01-01

    Cooking and cooking burners emit pollutants that can adversely affect indoor air quality in residences and significantly impact occupant health. Effective kitchen exhaust ventilation can reduce exposure to cooking-related air pollutants as an enabling step to healthier, low-energy homes. This report identifies barriers to the widespread adoption of kitchen exhaust ventilation technologies and practice and proposes a suite of strategies to overcome these barriers. The recommendations have been vetted by a group of industry, regulatory, health, and research experts and stakeholders who convened for two web-based meetings and provided input and feedback to early drafts of this document. The most fundamental barriers are (1) the common misconception, based on a sensory perception of risk, that kitchen exhaust when cooking is unnecessary and (2) the lack of a code requirement for kitchen ventilation in most US locations. Highest priority objectives include the following: (1) Raise awareness among the public and the building industry of the need to install and routinely use kitchen ventilation; (2) Incorporate kitchen exhaust ventilation as a requirement of building codes and improve the mechanisms for code enforcement; (3) Provide best practice product and use-behavior guidance to ventilation equipment purchasers and installers, and; (4) Develop test methods and performance targets to advance development of high performance products. A specific, urgent need is the development of an over-the-range microwave that meets the airflow and sound requirements of ASHRAE Standard 62.2.

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

    Directory of Open Access Journals (Sweden)

    Thomas Saïas

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

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

    Science.gov (United States)

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

    2016-06-01

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

  13. 16 CFR 641.1 - Duties of users of consumer reports regarding address discrepancies.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Duties of users of consumer reports... CREDIT REPORTING ACT DUTIES OF USERS OF CONSUMER REPORTS REGARDING ADDRESS DISCREPANCIES § 641.1 Duties of users of consumer reports regarding address discrepancies. (a) Scope. This section applies to...

  14. Keeping warm? Self-reported housing and home energy efficiency factors impacting on older people heating homes in North Wales

    International Nuclear Information System (INIS)

    Burholt, Vanessa; Windle, Gill

    2006-01-01

    This paper examines a representative sample (N=421) of older people (aged 70+) living in rural North Wales with regard to relationships between fuel poverty, feeling cold in one's home and a range of self-reported housing and home energy efficiency items. In the Welsh context, the combination of poor housing stock and low-level income is likely to increase the chance of older people experiencing fuel poverty, therefore the analyses are relevant to both energy and social policy. The paper hypothesises that: (i) People in 'fuel poor' homes are: low-income households; living in older houses; lacking home energy efficiency measures; (ii) not all people facing difficulties heating their home (i.e. wearing extra clothing to keep warm during cold spells) are identified as 'fuel poor', but there will be an association between taking extra measures to keep warm and low income; older houses and lacking home energy efficiency factors. The results partially support the hypotheses. An estimation is made of the expenditure required to counter the factors associated with fuel poverty and cold homes in the region. The paper concludes with implications for the UK Fuel Poverty Strategy

  15. Adaptation and Validation of the HOME-SF as a Caregiver-Report Home Environment Measure for Use in the Taiwan Birth Cohort Study (TBCS)

    Science.gov (United States)

    Wu, Jennifer Chun-Li; Chiang, Tung-liang; Bradley, Robert H.

    2011-01-01

    This study aimed to develop a brief caregiver-report instrument for measuring the home environment of children aged three and under, as part of the Taiwan Birth Cohort Study (TBCS). Instrument development was conducted by translating and adapting the Home Observation for the Measurement of Environment Inventory-Short Form (HOME-SF) which comprises…

  16. Measure Guideline: Selecting Ventilation Systems for Existing Homes

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, Robb [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2014-02-01

    This document addresses adding -or improving - mechanical ventilation systems to existing homes. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including some discussion of relevant codes and standards. Advantages, disadvantages, and approximate costs of various system types are presented along with general guidelines for implementing the systems in homes. CARB intends for this document to be useful to decision makers and contractors implementing ventilation systems in homes. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors. It is the intent of this document to assist contractors in making more informed decisions when selecting systems. Ventilation is an integral part of a high-performance home. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability.

  17. Smart homes and home health monitoring technologies for older adults: A systematic review.

    Science.gov (United States)

    Liu, Lili; Stroulia, Eleni; Nikolaidis, Ioanis; Miguel-Cruz, Antonio; Rios Rincon, Adriana

    2016-07-01

    Around the world, populations are aging and there is a growing concern about ways that older adults can maintain their health and well-being while living in their homes. The aim of this paper was to conduct a systematic literature review to determine: (1) the levels of technology readiness among older adults and, (2) evidence for smart homes and home-based health-monitoring technologies that support aging in place for older adults who have complex needs. We identified and analyzed 48 of 1863 relevant papers. Our analyses found that: (1) technology-readiness level for smart homes and home health monitoring technologies is low; (2) the highest level of evidence is 1b (i.e., one randomized controlled trial with a PEDro score ≥6); smart homes and home health monitoring technologies are used to monitor activities of daily living, cognitive decline and mental health, and heart conditions in older adults with complex needs; (3) there is no evidence that smart homes and home health monitoring technologies help address disability prediction and health-related quality of life, or fall prevention; and (4) there is conflicting evidence that smart homes and home health monitoring technologies help address chronic obstructive pulmonary disease. The level of technology readiness for smart homes and home health monitoring technologies is still low. The highest level of evidence found was in a study that supported home health technologies for use in monitoring activities of daily living, cognitive decline, mental health, and heart conditions in older adults with complex needs. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  18. Home Rx: The Health Benefits of Home Performance

    Energy Technology Data Exchange (ETDEWEB)

    Wilson, Jonathan [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Jacobs, David [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Reddy, Amanda [National Center for Healthy Housing (NCHH), Columbia, MD (United States); Tohn, Ellen [Tohn Environmental Strategies, Wayland, MA (United States); Cohen, Jonathan [Dept. of Energy (DOE), Washington DC (United States); Jacobsohn, Ely [Dept. of Energy (DOE), Washington DC (United States)

    2016-12-01

    Evidence in a new, groundbreaking U.S. Department of Energy report, Home Rx: The Health Benefits of Home Performance, shows that home performance upgrades can improve the quality of a home’s indoor environment by reducing the prevalence of harmful indoor air pollutants and contaminants. Until recently, no systematic review of this evidence had been conducted, limiting full understanding of the link between home performance and health. This new report summarizes current knowledge and identifies research gaps. The design characteristics and results of each of the 40 studies considered in the report are summarized in a searchable matrix.

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

    Energy Technology Data Exchange (ETDEWEB)

    Quarles, Stephen, L.; Sindelar, Melissa

    2011-12-13

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

  20. Caring for patients on home enteral nutrition: Reported complications by home carers and perspectives of community nurses.

    Science.gov (United States)

    Lim, Mei Ling; Yong, Bei Yi Paulynn; Mar, Mei Qi Maggie; Ang, Shin Yuh; Chan, Mei Mei; Lam, Madeleine; Chong, Ngian Choo Janet; Lopez, Violeta

    2018-07-01

    To explore the experiences of community nurses and home carers, in caring for patients on home enteral nutrition. The number of patients on home enteral nutrition is on the increase due to advancement in technology and shift in focus of providing care from acute to community care settings. A mixed-method approach was adopted. (i) A face-to-face survey design was used to elicit experience of carers of patients on home enteral nutrition. (ii) Focus group interviews were conducted with community nurses. Ninety-nine carers (n = 99) were recruited. Patient's mean age that they cared for was aged 77.7 years (SD = 11.2), and they had been on enteral feeding for a mean of 29 months (SD = 23.0). Most were bed-bound (90%) and required full assistance with their feeding (99%). Most were not on follow-up with dietitians (91%) and dentists (96%). The three most common reported gastrointestinal complications were constipation (31%), abdominal distension (28%) and vomiting (22%). Twenty community nurses (n = 20) were recruited for the focus group interviews. Four main themes emerged from the analysis: (i) challenge of accessing allied health services in the community; (ii) shorter length of stay in the acute care setting led to challenges in carers' learning and adaptation; (iii) transition gaps between hospital and home care services; and (iv) managing expectations of family. To facilitate a better transition of care for patients, adequate training for carers, standardising clinical practice in managing patients with home enteral nutrition and improving communication between home care services and the acute care hospitals are needed. This study highlighted the challenges faced by community home care nurses and carers. Results of this study would help to inform future policies and practice changes that would improve the quality of care received by patients on home enteral nutrition. © 2018 John Wiley & Sons Ltd.

  1. Smart assistants for smart homes

    OpenAIRE

    Rasch, Katharina

    2013-01-01

    The smarter homes of tomorrow promise to increase comfort, aid elderly and disabled people, and help inhabitants save energy. Unfortunately, smart homes today are far from this vision – people who already live in such a home struggle with complicated user interfaces, inflexible home configurations, and difficult installation procedures. Under these circumstances, smart homes are not ready for mass adoption. This dissertation addresses these issues by proposing two smart assistants for smart h...

  2. Eating dinner away from home: Perspectives of middle-to high-income parents.

    Science.gov (United States)

    Robson, Shannon M; Crosby, Lori E; Stark, Lori J

    2016-01-01

    This study sought to understand barriers and facilitators for preparing and eating dinner at home in families who report eating dinner away from home ≥3 times per week. Cross-sectional, mixed methods (focus groups, questionnaires) study. Twenty-seven parents with a child 3-10 years-old who reported eating dinner away from home ≥3 times per week from a pediatric medical center in the Midwest participated. The key concepts analytic framework guided focus group analysis. Descriptive statistics were used to characterize parent demographics, anthropometrics, attitudes and confidence toward cooking, perceptions of dinner costs and portions, and parent and child dinners. Parents reported confidence in cooking a home prepared meal, but that eating away from home was reinforcing because it provided quality family time and diminished barriers such as picky eating and perceived costs. Home cooking was also hindered by early school lunch and after-school sports as children were not hungry or home at the typical dinner hour and parents did not want to cook after 8pm. Parents estimated preparing and eating a meal at home took significantly more time than driving and eating out (80.7 min vs. 30.3 min, p < 0.001). Parents significantly (F (3, 104) = 8.80, p < 0.001) overestimated the cost of home-prepared meals compared to take-out and frozen meals. Portion size was also overestimated for a protein serving. Findings are limited to predominantly married, female parents whom are highly educated and working. To reduce eating out, interventions should address family factors (e.g., time management, quality time) and child behavior (e.g., picky eating). Innovative interventions that include experiential cooking opportunities that incorporate time management, address picky eating and enthusiasm for cooking with education on decreasing costs may be particularly beneficial for middle-to high-income families. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. DTU International Energy Report 2013

    DEFF Research Database (Denmark)

    to make this possible. This energy report addresses energy storage from a broad perspective: It analyses smaller stores that can be used locally in for example heat storage in the individual home or vehicle, such as electric cars or hydrogen cars. The report also addresses decentralized storage...... as flywheels and batteries linked to decentralized energy systems. In addition it addresses large central storages as pumped hydro storage and compressed air energy storage and analyse this in connection with international transmission and trading over long distances. The report addresses electrical storage...

  4. Use of 222Rn-resistant techniques in new home construction

    International Nuclear Information System (INIS)

    Watson, J.E. Jr.; Cote, R.A.

    1999-01-01

    The objective of this project was to assess the status of the use of 222 Rn-resistant construction techniques in new home construction in the eight Zone 1 counties of North Carolina. Zone 1 counties have an average predicted indoor 222 Rn screening potential greater than 148 Bq m -3 (4 pCi L -1 ). To facilitate a response from builders, a brief survey form was designed and printed on the back of a self-addressed, postage-paid postcard. This survey form was mailed to 460 home builders in the Zone 1 counties. The response rate was 17%, which can be compared to the 4.9% response rate obtained in a national survey conducted by the National Association of Home Builders Research Center. In their survey, 62% of the responding builders reported that they had built some or many homes in 1996 using construction techniques to reduce the entry of radon into homes, but only 10% of the builders reported using these techniques for many homes. The National Association of Home Builders survey determined that, nationally, 30% of homes built in Zone 1 counties had 222 Rn venting features. There is the potential for bias in the results of their survey (as well as in the results of the National Association of Home Builders survey) since the response rates were low

  5. Home, Smart Home

    DEFF Research Database (Denmark)

    Hansen, Ellen Kathrine; Olesen, Gitte Gylling Hammershøj; Mullins, Michael

    2013-01-01

    The article places focus on how smart technologies integrated in a one family- home and particular the window offer unique challenges and opportunities for designing buildings with the best possible environments for people and nature. Toward an interdisciplinary approach, we address the interaction...... between daylight defined in technical terms and daylight defined in aesthetic, architectural terms. Through field-tests of a Danish carbon-neutral home and an analysis of five key design parameters, we explore the contradictions and potentials in smart buildings, using the smart window as example of how...... to the energy design is central. The study illuminates an approach of the design of smart houses as living organisms by connecting technology with the needs of the occupants with the power and beauty of daylight....

  6. Validity of parent-reported weight and height of preschool children measured at home or estimated without home measurement: a validation study

    Directory of Open Access Journals (Sweden)

    Cox Bianca

    2011-07-01

    Full Text Available Abstract Background Parental reports are often used in large-scale surveys to assess children's body mass index (BMI. Therefore, it is important to know to what extent these parental reports are valid and whether it makes a difference if the parents measured their children's weight and height at home or whether they simply estimated these values. The aim of this study is to compare the validity of parent-reported height, weight and BMI values of preschool children (3-7 y-old, when measured at home or estimated by parents without actual measurement. Methods The subjects were 297 Belgian preschool children (52.9% male. Participation rate was 73%. A questionnaire including questions about height and weight of the children was completed by the parents. Nurses measured height and weight following standardised procedures. International age- and sex-specific BMI cut-off values were employed to determine categories of weight status and obesity. Results On the group level, no important differences in accuracy of reported height, weight and BMI were identified between parent-measured or estimated values. However, for all 3 parameters, the correlations between parental reports and nurse measurements were higher in the group of children whose body dimensions were measured by the parents. Sensitivity for underweight and overweight/obesity were respectively 73% and 47% when parents measured their child's height and weight, and 55% and 47% when parents estimated values without measurement. Specificity for underweight and overweight/obesity were respectively 82% and 97% when parents measured the children, and 75% and 93% with parent estimations. Conclusions Diagnostic measures were more accurate when parents measured their child's weight and height at home than when those dimensions were based on parental judgements. When parent-reported data on an individual level is used, the accuracy could be improved by encouraging the parents to measure weight and height

  7. Report: Review of Hotline Complaint on Employee Granted Full-Time Work-at-Home Privilege

    Science.gov (United States)

    Report #10-P-0002, October 7, 2009. We found an unauthorized, full-time work-at-home arrangement that has existed for 9 years and allows a NETI employee to work from home in Ohio instead of an office in Washington, DC.

  8. Nursing home administrators’ perspectives on a study feedback report: a cross sectional survey

    Directory of Open Access Journals (Sweden)

    Boström Anne-Marie

    2012-09-01

    Full Text Available Abstract Background This project is part of the Translating Research in Elder Care (TREC program of research, a multi-level and longitudinal research program being conducted in 36 nursing homes in three Canadian Prairie Provinces. The overall goal of TREC is to improve the quality of care for older persons living in nursing homes and the quality of work life for care providers. The purpose of this paper is to report on development and evaluation of facility annual reports (FARs from facility administrators’ perspectives on the usefulness, meaningfulness, and understandability of selected data from the TREC survey. Methods A cross sectional survey design was used in this study. The feedback reports were developed in collaboration with participating facility administrators. FARs presented results in four contextual areas: workplace culture, feedback processes, job satisfaction, and staff burnout. Six weeks after FARs were mailed to each administrator, we conducted structured telephone interviews with administrators to elicit their evaluation of the FARs. Administrators were also asked if they had taken any actions as a result of the FAR. Descriptive and inferential statistics, as well as content analysis for open-ended questions, were used to summarize findings. Results Thirty-one facility administrators (representing thirty-two facilities participated in the interviews. Six administrators had taken action and 18 were planning on taking action as a result of FARs. The majority found the four contextual areas addressed in FAR to be useful, meaningful, and understandable. They liked the comparisons made between data from years one and two and between their facility and other TREC study sites in their province. Twenty-two indicated that they would like to receive information on additional areas such as aggressive behaviours of residents and information sharing. Twenty-four administrators indicated that FARs contained enough information, while eight

  9. Randomized trial of the ForeseeHome monitoring device for early detection of neovascular age-related macular degeneration. The HOme Monitoring of the Eye (HOME) study design - HOME Study report number 1.

    Science.gov (United States)

    Chew, Emily Y; Clemons, Traci E; Bressler, Susan B; Elman, Michael J; Danis, Ronald P; Domalpally, Amitha; Heier, Jeffrey S; Kim, Judy E; Garfinkel, Richard A

    2014-03-01

    To evaluate the effects of a home-monitoring device with tele-monitoring compared with standard care in detection of progression to choroidal neovascularization (CNV) associated with age-related macular degeneration (AMD), the leading cause of blindness in the US. Participants, aged 55 to 90 years, at high risk of developing CNV associated with AMD were recruited to the HOme Monitoring of Eye (HOME) Study, an unmasked, multi-center, randomized trial of the ForeseeHome (FH) device plus standard care vs. standard care alone. The FH device utilizes preferential hyperacuity perimetry and tele-monitoring to detect changes in vision function associated with development of CNV, potentially prior to symptom and visual acuity loss. After establishing baseline measurements, subsequent changes on follow-up are detected by the device, causing the monitoring center to alert the clinical center to recall participants for an exam. Standard care consists of instructions for self-monitoring visual changes with subsequent self-report to the clinical center. The primary objective of this study is to determine whether home monitoring plus standard care in comparison with standard care alone, results in earlier detection of incident CNV with better present visual acuity. The primary outcome is the decline in visual acuity at CNV diagnosis from baseline. Detection of CNV prior to substantial vision loss is critical as vision outcome following anti-angiogenic therapy is dependent on the visual acuity at initiation of treatment. HOME Study is the first large scale study to test the use of home tele-monitoring system in the management of AMD patients. Published by Elsevier Inc.

  10. A Web site-based reporting system for monitoring home treatment during oral immunotherapy for food allergy.

    Science.gov (United States)

    Nachshon, Liat; Goldberg, Michael R; Elizur, Arnon; Levy, Michael B; Schwartz, Naama; Katz, Yitzhak

    2015-06-01

    Reactions during the home treatment phase of oral immunotherapy (OIT) are not uncommon. An ongoing accurate reporting of home treatment outcomes is crucial for the safety and success of OIT. Previous reports have shown that as few as 20% of patients are truly compliant with paper-based diaries. To develop a Web site-based electronic reporting system (web-RS) for monitoring home treatment during OIT for food allergy. A web-RS was developed and incorporated a thorough questionnaire querying for pertinent data including the dose(s) consumed, occurrence and details of adverse reactions, treatment(s), and relevant potential exacerbating factors. All patients enrolled in milk, peanut, or egg OIT programs for at least 4 weeks from November 2012 through January 2014 were introduced to web-RS (n = 157). Successful reporting through web-RS was defined by consecutive reporting during the first home treatment phase (24 days) after its introduction. Comparisons were made with a previous group of OIT-treated patients (n = 100) who reported by E-mail. Successful reporting was achieved by 142 of 157 patients (90.44%) in contrast to a 75% success rate with E-mail (P = .0009). The odds for successful reporting using web-RS were 3.1 (95% confidence interval 1.6-6.3) times higher compared with using E-mail. Mild reactions were reported more frequently with web-RS (P = .0032). Patient reports were constantly available in real time for medical staff review. No complaints regarding web-RS feasibility were reported. One risk factor for failure to use web-RS was a patient's prior successful OIT experience without using web-RS (P = .012). A web-RS can be a powerful tool for improving OIT safety by achieving a high level of patient cooperation in reporting home treatment results. Copyright © 2015 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. Addressing cancer patient and caregiver role transitions during home hospice nursing care.

    Science.gov (United States)

    Hudson, Janella; Reblin, Maija; Clayton, Margaret F; Ellington, Lee

    2018-05-15

    Many family caregivers and hospice patients experience role changes resulting from advancing illness and the need for increased caregiver responsibility. Successful navigation of conflicts that arise because of these role transitions has been linked to higher quality of patient care and improved caregiver bereavement adjustment. Nursing communication with patients and their caregivers plays an important role in facilitating these transitions. Our objective is to describe patient-caregiver-nurse communication during transitions at end of life. A secondary, qualitative analysis was conducted on transcripts. Using an iterative process of constant comparison, coders inductively categorized nurse, caregiver, and patient communication behavior into overarching themes. Participants were home hospice nurses and cancer patient/spouse caregiver dyads; participants were >45 years of age, English speaking, and cognitively able to participate. Research took place in the home during nurse visits.ResultNineteen unique home hospice visits were analyzed. Patient-caregiver conflict occurred in two major content themes (1) negotiating transitions in patient independence and (2) navigating caregiver/patient emotions (e.g., frustration, sadness). Nurse responses to transition conflict included problem-solving, mediating, or facilitating discussions about conflicts. Nurse responses to emotional conflict included validation and reassurance.Significance of resultsOur findings provide insight into the topics and processes involved in patient and caregiver transitions in home hospice and the role hospice nursing communication plays in mediating potential conflict. Nurses are often asked to take on the role of mediator, often with little conflict resolution communication education; results can be used for nursing education.

  12. 25 CFR 1000.382 - What may the Tribe's/Consortium's annual report on self-governance address?

    Science.gov (United States)

    2010-04-01

    ...-governance address? 1000.382 Section 1000.382 Indians OFFICE OF THE ASSISTANT SECRETARY, INDIAN AFFAIRS... report on self-governance address? (a) The Tribe's/Consortium's annual self-governance report may address... the programs and services funded under self-governance, summarized and annotated as the Tribe may deem...

  13. Do care homes deliver person-centred care? A cross-sectional survey of staff-reported abusive and positive behaviours towards residents from the MARQUE (Managing Agitation and Raising Quality of Life) English national care home survey.

    Science.gov (United States)

    Cooper, Claudia; Marston, Louise; Barber, Julie; Livingston, Deborah; Rapaport, Penny; Higgs, Paul; Livingston, Gill

    2018-01-01

    There are widespread concerns about abuse of care home residents. We report, in the largest care home survey, prevalence of staff anonymously-reported, perpetrated/witnessed abusive behaviours towards care home residents over 3 months. We also report positive care behaviours. 1544 staff in 92 English care home units completed the revised Modified Conflict Tactics Scale and Maslach Burnout Inventory. Most staff reported positive care behaviours, but specific person-centred activities were sometimes infrequent. Many care home staff were never or almost never aware of a resident being taken out of the home for their enjoyment (34%, n = 520); or an activity planned around a resident's interests (15%, n = 234). 763 (51%; 95% Confidence Interval (CI) 47% to 54%) of care home staff reported carrying out or observing potentially abusive or neglectful behaviours at least sometimes in the preceding 3 months; some abuse was reported as happening "at least sometimes" in 91/92 care homes. Neglect was most frequently reported: making a resident wait for care (n = 399, 26%), avoiding a resident with challenging behaviour (n = 391, 25%), giving residents insufficient time for food (n = 297, 19%), and taking insufficient care when moving residents (n = 169, 11%). 1.1% of staff reported physical and 5% verbal abuse. More staff reported abusive/neglectful behaviour in homes with higher staff burnout-depersonalisation scores (adjusted odds ratio 1.191, CI 1.052-1.349). Staff anonymous reports of abusive behaviour and neglect could be used to monitor care quality, as cases currently reported are probably tip of the iceberg, and be an outcome in intervention studies.

  14. Review of survey data on the importance of energy efficiency to new home buyers

    Energy Technology Data Exchange (ETDEWEB)

    Hendrickson, P.L.

    1984-10-01

    The surveys reviewed for this report support the notion that the Council's model conservation standards will be received reasonably well and can be successfully marketed. A number of subtopics are addressed including the home purchase process and the role of energy efficiency considerations in the process, the importance of energy efficiency considerations in the decision to purchase a new home, the relative importance of energy efficiency in comparison to other home selection attributes, homeowner preferences for particular energy efficiency features, and measures of the willingness to pay for energy efficiency improvements.

  15. Project CHERISH (Children in Home Environments: Regulation To Improve Safety and Health). Final Report.

    Science.gov (United States)

    Grubb, Paul Dallas

    In 1990, Project CHERISH (Children in Home Environments: Regulation to Increase Safety and Health) enabled the Texas Department of Human Services to implement and evaluate several innovative strategies to strengthen regulation of family day care homes. This report contains descriptions of those strategies, an evaluation of their efficacy, and…

  16. Clinical use of Nintendo Wii bowling simulation to decrease fall risk in an elderly resident of a nursing home: a case report.

    Science.gov (United States)

    Clark, Robert; Kraemer, Theresa

    2009-01-01

    Of the estimated 1.7 million residents of nursing homes in the United States, approximately half fall annually; and 11% of these sustain injury. This is twice the rate for persons dwelling in the community. By addressing fall risk, physical therapists have an opportunity to reduce falls which are the leading cause of injury deaths, as well as the most common cause of nonfatal injuries for older adults in the United States. This case report examines the effect of a novel interactive video game intervention to address balance dysfunction in an elderly resident of a nursing home who was at risk for falls. The patient is an 89-year-old resident diagnosed with an unspecified balance disorder and a history of multiple falls. Self reports of gait abnormalities, scores on several clinical measures, and her fall history classified her as having substantial risk for future falls. A nontraditional approach to balance training, employing the Nintendo Wii bowling simulation, was used as intervention for this patient's balance disorder. After 6 one-hour treatment sessions, the patient's Berg Balance Score improved from 48 to 53. On the Dynamic Gait Index, the patient improved her score from 19 to 21. The patient's Timed Up and Go Test improved from 14.9 to 10.5 seconds, all suggesting a reduced risk of falling. The patient's ABC Score improved from 88 to 90%. Physical therapy intervention, using the Nintendo Wii bowling simulation, may have decreased fall risk for this individual.

  17. Energy-efficient mortgages and home energy rating systems: A report on the nation`s progress

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B.C.; Eckert, J.

    1993-09-01

    This report summarizes progress throughout the nation in establishing voluntary programs linking home energy rating systems (HERS) and energy-efficient mortgages (EEMs). These programs use methods for rating the energy efficiency of new and existing homes and predicting energy cost savings so lenders can factor in energy cost savings when underwriting mortgages. The programs also encourage lenders to finance cost-effective energy-efficiency improvements to existing homes with low-interest mortgages or other instruments. The money saved on utility bills over the long term can more than offset the cost of such energy-efficiency improvements. The National Collaborative on HERS and EEMs recommended that this report be prepared.

  18. Exploring new operational research opportunities within the Home Care context: the chemotherapy at home.

    Science.gov (United States)

    Chahed, Salma; Marcon, Eric; Sahin, Evren; Feillet, Dominique; Dallery, Yves

    2009-06-01

    Home Care (HC) services provide complex and coordinated medical and paramedical care to patients at their homes. As health care services move into the home setting, the need for developing innovative approaches that improve the efficiency of home care organizations increases. We first conduct a literature review of investigations dealing with operation planning within the area of home care management. We then address a particular issue dealing with the planning of operations related to chemotherapy at home as it is an emergent problem in the French context. Our interest is focused on issues specific to the anti-cancer drug supply chain. We identify various models that can be developed and analyze one of them.

  19. 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.

  20. Home networking architecture for IPv6

    OpenAIRE

    Arkko, Jari; Weil, Jason; Troan, Ole; Brandt, Anders

    2012-01-01

    This text describes evolving networking technology within increasingly large residential home networks. The goal of this document is to define an architecture for IPv6-based home networking while describing the associated principles, considerations and requirements. The text briefly highlights the specific implications of the introduction of IPv6 for home networking, discusses the elements of the architecture, and suggests how standard IPv6 mechanisms and addressing can be employed in home ne...

  1. National status report: Home energy rating systems and energy-efficient mortgages

    Energy Technology Data Exchange (ETDEWEB)

    Plympton, P.

    2000-04-27

    The Energy Policy Act of 1992 included several provisions promoting the use of HERS and EEMs, which strengthened efforts to develop a national infrastructure for HERS and to promote the use of EEMs. This report documents HERS and EEMs activities since 1992 by the U.S. Department of Energy, the U.S. Environmental Protection Agency, the U.S. Department of Housing and Urban Development, mortgage lenders, and other organizations. Though the process of establishing HERS has faced some barriers, this report shows that, as of November 1999, home energy ratings were available in 47 states and the District of Columbia, which represents a significant increase from 1993 when home energy ratings were available in 17 states. Both national and state organizations have developed HERS and related residential energy-efficiency programs. The availability and use of EEMs has also increased significantly. The number of EEMs supported by the Federal Housing Administration has increased more than eight times in the last three years. More than $2.5 billion in federally supported EEMs have been issued to date. Several national lenders offer EEMs, and six states have state-specific EEM or loan programs. EEMs have been used to finance energy-efficient homes in every state.

  2. Diarrhea & Child Care: Controlling Diarrhea in Out-of-Home Child Care. NCEDL Spotlights, No. 4.

    Science.gov (United States)

    Churchill, Robin B.; Pickering, Larry K.

    This report, the fourth in the National Center for Early Development and Learning's (NCEDL) "Spotlights" series, is based on excerpts from a paper presented during a "Research into Practice in Infant/Toddler Care" synthesis conference in fall 1997. The report addresses controlling diarrhea in out-of-home child care. The report…

  3. Home parenteral nutrition in children

    International Nuclear Information System (INIS)

    Kalousova, J.; Rouskova, B.; Styblova, J.

    2011-01-01

    Parenteral nutrition delivered at home presents a major improvement in the quality of life of children dependent on long term parenteral nutrition. Indications, technical conditions, logistics, complications, prognosis of home parenteral nutrition as well as some health-care issues to be addressed by pediatric practitioner are summarized. (author)

  4. 76 FR 28917 - Medical Foster Homes

    Science.gov (United States)

    2011-05-19

    ... facilities do not adequately protect bedridden patients. The current regulations are only intended to address homes where personal care services are provided to veterans and are not intended to address bedridden...

  5. Home care, hospitalizations and doctor visits

    OpenAIRE

    Gonçalves Judite; Weaver France

    2014-01-01

    This study estimates the effects of formal home care on hospitalizations and doctor visits. We compare the effects of medically- and non-medically-related home care and investigate heterogeneous effects by age group and informal care availability. Two-part models are estimated, using data from Switzerland. In this federal country, home care policy is decentralized into cantons (i.e. states). The endogeneity of home care is addressed by using instrumental variables, canton and time fixed effec...

  6. Maltreatment histories of aging out foster youth: A comparison of official investigated reports and self-reports of maltreatment prior to and during out-of-home care.

    Science.gov (United States)

    Havlicek, Judy; Courtney, Mark E

    2016-02-01

    This study compared official investigated reports of child maltreatment with retrospective self-reports prior to and during out-of-home care for a sample of foster youth who reached the age of majority in out-of-home care in Illinois. Using matched administrative and self-reported data for 474 youth who completed a baseline interview in the Midwest Evaluation of Adult Functioning of Former Foster Youth (i.e. the Midwest study) at ages 17-18, and 386 youth who completed a follow up interview at age 19, this study finds that official reports and self-reports of maltreatment prior to and during out-of-home care differ significantly. Findings from this study add insight into measurement discrepancies, and help to inform understanding of the extent of maltreatment experienced by this sub-sample of young people exiting out-of-home care in adulthood. Study findings have implications for independent living policy and practice in child welfare. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Building America Case Study: Selecting Ventilation Systems for Existing Homes (Fact Sheet)

    Energy Technology Data Exchange (ETDEWEB)

    2014-12-01

    This document addresses adding -or improving - mechanical ventilation systems to existing homes. The purpose of ventilation is to remove contaminants from homes, and this report discusses where, when, and how much ventilation is appropriate in a home, including some discussion of relevant codes and standards. Advantages, disadvantages, and approximate costs of various system types are presented along with general guidelines for implementing the systems in homes. CARB intends for this document to be useful to decision makers and contractors implementing ventilation systems in homes. Choosing the "best" system is not always straightforward; selecting a system involves balancing performance, efficiency, cost, required maintenance, and several other factors. It is the intent of this document to assist contractors in making more informed decisions when selecting systems. Ventilation is an integral part of a high-performance home. With more air-sealed envelopes, a mechanical means of removing contaminants is critical for indoor environmental quality and building durability.

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

    Science.gov (United States)

    2016-11-03

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

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

    Science.gov (United States)

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

    2011-01-01

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

  10. 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

  11. Solar Mosaic Inc. Mosaic Home Solar Loan SunShot 9 Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Walsh, Colin James [Solar Mosaic Inc., Oakland, CA (United States)

    2017-02-09

    The 6686 Mosaic SunShot award has helped Solar Mosaic Inc to progress from an early stage startup focused on commercial crowdfunding to a leading multi-state residential solar lender. The software platform is now used by the majority of the nation's top solar installers and offers a variety of simple home solar loans. Mosaic is has originated approximately $1Bil in solar loans to date to put solar on over 35k rooftops. The company now lends to homeowners with a wide range of credit scores across multiple states and mitigates boundaries preventing them from profiting from ownership of a home solar system. The project included milestones in 5 main categories: 1. Lending to homeowners outside of CA 2. Lending to homeowners with FICO scores under 700 3. Packaging O&M with the home solar loan 4. Allowing residential installers to process home solar loans via API 5. Lowering customer acquisition costs below $1500 This report includes a detailed review of the final results achieved and key findings.

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

    Science.gov (United States)

    Park, Jeongyoung; Werner, Rachel M

    2011-07-01

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

  13. Experienced discrimination in home mortgage lending

    DEFF Research Database (Denmark)

    Secchi, Davide; Seri, Raffaello

    2017-01-01

    This article proposes a framework for the analysis of experienced discrimination in home mortgages. It addresses the problem of home mortgage lending discrimination in one of the richest areas of northern Italy. Employees of a local hospital were interviewed to study their perception (or experien...

  14. Marketing energy conservation options to Northwest manufactured home buyers

    Energy Technology Data Exchange (ETDEWEB)

    Hendrickson, P.L.; Mohler, B.L.; Taylor, Z.T.; Lee, A.D.; Onisko, S.A.

    1985-06-01

    This study relies on extensive, existing survey data and new analyses to develop information that would help design a marketing plan to achieve energy conservation in new manufactured homes. Existing surveys present comprehensive information about regional manufactured home occupants and their homes that are relevant to a potential conservation marketing plan. An independent analysis of the cost-effectiveness of various efficiency improvements provides background information for designing a marketing plan. This analysis focuses on the economic impacts of alternative energy conservation options as perceived by the home owner. Identifying impediments to conservation investments is also very important in designing a marketing plan. A recent report suggests that financial constraints and the need for better information and knowledge about conservation pose the major conservation investment barriers. Since loan interest rates for new manufactured homes typically exceed site-built rates by a considerable amount and the buyers tend to have lower incomes, the economics of manufactured home conservation investments are likely to significantly influence their viability. Conservation information and its presentation directly influences the manufactured home buyer's decision. A marketing plan should address these impediments and their implications very clearly. Dealers express a belief that consumer satisfaction is the major advantage to selling energy efficient manufactured homes. This suggests that targeting dealers in a marketing plan and providing them direct information on consumers' indicated attitudes may be important. 74 refs.

  15. IPv6 addressing proxy: mapping native addressing from legacy technologies and devices to the Internet of Things (IPv6).

    Science.gov (United States)

    Jara, Antonio J; Moreno-Sanchez, Pedro; Skarmeta, Antonio F; Varakliotis, Socrates; Kirstein, Peter

    2013-05-17

    Sensors utilize a large number of heterogeneous technologies for a varied set of application environments. The sheer number of devices involved requires that this Internet be the Future Internet, with a core network based on IPv6 and a higher scalability in order to be able to address all the devices, sensors and things located around us. This capability to connect through IPv6 devices, sensors and things is what is defining the so-called Internet of Things (IoT). IPv6 provides addressing space to reach this ubiquitous set of sensors, but legacy technologies, such as X10, European Installation Bus (EIB), Controller Area Network (CAN) and radio frequency ID (RFID) from the industrial, home automation and logistic application areas, do not support the IPv6 protocol. For that reason, a technique must be devised to map the sensor and identification technologies to IPv6, thus allowing homogeneous access via IPv6 features in the context of the IoT. This paper proposes a mapping between the native addressing of each technology and an IPv6 address following a set of rules that are discussed and proposed in this work. Specifically, the paper presents a technology-dependent IPv6 addressing proxy, which maps each device to the different subnetworks built under the IPv6 prefix addresses provided by the internet service provider for each home, building or user. The IPv6 addressing proxy offers a common addressing environment based on IPv6 for all the devices, regardless of the device technology. Thereby, this offers a scalable and homogeneous solution to interact with devices that do not support IPv6 addressing. The IPv6 addressing proxy has been implemented in a multi-protocol Sensors 2013, 13 6688 card and evaluated successfully its performance, scalability and interoperability through a protocol built over IPv6.

  16. IPv6 Addressing Proxy: Mapping Native Addressing from Legacy Technologies and Devices to the Internet of Things (IPv6

    Directory of Open Access Journals (Sweden)

    Peter Kirstein

    2013-05-01

    Full Text Available Sensors utilize a large number of heterogeneous technologies for a varied set of application environments. The sheer number of devices involved requires that this Internet be the Future Internet, with a core network based on IPv6 and a higher scalability in order to be able to address all the devices, sensors and things located around us. This capability to connect through IPv6 devices, sensors and things is what is defining the so-called Internet of Things (IoT. IPv6 provides addressing space to reach this ubiquitous set of sensors, but legacy technologies, such as X10, European Installation Bus (EIB, Controller Area Network (CAN and radio frequency ID (RFID from the industrial, home automation and logistic application areas, do not support the IPv6 protocol. For that reason, a technique must be devised to map the sensor and identification technologies to IPv6, thus allowing homogeneous access via IPv6 features in the context of the IoT. This paper proposes a mapping between the native addressing of each technology and an IPv6 address following a set of rules that are discussed and proposed in this work. Specifically, the paper presents a technology-dependent IPv6 addressing proxy, which maps each device to the different subnetworks built under the IPv6 prefix addresses provided by the internet service provider for each home, building or user. The IPv6 addressing proxy offers a common addressing environment based on IPv6 for all the devices, regardless of the device technology. Thereby, this offers a scalable and homogeneous solution to interact with devices that do not support IPv6 addressing. The IPv6 addressing proxy has been implemented in a multi-protocol Sensors 2013, 13 6688 card and evaluated successfully its performance, scalability and interoperability through a protocol built over IPv6.

  17. IPv6 Addressing Proxy: Mapping Native Addressing from Legacy Technologies and Devices to the Internet of Things (IPv6)

    Science.gov (United States)

    Jara, Antonio J.; Moreno-Sanchez, Pedro; Skarmeta, Antonio F.; Varakliotis, Socrates; Kirstein, Peter

    2013-01-01

    Sensors utilize a large number of heterogeneous technologies for a varied set of application environments. The sheer number of devices involved requires that this Internet be the Future Internet, with a core network based on IPv6 and a higher scalability in order to be able to address all the devices, sensors and things located around us. This capability to connect through IPv6 devices, sensors and things is what is defining the so-called Internet of Things (IoT). IPv6 provides addressing space to reach this ubiquitous set of sensors, but legacy technologies, such as X10, European Installation Bus (EIB), Controller Area Network (CAN) and radio frequency ID (RFID) from the industrial, home automation and logistic application areas, do not support the IPv6 protocol. For that reason, a technique must be devised to map the sensor and identification technologies to IPv6, thus allowing homogeneous access via IPv6 features in the context of the IoT. This paper proposes a mapping between the native addressing of each technology and an IPv6 address following a set of rules that are discussed and proposed in this work. Specifically, the paper presents a technology-dependent IPv6 addressing proxy, which maps each device to the different subnetworks built under the IPv6 prefix addresses provided by the internet service provider for each home, building or user. The IPv6 addressing proxy offers a common addressing environment based on IPv6 for all the devices, regardless of the device technology. Thereby, this offers a scalable and homogeneous solution to interact with devices that do not support IPv6 addressing. The IPv6 addressing proxy has been implemented in a multi-protocol card and evaluated successfully its performance, scalability and interoperability through a protocol built over IPv6. PMID:23686145

  18. Vocational Home Economics Education. Coalition Statement. Second Edition.

    Science.gov (United States)

    Home Economics Education Association, Gainesville, VA.

    This pamphlet contains the statement of the Coalition of the American Home Economics Association, American Vocational Association, and Home Economics Education Association regarding the scope and definition of vocational home economics education. It is intended to serve as a basis for professional action. Sections of this statement address the…

  19. Nursing students' attitudes about home health nursing.

    Science.gov (United States)

    Prestia, Mindy; Murphy, Susan; Yoder, Marian

    2008-09-01

    In an effort to address the home care nursing shortage, this pilot study was designed to measure nursing students' attitudes toward home health nursing and to test the Home Health Attitude Questionnaire developed specifically for this study based on the Theory of Planned Behavior. Senior undergraduate nursing students and registered nursing to bachelor of science in nursing students completed the questionnaire.

  20. Longing for home: displacement, memory and identity.

    Science.gov (United States)

    Ben-Yoseph, Miriam

    2005-01-01

    This article focuses on the relationship between the country of birth and the ability of the individual from that country to create a sense of home, identity and belonging in other countries and cultures. What is home? Is home the place where you were born and raised, where your parents live or where they are buried? Is home the place from where you were dislocated or where you live now? What does longing for home mean? The author draws on theory to address these questions but her personal story plays a prominent part.

  1. Guidelines for Home Energy Professionals Project (Brochure)

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2014-03-01

    The Guidelines for Home Energy Professionals is a collaboration between the U.S. Department of Energy (DOE) and a wide range of home energy performance industry professionals. The Guidelines project, managed by the National Renewable Energy Laboratory (NREL) for DOE, addresses the need for a highly-skilled weatherization workforce equipped to complete consistent, high-quality home energy upgrades for single-family homes, multifamily homes, and manufactured housing. In doing so, it helps increase energy efficiency in housing, which can mitigate climate change, one of the major challenges of the 21st century.

  2. Design considerations for medical devices in the home environment.

    Science.gov (United States)

    Kaufman-Rivi, Diana; Collins-Mitchell, Janette; Jetley, Raoul

    2010-01-01

    Patient demographics, economic forces, and technological advancements contribute to the rise in home care services. Advanced medical devices and equipment originally designed for use by trained personnel in hospitals and clinics are increasingly migrating into the home. Unlike the clinical setting, the home is an uncontrolled environment with additional hazards. The compatibility of the device with the recipient's knowledge, abilities, lifestyle, and home environment plays a significant role in their therapy and rehabilitation. The advent of new device technologies such as wireless devices and interoperability of systems lends a new and complex perspective for medical device use in the home that must also be addressed. Adequately assessing and matching the patient and their caregiver with the appropriate device technology while considering the suitability of the home environment for device operation and maintenance is a challenge that relies on good human factors principles. There is a need to address these challenges in the growing home care sector In this article, the authors take a look at some important considerations and design issues for medical devices used in the home care environment.

  3. The 'Cancer Home-Life Intervention'

    DEFF Research Database (Denmark)

    Pilegaard, Marc Sampedro; la Cour, Karen; Gregersen Oestergaard, Lisa

    2018-01-01

    , occupational therapy-based and adaptive programme for people with advanced cancer targeting the performance of their prioritised everyday activities. SETTING/PARTICIPANTS: Home-living adults diagnosed with advanced cancer experiencing functional limitations were recruited from two Danish hospitals. They were......BACKGROUND: People with advanced cancer face difficulties with their everyday activities at home that may reduce their health-related quality of life. To address these difficulties, we developed the 'Cancer Home-Life Intervention'. AIM: To evaluate the efficacy of the 'Cancer Home Life......-Intervention' compared with usual care with regard to patients' performance of, and participation in, everyday activities, and their health-related quality of life. DESIGN AND INTERVENTION: A randomised controlled trial ( ClinicalTrials.gov NCT02356627). The 'Cancer Home-Life Intervention' is a brief, tailored...

  4. Securing a Home Energy Managing Platform

    DEFF Research Database (Denmark)

    Mikkelsen, Søren Aagaard; Jacobsen, Rune Hylsberg

    2016-01-01

    Energy management in households gets increasingly more attention in the struggle to integrate more sustainable energy sources. Especially in the electrical system, smart grid towards a better utilisation of the energy production and distribution infrastructure. The Home Energy Management System...... (HEMS) is a critical infrastructure component in this endeavour. Its main goal is to enable energy services utilising smart devices in the households based on the interest of the residential consumers and external actors. With the role of being both an essential link in the communication infrastructure...... for balancing the electrical grid and a surveillance unit in private homes, security and privacy become essential to address. In this chapter, we identify and address potential threats Home Energy Management Platform (HEMP) developers should consider in the progress of designing architecture, selecting hardware...

  5. Interventions to address deficits of pharmacological pain management in nursing home residents--A cluster-randomized trial.

    Science.gov (United States)

    Könner, F; Budnick, A; Kuhnert, R; Wulff, I; Kalinowski, S; Martus, P; Dräger, D; Kreutz, R

    2015-10-01

    To evaluate the effect of interventions for general practitioners and nursing home staff to improve pain severity and appropriateness of pain medication in nursing home residents (NHR). This cluster-randomized controlled trial was conducted in six nursing homes in the intervention and control group, respectively. Pain management was analysed before (T0) and after (T1, T2) an educational intervention in 239 NHR, aged ≥65 years, without moderate or severe cognitive impairment. Primary and secondary outcomes were average pain severity and appropriateness of pain medication as determined with the Numeric Rating Scale and Pain Medication Appropriateness Scale (PMASD ), respectively. At T0, 72.2% and 73.7% of NHR (mean age 83 years) reported pain (average pain severity 2.4) in the intervention and control group, respectively. The PMASD at T0 was 53.9 in the intervention group and 60.8 in the control group (p = 0.12), while 20.6% compared to 6.9% (p = 0.009) received no pain medication in the two groups. At T2, non-significant improvements in the average pain severity (1.59) and PMASD (61.07) were observed in the intervention group. Moreover, the mean individual PMASD increased by 8.09 (p = 0.03) and the proportion of NHR without pain medication decreased by 50% (p = 0.03) in the intervention group. No appreciable changes were found in the control group at T2. NHR exhibited a high prevalence of pain with overall low severity, while a high proportion of individuals received inappropriate pain medications. Both findings were not significantly improved by the intervention, although some aspects of drug treatment were meaningful improved. © 2015 European Pain Federation - EFIC®

  6. Influenza and pneumococcal vaccine uptake among nursing home residents in Nottingham, England: a postal questionnaire survey

    Directory of Open Access Journals (Sweden)

    Vivancos Roberto

    2008-05-01

    Full Text Available Abstract Background Previous studies have shown influenza vaccine uptake in UK nursing home residents to be low. Very little information exists regarding the uptake of pneumococcal vaccine in this population. The formulation of policies relating to the vaccination of residents has been proposed as a simple step that may help improve vaccine uptake in care homes. Methods A postal questionnaire was sent to matrons of all care homes with nursing within the Greater Nottingham area in January 2006. Non respondents were followed up with up to 3 phone calls. Results 30% (16/53 of respondents reported having a policy addressing influenza vaccination and 15% (8/53 had a policy addressing pneumococcal vaccination. Seasonal influenza vaccine coverage in care homes with a vaccination policy was 87% compared with 84% in care homes without a policy (p = 0.47. The uptake of pneumococcal vaccination was found to be low, particularly in care homes with no vaccination policy. Coverage was 60% and 32% in care homes with and without a vaccination policy respectively (p = 0.06. This result was found to be statistically significant on multivariate analysis (p = 0.03, R = 0.46 Conclusion The uptake of influenza vaccine among care home residents in the Nottingham region is relatively high, although pneumococcal vaccine uptake is low. This study shows that there is an association between pneumococcal vaccine uptake and the existence of a vaccination policy in care homes, and highlights that few care homes have vaccination policies in place.

  7. 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

  8. Implementing a Zero Energy Ready Home Multifamily Project

    Energy Technology Data Exchange (ETDEWEB)

    Springer, David [National Renewable Energy Laboratory (NREL), Golden, CO (United States); German, Alea [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2015-08-17

    Building cost-effective, high-performance homes that provide superior comfort, health, and durability is the goal of the U.S. Department of Energy’s (DOE’s) Zero Energy Ready Home (ZERH) program. Building America research and other innovative programs throughout the country have addressed many of the technical challenges of building to the ZERH standard. The cost-effectiveness of measure packages that result in 30% source energy savings compared to a code-compliant home have been demonstrated. However, additional challenges remain, particularly with respect to convincing production builders of the strong business case for ZERH. The Alliance for Residential Building Innovation (ARBI) team believes that the keys to successfully engaging builders and developers in the California market are to help them leverage development agreement requirements, code compliance requirements, incentives, and competitive market advantages of ZERH certification, and navigate through this process. A primary objective of this project was to gain a highly visible foothold for residential buildings that are built to the DOE ZERH specification that can be used to encourage participation by other California builders. This report briefly describes two single-family homes that were ZERH certified and focuses on the experience of working with developer Mutual Housing on a 62-unit multifamily community at the Spring Lake subdivision in Woodland, California. The Spring Lake project is expected to be the first ZERH-certified multifamily project in the country. This report discusses the challenges encountered, lessons learned, and how obstacles were overcome.

  9. Home e-health system integration in the Smart Home through a common media server.

    Science.gov (United States)

    Pau, I; Seoane, F; Lindecrantz, K; Valero, M A; Carracedo, J

    2009-01-01

    Home e-health systems and services are revealed as one of the most important challenges to promote Quality of Life related to Health in the Information Society. Leading companies have worked on e-health systems although the majority of them are addressed to hospital or primary care settings. The solution detailed in this paper offers a personal health system to be integrated with Smart Home services platform to support home based e-care. Thus, the home e-health system and architecture detailed in this research work is ready to supply a seamless personal care solution both from the biomedical data analysis, service provision, security guarantee and information management s point of view. The solution is ready to be integrated within the Accessible Digital Home, a living lab managed by Universidad Politécnica de Madrid for R&D activities.

  10. Home Health Care Agencies

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of all Home Health Agencies that have been registered with Medicare. The list includes addresses, phone numbers, and quality measure ratings for each agency.

  11. Second-home electricity consumption

    International Nuclear Information System (INIS)

    Andersen, Frits M.; Christensen, Morten S.; Jensen, Ole Michael; Kofoed, Niels-Ulrik; Morthorst, Poul Erik

    2008-01-01

    In Denmark, electricity consumption in first and second homes has developed quite differently. Since 1990, electricity consumption in ordinary residences has grown moderately, while consumption in weekend and second homes has increased considerably. In turn, this development has been blamed on a growing number of luxury cottages, new legislation permitting senior citizens to have their permanent address in their second home and a growing number of electric appliances. In order to examine the growing electricity consumption in second homes and to estimate future demand, a multidisciplinary study combining top-down and bottom-up analyses was conducted, i.e., combining models using aggregated economic parameters and feasibility studies using technical parameters, respectively. The top-down estimation showed that changes in electricity consumption in second homes correlate to changes in income. The bottom-up estimation showed that consumption was mainly affected by the frequency with which second homes were used in the winter time. This indicates that additional second homes, increased full-time use and intensified use of electric appliances are the main reasons for the observed increases in electricity consumption. Luxury tourism use and senior citizens' that use a few per cent of the second homes as their home contribute to a minor degree to the overall increase of electricity consumption. Scenarios show that this development may accelerate with increased leisure time, increased use and more permanent settlement in second homes

  12. Developing the home energy report: An everyday householder-centred approach

    Energy Technology Data Exchange (ETDEWEB)

    Parnell, R.; Popovic Larsen, O. [Sheffield Univ., School of Architecture, Sheffield (United Kingdom)

    2005-10-01

    A compulsory home energy report (Her) is to be introduced by the government in England and Wales as part of the Home Information Pack. This will, in part, meet the requirements of the European Directive on The Energy Performance of Buildings, providing energy performance certificates for dwellings when sold on the open market and information on measures to improve energy performance. This paper presents the results of a study, which explored the effectiveness of an Her in use. The study found that householders intended to take-up 27.1% ({+-}5.7%; n = 231, p < 0.05) of the recommended measures and 46.3% ({+-}6.4%; n = 231, p < 0.05) of householders intended to install at least one recommended measure within a year. However, preliminary findings suggest that actual take-up is lower than the intended rate and measures adopted tend to be those that are least effective. The paper draws on an everyday householder-centred framework in order to make proposals for the improved effectiveness of the HER programme in England and Wales. These recommendations have implications for: the report's motivational content; the presentation of information; and the environment in which information is delivered and action is supported. (Author)

  13. 6. Home deliveries

    African Journals Online (AJOL)

    Sitwala

    determine factors associated with home deliveries. Main outcome ... deliver at home than a health facility compared to those who .... regression analysis, women who had four years of schooling or .... by report bias, the burden of home deliveries is a real challenge .... Journal of Econometrics 1987; 36: 185-204. 14. Michelo ...

  14. A cloud-based home health care information sharing system to connect patients with home healthcare staff -A case report of a study in a mountainous region.

    Science.gov (United States)

    Nomoto, Shinichi; Utsumi, Momoe; Sasayama, Satoshi; Dekigai, Hiroshi

    2017-01-01

    We have developed a cloud system, the e-Renraku Notebook (e-RN) for sharing of home care information based on the concept of "patient-centricity". In order to assess the likelihood that our system will enhance the communication and sharing of information between home healthcare staff members and home-care patients, we selected patients who were residing in mountainous regions for inclusion in our study. We herein report the findings.Eighteen staff members from 7 medical facilities and 9 patients participated in the present study.The e-RN was developed for two reasons: to allow patients to independently report their health status and to have staff members view and respond to the information received. The patients and staff members were given iPads with the pre-installed applications and the information being exchanged was reviewed over a 54-day period.Information was mainly input by the patients (61.6%), followed by the nurses who performed home visits (19.9%). The amount of information input by patients requiring high-level nursing care and their corresponding staff member was significantly greater than that input by patients who required low-level of nursing care.This patient-centric system in which patients can independently report and share information with a member of the healthcare staff provides a sense of security. It also allows staff members to understand the patient's health status before making a home visit, thereby giving them a sense of security and confidence. It was also noteworthy that elderly patients requiring high-level nursing care and their staff counterpart input information in the system significantly more frequently than patients who required low-level care.

  15. Effect of Home Care Nursing on Patients Discharged From Hospital With Self-Reported Signs of Constipation

    DEFF Research Database (Denmark)

    Konradsen, Hanne; Rasmussen, Marie Louise Thiese; Noiesen, Eline

    2017-01-01

    Constipation is a common health problem in relation to hospitalization. This randomized controlled trial aimed to investigate whether advice from a home care nurse after discharge had an effect on self-reported signs of constipation. A total of 59 patients were included in the study on the basis...... of their self-reported signs of constipation evaluated using the Constipation Assessment Scale. Advice from the home care nurses was given on the intake of fiber and liquid and mobilization related to scorings on the Constipation Risk Assessment Scale, the administration of laxatives, and referral...

  16. Home-based humidification for mucositis in patients undergoing radical radiotherapy: preliminary report.

    Science.gov (United States)

    Morton, Randall P; Thomson, Vicki C; Macann, Andrew; Gerard, Catherine M; Izzard, Mark; Hay, K David

    2008-04-01

    Oropharyngeal mucositis is a frequent, severe complication of local irradiation for tumours in the head and neck. We postulated that heated humidification of inspired air via a nasal interface may palliate symptoms of mucositis by reducing the discomfort associated with dry, sticky secretions. We sought to review the effect of home-based humidification on hospital admissions and the patient reported experience of that humidification. This study was a retrospective review. A historical (control) group of patients did not receive home humidification at any stage (n = 55) and a study group (n = 53) received home humidification at or after the onset of grade 3 mucositis. A questionnaire was sent to study group patients to obtain information about their experience of using the humidifier at home. There were no demographic differences between the study and control groups, but the study group had significantly more advanced cancer (stage IV; p = .0307) and significantly higher total fractions and days treated (p humidification were admitted after starting that use (p humidification was of benefit, and 81% stated that it relieved mouth or throat pain. Humidification of inspired gas offers a simple, drug-free option for managing a number of the adverse mucosal effects of radiation and chemoradiation in head and neck cancer patients.

  17. Safety of union home care aides in Washington State.

    Science.gov (United States)

    Schoenfisch, Ashley L; Lipscomb, Hester; Phillips, Leslie E

    2017-09-01

    A rate-based understanding of home care aides' adverse occupational outcomes related to their work location and care tasks is lacking. Within a 30-month, dynamic cohort of 43 394 home care aides in Washington State, injury rates were calculated by aides' demographic and work characteristics. Injury narratives and focus groups provided contextual detail. Injury rates were higher for home care aides categorized as female, white, 50 to working through an agency (versus individual providers). In addition to direct occupational hazards, variability in workload, income, and supervisory/social support is of concern. Policies should address the roles and training of home care aides, consumers, and managers/supervisors. Home care aides' improved access to often-existing resources to identify, manage, and eliminate occupational hazards is called for to prevent injuries and address concerns related to the vulnerability of this needed workforce. © 2017 Wiley Periodicals, Inc.

  18. Home Performance with Energy Star (HPwES) Program Report

    Energy Technology Data Exchange (ETDEWEB)

    none,

    2013-01-01

    This report summarizes the Department’s review of comments received on the HPwES v2 proposal and presents a multi-year action plan to both address Department goals and incorporate industry feedback.

  19. Stroke and Nursing Home care: a national survey of nursing homes.

    LENUS (Irish Health Repository)

    Cowman, Seamus

    2010-01-01

    BACKGROUND: Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. METHODS: A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30) efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. RESULTS: Across all nursing homes (n = 60), 18% (n = 570) of the residents had previously had a stroke. In homes (n = 30), where interviews with residents with stroke (n = 257), only 7% (n = 18) residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239) residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. CONCLUSIONS: This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care) for stroke survivors who reside in nursing homes in Ireland.

  20. Volunteers in the Danish Home Guard 2016

    DEFF Research Database (Denmark)

    Fridberg, Torben; Larsen, Mona

    This report maps the composition of a group of volunteer members of the Home Guard, as well as their opinions and expectations of the Home Guard and their own voluntary efforts. The report is a follow-up to two previous surveys completed in 2007 and 2011 and it therefore also highlights changes...... from 2007 to 2011 and 2016. Based on a questionnaire survey, the report paints a picture of who the volunteers are, what motivates them and how they perceive their surrounding environment’s view of them as members of the Home Guard. The report also focuses on the volunteers’ view of the Home Guard......’s tasks and activities both in Denmark and abroad. Finally, the report describes the volunteers’ perception of the Home Guards’ communication and campaigns. The report was commissioned and financed by the Danish Home Guard Command....

  1. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    OpenAIRE

    Chalmers, J.R.; Simpson, E.; Apfelbacher, C.J.; Thomas, K.S.; von Kobyletzki, L.; Schmitt, J.; Singh, J.A.; Svensson, Å.; Williams, H.C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T.L.

    2016-01-01

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23–24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and quality of life for the HOME core outcome set for atopic eczema (AE). Following presentations, which included data from systematic reviews, consensus discussions were held in a mixture of whole group a...

  2. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    NARCIS (Netherlands)

    Chalmers, J. R.; Simpson, E.; Apfelbacher, C. J.; Thomas, K. S.; von Kobyletzki, L.; Schmitt, J.; Singh, J. A.; Svensson, A.; Williams, H. C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T. L.; Block, J.; Bragg, A.; Burton, T.; Clemmensen, K. K. Bjerring; Creswell-Melville, A.; Dinesen, M.; Drucker, A.; Eckert, L.; Flohr, C.; Garg, M.; Gerbens, L. A. A.; Graff, A. L. B.; Hanifin, J.; Heinl, D.; Humphreys, R.; Ishii, H. A.; Kataoka, Y.; Leshem, Y. A.; Marquort, B.; Massuel, M. -A.; Merhand, S.; Mizutani, H.; Murota, H.; Murrell, D. F.; Nakahara, T.; Nasr, I.; Nograles, K.; Ohya, Y.; Osterloh, I.; Pander, Jan; Prinsen, C.; Purkins, L.; Ridd, M.; Sach, T.; Schuttelaar, M. -L. A.; Shindo, S.; Smirnova, J.; Sulzer, A.; Gjerde, E. Synnove; Takaoka, R.; Talmo, H. Vestby; Tauber, M.; Torchet, F.; Volke, A.; Wahlgren, C. -F.; Weidinger, S.; Weisshaar, E.; Wollenberg, A.; Yamaga, K.; Zhao, C. Y.; Spuls, P. I.

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmo, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and

  3. Technical Barriers, Gaps, and Opportunities Related to Home Energy Upgrade Market Delivery

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, M. V. A.

    2011-11-01

    This report outlines the technical barriers, gaps, and opportunities that arise in executing home energy upgrade market delivery approaches, as identified through research conducted by the U.S. Department of Energy's Building America program. The objective of this report is to outline the technical1 barriers, gaps, and opportunities that arise in executing home energy upgrade market delivery approaches, as identified through research conducted by the U.S. Department of Energy's (DOE) Building America program. This information will be used to provide guidance for new research necessary to enable the success of the approaches. Investigation for this report was conducted via publications related to home energy upgrade market delivery approaches, and a series of interviews with subject matter experts (contractors, consultants, program managers, manufacturers, trade organization representatives, and real estate agents). These experts specified technical barriers and gaps, and offered suggestions for how the technical community might address them. The potential benefits of home energy upgrades are many and varied: reduced energy use and costs; improved comfort, durability, and safety; increased property value; and job creation. Nevertheless, home energy upgrades do not comprise a large part of the overall home improvement market. Residential energy efficiency is the most complex climate intervention option to deliver because the market failures are many and transaction costs are high (Climate Change Capital 2009). The key reasons that energy efficiency investment is not being delivered are: (1) The opportunity is highly fragmented; and (2) The energy efficiency assets are nonstatus, low-visibility investments that are not properly valued. There are significant barriers to mobilizing the investment in home energy upgrades, including the 'hassle factor' (the time and effort required to identify and secure improvement works), access to financing, and the

  4. Second-home electricity consumption

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, Frits M.; Morthorst, Poul Erik [Risoe, Systems Analysis Department, Technical University of Denmark, P.O. Box 49, DK-4000 Roskilde (Denmark); Christensen, Morten S.; Kofoed, Niels-Ulrik [Esbensen Consulting Engineers, Carl Jacobsens Vej 25D, DK-2500 Valby (Denmark); Jensen, Ole Michael [Danish Building Research Institute, Department of Energy and Environment, University of Aalborg, P.O. Box 119, DK-2970 Horsholm (Denmark)

    2008-01-15

    In Denmark, electricity consumption in first and second homes has developed quite differently. Since 1990, electricity consumption in ordinary residences has grown moderately, while consumption in weekend and second homes has increased considerably. In turn, this development has been blamed on a growing number of luxury cottages, new legislation permitting senior citizens to have their permanent address in their second home and a growing number of electric appliances. In order to examine the growing electricity consumption in second homes and to estimate future demand, a multidisciplinary study combining top-down and bottom-up analyses was conducted, i.e., combining models using aggregated economic parameters and feasibility studies using technical parameters, respectively. The top-down estimation showed that changes in electricity consumption in second homes correlate to changes in income. The bottom-up estimation showed that consumption was mainly affected by the frequency with which second homes were used in the winter time. This indicates that additional second homes, increased full-time use and intensified use of electric appliances are the main reasons for the observed increases in electricity consumption. Luxury tourism use and senior citizens' that use a few per cent of the second homes as their home contribute to a minor degree to the overall increase of electricity consumption. Scenarios show that this development may accelerate with increased leisure time, increased use and more permanent settlement in second homes. (author)

  5. Solar Energy: Uses for Your Home. The CIRcular: Consumer Information Report 15.

    Science.gov (United States)

    Bank of America NT & SA, San Francisco, CA.

    This report defines active and passive solar energy systems, describes home uses for solar energy, and offers guidelines for choosing and installing a system. Much of the information is specific to the state of California. Uses for solar energy which are presented include passive space heating, passive cooling, active space heating, household…

  6. SIRI on your wrist: making your home smart

    OpenAIRE

    Ojuroye, Olivia; Wilde, Adriana

    2015-01-01

    The adoption of smart devices in the homes is on the increase. There are tangible benefits for those making the leap, such as increased independence and improved quality of life. This project addresses these issues with the development of a two-part proof-of-concept system for smart home dwellers, consisting of a flexible wearable wristband device that communicates wirelessly with a voice-activated home hub, which, in a future version of this project, would increase accessibility in the home ...

  7. Report from the fourth international consensus meeting to harmonize core outcome measures for atopic eczema/dermatitis clinical trials (HOME initiative)

    NARCIS (Netherlands)

    Chalmers, J. R.; Simpson, E.; Apfelbacher, C. J.; Thomas, K. S.; von Kobyletzki, L.; Schmitt, J.; Singh, J. A.; Svensson, Å; Williams, H. C.; Abuabara, K.; Aoki, V.; Ardeleanu, M.; Awici-Rasmussen, M.; Barbarot, S.; Berents, T. L.; Block, J.; Bragg, A.; Burton, T.; Bjerring Clemmensen, K. K.; Creswell-Melville, A.; Dinesen, M.; Drucker, A.; Eckert, L.; Flohr, C.; Garg, M.; Gerbens, L. A. A.; Graff, A. L. B.; Hanifin, J.; Heinl, D.; Humphreys, R.; Ishii, H. A.; Kataoka, Y.; Leshem, Y. A.; Marquort, B.; Massuel, M.-A.; Merhand, S.; Mizutani, H.; Murota, H.; Murrell, D. F.; Nakahara, T.; Nasr, I.; Nograles, K.; Ohya, Y.; Osterloh, I.; Pander, J.; Prinsen, C.; Purkins, L.; Ridd, M.; Sach, T.; Schuttelaar, M.-L. A.; Shindo, S.; Smirnova, J.; Sulzer, A.; Synnøve Gjerde, E.; Takaoka, R.; Vestby Talmo, H.; Tauber, M.; Torchet, F.; Volke, A.; Wahlgren, C.-F.; Weidinger, S.; Weisshaar, E.; Wollenberg, A.; Yamaga, K.; Zhao, C. Y.; Spuls, P. I.

    2016-01-01

    This article is a report of the fourth meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in Malmö, Sweden on 23-24 April 2015 (HOME IV). The aim of the meeting was to achieve consensus over the preferred outcome instruments for measuring patient-reported symptoms and

  8. Maternity waiting homes in Southern Lao PDR: the unique 'silk home'.

    Science.gov (United States)

    Eckermann, Elizabeth; Deodato, Giovanni

    2008-10-01

    The concept of maternity waiting homes (MWH) has a long history spanning over 100 years. The research reported here was conducted in the Thateng District of Sekong Province in southern Lao People's Democratic Republic (PDR) to establish whether the MWH concept would be affordable, accessible, and most importantly acceptable, as a strategy to improve maternal outcomes in the remote communities of Thateng with a high proportion of the population from ethnic minority groups. The research suggested that there were major barriers to minority ethnic groups using existing maternal health services (reflected in very low usage of trained birth attendants and hospitals and clinics) in Thateng. Unless MWH are adapted to overcome these potential barriers, such initiatives will suffer the same fate as existing maternal facilities. Consequently, the Lao iteration of the concept, as operationalized in the Silk Homes project in southern Lao PDR is unique in combining maternal and infant health services with opportunities for micro credit and income generating activities and allowing non-harmful traditional practices to co-exist alongside modern medical protocols. These innovative approaches to the MWH concept address the major economic, social and cultural barriers to usage of safe birthing options in remote communities of southern Lao PDR.

  9. Medical homes for at-risk children: parental reports of clinician-parent relationships, anticipatory guidance, and behavior changes.

    Science.gov (United States)

    Nelson, Catherine S; Higman, Susan M; Sia, Calvin; McFarlane, Elizabeth; Fuddy, Loretta; Duggan, Anne K

    2005-01-01

    Family-centeredness, compassion, and trust are 3 attributes of the clinician-parent relationship in the medical home. Among adults, these attributes are associated with patients' adherence to clinicians' advice. The objectives were (1) to measure medical home attributes related to the clinician-parent relationship, (2) to measure provision of anticipatory guidance regarding injury and illness prevention, (3) to relate anticipatory guidance to parental behavior changes, and (4) to relate medical home attributes to anticipatory guidance and parental behavior changes. A cross-sectional study of data collected among at-risk families when children were 1 year of age, in a randomized, controlled trial of a home-visiting program to prevent child abuse and neglect, was performed. Modified subscales of the Primary Care Assessment Survey were used to measure parental ratings of clinicians' family-centeredness, compassion, and trust. Parental reports of provision of anticipatory guidance regarding injury and illness prevention topics (smoke alarms, infant walkers, car seats, hot water temperature, stair guards, sunscreen, firearm safety, and bottle propping) and behavior changes were recorded. Of the 564 mothers interviewed when their children were 1 year of age, 402 (71%) had a primary care provider and had complete data for anticipatory guidance items. By definition, poverty, partner violence, poor maternal mental health, and maternal substance abuse were common in the study sample. Maternal ratings of clinicians' family-centeredness, compassion, and trust were fairly high but ranged widely and varied among population subgroups. Families reported anticipatory guidance for a mean of 4.6 +/- 2.2 topics relevant for discussion. Each medical home attribute was positively associated with parental reports of completeness of anticipatory guidance, ie, family-centeredness (beta = .026, SE = .004), compassion (beta = .019, SE = .005), and trust (beta = .016, SE = .005). Parents

  10. Indoor air quality in 300 homes in Kingston/Harriman, Tennessee: winter phase status report

    Energy Technology Data Exchange (ETDEWEB)

    Hawthorne, A.R.; Uziel, M.; Vo-Dinh, T.; Cohen, M.A.; Orebaugh, C.T.; Miller, G.H.; Ironsides, K.; Monar, K.P.; Dudney, C.S.; Tyndall, R.L.

    1986-10-01

    This report summarizes the status of the 300-Home Kingston/Harriman Indoor Air Quality Study at the end of the winter phase of monitoring. Plans for the summer monitoring phase are also presented. The report is organized by the major pollutants monitored. Reporting focuses on study protocols and summaries of winter monitoring activities. A minimum of results are presented since, for many pollutants, laboratory analyses are not yet complete.

  11. 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...

  12. Content and Design Features of Academic Health Sciences Libraries' Home Pages.

    Science.gov (United States)

    McConnaughy, Rozalynd P; Wilson, Steven P

    2018-01-01

    The goal of this content analysis was to identify commonly used content and design features of academic health sciences library home pages. After developing a checklist, data were collected from 135 academic health sciences library home pages. The core components of these library home pages included a contact phone number, a contact email address, an Ask-a-Librarian feature, the physical address listed, a feedback/suggestions link, subject guides, a discovery tool or database-specific search box, multimedia, social media, a site search option, a responsive web design, and a copyright year or update date.

  13. Stroke and Nursing Home care: a national survey of nursing homes

    Directory of Open Access Journals (Sweden)

    McGee Hannah

    2010-01-01

    Full Text Available Abstract Background Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. Methods A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30 efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. Results Across all nursing homes (n = 60, 18% (n = 570 of the residents had previously had a stroke. In homes (n = 30, where interviews with residents with stroke (n = 257, only 7% (n = 18 residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239 residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. Conclusions This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care for stroke survivors who reside in nursing homes in Ireland.

  14. The relationship between planned and reported home infant sleep locations among mothers of late preterm and term infants.

    Science.gov (United States)

    Tully, Kristin P; Holditch-Davis, Diane; Brandon, Debra

    2015-07-01

    To compare maternal report of planned and practiced home sleep locations of infants born late preterm (34 0/7 to 36 6/7 gestational weeks) with those infants born term (≥37 0/7 gestational weeks) over the first postpartum month. Open-ended semi-structured maternal interviews were conducted in a US hospital following birth and by phone at 1 month postpartum during 2010-2012. Participants were 56 mother-infant dyads: 26 late preterm and 30 term. Most women planned to room share at home with their infants and reported doing so for some or all of the first postpartum month. More women reported bed sharing during the first postpartum month than had planned to do so in both the late preterm and term groups. The primary reason for unplanned bed sharing was to soothe nighttime infant fussiness. Those participants who avoided bed sharing at home commonly discussed their fear for infant safety. A few parents reported their infants were sleeping propped on pillows and co-sleeping on a recliner. Some women in both the late preterm and term groups reported lack of opportunity to obtain a bassinet prior to childbirth. The discrepancy between plans for infant sleep location at home and maternally reported practices were similar in late preterm and term groups. Close maternal proximity to their infants at night was derived from the need to assess infant well-being, caring for infants, and women's preferences. Bed sharing concerns related to infant safety and the establishment of an undesirable habit, and alternative arrangements included shared recliner sleep.

  15. Challenges and Strategies for Prevention of Multidrug-Resistant Organism Transmission in Nursing Homes.

    Science.gov (United States)

    Dumyati, Ghinwa; Stone, Nimalie D; Nace, David A; Crnich, Christopher J; Jump, Robin L P

    2017-04-01

    Nursing home residents are at high risk for colonization and infection with bacterial pathogens that are multidrug-resistant organisms (MDROs). We discuss challenges and potential solutions to support implementing effective infection prevention and control practices in nursing homes. Challenges include a paucity of evidence that addresses MDRO transmission during the care of nursing home residents, limited staff resources in nursing homes, insufficient infection prevention education in nursing homes, and perceptions by nursing home staff that isolation and contact precautions negatively influence the well being of their residents. A small number of studies provide evidence that specifically address these challenges. Their outcomes support a paradigm shift that moves infection prevention and control practices away from a pathogen-specific approach and toward one that focuses on resident risk factors.

  16. Report from the third international consensus meeting to harmonise core outcome measures for atopic eczema/dermatitis clinical trials (HOME)

    Science.gov (United States)

    Chalmers, JR; Schmitt, J; Apfelbacher, C; Dohil, M; Eichenfield, LF; Simpson, EL; Singh, J; Spuls, P; Thomas, KS; Admani, S; Aoki, V; Ardeleanu, M; Barbarot, S; Berger, T; Bergman, JN; Block, J; Borok, N; Burton, T; Chamlin, SL; Deckert, S; DeKlotz, CC; Graff, LB; Hanifin, JM; Hebert, AA; Humphreys, R; Katoh, N; Kisa, RM; Margolis, DJ; Merhand, S; Minnillo, R; Mizutani, H; Nankervis, H; Ohya, Y; Rodgers, P; Schram, ME; Stalder, JF; Svensson, A; Takaoka, R; Teper, A; Tom, WL; von Kobyletzki, L; Weisshaar, E; Zelt, S; Williams, HC

    2014-01-01

    Summary This report provides a summary of the third meeting of the Harmonising Outcome Measures for Eczema (HOME) initiative held in San Diego, CA, U.S.A., 6–7 April 2013 (HOME III). The meeting addressed the four domains that had previously been agreed should be measured in every eczema clinical trial: clinical signs, patient-reported symptoms, long-term control and quality of life. Formal presentations and nominal group techniques were used at this working meeting, attended by 56 voting participants (31 of whom were dermatologists). Significant progress was made on the domain of clinical signs. Without reference to any named scales, it was agreed that the intensity and extent of erythema, excoriation, oedema/papulation and lichenification should be included in the core outcome measure for the scale to have content validity. The group then discussed a systematic review of all scales measuring the clinical signs of eczema and their measurement properties, followed by a consensus vote on which scale to recommend for inclusion in the core outcome set. Research into the remaining three domains was presented, followed by discussions. The symptoms group and quality of life groups need to systematically identify all available tools and rate the quality of the tools. A definition of long-term control is needed before progress can be made towards recommending a core outcome measure. What's already known about this topic? Many different scales have been used to measure eczema, making it difficult to compare trials in meta-analyses and hampering improvements in clinical practice. HOME core outcome measures must pass the OMERACT (Outcome Measures in Rheumatology) filter of truth (validity), discrimination (sensitivity to change and responsiveness) and feasibility (ease of use, costs, time to perform and interpret). It has been previously agreed as part of the consensus process that four domains should be measured by the core outcomes: clinical signs, patient-reported

  17. Home care in Australia: an integrative review.

    Science.gov (United States)

    Palesy, Debra; Jakimowicz, Samantha; Saunders, Carla; Lewis, Joanne

    2018-01-01

    The home care sector comprises one of Australia's fastest growing workforces, yet few papers capture the overall landscape of Australian home care. This integrative review investigates home care with the aim of better understanding care recipients and their needs, funding, and regulation; care worker skills, tasks, demographics, employment conditions, and training needs. Over 2,700 pieces of literature were analyzed to inform this review. Results suggest sector fragmentation and a home care workforce who, although well-placed to improve outcomes for care recipients, are in need of better training and employment support. Suggestions for future research regarding Australian home care include studies that combine both aged and disability aspects of care, more research around care recipients, priority needs and strategies for addressing them, and how best to prepare home care workers for their roles.

  18. A home healthcare system in the cloud - Addressing security and privacy challenges

    OpenAIRE

    Deng M.; Petkovic M.; Nalin M.; Baroni I.

    2011-01-01

    Cloud computing is an emerging technology that is expected to support Internet scale critical applications which could be essential to the healthcare sector. Its scalability, resilience, adaptability, connectivity, cost reduction, and high performance features have high potential to lift the efficiency and quality of healthcare. However,it is also important to understand specific risks related to security and privacy that this technology brings. This paper focuses on a home healthcare system ...

  19. Creating a successful culturally sensitive home care program.

    Science.gov (United States)

    Blanter, R; Page, P M

    1995-12-01

    Providing quality home care services to immigrants requires an integrated, holistic approach that genuinely addresses language and cultural differences. One home care agency in Massachusetts developed a team-oriented, culturally sensitive outreach program that ensures non-English-speaking patients the same level of service that the general population receives.

  20. Evaluation of owner experiences and adherence to home-cooked diet recipes for dogs.

    Science.gov (United States)

    Johnson, L N; Linder, D E; Heinze, C R; Kehs, R L; Freeman, L M

    2016-01-01

    To evaluate owner experiences and adherence to home-cooked diet recipes for dogs. Clients of a veterinary teaching hospital clinical nutrition service who had a home-cooked diet recipe formulated for their dogs between March 2011 and December 2013 were given a survey by email, postal mail and telephone. Survey questions addressed motivations, positive and negative aspects of feeding home-cooked diets and current feeding practices. Responses were compared to animals' medical records to determine adherence. Of the 93 owners who were contacted, 53 (57%) completed the survey. Of the 53 respondents, 43 owners (81%) reported that they were still feeding an home-cooked diet or had fed an home-cooked diet until the time of their dogs' deaths. The most common motivation for feeding a home-cooked diet was suitability for specific medical needs. Of the 30 surveys that included a complete diet history, only four (13%) demonstrated exact adherence to home-cooked diet recipes. Most respondents liked and continued to feed a home-cooked diet, but few owners adhered to prescribed recipes and many dogs required recipe modifications. It is important to counsel dog owners about benefits and drawbacks of feeding home-cooked diets, importance of recipe adherence and necessity for follow-up after diet formulation with a board-certified veterinary nutritionist. © 2015 British Small Animal Veterinary Association.

  1. Final Report on Internet Addressable Lightswitch; TOPICAL

    International Nuclear Information System (INIS)

    Rubinstein, Francis; Pettler, Peter

    2001-01-01

    This report describes the work performed to develop and test a new switching system and communications network that is useful for economically switching lighting circuits in existing commercial buildings. The first section of the report provides the general background of the IBECS (Integrated Building Environmental Communications System) research and development work as well as the context for the development of the new switching system. The research and development effort that went into producing the first proof-of-concept (the IBECS Addressable Power Switch or APS) and the physical prototype of that concept is detailed in the second section. In the third section of the report, we detail the refined Powerline Carrier Based IBECS Title 24 Wall Switch system that evolved from the APS prototype. The refined system provided a path for installing IBECS switching technology in existing buildings that may not be already wired for light level switching control. The final section of the report describes the performance of the IBECS Title 24 Switch system as applied to a small demonstration in two offices at LBNL's Building 90. We learned that the new Powerline Carrier control systems (A-10 technology) that have evolved from the early X-10 systems have solved most of the noise problems that dogged the successful application of X-10 technologies in commercial buildings. We found that the new A-10 powerline carrier control technology can be reliable and effective for switching lighting circuits even in electrically noisy office environments like LBNL. Thus we successfully completed the task objectives by designing, building and demonstrating a new switching system that can provide multiple levels of light which can be triggered either from specially designed wall switches or from a digital communications network. By applying commercially available powerline carrier based technologies that communicate over the in-place lighting wiring system, this type of control can be

  2. Peak-load shaving in smart homes via online scheduling

    DEFF Research Database (Denmark)

    Costanzo, Giuseppe Tommaso; Kheir, J.; Guchuan Zhu

    2011-01-01

    This paper addresses the problem of load-shaving in Smart Homes in view of improving energy efficiency in Smart Grids. An architecture of home power management systems, allowing the separation of domestic power load control from grid dynamics, is introduced. In this framework, the operation...

  3. Exploring workplace violence among home care workers in a consumer-driven home health care program.

    Science.gov (United States)

    Nakaishi, Lindsay; Moss, Helen; Weinstein, Marc; Perrin, Nancy; Rose, Linda; Anger, W Kent; Hanson, Ginger C; Christian, Mervyn; Glass, Nancy

    2013-10-01

    Nominal research has examined sexual harassment and workplace violence against home care workers within consumer-driven home care models such as those offered in Oregon. This study examined home care workers' experiences of violence while providing care to consumer employers, the patients who hire and manage home care workers. Focus groups and interviews were conducted in Oregon with 83 home care workers, 99 Oregon Department of Human Services (DHS) employees, and 11 consumer employers. Home care workers reported incidents of workplace physical violence (44%), psychological abuse (65%), sexual harassment (41%), and sexual violence (14%). Further, three themes were identified that may increase the risk of workplace violence: (1) real and perceived barriers to reporting violence; (2) tolerance of violence; and (3) limited training to prevent violence. To ensure worker safety while maintaining quality care, safety policies and training for consumer employers, state DHS employees, and home care workers must be developed. Copyright 2013, SLACK Incorporated.

  4. Medicare and Medicaid Programs; CY 2018 Home Health Prospective Payment System Rate Update and CY 2019 Case-Mix Adjustment Methodology Refinements; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2017-11-07

    This final rule updates the home health prospective payment system (HH PPS) payment rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor, effective for home health episodes of care ending on or after January 1, 2018. This rule also: Updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking; implements the third year of a 3-year phase-in of a reduction to the national, standardized 60-day episode payment to account for estimated case-mix growth unrelated to increases in patient acuity (that is, nominal case-mix growth) between calendar year (CY) 2012 and CY 2014; and discusses our efforts to monitor the potential impacts of the rebasing adjustments that were implemented in CY 2014 through CY 2017. In addition, this rule finalizes changes to the Home Health Value-Based Purchasing (HHVBP) Model and to the Home Health Quality Reporting Program (HH QRP). We are not finalizing the implementation of the Home Health Groupings Model (HHGM) in this final rule.

  5. Relationship between staff-reported culture change and occupancy rate and organizational commitment among nursing homes in South Korea.

    Science.gov (United States)

    Lee, Minhong; Choi, Jae-Sung; Lim, Jinseop; Kim, Young Sun

    2013-04-01

    This study aims to examine culture change in nursing homes in South Korea and to identify the outcomes of culture change implementation. Data were taken from survey responses from 223 top- or mid-level staff among nursing homes in South Korea that were selected through a proportionate random-stratified sampling method from four regions nationwide. Culture change in nursing homes was operationalized by five person-directed care (PDC) constructs and three organizational environment constructs, and outcome quality was indicated by changes to occupancy rate and organizational commitment. After controlling for facility characteristics, the effect of staff-reported culture change on occupancy rate and organizational commitment was analyzed through the multiple-regression method. Consistent with previous research, this study revealed positive effects of culture change for nursing homes in South Korea. The study found that staff-reported culture change correlated with occupancy rate and organizational commitment. Given that culture change variables were significantly related to occupancy rate and organizational commitment, the findings of the study provide a persuasive argument that policies and/or programs to support culture change in nursing homes should be enhanced. Management-level workers in these facilities should have the skills and knowledge to foster more PDC and a more person-directed environment.

  6. Medicare constrains social workers' and nurses' home care for clients with Alzheimer's disease.

    Science.gov (United States)

    Cabin, William D

    2015-01-01

    The Medicare home health prospective payment system (PPS) has existed for 13 years, yielding significant profits to providers. However, studies indicate many unresolved questions about whether PPS improves patient quality of care, is cost-effective, and reduces patient levels of unmet need. In addition, PPS has undermined the provision of social work home health services. The article presents the views of 29 home health care nurses regarding the impact ofPPS on their care decisions for people with Alzheimer's disease and their caregivers. The nurses identify Alzheimer's disease symptom management and psychosocial needs as phantoms, omnipresent below the surface but not attended to by home care clinicians. The interviews support the greater involvement of social workers to more adequately address the psychosocial needs of Medicare home health patients. The article contends that the current failure to simultaneously address the cost, needs, and quality-of-life issues of people with Alzheimer's disease who are cared for at home is analogous to the end-of-life care situation before passage of the Medicare Hospice Benefit. A collaborative demonstration project--social work and nursing--is proposed to determine how PPS might better address quality of life and costs of home-based people with Alzheimer's disease and their caregivers.

  7. A Comparison of Self-Reported Hearing Handicap and Audiometric Thresholds in Nursing Home Residents

    Directory of Open Access Journals (Sweden)

    Nematolla Rouhbakhsh

    2007-12-01

    Full Text Available Background and Aim: Self-reported and questionaire method for hearing impairment assessment allow us to study and to detect the invisible related issues, while They can not be done by traditional audiometry procedures. The purpose of this study is to compare measurement of hearing handicap using self-reported and staff version of NHHI and hearing thresholds in nursing home residents. Materials and Method: The study participants were 43 individuals, 23 males and 20 females, aged 45-95 years. Pure tone average were calculated after conventional Pure tone audiometry . the self- and staff- reported questionnaire were also fulfilled. Results: Nine (20.9% individuals have normal hearing, 6 (14% have slight, 10 (23.3% mild, 7 (16.3% moderate, 6 (16.3% moderate to severe, 4 (9.3% severe, and 1 (2.3% profound hearing loss. Mean score of self and of staff reported versions were 32.22 % +29.31 and 32.67% +30.98, respectively. According to Kruskal-wallis test, there were significant correlation between self-reported and hearing level and between staff-reported and hearing level. The Pierson coefficient variation test between self and staff-reported, and self-reported and hearing level, staff-reported and hearing level showed significant correlation. Conclusion: The NHHI self assessment associated with other equipments significantly improved the identification and assessment of adults and elderly hearing handicap in nursing home residents. According to the study condition, it may be concluded that the self and staff version of NHHI questionnaire are significantly identical and can be used instead.

  8. The perceptions of cognitively impaired patients and their caregivers of a home telecare system.

    Science.gov (United States)

    Mehrabian, Shima; Extra, Jocelyne; Wu, Ya-Huei; Pino, Maribel; Traykov, Latchezar; Rigaud, Anne-Sophie

    2015-01-01

    Assistive and telecare technologies have been developed to support older adults with cognitive impairments, as well as their caregivers, from their homes. The way potential users perceive telecare and smart home systems plays a key role in their acceptance of this new technology. We evaluate the acceptance of home telecare technologies among patients suffering from cognitive impairment and their caregivers. Prototypes of telecare devices were developed to demonstrate their features and capabilities and to train patients, families, and health care professionals in their use. We conducted semistructured interviews to elicit the perceptions of 30 patients with mild cognitive impairment, 32 patients with Alzheimer's disease, and 30 caregivers, regarding the risks and advantages of home telecare and smart houses. Survey results reflected participants' largely positive reactions to these technologies. Regarding home telecare, the cognitive stimulation program earned the highest proportion of positive responses, followed by the devices' care of emergencies. The participants generally agreed that home telecare and smart houses could significantly improve their quality of life. However, some technical and ethical concerns, such as the way of provision, installation, and monitoring of the systems, were reported to be in need of addressing before implementation of this system.

  9. Testing an app for reporting health concerns-Experiences from older people and home care nurses.

    Science.gov (United States)

    Göransson, Carina; Eriksson, Irene; Ziegert, Kristina; Wengström, Yvonne; Langius-Eklöf, Ann; Brovall, Maria; Kihlgren, Annica; Blomberg, Karin

    2017-12-05

    To explore the experiences of using an app among older people with home-based health care and their nurses. Few information and communication technology innovations have been developed and tested for older people with chronic conditions living at home with home-based health care support. Innovative ways to support older people's health and self-care are needed. Explorative qualitative design. For 3 months to report health concerns, older people receiving home-based health care used an interactive app, which included direct access to self-care advice, graphs and a risk assessment model that sends alerts to nurses for rapid management. Interviews with older people (n = 17) and focus group discussions with home care nurses (n = 12) were conducted and analysed using thematic analysis. The findings reveal that a process occurs. Using the app, the older people participated in their care, and the app enabled learning and a new way of communication. The interaction gave a sense of security and increased self-confidence among older people. The home care nurses viewed the alerts as appropriate for the management of health concerns. However, all participants experienced challenges in using new technology and had suggestions for improvement. The use of an app appears to increase the older people's participation in their health care and offers them an opportunity to be an active partner in their care. The app as a new way to interact with home care nurses increased the feeling of security. The older people were motivated to learn to use the app and described potential use for it in the future. The use of an app should be considered as a useful information and communication technology innovation that can improve communication and accessibility for older people with home-based health care. © 2017 John Wiley & Sons Ltd.

  10. Measures of emergency preparedness contributing to nursing home resilience.

    Science.gov (United States)

    Lane, Sandi J; McGrady, Elizabeth

    2017-12-13

    Resilience approaches have been successfully applied in crisis management, disaster response, and high reliability organizations and have the potential to enhance existing systems of nursing home disaster preparedness. This study's purpose was to determine how the Center for Medicare and Medicaid Services (CMS) "Emergency Preparedness Checklist Recommended Tool for Effective Health Care Facility Planning" contributes to organizational resilience by identifying the benchmark resilience items addressed by the CMS Emergency Preparedness Checklist and items not addressed by the CMS Emergency Preparedness Checklist, and to recommend tools and processes to improve resilience for nursing homes. The CMS Emergency Preparedness Checklist items were compared to the Resilience Benchmark Tool items; similar items were considered matches. Resilience Benchmark Tool items with no CMS Emergency Preparedness Checklist item matches were considered breaches in nursing home resilience. The findings suggest that the CMS Emergency Preparedness Checklist can be used to measure some aspects of resilience, however, there were many resilience factors not addressed. For nursing homes to prepare and respond to crisis situations, organizations need to embrace a culture that promotes individual resilience-related competencies that when aggregated enable the organization to improve its resiliency. Social workers have the skills and experience to facilitate this change.

  11. Named data networking-based smart home

    Directory of Open Access Journals (Sweden)

    Syed Hassan Ahmed

    2016-09-01

    Full Text Available Named data networking (NDN treats content/data as a “first class citizen” of the network by giving it a “name”. This content “name” is used to retrieve any information, unlike in device-centric networks (i.e., the current Internet, which depend on physical IP addresses. Meanwhile, the smart home concept has been gaining attention in academia and industries; various low-cost embedded devices are considered that can sense, process, store, and communicate data autonomously. In this paper, we study NDN in the context of smart-home communications, discuss the preliminary evaluations, and describe the future challenges of applying NDN in smart-home applications.

  12. Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

    Directory of Open Access Journals (Sweden)

    Palmer Laura

    2003-05-01

    Full Text Available Abstract Background In November 2002, the Centers for Medicare & Medicaid Services (CMS launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs that led quality improvement efforts in nursing homes from the six pilot states. Results QIOs in the six pilot states found several key outcomes of the Nursing Home Quality Initiative that help to maximize the potential of public reporting to leverage effective improvement in nursing home quality of care. First, public reporting focuses the attention of all stakeholders in the nursing home industry on achieving good quality outcomes on a defined set of measures, and creates an incentive for partnership formation. Second, publicly reported quality measures motivate nursing home providers to improve in certain key clinical areas, and in particular to seek out new ways of changing processes of care, such as engaging physicians and the medical director more directly. Third, the lessons learned by QIOs in the pilot of this Initiative indicate that certain approaches to providing quality improvement assistance are key to guiding nursing home providers' desire and enthusiasm to improve towards a using a systematic approach to quality improvement. Conclusion The Nursing Home Quality Initiative has already demonstrated the potential of public reporting to foster collaboration and coordination among nursing home stakeholders and to heighten interest of nursing homes in quality improvement techniques. The lessons learned from this pilot project have implications for any organizations or individuals planning quality improvement projects in the nursing home setting.

  13. Remote Health Care Provision in Care Homes.

    Science.gov (United States)

    Newbould, Louise; Mountain, Gail; Hawley, Mark; Ariss, Steve

    2017-01-01

    A survey was developed to map provision, knowledge, attitudes and views towards videoconferencing in care homes in Yorkshire and The Humber. The survey was sent to 859 care homes, with a 14% response rate. Twelve homes reported using videoconferencing. Non-users appeared skeptical, managers using the system reported improvements in outcomes.

  14. Final Scientific/Technical Report: Context-Aware Smart Home Energy Manager (CASHEM)

    Energy Technology Data Exchange (ETDEWEB)

    Foslien, Wendy K. [Honeywell International Inc., Golden Valley, MN (United States); Curtner, Keith L. [Honeywell International Inc., Golden Valley, MN (United States)

    2013-01-15

    Because of growing energy demands and shortages, residential home owners are turning to energy conservation measures and smart home energy management devices to help them reduce energy costs and live more sustainably. In this context, the Honeywell team researched, developed, and tested the Context Aware Smart Home Energy Manager (CASHEM) as a trusted advisor for home energy management. The project focused on connecting multiple devices in a home through a uniform user interface. The design of the user interface was an important feature of the project because it provided a single place for the homeowner to control all devices and was also where they received coaching. CASHEM then used data collected from homes to identify the contexts that affect operation of home appliances. CASHEM's goal was to reduce energy consumption while keeping the user's key needs satisfied. Thus, CASHEM was intended to find the opportunities to minimize energy consumption in a way that fit the user's lifestyle.

  15. Strategies Reported Used by Instructors to Address Student Alternate Conceptions in Chemical Equilibrium

    Science.gov (United States)

    Piquette, Jeff S.; Heikkinen, Henry W.

    2005-01-01

    This study explores general-chemistry instructors' awareness of and ability to identify and address common student learning obstacles in chemical equilibrium. Reported instructor strategies directed at remediating student alternate conceptions were investigated and compared with successful, literature-based conceptual change methods. Fifty-two…

  16. Facilitating home birth.

    Science.gov (United States)

    Finigan, Valerie; Chadderton, Diane

    2015-06-01

    The birth of a baby is a family experience. However, in the United Kingdom birth often occurs outside the family environment, in hospital. Both home and hospital births have risks and benefits, but research shows that, for most women, it is as safe to give birth at home as it is in hospital. Women report home-birth to be satisfying with lowered risks of intervention and less likelihood of being separated from their family. It is also more cost effective for the National Health Service. Yet, whilst midwives are working hard to promote home birth as an option, it remains controversial. The aim of this paper is to raise awareness of the safety of home birth and the needs of women and midwives when a home birth is chosen. It provides an overview of care required and the role of the midwife in the ensuring care is woman-centred and personalised.

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

    Science.gov (United States)

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

    2018-07-01

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

  18. Supporting the information domains of fall-risk management in home care via health information technology.

    Science.gov (United States)

    Alhuwail, Dari; Koru, Güneş; Mills, Mary Etta

    2016-01-01

    In the United States, home care clinicians often start the episode of care devoid of relevant fall-risk information. By collecting and analyzing qualitative data from 30 clinicians in one home health agency, this case study aimed to understand how the currently adopted information technology solutions supported the clinicians' fall-risk management (FRM) information domains, and explored opportunities to adopt other solutions to better support FRM. The currently adopted electronic health record system and fall-reporting application served only some information domains with a limited capacity. Substantial improvement in addressing the FRM information domains is possible by effectively modifying the existing solutions and purposefully adopting new solutions.

  19. Sexual Abuse of Older Nursing Home Residents: A Literature Review

    Directory of Open Access Journals (Sweden)

    Wenche Malmedal

    2015-01-01

    Full Text Available Despite an increasing literature related to elder abuse, sexual abuse of older persons in general and of vulnerable adults living in nursing homes in particular is still sparsely described. The purpose of this study was to assess the state of knowledge on the subject of sexual abuse against older nursing home residents through a literature review. Systematic searches in reference databases including Cinahl, Medline, OVID Nursing Database, ISI Web of Science, PsycINFO, Cochrane Library, and SveMed + were conducted. Through several phases of selection of the articles, using strict inclusion and exclusion criteria, six articles were chosen for a deeper examination. Findings from the review show that sexual abuse occurs in nursing homes and that both older women and men are victims of sexual abuse. Perpetrators appear mainly to be staff and other residents and mainly to be men, but also women abuse both older men and older women. Findings from the literature review show that there is a need for knowledge and further research on the topic of sexual abuse against older residents in nursing homes. Furthermore, there is a need for good policies and reporting systems, as an important step in seriously addressing sexual abuse against older persons.

  20. The new affordances in the home environment for motor development - infant scale (AHEMD-IS): Versions in English and Portuguese languages

    Science.gov (United States)

    Caçola, Priscila M.; Gabbard, Carl; Montebelo, Maria I. L.; Santos, Denise C. C.

    2015-01-01

    The home environment has been established as a crucial factor for motor development, especially in infants. Exploring the home environment can have significant implications for intervention, as it is common practice in physical therapy to have professionals advise patients on home activities. Since 2010, our group has been working on the development of the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS), a parental self-reporting instrument designed to assess the quality and quantity of factors (affordances) in the home environment. In Brazil, the instrument has been translated as "Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê", and it has been extensively used in several studies that address infant development. These studies in Brazil and other parts of the world highly recommended the need for a normative sample and standardized scoring system. A description of the study that addressed that need, along with the English version of the questionnaire and score sheets, was recently published in the well-known and respected journal Physical Therapy. Our intent with the present short communication is to notify Brazilian investigators and clinicians of this latest update so they can download the new instrument, as well as present the Brazilian (Portuguese) version of the AHEMD-IS along with its scoring system. PMID:26647753

  1. Ownership conversions and nursing home performance.

    Science.gov (United States)

    Grabowski, David C; Stevenson, David G

    2008-08-01

    To examine the effects of ownership conversions on nursing home performance. Online Survey, Certification, and Reporting system data from 1993 to 2004, and the Minimum Data Set (MDS) facility reports from 1998 to 2004. Regression specification incorporating facility fixed effects, with terms to identify trends in the pre- and postconversion periods. The annual rate of nursing home conversions almost tripled between 1994 and 2004. Our regression results indicate converting facilities are generally different throughout the pre/postconversion years, suggesting little causal effect of ownership conversions on nursing home performance. Before and after conversion, nursing homes converting from nonprofit to for-profit status generally exhibit deterioration in their performance, while nursing homes converting from for-profit to nonprofit status generally exhibit improvement. Policy makers have expressed concern regarding the implications of ownership conversions for nursing home performance. Our results imply that regulators and policy makers should not only monitor the outcomes of nursing home conversions, but also the targets of these conversions.

  2. Business case for smart homes

    NARCIS (Netherlands)

    Franck, E.; Nauta, J.; Haan, R. de

    2016-01-01

    The application of home automation in “smart homes” has been successful from a technological point of view. In practice, however, few projects seem able to survive after the initial financing period has ended, failing to establish a positive business case. This chapter addresses why the positive

  3. On-line hemodiafiltration at home.

    Science.gov (United States)

    Vega, Almudena; Abad, Soraya; Macías, Nicolás; Aragoncillo, Inés

    2018-04-01

    Survival with online hemodiafiltration (OL-HDF) is higher than with hemodialysis; frequent hemodialysis has also improved survival and quality of life. Home hemodialysis facilitates frequent therapy. We report our experience with 2 patients with stage 5 CKD who started home hemodialysis with OL-HDF in November 2016. After a training period at the hospital, they started home hemodialysis with OL-HDF after learning how to manage dialysis monitors and how to administer water treatment. We used the "5008-home" (FMC © ) monitor, and the Acqua C © (Fresenius Medical Care) for water treatment. Water conductivity was always checked before and during dialysis sessions and was always 2.5 to 3 mS/cm. Water cultures always fulfilled the criteria for ultrapurity. As far as we know, this is the first report on patients receiving OL-HDF at home. The technique proved to be safe and valid for renal replacement therapy and transfers the benefits of hospital convective therapy to the home setting. Future data will enable us to determine whether survival has also improved. © 2017 International Society for Hemodialysis.

  4. Specific Physician Orders Improve Pain Detection and Pain Reports in Nursing Home Residents: Preliminary Data.

    Science.gov (United States)

    Monroe, Todd B; Misra, Sumathi; Habermann, Ralf C; Dietrich, Mary S; Bruehl, Stephen P; Cowan, Ronald L; Newhouse, Paul A; Simmons, Sandra F

    2015-10-01

    Despite evidence that many nursing home residents' pain is poorly managed, reasons for this poor management remain unanswered. The aim of this study was to determine if specific order sets related to pain assessment would improve pain management in nursing home (NH) residents. Outcomes included observed nurse pain assessment queries and resident reports of pain. The pretest/post-test study was performed in a 240-bed for-profit nursing home in the mid-southern region of the United States and participants were 43 nursing home residents capable of self-consent. Medical chart abstraction was performed during a 2-week (14-day) period before the implementation of specific order sets for pain assessment (intervention) and a 2-week (14-day) period after the intervention. Trained research assistants observed medication administration passes and performed participant interviews after each medication pass. One month after intervention implementation, 1 additional day of observations was conducted to determine data reliability. Nurses were observed to ask residents about pain more frequently, and nurses continued to ask about pain at higher rates 1 month after the intervention was discontinued. The proportion of residents who reported pain also significantly increased in response to increased nurse queries (e.g., "Do you have any pain right now?"), which underscores the importance of nurses directly asking residents about pain. Notably 70% of this long-stay NH population only told the nurses about their pain symptoms when asked directly. Findings uncover that using specific pain order sets seems to improve the detection of pain, which should be a routine part of nursing assessment. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  5. Mobilizing Older Adults: Harnessing the Potential of Smart Home Technologies. Contribution of the IMIA Working Group on Smart Homes and Ambient Assisted Living.

    Science.gov (United States)

    Demiris, G; Thompson, H J

    2012-01-01

    This paper highlights the potential of smart home applications to not only assess mobility determinants for older adults in the home environment but also provide the opportunity for tailored interventions. We present a theoretical framework for assessing mobility parameters and utilizing this information to enable behavior change based on the Health Belief Model. We discuss examples that showcase the potential of smart home systems to not only measure but also improve mobility for community dwelling older adults. Mobility is a complex construct that cannot be addressed with a single monitoring approach or a single intervention. Instead, tailored interventions that address specific needs and behaviors of individuals and take into consideration preferences of older adults and potentially their social network are needed to effectively enforce positive behavior change. Smart home systems have the ability to capture details of one's daily living that could otherwise not be easily obtained; however, such data repositories alone are not sufficient to improve clinical outcomes if appropriate mechanisms for data mining and analysis, as well as tailored response systems are not in place. Unleashing the potential of smart home applications to measure and improve mobility has the potential of transforming elder care and providing potentially cost-effective tools to support independence for older adults. A technologically driven smart home application can maximize its clinical relevance by pursuing interactive features that can lead to behavior change.

  6. Neuropsychology reports for childhood brain tumor survivors: implementation of recommendations at home and school.

    Science.gov (United States)

    Cheung, Lorraine L T; Wakefield, Claire E; Ellis, Sarah J; Mandalis, Anna; Frow, Eleanor; Cohn, Richard J

    2014-06-01

    As pediatric brain tumor survivors may experience cognitive decline post-treatment, a neuropsychology assessment is often conducted. The assessment evaluates the child's cognitive functioning and highlights potential challenges. Whilst neuropsychology reports provide recommendations for the home and school, how this translates in practice is under researched. This study explored parent and teacher understanding of neuropsychology reports, implementation rates for recommendations and their perceived effectiveness. Barriers to implementation were also investigated. Twenty-five semi-structured interviews were conducted with 17 parents and 8 teachers of childhood brain tumor survivors from 15 Australian families who had received a neuropsychology report within 2 years of the interview. Twenty-four neuropsychology reports encompassing 131 recommendations were reviewed. The qualitative methodological framework of Miles and Huberman [Miles M, Huberman A. Qualitative data analysis: An expanded sourcebook. London: Sage; 1994] was used to analyze interview transcripts with QSR NVivo 9.0. The majority of parents and teachers had a sound understanding of the report. Implementation of recommendations at home and school was 47% and 41%, respectively. Recommendations that did not require extra effort and organization appeared more likely to be implemented, however, those perceived to be more effective or helpful did not necessarily have higher implementation rates. Key reported barriers to implementation barrier were patient reluctance, and a lack of parents' willingness to adopt the recommendation. Patient understanding and willingness play a significant role in the implementation of neuropsychology recommendations. Collaboration and clear communication between the patient, teacher, parent, and neuropsychologist is vital for effective management. © 2014 Wiley Periodicals, Inc.

  7. 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).

  8. The Importance of Literacy in the Home Language

    Directory of Open Access Journals (Sweden)

    Susana A. Eisenchlas

    2013-10-01

    Full Text Available While advantages of literacy in the home language have been widely documented, the Australian education system has not been proactive in providing institutional support for its development. This paper investigates the impact of (illiteracy in the home language on the academic, affective, and social development of bilingual/multilingual children and proposes principles that home-language-literacy programs should meet to be effective. It discusses programs that, although designed to develop literacy or second-language proficiency mainly in classroom contexts, could be easily adapted to address the needs of the linguistically and culturally diverse Australian context. We argue that the cost of not investing in successful home-language-literacy programs will be higher in the long run than their implementation costs and recommend that Australia should consider supporting grassroots home-language-literacy programs in a push to improve overall literacy outcomes for Australian home-language speakers.

  9. Medicare and Medicaid Programs; CY 2016 Home Health Prospective Payment System Rate Update; Home Health Value-Based Purchasing Model; and Home Health Quality Reporting Requirements. Final rule.

    Science.gov (United States)

    2015-11-05

    This final rule will update Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2016. As required by the Affordable Care Act, this rule implements the 3rd year of the 4-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule updates the HH PPS case-mix weights using the most current, complete data available at the time of rulemaking and provides a clarification regarding the use of the "initial encounter'' seventh character applicable to certain ICD-10-CM code categories. This final rule will also finalize reductions to the national, standardized 60-day episode payment rate in CY 2016, CY 2017, and CY 2018 of 0.97 percent in each year to account for estimated case-mix growth unrelated to increases in patient acuity (nominal case-mix growth) between CY 2012 and CY 2014. In addition, this rule implements a HH value-based purchasing (HHVBP) model, beginning January 1, 2016, in which all Medicare-certified HHAs in selected states will be required to participate. Finally, this rule finalizes minor changes to the home health quality reporting program and minor technical regulations text changes.

  10. Home and Office Blood Pressure Control among Treated Hypertensive Patients in Japan: Findings from the Japan Home versus Office Blood Pressure Measurement Evaluation (J-HOME Study

    Directory of Open Access Journals (Sweden)

    Nariyasu Mano

    2010-02-01

    Full Text Available Appropriate control of blood pressure (BP is essential for prevention of future cardiovascular events. However, BP control among treated hypertensive patients has been insufficient. Recently, the usefulness of self-measured BP at home (home BP measurement for the management of hypertension has been reported in many studies. We evaluated BP control both at home and in the office among treated hypertensive patients in primary care settings in Japan (the J-HOME study. We found poor control of home and office BPs and clarified some factors affecting control. We also examined factors associated with the magnitude of the white-coat effect, the morning–evening BP difference, and home heart rate in this J-HOME study.

  11. A Personal Journey Into Home Learning

    Directory of Open Access Journals (Sweden)

    Colleen RAJA

    2012-12-01

    Full Text Available In this narrative the author, Colleen Raja, shares her personal experience and reflections on the decision she made to homeschool. Through reflection and story she shares her own struggles and triumphs in learning about herself, her surroundings and the true desires and needs of her children. She also addresses and debunks some of the typical stereotypes and objections to home learning. In the end she sees that what had taken her several years to discover about and desire from the lifestyle of home learning took her children mere moments to embrace.

  12. Smart homes design, implementation and issues

    CERN Document Server

    Suryadevara, Nagender Kumar

    2015-01-01

    The book addresses issues towards the design and development of Wireless Sensor Network based Smart Home and fusion of Real-Time Data for Wellness Determination of an elderly person living alone in a Smart Home. The fundamentals of selection of sensor, fusion of sensor data, system design, modelling, characterizations, experimental investigations and analyses have been covered. This book will be extremely useful for the engineers and researchers especially higher undergraduate, postgraduate students as well as practitioners working on the development of Wireless Sensor Networks, Internet of Things and Data Mining.

  13. Semantic Technologies for User-Centric Home Network Management

    OpenAIRE

    Ibrahim Rana, Annie

    2015-01-01

    Home area network (HAN) management is problematic for ordinary home users. Lack of user expertise, potential complexity of administration tasks, extreme diversity of network devices, price pressures producing devices with minimal feature sets, and highly dynamic requirements of user applications are some of the main challenges in HANs. As networking becomes enabled in many more HAN devices, these problems are set to increase. A viable solution to address these challenges lie...

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

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B.

    2000-04-04

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

  15. Home Use of a Pyrethroid-Containing Pesticide and Facial Paresthesia in a Toddler: A Case Report

    Directory of Open Access Journals (Sweden)

    Alexandra Perkins

    2016-08-01

    Full Text Available Paresthesias have previously been reported among adults in occupational and non-occupational settings after dermal contact with pyrethroid insecticides. In this report, we describe a preverbal 13-month-old who presented to his primary care pediatrician with approximately 1 week of odd facial movements consistent with facial paresthesias. The symptoms coincided with a period of repeat indoor spraying at his home with a commercially available insecticide containing two active ingredients in the pyrethroid class. Consultation by the Northwest Pediatric Environmental Health Specialty Unit and follow-up by the Washington State Department of Health included urinary pyrethroid metabolite measurements during and after the symptomatic period, counseling on home clean up and use of safer pest control methods. The child’s symptoms resolved soon after home cleanup. A diagnosis of pesticide-related illness due to pyrethroid exposure was made based on the opportunity for significant exposure (multiple applications in areas where the child spent time, supportive biomonitoring data, and the consistency and temporality of symptom findings (paresthesias. This case underscores the vulnerability of children to uptake pesticides, the role of the primary care provider in ascertaining an exposure history to recognize symptomatic illness, and the need for collaborative medical and public health efforts to reduce significant exposures in children.

  16. Videoconferencing for Health Care Provision for Older Adults in Care Homes: A Review of the Research Evidence

    Directory of Open Access Journals (Sweden)

    Louise Newbould

    2017-01-01

    Full Text Available A scoping review was conducted to map the research evidence on the use of videoconferencing for remote health care provision for older adults in care homes. The review aimed to identify the nature and extent of the existing evidence base. Databases used were Embase, Medline, Web of Science, and Cochrane Library Reviews. The review identified 26 articles for inclusion, of which 14 were case studies, making the most used study design. Papers described videoconferencing as being used for assessment, management of health care, clinical support, and diagnosis, with eight of the papers reporting the use of videoconferencing for more than one clinical purpose. A further eight papers reported the use of videoconferencing for assessment alone. The literature reported the collection of various types of data, with 12 papers describing the use of both qualitative and quantitative data. The outcomes mainly addressed staff satisfaction (n=9 and resident satisfaction (n=8. Current evidence supports the feasibility of videoconferencing in care homes. However, research needs to be undertaken to establish the contexts and mechanisms that underpin the successful implementation of videoconferencing in care homes and to define useful measures for success.

  17. Videoconferencing for Health Care Provision for Older Adults in Care Homes: A Review of the Research Evidence.

    Science.gov (United States)

    Newbould, Louise; Mountain, Gail; Hawley, Mark S; Ariss, Steven

    2017-01-01

    A scoping review was conducted to map the research evidence on the use of videoconferencing for remote health care provision for older adults in care homes. The review aimed to identify the nature and extent of the existing evidence base. Databases used were Embase, Medline, Web of Science, and Cochrane Library Reviews. The review identified 26 articles for inclusion, of which 14 were case studies, making the most used study design. Papers described videoconferencing as being used for assessment, management of health care, clinical support, and diagnosis, with eight of the papers reporting the use of videoconferencing for more than one clinical purpose. A further eight papers reported the use of videoconferencing for assessment alone. The literature reported the collection of various types of data, with 12 papers describing the use of both qualitative and quantitative data. The outcomes mainly addressed staff satisfaction ( n = 9) and resident satisfaction ( n = 8). Current evidence supports the feasibility of videoconferencing in care homes. However, research needs to be undertaken to establish the contexts and mechanisms that underpin the successful implementation of videoconferencing in care homes and to define useful measures for success.

  18. Volunteers in the Danish Home Guard 2011

    DEFF Research Database (Denmark)

    Fridberg, Torben; Damgaard, Malene

    voluntary work than the population as a whole. The report also shows that one in three active members of the Home Guard would like to be deployed on international operations to support the armed forces. The young members are especially willing – and these members have increased in recent years. This report......This report describes the composition of the Home Guard’s volunteer members and their attitudes to and expectations for the Home Guard. A similar survey was carried out in 2007, and the present report therefore also examines the trends from 2007 to 2011. Among other things, the report shows...... that the voluntary members are a stable resource, as on average they have been members of the Home Guard for more than 24 years. There is a clear majority of men aged 25-50. Relatively many have vocational training, and many are employed in the private sector. Members are also relatively more active in other...

  19. 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.

  20. The new affordances in the home environment for motor development - infant scale (AHEMD-IS: Versions in English and Portuguese languages

    Directory of Open Access Journals (Sweden)

    Priscila M. Caçola

    2015-12-01

    Full Text Available The home environment has been established as a crucial factor for motor development, especially in infants. Exploring the home environment can have significant implications for intervention, as it is common practice in physical therapy to have professionals advise patients on home activities. Since 2010, our group has been working on the development of the Affordances in the Home Environment for Motor Development - Infant Scale (AHEMD-IS, a parental self-reporting instrument designed to assess the quality and quantity of factors (affordances in the home environment. In Brazil, the instrument has been translated as "Affordances no Ambiente Domiciliar para o Desenvolvimento Motor - Escala Bebê", and it has been extensively used in several studies that address infant development. These studies in Brazil and other parts of the world highly recommended the need for a normative sample and standardized scoring system. A description of the study that addressed that need, along with the English version of the questionnaire and score sheets, was recently published in the well-known and respected journal Physical Therapy. Our intent with the present short communication is to notify Brazilian investigators and clinicians of this latest update so they can download the new instrument, as well as present the Brazilian (Portuguese version of the AHEMD-IS along with its scoring system.

  1. Medicare and Medicaid programs; CY 2015 Home Health Prospective Payment System rate update; Home Health Quality Reporting Requirements; and survey and enforcement requirements for home health agencies. Final rule.

    Science.gov (United States)

    2014-11-06

    This final rule updates Home Health Prospective Payment System (HH PPS) rates, including the national, standardized 60-day episode payment rates, the national per-visit rates, and the non-routine medical supply (NRS) conversion factor under the Medicare prospective payment system for home health agencies (HHAs), effective for episodes ending on or after January 1, 2015. As required by the Affordable Care Act, this rule implements the second year of the four-year phase-in of the rebasing adjustments to the HH PPS payment rates. This rule provides information on our efforts to monitor the potential impacts of the rebasing adjustments and the Affordable Care Act mandated face-to-face encounter requirement. This rule also implements: Changes to simplify the face-to-face encounter regulatory requirements; changes to the HH PPS case-mix weights; changes to the home health quality reporting program requirements; changes to simplify the therapy reassessment timeframes; a revision to the Speech-Language Pathology (SLP) personnel qualifications; minor technical regulations text changes; and limitations on the reviewability of the civil monetary penalty provisions. Finally, this rule also discusses Medicare coverage of insulin injections under the HH PPS, the delay in the implementation of the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), and a HH value-based purchasing (HH VBP) model.

  2. Time-dependent, low-dose reporting limit for dosimeters that are taken home at the end of the workday

    International Nuclear Information System (INIS)

    Sonder, E.

    1994-01-01

    In routine personnel dosimetry, it is usual to report doses only where th occupational dose (measured dose with background subtracted) is greater than previously determined reporting limit. The reporting limit, although se administratively, should be justified by an assessment of the errors inherent in th personnel and background dose measurements, and estimates of the probability that a zero exposure will yield a dosimeter response equal to the reporting limit. For background subtraction and reporting limits, it was realized that the source of low-dose uncertainty is very much dependent on whether dosimeters are held in racks at the work site or remain with the employee. The External dosimetry Program for the DOE facilities at Oak Ridge, Tennessee, is operated such that dosimeters are taken home by the employee at the end of each workday. This report is a summary measurements of background radiation in a variety of home locations, and calculations of the effect of the variation of this background on the uncertainty low-level occupational dose and on the reporting level. When dosimeters are stored at a given location (e.g., the facility gate), it theoretically possible to determine the background there to any desired accuracy; the errors in occupational dose are then those due to measurement noise and dosimeter calibration. However, when different dosimeters are stored in different homes, th difference in background between a particular location and the average for a locations appears as an added uncertainty in the occupational dose. Since this difference is not random, but fixed for a given location, the error due to this difference increases linearly with assignment time. From the background measurements, time-dependent values of the standard deviation of occupational do and critical levels are derived and used to define an expression for the reporting limit

  3. Achieving Improvement Through Nursing Home Quality Measurement

    OpenAIRE

    Harris, Yael; Clauser, Steven B.

    2002-01-01

    CMS has initiated the Nursing Home Quality Initiative (NHQI) to improve the quality of nursing home care. Central to the NHQI is the public reporting of nursing home quality measures that serve as the basis for the Initiative's communication and quality improvement program. This article provides an overview of the NHQI, focusing on the role of nursing home quality measures in achieving improvements in nursing home care. We also describe the evolution of quality measurement in nursing homes, a...

  4. The contribution of work characteristics, home characteristics and gender to burnout in medical residents.

    Science.gov (United States)

    Verweij, Hanne; van der Heijden, Frank M M A; van Hooff, Madelon L M; Prins, Jelle T; Lagro-Janssen, Antoine L M; van Ravesteijn, Hiske; Speckens, Anne E M

    2017-10-01

    Burnout is highly prevalent in medical residents. In order to prevent or reduce burnout in medical residents, we should gain a better understanding of contributing and protective factors of burnout. Therefore we examined the associations of job demands and resources, home demands and resources, and work-home interferences with burnout in male and female medical residents. This study was conducted on a nation-wide sample of medical residents. In 2005, all Dutch medical residents (n = 5245) received a self-report questionnaire on burnout, job and home demands and resources and work-home interference. Path analysis was used to examine the associations between job and home characteristics and work-home interference and burnout in both males and females. In total, 2115 (41.1 %) residents completed the questionnaire. In both sexes emotional demands at work and the interference between work and home were important contributors to burnout, especially when work interferes with home life. Opportunities for job development appeared to be an important protective factor. Other contributing and protective factors were different for male and female residents. In females, social support from family or partner seemed protective against burnout. In males, social support from colleagues and participation in decision-making at work seemed important. Effectively handling emotional demands at work, dealing with the interference between work and home, and having opportunities for job development are the most essential factors which should be addressed. However it is important to take gender differences into consideration when implementing preventive or therapeutic interventions for burnout in medical residents.

  5. Intelligent home risk assessment systems and integration with biometric identification

    Science.gov (United States)

    Roper, William E.

    2003-08-01

    An overview is given of the Home of the 21st Century Laboratory. The laboratory is operated as a joint program with America-On-Line and George Washington University. The program is described with illustrations and discussion of the systems that are part of the laboratory. The concept of application for face recognition systems in the intelligent home of the future is presented and some initial approaches in using biometrics are shown. Issues of privacy and sharing of information within and outside the home are addressed. Issues include safety and security concerns vs. inappropriate observations of activities in and outside the home. Technology options currently available for application in the home are described and assessed.

  6. 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...

  7. Protecting care home residents from mistreatment and abuse: on the need for policy

    Directory of Open Access Journals (Sweden)

    Phelan A

    2015-11-01

    Full Text Available Amanda Phelan School of Nursing, Midwifery and Health Systems, University College Dublin, Ireland Abstract: With a rising older person population with increasing life expectancies, the demand for care homes will increase in the future. Older people in care homes are particularly vulnerable due to their dependencies related to cognitive and/or functional self-care challenges. Although many care homes provide good care, maltreatment and abuse of older people can and does occur. One major step in preventing and addressing maltreatment in care homes is having comprehensive and responsive policy, which delineates national expectations that are locally implemented. This paper examines the literature related to maltreatment in care homes and argues for policy based on a multisystems approach. Policy needs to firstly acknowledge and address general societal issues which tacitly impact on older person care delivery, underpin how care homes and related systems should be operationalized, and finally delineate expected standards and outcomes for individual experience of care. Such a policy demands attention at every level of the health care and societal system. Furthermore, contemporary issues central to policy evolution in care homes are discussed, such as safeguarding education and training and fostering organization whistle-blowing protection. Keywords: care homes, maltreatment, policy, older people

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

    Science.gov (United States)

    Zeltzer, Barry B; Kohn, Robert

    2006-04-01

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

  9. Social inequality and HIV-testing: Comparing home- and clinic-based testing in rural Malawi

    Directory of Open Access Journals (Sweden)

    Alexander A. Weinreb

    2009-10-01

    Full Text Available The plan to increase HIV testing is a cornerstone of the international health strategy against the HIV/AIDS epidemic, particularly in sub-Saharan Africa. This paper highlights a problematic aspect of that plan: the reliance on clinic- rather than home-based testing. First, drawing on DHS data from across Africa, we demonstrate the substantial differences in socio-demographic and economic profiles between those who report having ever had an HIV test, and those who report never having had one. Then, using data from a random household survey in rural Malawi, we show that substituting home-based for clinic-based testing may eliminate this source of inequality between those tested and those not tested. This result, which is stable across modeling frameworks, has important implications for accurately and equitably addressing the counseling and treatment programs that comprise the international health strategy against AIDS, and that promise to shape the future trajectory of the epidemic in Africa and beyond.

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

    Science.gov (United States)

    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.

  11. The risks from radon in homes

    International Nuclear Information System (INIS)

    Duggan, M.J.

    1990-01-01

    A report has been proposed by a Working group of the Institute of Radiation Protection on the risks from radon in homes. The report includes a historical perspective, properties and behavior of radon and its daughters, measurement of radon exposure in UK homes, remedial action, quantification of the risk and lifetime risks from other causes. (UK)

  12. Planned home birth: the professional responsibility response.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B; Brent, Robert L; Levene, Malcolm I; Arabin, Birgit

    2013-01-01

    This article addresses the recrudescence of and new support for midwife-supervised planned home birth in the United States and the other developed countries in the context of professional responsibility. Advocates of planned home birth have emphasized patient safety, patient satisfaction, cost effectiveness, and respect for women's rights. We provide a critical evaluation of each of these claims and identify professionally appropriate responses of obstetricians and other concerned physicians to planned home birth. We start with patient safety and show that planned home birth has unnecessary, preventable, irremediable increased risk of harm for pregnant, fetal, and neonatal patients. We document that the persistently high rates of emergency transport undermines patient safety and satisfaction, the raison d'etre of planned home birth, and that a comprehensive analysis undermines claims about the cost-effectiveness of planned home birth. We then argue that obstetricians and other concerned physicians should understand, identify, and correct the root causes of the recrudescence of planned home birth; respond to expressions of interest in planned home birth by women with evidence-based recommendations against it; refuse to participate in planned home birth; but still provide excellent and compassionate emergency obstetric care to women transported from planned home birth. We explain why obstetricians should not participate in or refer to randomized clinical trials of planned home vs planned hospital birth. We call on obstetricians, other concerned physicians, midwives and other obstetric providers, and their professional associations not to support planned home birth when there are safe and compassionate hospital-based alternatives and to advocate for a safe home-birth-like experience in the hospital. Copyright © 2013 Mosby, Inc. All rights reserved.

  13. What Consumers Say About Nursing Homes in Online Reviews.

    Science.gov (United States)

    Kellogg, Caitlyn; Zhu, Yujun; Cardenas, Valeria; Vazquez, Katalina; Johari, Kayla; Rahman, Anna; Enguidanos, Susan

    2018-04-20

    Although patient-centered care is an expressed value of our healthcare system, no studies have examined what consumers say in online reviews about nursing homes (NHs). Insight into themes addressed in these reviews could inform improvement efforts that promote patient-centered NH care. We analyzed nursing home (NH) Yelp reviews. From a list of all NHs in California, we drew a purposeful sample of 51 NHs, selecting facilities representing a range of geographical areas and occupancy rates. Two research teams analyzed the reviews using grounded theory to identify codes and tracked how frequently each code was mentioned. We evaluated 264 reviews, identifying 24 codes, grouped under five categories: quality of staff care and staffing; physical facility and setting; resident safety and security; clinical care quality; and financial issues. More than half (53.41%) of Yelp reviewers posted comments related to staff attitude and caring and nearly a third (29.2%) posted comments related to staff responsiveness. Yelp reviewers also often posted about NHs' physical environment. Infrequently mentioned were the quality of health care provided and concerns about resident safety and security. Our results are consistent with those from related studies. Yelp reviewers focus on NH aspects that are not evaluated in most other NH rating systems. The federal Nursing Home Compare website, for instance, does not report measures of staff attitudes or the NH's physical setting. Rather, it reports measures of staffing levels and clinical processes and outcomes. We recommend that NH consumers consult both types of rating systems because they provide complementary information.

  14. Sensor technology for smart homes.

    Science.gov (United States)

    Ding, Dan; Cooper, Rory A; Pasquina, Paul F; Fici-Pasquina, Lavinia

    2011-06-01

    A smart home is a residence equipped with technology that observes the residents and provides proactive services. Most recently, it has been introduced as a potential solution to support independent living of people with disabilities and older adults, as well as to relieve the workload from family caregivers and health providers. One of the key supporting features of a smart home is its ability to monitor the activities of daily living and safety of residents, and in detecting changes in their daily routines. With the availability of inexpensive low-power sensors, radios, and embedded processors, current smart homes are typically equipped with a large amount of networked sensors which collaboratively process and make deductions from the acquired data on the state of the home as well as the activities and behaviors of its residents. This article reviews sensor technology used in smart homes with a focus on direct environment sensing and infrastructure mediated sensing. The article also points out the strengths and limitations of different sensor technologies, as well as discusses challenges and opportunities from clinical, technical, and ethical perspectives. It is recommended that sensor technologies for smart homes address actual needs of all stake holders including end users, their family members and caregivers, and their doctors and therapists. More evidence on the appropriateness, usefulness, and cost benefits analysis of sensor technologies for smart homes is necessary before these sensors should be widely deployed into real-world residential settings and successfully integrated into everyday life and health care services. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. HomePort

    DEFF Research Database (Denmark)

    Le Guilly, Thibaut; Olsen, Petur; Ravn, Anders Peter

    2013-01-01

    Ambient Intelligence systems use many sensors and actuators, with a diversity of networks, protocols and technologies which makes it impossible to access the devices in a common manner. This paper presents the HomePort software, which provides an open source RESTful interface to heterogeneous...... sensor networks, allowing a simple unified access to virtually any kind of protocol using well known standards. HomePort includes means to provide event notification, as well as a tracing mechanism. The software is implemented and we report on initial experiments and provide an evaluation that shows...

  16. Music@Home: A novel instrument to assess the home musical environment in the early years.

    Science.gov (United States)

    Politimou, Nina; Stewart, Lauren; Müllensiefen, Daniel; Franco, Fabia

    2018-01-01

    The majority of children under the age of 5 appear to show spontaneous enjoyment of singing, being exposed to music and interacting with musical instruments, but whether variations in engaging in such activities in the home could contribute to developmental outcomes is still largely unknown. Critically, researchers lack a comprehensive instrument with good psychometric properties to assess the home musical environment from infancy to the preschool years. To address this gap, this paper presents two studies that describe the development and validation of the Music@Home questionnaire, which comprises two versions: Infant and Preschool. In Study 1, an initial pool of items was generated and administered to a wide audience of parents (n = 287 for the Infant, n = 347 for the Preschool version). Exploratory factor analysis was used to identify different dimensions comprising the home musical environment of both infants and pre-schoolers, and to reduce the initial pool of items to a smaller number of meaningful items. In Study 2, convergent and divergent validity and internal and test-retest reliability of the new instrument were established, using data from a different sample of participants (n = 213 for the Infant, n = 213 for the Preschool version). The second study also investigated associations between the Music@Home and musical characteristics of the parents, such as their musical education and personal engagement with music. Overall, the Music@Home constitutes a novel, valid and reliable instrument that allows for the systematic assessment of distinct aspects of the home musical environment in families with children under the age of 5. Furthermore, the Infant and Preschool versions of the Music@Home present differential associations with musical characteristics of the parents opening a new area of inquiry into how musical exposure and interaction in the home may vary across different developmental stages.

  17. Music@Home: A novel instrument to assess the home musical environment in the early years

    Science.gov (United States)

    Stewart, Lauren; Müllensiefen, Daniel; Franco, Fabia

    2018-01-01

    The majority of children under the age of 5 appear to show spontaneous enjoyment of singing, being exposed to music and interacting with musical instruments, but whether variations in engaging in such activities in the home could contribute to developmental outcomes is still largely unknown. Critically, researchers lack a comprehensive instrument with good psychometric properties to assess the home musical environment from infancy to the preschool years. To address this gap, this paper presents two studies that describe the development and validation of the Music@Home questionnaire, which comprises two versions: Infant and Preschool. In Study 1, an initial pool of items was generated and administered to a wide audience of parents (n = 287 for the Infant, n = 347 for the Preschool version). Exploratory factor analysis was used to identify different dimensions comprising the home musical environment of both infants and pre-schoolers, and to reduce the initial pool of items to a smaller number of meaningful items. In Study 2, convergent and divergent validity and internal and test-retest reliability of the new instrument were established, using data from a different sample of participants (n = 213 for the Infant, n = 213 for the Preschool version). The second study also investigated associations between the Music@Home and musical characteristics of the parents, such as their musical education and personal engagement with music. Overall, the Music@Home constitutes a novel, valid and reliable instrument that allows for the systematic assessment of distinct aspects of the home musical environment in families with children under the age of 5. Furthermore, the Infant and Preschool versions of the Music@Home present differential associations with musical characteristics of the parents opening a new area of inquiry into how musical exposure and interaction in the home may vary across different developmental stages. PMID:29641607

  18. Private investment purchase and nursing home financial health.

    Science.gov (United States)

    Orfaly Cadigan, Rebecca; Stevenson, David G; Caudry, Daryl J; Grabowski, David C

    2015-02-01

    To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 1998-2010. Regression specification incorporating facility and time fixed effects. We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the company's real estate holdings. Private investment acquired facilities are an important feature of today's nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. © Health Research and Educational Trust.

  19. The virtual dental home: a critique.

    Science.gov (United States)

    Friedman, Jay W; Nash, David A; Mathu-Muju, Kavita R

    2017-09-01

    The Virtual Dental Home is a concept of the Pacific Center for Special Care of the Arthur A. Dugoni School of Dentistry in San Francisco. It is designed to improve access to dental care for underserved populations, specifically children and institutionalized adults. This article describes the development and implementation of the Virtual Dental Home, subsequently critiquing the concept. The criteria for a dental home are not met by the program. It is the equivalent of a traditional public oral health prevention and screening program, with the additional dimension of allowing dental hygienists and assistants to place interim glass ionomer restorations in dental cavities. The critique questions the need to insert a "cloud" dentist into the process. The routine utilization of radiographs is also challenged. The VDH not only lacks the attributes of a dental home, it has not been shown to be as efficient and effective as traditional programs staffed by dental hygienists and dental therapists. The article concludes by describing how programs utilizing dental therapists could address the deficiencies of the Virtual Dental Home, effectively improving access to oral health care for underserved populations. © 2017 American Association of Public Health Dentistry.

  20. Summary of technical information and agreements from Nuclear Management and Resources Council industry reports addressing license renewal

    International Nuclear Information System (INIS)

    Regan, C.; Lee, S.

    1996-10-01

    In about 1990, the Nuclear Management and Resources Council (NUMARC) submitted for NRC review ten industry reports (IRs) addressing aging issues associated with specific structures and components of nuclear power plants ad one IR addressing the screening methodology for integrated plant assessment. The NRC staff had been reviewing the ten NUMARC IRs; their comments on each IR and NUMARC responses to the comments have been compiled as public documents. This report provides a brief summary of the technical information and NUMARC/NRC agreements from the ten IRs, except for the Cable License Renewal IR. The technical information and agreements documented herein represent the status of the NRC staffs review when the NRC staff and industry resources were redirected to address rule implementation issues. The NRC staff plans to incorporate appropriate technical information and agreements into the draft standard review plan for license renewal

  1. Is higher nursing home quality more costly?

    Science.gov (United States)

    Giorgio, L Di; Filippini, M; Masiero, G

    2016-11-01

    Widespread issues regarding quality in nursing homes call for an improved understanding of the relationship with costs. This relationship may differ in European countries, where care is mainly delivered by nonprofit providers. In accordance with the economic theory of production, we estimate a total cost function for nursing home services using data from 45 nursing homes in Switzerland between 2006 and 2010. Quality is measured by means of clinical indicators regarding process and outcome derived from the minimum data set. We consider both composite and single quality indicators. Contrary to most previous studies, we use panel data and control for omitted variables bias. This allows us to capture features specific to nursing homes that may explain differences in structural quality or cost levels. Additional analysis is provided to address simultaneity bias using an instrumental variable approach. We find evidence that poor levels of quality regarding outcome, as measured by the prevalence of severe pain and weight loss, lead to higher costs. This may have important implications for the design of payment schemes for nursing homes.

  2. Therapeutic home adaptations for older adults with disabilities.

    Science.gov (United States)

    Unwin, Brian K; Andrews, Christopher M; Andrews, Patrick M; Hanson, Janice L

    2009-11-01

    Family physicians commonly care for older patients with disabilities. Many of these patients need help maintaining a therapeutic home environment to preserve their comfort and independence. Patients often have little time to decide how to address the limitations of newly-acquired disabilities. Physicians can provide patients with general recommendations in home modification after careful history and assessment. Universal design features, such as one-story living, no-step entries, and wide hallways and doors, are key adaptations for patients with physical disabilities. Home adaptations for patients with dementia include general safety measures such as grab bars and door alarms, and securing potentially hazardous items, such as cleaning supplies and medications. Improved lighting and color contrast, enlarged print materials, and vision aids can assist patients with limited vision. Patients with hearing impairments may benefit from interventions that provide supplemental visual and vibratory cues and alarms. Although funding sources are available, home modification is often a nonreimbursed expense. However, sufficient home modifications may allow the patient and caregivers to safely remain in the home without transitioning to a long-term care facility.

  3. Private Investment Purchase and Nursing Home Financial Health

    Science.gov (United States)

    Cadigan, Rebecca Orfaly; Stevenson, David G; Caudry, Daryl J; Grabowski, David C

    2015-01-01

    Objective To explore the impact of nursing home acquisition by private investment firms on nursing home costs, revenue, and overall financial health. Data Sources Merged data from the Medicare Cost Reports and the Online Survey, Certification, and Reporting system for the period 1998–2010. Study Design Regression specification incorporating facility and time fixed effects. Principal Findings We found little impact on the financial health of nursing homes following purchase by private investment companies. However, our findings did suggest that private investment firms acquired nursing home chains in good financial health, possibly to derive profit from the company’s real estate holdings. Conclusions Private investment acquired facilities are an important feature of today’s nursing home sector. Although we did not observe a negative impact on the financial health of nursing homes, this development raises important issues about ownership oversight and transparency for the entire nursing home sector. PMID:25104476

  4. Social barriers to the adoption of smart homes

    International Nuclear Information System (INIS)

    Balta-Ozkan, Nazmiye; Davidson, Rosemary; Bicket, Martha; Whitmarsh, Lorraine

    2013-01-01

    The aim of this paper is to explore social barriers to the adoption of smart homes through the analysis of expert views and public attitudes. Smart home services aim to improve the comfort, convenience and safety of householders, as well as allowing them to use energy more efficiently and cope with increasing costs. Despite the existence of smart homes and smart home technologies for some time, their prevalence is not widespread, and thus their potential largely untapped. Using a combination of in-depth deliberative public workshops, expert interviews and a review of the existing literature, this paper explores social barriers to smart home diffusion, including how these vary by expertise, life-stage and location. The research highlights the importance of barriers such as control, security, and cost, providing insights for policymakers as well as smart-home designers and developers as to how these might be addressed. - Highlights: • Smart homes and related technologies can provide a variety of benefits. • Technologies need to be reliable and fit into householders’ lifestyles. • Public concerns relate to cost, control and privacy. • Trust in energy companies and government is important

  5. Nursing home safety: does financial performance matter?

    Science.gov (United States)

    Oetjen, Reid M; Zhao, Mei; Liu, Darren; Carretta, Henry J

    2011-01-01

    This study examines the relationship between financial performance and selected safety measures of nursing homes in the State of Florida. We used descriptive analysis on a total sample of 1,197. Safety information was from the Online Survey, Certification and Reporting (OSCAR) data of 2003 to 2005, while the financial performance measures were from the Medicare cost reports of 2002 to 2004. Finally, we examined the most frequently cited deficiencies as well as the relationship between financial performance and quality indicators. Nursing homes in the bottom quartile of financial performance perform poorly on most resident-safety measures of care; however, nursing homes in the top two financial categories also experienced a higher number of deficiencies. Nursing homes in the next to lowest quartile of financial performance category best perform on most of these safety measures. The results reinforce the need to monitor nursing home quality and resident safety in US nursing homes, especially among facilities with poor overall financial performance.

  6. Reengineering hemodialysis for the home environment.

    Science.gov (United States)

    Treu, Denny

    2010-01-01

    Denny Treu of NxStage Medical, Inc., who has led the development of six dialysis systems with various companies, reports here on a home hemodialysis system that his company successfully designed specifically for home use.

  7. Effect of Home Care Nursing on Patients Discharged From Hospital With Self-Reported Signs of Constipation: A Randomized Trial.

    Science.gov (United States)

    Konradsen, Hanne; Rasmussen, Marie Louise Thiese; Noiesen, Eline; Trosborg, Ingelise

    Constipation is a common health problem in relation to hospitalization. This randomized controlled trial aimed to investigate whether advice from a home care nurse after discharge had an effect on self-reported signs of constipation. A total of 59 patients were included in the study on the basis of their self-reported signs of constipation evaluated using the Constipation Assessment Scale. Advice from the home care nurses was given on the intake of fiber and liquid and mobilization related to scorings on the Constipation Risk Assessment Scale, the administration of laxatives, and referral to a physician when needed. Results showed a tendency toward the visits being effective, but a more complex intervention might be needed.

  8. Amigo - Ambient Intelligence for the networked home environment

    OpenAIRE

    Janse, M.D.

    2008-01-01

    The Amigo project develops open, standardized, interoperable middleware and attractive user services for the networked home environment. Fifteen of Europe's leading companies and research organizations in mobile and home networking, software development, consumer electronics and domestic appliances have joined together in the Amigo project to develop an integrated interoperable home networking framework. Amigo is an IST-funded IP project. This report is the final report providing an overview ...

  9. 76 FR 79050 - Federal Home Loan Bank Housing Goals: Mortgage Reporting Amendments

    Science.gov (United States)

    2011-12-21

    ... FEDERAL HOUSING FINANCE AGENCY 12 CFR Part 1281 RIN 2590-AA48 Federal Home Loan Bank Housing Goals... governing housing goals for the Federal Home Loan Banks (Banks) to make those requirements consistent with... Section 1205 of the Housing and Economic Recovery Act of 2008 (HERA) amended the Federal Home Loan Bank...

  10. Stressors and Well-Being among Caregivers to Older Adults with Dementia: The In-Home versus Nursing Home Experience.

    Science.gov (United States)

    Stephens, Mary Ann Parris; And Others

    1991-01-01

    Examined differences in stressors and well-being for caregivers who care for relative with dementia at home and those with relative in nursing home (n=120). Found no differences in depression or somatic complaints, but nursing home caregivers reported fewer social disruptions and more stressors resulting from activities of daily living assistance,…

  11. [Analysis of public quality reports for home care and long-term care with respect to their usefulness for the customer].

    Science.gov (United States)

    Sünderkamp, Susanne; Weiß, Christian; Rothgang, Heinz

    2014-10-01

    Public quality reports, based on new legislative regulations of 2008, were supposed to offer potential customers the possibility to make a well-informed choice of a care provider. This empirical study on marks for long-term care is based on the public quality reports of the Medical Service of the Health Insurance Companies (MDK), of 11 884 home care services and 10 310 nursing homes, which corresponds to a comprehensive survey of almost all care providers in Germany. Descriptive statistical methods and discussion of the results concerning the customer benefit. The analysis of transparency reports reveals a limited value for customers, which is particularly caused by very good quality results with low scattering. In addition, a high amount of missing data - especially in the area of home care providers - leads to a growing influence of service criteria on the final grade. Though deficits in nursing might be compensated by good marks in service criteria, it rarely occurs. At present, a more detailed look at risk criteria hardly improves the customer benefit. The marks for nursing need to be improved to increase their informative value for the customer.

  12. A Qualitative Exploration of Co-location as an Intervention to Strengthen Home Visiting Implementation in Addressing Maternal Child Health.

    Science.gov (United States)

    Kellom, Katherine S; Matone, Meredith; Adejare, Aderinola; Barg, Frances K; Rubin, David M; Cronholm, Peter F

    2018-06-01

    Objectives The aim of this paper is to explore the process and impact of co-locating evidence-based maternal and child service models to inform future implementation efforts. Methods As part of a state-wide evaluation of maternal and child home visiting programs, we conducted semi-structured interviews with administrators and home visitors from home visiting agencies across Pennsylvania. We collected 33 interviews from 4 co-located agencies. We used the Consolidated Framework for Implementation Research (CFIR) to describe the key elements mitigating implementation of multiple home visiting models. Results A primary advantage of co-location described by participants was the ability to increase the agency's base of eligible clients through the implementation of a model with different program eligibility (e.g. income, child age) than the existing agency offering. Model differences related to curriculum (e.g. content or intensity/meeting frequency) enabled programs to more selectively match clients to models. To recruit eligible clients, new models were able to build upon the existing service networks of the initial program. Co-location provided organizational opportunities for shared trainings, enabling administrative efficiencies and collaborative staff learning. Programs implemented strategies to build synergies with complementary model features, for instance using the additional program option to serve waitlisted clients and to transition services after one model is completed. Conclusions for Practice Considerable benefits are experienced when home visiting models co-locate. This research builds on literature encouraging collaboration among community agencies and provides insight on a specific facilitative approach. This implementation strategy informs policy across the social services spectrum and competitive funding contexts.

  13. The Dynamic Family Home: a qualitative exploration of physical environmental influences on children's sedentary behaviour and physical activity within the home space.

    Science.gov (United States)

    Maitland, Clover; Stratton, Gareth; Foster, Sarah; Braham, Rebecca; Rosenberg, Michael

    2014-12-24

    Recent changes in home physical environments, such as decreasing outdoor space and increasing electronic media, may negatively affect health by facilitating sedentariness and reducing physical activity. As children spend much of their time at home they are particularly vulnerable. This study qualitatively explored family perceptions of physical environmental influences on sedentary behaviour and physical activity within the home space. Home based interviews were conducted with 28 families with children aged 9-13 years (total n = 74 individuals), living in Perth, Australia. Families were stratified by socioeconomic status and selected to provide variation in housing. Qualitative methods included a family interview, observation and home tour where families guided the researcher through their home, enabling discussion while in the physical home space. Audio recordings were transcribed verbatim and thematically analysed. Emergent themes related to children's sedentariness and physical activity included overall size, space and design of the home; allocation of home space; equipment within the home space; perceived safety of the home space; and the changing nature of the home space. Families reported that children's activity options were limited when houses and yards were small. In larger homes, multiple indoor living rooms usually housed additional sedentary entertainment options, although parents reported that open plan home layouts could facilitate monitoring of children's electronic media use. Most families reported changing the allocation and contents of their home space in response to changing priorities and circumstances. The physical home environment can enhance or limit opportunities for children's sedentary behaviour and physical activity. However, the home space is a dynamic ecological setting that is amenable to change and is largely shaped by the family living within it, thus differentiating it from other settings. While size and space were considered

  14. 12 CFR 41.82 - Duties of users regarding address discrepancies.

    Science.gov (United States)

    2010-01-01

    ... CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal... consumer reports (user) that receives a notice of address discrepancy from a consumer reporting agency... request the consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable...

  15. 12 CFR 571.82 - Duties of users regarding address discrepancies.

    Science.gov (United States)

    2010-01-01

    ... CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies and Records Disposal... consumer reports (user) that receives a notice of address discrepancy from a consumer reporting agency... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1...

  16. Problems With Deployment of Multi-Domained, Multi-Homed Mobile Networks

    Science.gov (United States)

    Ivancic, William D.

    2008-01-01

    This document describes numerous problems associated with deployment of multi-homed mobile platforms consisting of multiple networks and traversing large geographical areas. The purpose of this document is to provide insight to real-world deployment issues and provide information to groups that are addressing many issues related to multi-homing, policy-base routing, route optimization and mobile security - particularly those groups within the Internet Engineering Task Force.

  17. Marketing and promoting solar water heaters to home builders

    Energy Technology Data Exchange (ETDEWEB)

    Keller, C.; Ghent, P.

    1999-12-06

    This is the final report of a four-task project to develop a marketing plan designed for businesses interested in marketing solar water heaters in the new home industry. This report outlines suggested marketing communication materials and other promotional tools focused on selling products to the new home builder. Information relevant to promoting products to the new home buyer is also included.

  18. Pain management in the nursing home.

    Science.gov (United States)

    Dumas, Linda G; Ramadurai, Murali

    2009-06-01

    This article is about pain management and some of the best practices to address the problem of pain in nursing home patients who have a serious illness and multiple comorbid conditions. Management of the emotional distress that accompanies chronic or acute pain is of foremost concern. In this article, the topics discussed include general pain management in a nursing home for a long-term care resident who has chronic pain, the relief of symptoms and suffering in a patient who is on palliative care and hospice, and the pain management of a postoperative patient with acute pain for a short transitional period (post-acute illness or surgery).

  19. Brain Computer Interfaces on Track to Home: Results of the Evaluation at Disabled End-Users's Homes and Lessons Learnt

    Directory of Open Access Journals (Sweden)

    Felip eMiralles

    2015-11-01

    Full Text Available The BackHome system is a multi-functional BCI system, the final outcome of a User Centred Design approach, whose ambition is to move BCI systems from laboratories into the home of people in need for their independent home use. The paper presents the results of testing and evaluation of the BackHome system with end-users at their own homes. Results show moderate to good acceptance from end-users, caregivers and therapists; which reported promising usability levels, good user satisfaction and levels of control in the use of services and home support based on remote monitoring tools.

  20. Report: Complaints Regarding Debris Management at the West, Texas, Fertilizer Plant Explosion Have Been Addressed

    Science.gov (United States)

    Report #14-P-0123, February 24, 2014. Debris from a fertilizer plant explosion was moved without EPA or TCEQ knowledge but is being managed. A water main break existed under the debris but has been addressed. The debris was found to be non-hazardous.

  1. Use of Clinical Health Information Technology in Nursing Homes: Nursing Home Characteristics and Quality Measures

    Science.gov (United States)

    Spinelli-Moraski, Carla

    2014-01-01

    This study compares quality measures among nursing homes that have adopted different levels of clinical health information technology (HIT) and examines the perceived barriers and benefits of the adoption of electronic health records as reported by Nursing Home Administrators and Directors of Nursing. A cross-sectional survey distributed online to…

  2. Measurement of overall quality of life in nursing homes through self report : the role of cognitive impairment

    NARCIS (Netherlands)

    Gerritsen, Debby Lydia; Steverink, Nardi; Ooms, Marcel E.; de Vet, Henrica C. W.; Ribbe, Miel W.

    Measuring quality of life is a necessity for adequate interventions. This paper concerns the usefulness of six self-report measures for overall quality of life for nursing home residents with various levels of cognitive impairment. It was investigated which proportion of residents from four

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

    Science.gov (United States)

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

    2014-12-01

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

  4. Nursing Home - Pain - Percentage of Residents Reporting Pain

    Data.gov (United States)

    U.S. Department of Health & Human Services — Adequate pain management is an important indicator of quality of care and quality of life. Nursing home staff should check patients regularly to see if they are...

  5. The prevalence and risk factors for percutaneous injuries in registered nurses in the home health care sector.

    Science.gov (United States)

    Gershon, Robyn R M; Pearson, Julie M; Sherman, Martin F; Samar, Stephanie M; Canton, Allison N; Stone, Patricia W

    2009-09-01

    Patients continue to enter home health care (HHC) "sicker and quicker," often with complex health problems that require extensive intervention. This higher level of acuity may increase the risk of percutaneous injury (PI), yet information on the risk and risk factors for PI and other types of exposures in this setting is exceptionally sparse. To address this gap, a large cross-sectional study of self-reported exposures in HHC registered nurses (RNs) was conducted. A convenience sample of HHC RNs (N=738) completed a survey addressing 5 major constructs: (1) worker-centered characteristics, (2) patient-related characteristics, (3) household characteristics, (4) organizational factors, and (5) prevalence of PIs and other blood and body fluid exposures. Analyses were directed at determining significant risk factors for exposure. Fourteen percent of RNs reported one or more PIs in the past 3 years (7.6 per 100 person-years). Nearly half (45.8%) of all PIs were not formally reported. PIs were significantly correlated with a number of factors, including lack of compliance with Standard Precautions (odds ratio [OR], 1.72; P=.019; 95% confidence interval [CI]: 1.09-2.71); recapping of needles (OR, 1.78; P=.016; 95% CI: 1.11-2.86); exposure to household stressors (OR, 1.99; P=.005; 95% CI: 1.22-3.25); exposure to violence (OR, 3.47; P=.001; 95% CI: 1.67-7.20); mandatory overtime (OR, 2.44; P=.006; 95% CI: 1.27-4.67); and safety climate (OR, 1.88; P=.004; 95% CI: 1.21-2.91) among others. The prevalence of PI was substantial. Underreporting rates and risk factors for exposure were similar to those identified in other RN work populations, although factors uniquely associated with home care were also identified. Risk mitigation strategies tailored to home care are needed to reduce risk of exposure in this setting.

  6. Malnutrition and mealtime ambiance in nursing homes

    NARCIS (Netherlands)

    Nijs, K.A.N.D.; Graaf, de C.; Staveren, van W.A.; Groot, de C.P.G.M.

    2009-01-01

    Inadequate nutritional intake is the predominant cause of malnutrition in older persons. It is one of the most common and devastating conditions in nursing home residents. It is multifactorial and treatment or nutrition care plans should try to address the main causes. Such plans often include means

  7. Home Cervical Traction to Reduce Neck Pain in Fighter Pilots.

    Science.gov (United States)

    Chumbley, Eric M; O'Hair, Nicole; Stolfi, Adrienne; Lienesch, Christopher; McEachen, James C; Wright, Bruce A

    2016-12-01

    Most fighter pilots report cervical pain during their careers. Recommendations for remediation lack evidence. We sought to determine whether regular use of a home cervical traction device could decrease reported cervical pain in F-15C pilots. An institutional review board-approved, Health Insurance Portability and Accountability Act-compliant, controlled crossover study was undertaken with 21 male F-15C fighter pilots between February and June 2015. Of the 21 subjects, 12 completed 6 wk each of traction and control, while logging morning, postflying, and post-traction pain. Pain was compared with paired t-tests between the periods, from initial pain scores to postflying, and postflying to post-traction. In the traction phase, initial pain levels increased postflight, from 1.2 (0.7) to 1.6 (1.0) Subsequent post-traction pain levels decreased to 1.3 (0.9), with a corresponding linear decrease in pain relative to pain reported postflight. The difference in pain levels after traction compared to initial levels was not significant, indicating that cervical traction was effective in alleviating flying-related pain. Control pain increased postflight from 1.4 (0.9) to 1.9 (1.3). Daily traction phase pain was lower than the control, but insignificant. To our knowledge, this is the first study of home cervical traction to address fighter pilots' cervical pain. We found a small but meaningful improvement in daily pain rating when using cervical traction after flying. These results help inform countermeasure development for pilots flying high-performance aircraft. Further study should clarify the optimal traction dose and timing in relation to flying.Chumbley EM, O'Hair N, Stolfi A, Lienesch C, McEachen JC, Wright BA. Home cervical traction to reduce neck pain in fighter pilots. Aerosp Med Hum Perform. 2016; 87(12):1010-1015.

  8. Addressing the need to capture scenarios, intentions and preferences : interactive intentional programming in the smart home

    NARCIS (Netherlands)

    Funk, M.; Chen, L.; Chen, Y.-K.; Yang, S.-W.

    2018-01-01

    The Internet of Things (IoT) and connected products have become ubiquitous technological advances into personal and professional living spaces, such as the smart home. What connectivity and distributed computing have made possible, is still programmed only in more or less simplified rule systems (or

  9. 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.

  10. The haemtrack home therapy reporting system: Design, implementation, strengths and weaknesses: A report from UK Haemophilia Centre Doctors Organisation.

    Science.gov (United States)

    Hay, C R M; Xiang, H; Scott, M; Collins, P W; Liesner, R; Dolan, G; Hollingsworth, R

    2017-09-01

    Haemtrack is an electronic home treatment diary for patients with inherited bleeding disorders, introduced in 2008. It aimed to improve the timeliness and completeness of patient-reported treatment records, to facilitate analysis of treatment and outcome trends. The system is easy to use, responsive and accessible. The software uses Microsoft technologies with a SQL Server database and an ASP.net website front-end, running on personal computers, android and I-phones. Haemtrack interfaces with the UK Haemophilia Centre Information System and the National Haemophilia Database (NHD). Data are validated locally by Haemophilia Centres and centrally by NHD. Data collected include as follows: treatment brand, dose and batch number, time/date of bleed onset and drug administration, reasons for treatment (prophylaxis, bleed, follow-up), bleed site, severity, pain-score and outcome. Haemtrack was used by 90% of haemophilia treatment centres (HTCs) in 2015, registering 2683 patients using home therapy of whom 1923 used Haemtrack, entering >17 000 treatments per month. This included 68% of all UK patients with severe haemophilia A. Reporting compliance varied and 55% of patients reported ≥75% of potential usage. Centres had a median 78% compliance overall. A strategy for progressively improving compliance is in place. Age distribution and treatment intensity were similar in Haemtrack users/non-users with severe haemophilia treated prophylactically. The Haemtrack system is a valuable tool that may improve treatment compliance and optimize treatment regimen. Analysis of national treatment trends and large-scale longitudinal, within-patient analysis of changes in regimen and/or product will provide valuable insights that will guide future clinical practice. © 2017 John Wiley & Sons Ltd.

  11. Allowing Family to be Family: End-of-Life Care in Veterans Affairs Medical Foster Homes.

    Science.gov (United States)

    Manheim, Chelsea E; Haverhals, Leah M; Jones, Jacqueline; Levy, Cari R

    2016-01-01

    The Medical Foster Home program is a unique long-term care program coordinated by the Veterans Health Administration. The program pairs Veterans with private, 24-hour a day community-based caregivers who often care for Veterans until the end of life. This qualitative study explored the experiences of care coordination for Medical Foster Home Veterans at the end of life with eight Veterans' family members, five Medical Foster Home caregivers, and seven Veterans Health Administration Home-Based Primary Care team members. A case study, qualitative content analysis identified these themes addressing care coordination and impact of the Medical Foster Home model on those involved: (a) Medical Foster Home program supports Veterans' families; (b) Medical Foster Home program supports the caregiver as family; (c) Veterans' needs are met socially and culturally at the end of life; and (d) the changing needs of Veterans, families, and caregivers at Veterans' end of life are addressed. Insights into how to best support Medical Foster Home caregivers caring for Veterans at the end of life were gained including the need for more and better respite options and how caregivers are compensated in the month of the Veteran's death, as well as suggestions to navigate end-of-life care coordination with multiple stakeholders involved.

  12. Determinants of occupational injury for US home health aides reporting one or more work-related injuries.

    Science.gov (United States)

    Hamadi, Hanadi; Probst, Janice C; Khan, Mahmud M; Bellinger, Jessica; Porter, Candace

    2017-08-04

    Home health aides (HHAs) work in a high-risk industry and experience high rates of work-related injury that have been significantly associated with reduction in workers and organisational productivity, quality and performance. The main objective of the study was to examine how worker environment and ergonomic factors affect HHA risk for reporting occupational injuries. We used cross-sectional analysis of data from the 2007 National Home Health and Hospice Aide Survey (NHHAS). The study sample consisted of a nationally represented sample of home health aides (n=3.377) with a 76.6% response rate. We used two scales 1 : a Work Environment Scale and 2 an Ergonomic Scale. Univariate and bivariate analyses were conducted to describe HHA work-related injury across individual, job and organisational factors. To measure scale reliability, Cronbach's alphas were calculated. Multivariable logistic regression was used to determine predictors of reported occupational injury. In terms of Work Environment Scale, the injury risk was decreased in HHAs who did not consistently care for the same patients (OR=0.96, 95% CI: 0.53 to 1.73). In terms of Ergonomic Scale, the injury risk was decreased only in HHAs who reported not needing any other devices for job safety (OR=0.30, 95% (CI): 0.15 to 0.61). No other Work Environment or Ergonomic Scale factors were associated with HHAs' risk of injury. This study has great implications on a subcategory of the workforce that has a limited amount of published work and studies, as of today, as well as an anticipated large demand for them. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Formal and informal home learning activities in relation to children's early numeracy and literacy skills: the development of a home numeracy model.

    Science.gov (United States)

    Skwarchuk, Sheri-Lynn; Sowinski, Carla; LeFevre, Jo-Anne

    2014-05-01

    The purpose of this study was to propose and test a model of children's home numeracy experience based on Sénéchal and LeFevre's home literacy model (Child Development, 73 (2002) 445-460). Parents of 183 children starting kindergarten in the fall (median child age=58 months) completed an early home learning experiences questionnaire. Most of the children whose parents completed the questionnaire were recruited for numeracy and literacy testing 1 year later (along with 32 children from the inner city). Confirmatory factor analyses were used to reduce survey items, and hierarchical regression analyses were used to predict the relation among parents' attitudes, academic expectations for their children, reports of formal and informal numeracy, and literacy home practices on children's test scores. Parental reports of formal home numeracy practices (e.g., practicing simple sums) predicted children's symbolic number system knowledge, whereas reports of informal exposure to games with numerical content (measured indirectly through parents' knowledge of children's games) predicted children's non-symbolic arithmetic, as did numeracy attitudes (e.g., parents' enjoyment of numeracy). The home literacy results replicated past findings; parental reports of formal literacy practices (e.g., helping their children to read words) predicted children's word reading, whereas reports of informal experiences (i.e., frequency of shared reading measured indirectly through parents' storybook knowledge) predicted children's vocabulary. These findings support a multifaceted model of children's early numeracy environment, with different types of early home experiences (formal and informal) predicting different numeracy outcomes. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Home advantage in the Winter Paralympic Games 1976-2014.

    Science.gov (United States)

    Wilson, Darryl; Ramchandani, Girish

    2017-01-01

    There is a limited amount of home advantage research concerned with winter sports. There is also a distinct lack of studies that investigate home advantage in the context of para sport events. This paper addresses this gap in the knowledge by examining home advantage in the Winter Paralympic Games. Using a standardised measure of success, we compared the performances of host nations at home with their own performances away from home between 1976 and 2014. Both country level and individual sport level analysis is conducted for this time period. Comparisons are also drawn with the Winter Olympic Games since 1992, the point from which both the Winter Olympic Games and the Winter Paralympic Games have been hosted by the same nations and in the same years. Clear evidence of a home advantage effect in the Winter Paralympic Games was found at country level. When examining individual sports, only alpine skiing and cross country skiing returned a significant home advantage effect. When comparing home advantage in the Winter Paralympic Games with the Winter Olympic Games for the last seven host nations (1992-2014), we found that home advantage was generally more pronounced (although not a statistically significant difference) in the case of the former. The causes of home advantage in the Winter Paralympic Games are unclear and should be investigated further.

  15. Testing feedback message framing and comparators to address prescribing of high-risk medications in nursing homes: protocol for a pragmatic, factorial, cluster-randomized trial.

    Science.gov (United States)

    Ivers, Noah M; Desveaux, Laura; Presseau, Justin; Reis, Catherine; Witteman, Holly O; Taljaard, Monica K; McCleary, Nicola; Thavorn, Kednapa; Grimshaw, Jeremy M

    2017-07-14

    Audit and feedback (AF) interventions that leverage routine administrative data offer a scalable and relatively low-cost method to improve processes of care. AF interventions are usually designed to highlight discrepancies between desired and actual performance and to encourage recipients to act to address such discrepancies. Comparing to a regional average is a common approach, but more recipients would have a discrepancy if compared to a higher-than-average level of performance. In addition, how recipients perceive and respond to discrepancies may depend on how the feedback itself is framed. We aim to evaluate the effectiveness of different comparators and framing in feedback on high-risk prescribing in nursing homes. This is a pragmatic, 2 × 2 factorial, cluster-randomized controlled trial testing variations in the comparator and framing on the effectiveness of quarterly AF in changing high-risk prescribing in nursing homes in Ontario, Canada. We grouped homes that share physicians into clusters and randomized these clusters into the four experimental conditions. Outcomes will be assessed after 6 months; all primary analyses will be by intention-to-treat. The primary outcome (monthly number of high-risk medications received by each patient) will be analysed using a general linear mixed effects regression model. We will present both four-arm and factorial analyses. With 160 clusters and an average of 350 beds per cluster, assuming no interaction and similar effects for each intervention, we anticipate 90% power to detect an absolute mean difference of 0.3 high-risk medications prescribed. A mixed-methods process evaluation will explore potential mechanisms underlying the observed effects, exploring targeted constructs including intention, self-efficacy, outcome expectations, descriptive norms, and goal prioritization. An economic analysis will examine cost-effectiveness analysis from the perspective of the publicly funded health care system. This protocol

  16. Development of the Intervention Materials for the HomeStyles Obesity Prevention Program for Parents of Preschoolers

    Directory of Open Access Journals (Sweden)

    Jennifer Martin-Biggers

    2015-08-01

    Full Text Available Home environment is key to the development of obesity-preventing behaviors during childhood, yet few resources help preschool parents address factors at home associated with obesity risk. This paper describes creation of materials for an in-home intervention (HomeStyles with this population. An advisory group of stakeholders and target audience members determined salient factors affecting childhood obesity to address in-home and developed program materials. The Social Cognitive Theory, Faith’s Core Behavior Change Strategies to Treat Childhood Obesity, Adult Learning Theory and motivational interviewing techniques guided development of 12 guides targeting strategies parents can use to shape the home environment. Interviews were conducted to determine effectiveness of the guides. Cognitive testing of guide design (n = 251 and content (n = 261 occurred in English and Spanish in New Jersey and Arizona with parents and home visitation staff who would present the guides. Interviews investigated perceptions of content usefulness and parent comprehension. Findings were also examined in light of theoretical underpinnings. Both home visitation staff and parents felt the guides were very readable and useful. Parents appreciated use of motivational interviewing techniques and Adult Learning Theory. Current research is testing these guides through an in-home, randomized control trial.

  17. Designing for Active Place Presence at Home

    DEFF Research Database (Denmark)

    Ylirisku, Salu; Jylhä, Antti; Lehtiö, Anu

    2016-01-01

    Technological support for augmenting the relationship that people establish with remote places has been studied fairly little as the primary focus in telepresence studies is the connection between people. This paper addresses the design challenge for supporting ‘active place presence’ at home...... to be considered when designing for active place presence at home........ A prototype, Hole in Space, was created to explore the design challenge. A longitudinal study of how an urban couple appropriated the prototype was conducted over the duration of seven months. The paper elaborates on how the Web-mediated design influenced place presence and outlines several aspects that need...

  18. Occupational Stress Among Home Healthcare Workers: Integrating Worker and Agency-Level Factors.

    Science.gov (United States)

    Zoeckler, Jeanette M

    2018-02-01

    Home healthcare work is physically and emotionally exhausting. In addition, home healthcare workers frequently work under precarious work arrangements for low wages and in poor work conditions. Little is known about how sources of job strain for home healthcare workers might be reduced. This research examines the occupational stressors among paid home care workers by analyzing home healthcare agency characteristics and individual home healthcare workers' experiences in upstate New York agencies (n = 9). The study augments existing theoretical models and describes new sources of stress arising from the nature of agency-based caregiving. Results feature the analysis of both agency executives' (n = 20) and home healthcare workers' narratives (n = 25) to make the agency's inner workings more transparent. Agency structures and culture are implicated in the lack of progress to address home care workers' health problems. Policy change should focus on compensation, healthier work conditions, and training requirements.

  19. 12 CFR 717.82 - Duties of users regarding address discrepancies.

    Science.gov (United States)

    2010-01-01

    ... CREDIT UNIONS FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address Discrepancies... applies to a user of consumer reports (user) that receives a notice of address discrepancy from a consumer... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1...

  20. Cyberbullying among primary school students in Turkey: self-reported prevalence and associations with home and school life.

    Science.gov (United States)

    Arslan, Sevda; Savaser, Sevim; Hallett, Victoria; Balci, Serap

    2012-10-01

    The current study examined the self-reported prevalence and nature of cyberbullying and victimization among second, third, and fourth grade students (N=372) and explored associated features of home and school life. Of the children in the current sample, 27 percent had been victims of cyberbullying, 18 percent had been aggressors, and 15 percent had been both cyberbullies and victims. Boys were significantly more likely to carry out cyberbullying than girls. Cyberbullying exposure (as both a bully and a victim) was significantly associated with low levels of self-reported school satisfaction (bullies odds ratio [OR]: 2.45; victims OR: 2.10; p<0.05) and achievement (bullies OR: 3.85; victims OR: 3.47, p<0.05). Paternal unemployment was also associated with a three-fold increase in the likelihood of being a cyberbully. Increased awareness and regulation is now required within schools and within the home to tackle this escalating problem.

  1. Home-School Links: Networking the Learning Community.

    Science.gov (United States)

    1996

    The topic of networking the learning community with home-school links is addressed in four papers: "Internet Access via School: Expectations of Students and Parents" (Roy Crotty); "The School Library as Community Information Gateway" (Megan Perry); "Rural Access to the Internet" (Ken Eustace); and "NetDay '96:…

  2. 12 CFR 334.82 - Duties of users regarding address discrepancies.

    Science.gov (United States)

    2010-01-01

    ... STATEMENTS OF GENERAL POLICY FAIR CREDIT REPORTING Duties of Users of Consumer Reports Regarding Address... section applies to a user of consumer reports (user) that receives a notice of address discrepancy from a... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief. (1...

  3. State-of-the-art report for solar water heaters in the Netherlands 2008

    International Nuclear Information System (INIS)

    Bosselaar, L.; Blezer, I.

    2009-01-01

    This state-of-the-art report addresses the implementation of solar heat in the Netherlands. The main appliance is the solar boiler for production of warm tap water in households. Other appliances are production of warm tap water in large buildings (e.g. homes for the elderly), heating of dwellings and heating of swimming pools. The aim of this report is to provide an overview of the market and techniques for this technology. Emphasis will be put on solar boilers, but other appliances will also be addressed [nl

  4. Autism and family home movies: a comprehensive review.

    Science.gov (United States)

    Palomo, Rubén; Belinchón, Mercedes; Ozonoff, Sally

    2006-04-01

    In this article, we focus on the early development of autism studied through family home movies. We review all investigations published in English that met specific methodological standards, including the use of comparison samples, coding blind to group membership, and adequate levels of interrater reliability. After discussing in detail the pros and cons of the home-movie methodology, we review the results of all empirical studies conducted to date. We then present a summary of the features found consistently across studies that differentiate autism from typical development and mental retardation in the first 2 years of life. How family home movies can contribute to our understanding of the regression phenomenon is also addressed. Finally, the results are interpreted from both a theoretical and clinical point of view.

  5. Feedback mechanisms of change: How problem alerts reported by youth clients and their caregivers impact clinician-reported session content

    Science.gov (United States)

    Douglas, Susan R.; Jonghyuk, Bae; de Andrade, Ana Regina Vides; Tomlinson, M. Michele; Hargraves, Ryan Pamela; Bickman, Leonard

    2015-01-01

    Objective This study explored how clinician-reported content addressed in treatment sessions was predicted by clinician feedback group and multi-informant cumulative problem alerts that appeared in computerized feedback reports for 299 clients aged 11 to 18 years receiving home-based community mental health treatment. Method Measures included a clinician-report of content addressed in sessions and additional measures of treatment progress and process (e.g., therapeutic alliance) completed by clinicians, clients, and their caregivers. Item responses in the top 25th percentile in severity from these measures appeared as ‘problem alerts’ on corresponding computerized feedback reports. Clinicians randomized to the feedback group received feedback weekly while the control group did not. Analyses were conducted using the Cox proportional hazards regression for recurrent events. Results For all content domains, the results of the survival analyses indicated a robust effect of the feedback group on addressing specific content in sessions, with feedback associated with shorter duration to first occurrence and increased likelihood of addressing or focusing on a topic compared to the non-feedback group. Conclusion There appears to be an important relationship between feedback and cumulative problem alerts reported by multiple informants as they influence session content. PMID:26337327

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

    OpenAIRE

    Nakari, Pentti J. E.

    2016-01-01

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

  7. Achievement and Demographics of Home School Students: 1998

    Directory of Open Access Journals (Sweden)

    Lawrence M. Rudner

    1999-03-01

    Full Text Available This report presents the results of the largest survey and testing program for students in home schools to date. In Spring 1998, 20,760 K-12 home school students in 11,930 families were administered either the Iowa Tests of Basic Skills (ITBS or the Tests of Achievement and Proficiency (TAP, depending on their current grade. The parents responded to a questionnaire requesting background and demographic information. Major findings include: the achievement test scores of this group of home school students are exceptionally high--the median scores were typically in the 70th to 80th percentile; 25% of home school students are enrolled one or more grades above their age-level public and private school peers; this group of home school parents has more formal education than parents in the general population; the median income for home school families is significantly higher than that of all families with children in the United States; and almost all home school students are in married couple families. Because this was not a controlled experiment, the study does not demonstrate that home schooling is superior to public or private schools and the results must be interpreted with caution. The report clearly suggests, however, that home school students do quite well in that educational environment.

  8. Homeworking: Home Office or Home Sweatshop? Report on Current Conditions of Homeworkers in Toronto's Garment Industry. NALL Working Paper.

    Science.gov (United States)

    Ng, Roxana; Wong, Renita Yuk-Lin; Choi, Angela

    The current conditions of home workers in the garment industry in Toronto, Canada, were examined through in-depth telephone interviews with 30 Chinese-speaking immigrant women who were employed as home workers in 1999. The paper dicusses the formal training and informal learning experiences of immigrant woman who are garment workers. A comparison…

  9. Patient-centered medical homes for patients with disabilities.

    Science.gov (United States)

    Hernandez, Brigida; Damiani, Marco; Wang, T Arthur; Driscoll, Carolyn; Dellabella, Peter; LePera, Nicole; Mentari, Michael

    2015-01-01

    The patient-centered medical home is an innovative approach to improve health care outcomes. To address the unique needs of patients with intellectual and developmental disabilities (IDDs), a large health care provider reevaluated the National Committee for Quality Assurance's 6 medical home standards: (a) enhance access and continuity, (b) identify and manage patient populations, (c) plan and manage care, (d) provide self-care and community support, (e) track and coordinate care, and (f) measure and improve performance. This article describes issues to consider when serving patients with IDDs.

  10. Background television in the homes of American children

    NARCIS (Netherlands)

    Lapierre, M.A.; Piotrowski, J.; Linebarger, D.L.

    2012-01-01

    Research has shown the negative consequences associated with children’s exposure to background television. Despite this evidence, researchers do not have reliable estimates of the prevalence of background television in American homes. This study sought to address this gap by providing the first

  11. Home/Hospital Instruction: Instructional Approach to Working with Students with Major Depressive Disorder

    Science.gov (United States)

    Newman, Cara

    2012-01-01

    School districts throughout the United States provide in-home schooling for students whose health problems, both physical and mental, prevent them from attending regular classes. This service is an outgrowth of the federal legislation which addressed the provision of education to all children with special needs. Home/Hospital teachers who serve…

  12. Conflict between nursing home staff and residents' families: does it increase burnout?

    Science.gov (United States)

    Abrahamson, Kathleen; Jill Suitor, J; Pillemer, Karl

    2009-09-01

    In this study, the authors examine the influence of conflict between nursing home staff and family members of residents on staff burnout. Data were collected from interviews with a representative sample of 655 nursing home nurses and nursing assistants. Hypotheses were tested using structural equation modeling. Results indicate that conflict with family members increases staff burnout and decreases staff satisfaction. Staff and family conflict increases when staff members feel they do not have enough time to complete required tasks. Level of conflict decreases when staff perceive that family members have care expectations that are similar to their own. Interestingly, staff who have personal experience as family caregivers are more likely to report conflict with family members of residents, a result that necessitates further study. Staff burnout and dissatisfaction affects both individuals and organizations. Policy that addresses staff and family interaction can have an important place in the design and delivery of long-term care.

  13. Home care in Europe: a systematic literature review

    NARCIS (Netherlands)

    Genet, N.; Boerma, W.G.W.; Kringos, D.S.; Bouman, A.; Francke, A.L.; Fagerström, C.; Melchiorre, M.G.; Greco, C.; Devillé, W.

    2011-01-01

    Background Health and social services provided at home are becoming increasingly important. Hence, there is a need for information on home care in Europe. The objective of this literature review was to respond to this need by systematically describing what has been reported on home care in Europe in

  14. Home care in Europe: a systematic literature review.

    NARCIS (Netherlands)

    Genet, N.; Boerma, W.G.W.; Kringos, D.S.; Bouman, A.; Francke, A.L.; Fagerstrom, C.; Melchiorre, M.G.; Greco, C.; Devillé, W.

    2011-01-01

    Background: Health and social services provided at home are becoming increasingly important. Hence, there is a need for information on home care in Europe. The objective of this literature review was to respond to this need by systematically describing what has been reported on home care in Europe

  15. Home care in Europe: a systematic literature review

    NARCIS (Netherlands)

    Genet, Nadine; Boerma, Wienke G. W.; Kringos, Dionne S.; Bouman, Ans; Francke, Anneke L.; Fagerström, Cecilia; Melchiorre, Maria Gabriella; Greco, Cosetta; Devillé, Walter

    2011-01-01

    Health and social services provided at home are becoming increasingly important. Hence, there is a need for information on home care in Europe. The objective of this literature review was to respond to this need by systematically describing what has been reported on home care in Europe in the

  16. A context management system for a cost-efficient smart home platform

    OpenAIRE

    J. Schneider; A. Klein; C. Mannweiler; H. D. Schotten

    2012-01-01

    This paper presents an overview of state-of-the-art architectures for integrating wireless sensor and actuators networks into the Future Internet. Furthermore, we will address advantages and disadvantages of the different architectures. With respect to these criteria, we develop a new architecture overcoming these weaknesses. Our system, called Smart Home Context Management System, will be used for intelligent home utilities, appliances, and electronics and includes physical...

  17. Simulation of Smart Home Activity Datasets

    Directory of Open Access Journals (Sweden)

    Jonathan Synnott

    2015-06-01

    Full Text Available A globally ageing population is resulting in an increased prevalence of chronic conditions which affect older adults. Such conditions require long-term care and management to maximize quality of life, placing an increasing strain on healthcare resources. Intelligent environments such as smart homes facilitate long-term monitoring of activities in the home through the use of sensor technology. Access to sensor datasets is necessary for the development of novel activity monitoring and recognition approaches. Access to such datasets is limited due to issues such as sensor cost, availability and deployment time. The use of simulated environments and sensors may address these issues and facilitate the generation of comprehensive datasets. This paper provides a review of existing approaches for the generation of simulated smart home activity datasets, including model-based approaches and interactive approaches which implement virtual sensors, environments and avatars. The paper also provides recommendation for future work in intelligent environment simulation.

  18. Simulation of Smart Home Activity Datasets.

    Science.gov (United States)

    Synnott, Jonathan; Nugent, Chris; Jeffers, Paul

    2015-06-16

    A globally ageing population is resulting in an increased prevalence of chronic conditions which affect older adults. Such conditions require long-term care and management to maximize quality of life, placing an increasing strain on healthcare resources. Intelligent environments such as smart homes facilitate long-term monitoring of activities in the home through the use of sensor technology. Access to sensor datasets is necessary for the development of novel activity monitoring and recognition approaches. Access to such datasets is limited due to issues such as sensor cost, availability and deployment time. The use of simulated environments and sensors may address these issues and facilitate the generation of comprehensive datasets. This paper provides a review of existing approaches for the generation of simulated smart home activity datasets, including model-based approaches and interactive approaches which implement virtual sensors, environments and avatars. The paper also provides recommendation for future work in intelligent environment simulation.

  19. Challenges and Opportunities To Achieve 50% Energy Savings in Homes. National Laboratory White Papers

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, Marcus V.A. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

    2011-07-01

    This report summarizes the key opportunities, gaps, and barriers identified by researchers from four national laboratories (Lawrence Berkeley National Laboratory, National Renewable Energy Laboratory, Oak Ridge National Laboratory, and Pacific Northwest National Laboratory) that must be addressed to achieve the longer term 50% saving goal for Building America to ensure coordination with the Building America industry teams who are focusing their research on systems to achieve the near-term 30% savings goal. Although new construction was included, the focus of the effort was on deep energy retrofits of existing homes.

  20. Findings from a participatory evaluation of a smart home application for older adults.

    Science.gov (United States)

    Demiris, George; Oliver, Debra Parker; Dickey, Geraldine; Skubic, Marjorie; Rantz, Marilyn

    2008-01-01

    The aim of this paper is to present a participatory evaluation of an actual "smart home" project implemented in an independent retirement facility. Using the participatory evaluation process, residents guided the research team through development and implementation of the initial phase of a smart home project designed to assist residents to remain functionally independent and age in place. We recruited nine residents who provided permission to install the technology in their apartments. We conducted a total of 75 interviews and three observational sessions. Residents expressed overall positive perceptions of the sensor technologies and did not feel that these interfered with their daily activities. The process of adoption and acceptance of the sensors included three phases, familiarization, adjustment and curiosity, and full integration. Residents did not express privacy concerns. They provided detailed feedback and suggestions that were integrated into the redesign of the system. They also reported a sense of control resulting from their active involvement in the evaluation process. Observational sessions confirmed that the sensors were not noticeable and residents did not change their routines. The participatory evaluation approach not only empowers end-users but it also allows for the implementation of smart home systems that address residents' needs.

  1. Architecture of Institution & Home. Architecture as Cultural Medium

    NARCIS (Netherlands)

    Robinson, J.W.

    2004-01-01

    This dissertation addresses how architecture functions as a cultural medium. It does so by by investigating how the architecture of institution and home each construct and support different cultural practices. By studying the design of ordinary settings in terms of how qualitative differences in

  2. Home literacy experiences and early childhood disability: a descriptive study using the National Household Education Surveys (NHES) program database.

    Science.gov (United States)

    Breit-Smith, Allison; Cabell, Sonia Q; Justice, Laura M

    2010-01-01

    The present article illustrates how the National Household Education Surveys (NHES; U.S. Department of Education, 2009) database might be used to address questions of relevance to researchers who are concerned with literacy development among young children. Following a general description of the NHES database, a study is provided that examines the extent to which parent-reported home literacy activities and child emergent literacy skills differ for children with (a) developmental disabilities versus those who are developing typically, (b) single disability versus multiple disabilities, and (c) speech-language disability only versus other types of disabilities. Four hundred and seventy-eight preschool-age children with disabilities and a typically developing matched sample (based on parent report) were identified in the 2005 administration of the Early Childhood Program Participation (ECPP) Survey in the NHES database. Parent responses to survey items were then compared between groups. After controlling for age and socioeconomic status, no significant differences were found in the frequency of home literacy activities for children with and without disabilities. Parents reported higher levels of emergent literacy skills for typically developing children relative to children with disabilities. These findings suggest the importance of considering the home literacy experiences and emergent literacy skills of young children with disabilities when making clinical recommendations.

  3. A home health agency's pandemic preparedness and experience with the 2009 H1N1 pandemic.

    Science.gov (United States)

    Rebmann, Terri; Citarella, Barbara; Subramaniam, Divya S; Subramaniam, Dipti P

    2011-11-01

    Adequate pandemic preparedness is imperative for home health agencies. A 23-item pandemic preparedness survey was administered to home health agencies in the spring of 2010. The Kruskal-Wallis (KW) test was used to evaluate the relationships between agency size and preparedness indicators. Significant findings were further analyzed by the Mann-Whitney (MW) U post hoc test. The response rate was 25% (526/2,119). Approximately one-third of respondents (30.4%; n = 131) reported experiencing trouble obtaining supplies during the 2009 H1N1 pandemic. Small agencies were significantly more likely (Krusal-Wallis [KW] = 9.2; P agency pandemic preparedness, including surge capacity and participation in disaster drills, that need to be addressed. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  4. Planned home birth in the United States and professionalism: a critical assessment.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B; Grünebaum, Amos; Arabin, Birgit; Levene, Malcolm I; Brent, Robert L

    2013-01-01

    Planned home birth has been considered by some to be consistent with professional responsibility in patient care. This article critically assesses the ethical and scientific justification for this view and shows it to be unjustified. We critically assess recent statements by professional associations of obstetricians, one that sanctions and one that endorses planned home birth. We base our critical appraisal on the professional responsibility model of obstetric ethics, which is based on the ethical concept of medicine from the Scottish and English Enlightenments of the 18th century. Our critical assessment supports the following conclusions. Because of its significantly increased, preventable perinatal risks, planned home birth in the United States is not clinically or ethically benign. Attending planned home birth, no matter one's training or experience, is not acting in a professional capacity, because this role preventably results in clinically unnecessary and therefore clinically unacceptable perinatal risk. It is therefore not consistent with the ethical concept of medicine as a profession for any attendant to planned home birth to represent himself or herself as a "professional." Obstetric healthcare associations should neither sanction nor endorse planned home birth. Instead, these associations should recommend against planned home birth. Obstetric healthcare professionals should respond to expressions of interest in planned home birth by pregnant women by informing them that it incurs significantly increased, preventable perinatal risks, by recommending strongly against planned home birth, and by recommending strongly for planned hospital birth. Obstetric healthcare professionals should routinely provide excellent obstetric care to all women transferred to the hospital from a planned home birth.The professional responsibility model of obstetric ethics requires obstetricians to address and remedy legitimate dissatisfaction with some hospital settings and

  5. Particulate Matter 2.5 Exposure and Self-Reported Use of Wood Stoves and Other Indoor Combustion Sources in Urban Nonsmoking Homes in Norway.

    Directory of Open Access Journals (Sweden)

    Annah B Wyss

    Full Text Available Few studies have examined particulate matter (PM exposure from self-reported use of wood stoves and other indoor combustion sources in urban settings in developed countries. We measured concentrations of indoor PM < 2.5 microns (PM2.5 for one week with the MicroPEM™ nephelometer in 36 households in the greater Oslo, Norway metropolitan area. We examined indoor PM2.5 levels in relation to use of wood stoves and other combustion sources during a 7 day monitoring period using mixed effects linear models with adjustment for ambient PM2.5 levels. Mean hourly indoor PM2.5 concentrations were higher (p = 0.04 for the 14 homes with wood stove use (15.6 μg/m3 than for the 22 homes without (12.6 μg/m3. Moreover, mean hourly PM2.5 was higher (p = 0.001 for use of wood stoves made before 1997 (6 homes, 20.2 μg/m3, when wood stove emission limits were instituted in Norway, compared to newer wood stoves (8 homes, 11.9 μg/m3 which had mean hourly values similar to control homes. Increased PM2.5 levels during diary-reported burning of candles was detected independently of concomitant wood stove use. These results suggest that self-reported use of wood stoves, particularly older stoves, and other combustion sources, such as candles, are associated with indoor PM2.5 measurements in an urban population from a high income country.

  6. Home Here, Home There: The lives and Landscape within High-tech Trans-Pacific Commuter Culture

    Directory of Open Access Journals (Sweden)

    Shenglin Chang

    2004-12-01

    -identity relationship. This article addresses how Taiwanese commuters within this trans-Pacific home phenomenon differ in comparison with previous immigrant groups who have either relinquished or replicated their home culture's landscape within a traditional one-way migration pattern. The article shows how trans-Pacific commuters have created a two-way system of migration - a "bi-gration", and how their bi-gration patterns engender a sense of "continuous staying" as they commute back and forth between their old and new homes. The sense of "continuous staying" is shown as the basis for rejecting a traditional, singular, static self in favour of a multiple, shifting sense of self, and of how this new construction of identity integrates with landscape and place across Taiwanese and American cultures.

  7. The perceptions of cognitively impaired patients and their caregivers of a home telecare system

    Directory of Open Access Journals (Sweden)

    Mehrabian S

    2014-12-01

    Full Text Available Shima Mehrabian,1 Jocelyne Extra,2 Ya-Huei Wu,2 Maribel Pino,2 Latchezar Traykov,1 Anne-Sophie Rigaud2 1Department of Neurology, University Hospital (UH “Alexandrovska”, Sofia, Bulgaria; 2Department of Gerontology, Hôpital Broca, Assitance Publique-Hôpitaux de Paris, EA 4468, Faculte de Médecine, Université Paris Descartes, Paris, France Abstract: Assistive and telecare technologies have been developed to support older adults with cognitive impairments, as well as their caregivers, from their homes. The way potential users perceive telecare and smart home systems plays a key role in their acceptance of this new technology. We evaluate the acceptance of home telecare technologies among patients suffering from cognitive impairment and their caregivers. Prototypes of telecare devices were developed to demonstrate their features and capabilities and to train patients, families, and health care professionals in their use. We conducted semistructured interviews to elicit the perceptions of 30 patients with mild cognitive impairment, 32 patients with Alzheimer’s disease, and 30 caregivers, regarding the risks and advantages of home telecare and smart houses. Survey results reflected participants' largely positive reactions to these technologies. Regarding home telecare, the cognitive stimulation program earned the highest proportion of positive responses, followed by the devices' care of emergencies. The participants generally agreed that home telecare and smart houses could significantly improve their quality of life. However, some technical and ethical concerns, such as the way of provision, installation, and monitoring of the systems, were reported to be in need of addressing before implementation of this system. Keywords: home telecare, Alzheimer’s disease, mild cognitive impairment, caregiver, cognitive stimulation

  8. Enhanced care assistant training to address the workforce crisis in home care: changes related to job satisfaction and career commitment.

    Science.gov (United States)

    Coogle, Constance L; Parham, Iris A; Jablonski, Rita; Rachel, Jason A

    2007-01-01

    Changes in job satisfaction and career commitment were observed as a consequence of a geriatric case management training program focusing on skills development among personal care attendants in home care. A comparison of pretraining and posttraining scores uncovered a statistically significant increase in Intrinsic Job Satisfaction scores for participants 18-39 years of age, whereas levels declined among the group of middle aged participants and no change was observed among participants age 52 and older. On the other hand, a statistically significant decline in Extrinsic Job Satisfaction was documented over all participants, but this was found to be primarily due to declines among participants 40-51 years of age. When contacted 6-12 months after the training series had concluded participants indicated that the training substantially increased the likelihood that they would stay in their current jobs and improved their job satisfaction to some extent. A comparison of pretraining and posttraining scores among participants providing follow-up data revealed a statistically significant improvement in levels of Career Resilience. These results are discussed as they relate to similar training models and national data sets, and recommendations are offered for targeting future educational programs designed to address the long-term care workforce shortage.

  9. Home Health Care for California's Injured Workers: Options for Implementing a Fee Schedule.

    Science.gov (United States)

    Wynn, Barbara O; Boustead, Anne

    2015-07-15

    The California Department of Industrial Relations/Division of Worker's Compensation asked RAND to provide technical assistance in developing a fee schedule for home health services provided to injured workers. The fee schedule needs to address the full spectrum of home health services ranging from skilled nursing and therapy services to unskilled personal care or chore services that may be provided by family members. RAND researchers consulted with stakeholders in the California workers' compensation system to outline issues the fee schedule should address, reviewed home health fee schedules used by other payers, and conducted interviews with WC administrators from other jurisdictions to elicit their experiences. California stakeholders identified unskilled attendant services as most problematic in determining need and payment rates, particularly services furnished by family members. RAND researchers concentrated on fee schedule options that would result in a single fee schedule covering the full range of home health care services furnished to injured workers and made three sets of recommendations. The first set pertains to obtaining additional information that would highlight the policy issues likely to occur with the implementation of the fee schedule and alternatives for assessing an injured worker's home health care needs. Another approach conforms most closely with the Labor Code requirements. It would integrate the fee schedules used by Medicare, In-Home Health Supportive Services, and the federal Office of Workers' Compensation. The third approach would base the home health fee schedule on rules used by the federal Office of Workers' Compensation.

  10. Modular Zero Energy. BrightBuilt Home

    Energy Technology Data Exchange (ETDEWEB)

    Aldrich, Robb [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States). Steven Winters Associates, Inc.; Butterfield, Karla [Consortium for Advanced Residential Buildings (CARB), Norwalk, CT (United States). Steven Winters Associates, Inc.

    2016-03-01

    Kaplan Thompson Architects (KTA) has specialized in sustainable, energy-efficient buildings, and they have designed several custom, zero-energy homes in New England. These zero-energy projects have generally been high-end, custom homes with budgets that could accommodate advanced energy systems. In an attempt to make zero energy homes more affordable and accessible to a larger demographic, KTA explored modular construction as way to provide high-quality homes at lower costs. In the mid-2013, KTA formalized this concept when they launched BrightBuilt Home (BBH). The BBH mission is to offer a line of architect-designed, high-performance homes that are priced to offer substantial savings off the lifetime cost of a typical home and can be delivered in less time. For the past two years, CARB has worked with BBH and Keiser Homes (the primary modular manufacturer for BBH) to discuss challenges related to wall systems, HVAC, and quality control. In Spring of 2014, CARB and BBH began looking in detail on a home to be built in Lincolnville, ME by Black Bros. Builders. This report details the solution package specified for this modular plan and the challenges that arose during the project.

  11. Home visiting and the biology of toxic stress: opportunities to address early childhood adversity.

    Science.gov (United States)

    Garner, Andrew S

    2013-11-01

    Home visiting is an important mechanism for minimizing the lifelong effects of early childhood adversity. To do so, it must be informed by the biology of early brain and child development. Advances in neuroscience, epigenetics, and the physiology of stress are revealing the biological mechanisms underlying well-established associations between early childhood adversity and suboptimal life-course trajectories. Left unchecked, mediators of physiologic stress become toxic, alter both genome and brain, and lead to a vicious cycle of chronic stress. This so-called "toxic stress" results a wide array of behavioral attempts to blunt the stress response, a process known as "behavioral allostasis." Although behaviors like smoking, overeating, promiscuity, and substance abuse decrease stress transiently, over time they become maladaptive and result in the unhealthy lifestyles and noncommunicable diseases that are the leading causes of morbidity and mortality. The biology of toxic stress and the concept of behavioral allostasis shed new light on the developmental origins of lifelong disease and highlight opportunities for early intervention and prevention. Future efforts to minimize the effects of childhood adversity should focus on expanding the capacity of caregivers and communities to promote (1) the safe, stable, and nurturing relationships that buffer toxic stress, and (2) the rudimentary but foundational social-emotional, language, and cognitive skills needed to develop healthy, adaptive coping skills. Building these critical caregiver and community capacities will require a public health approach with unprecedented levels of collaboration and coordination between the healthcare, childcare, early education, early intervention, and home visiting sectors.

  12. Home Activities Reports

    Data.gov (United States)

    Department of Housing and Urban Development — This monthly report is an Excel spreadsheet, broken up by state. PJs can use this report to view activities with the 2012 or 2013 program year in IDIS, including;...

  13. Use of the Home Safety Self-Assessment Tool (HSSAT) within Community Health Education to Improve Home Safety.

    Science.gov (United States)

    Horowitz, Beverly P; Almonte, Tiffany; Vasil, Andrea

    2016-10-01

    This exploratory research examined the benefits of a health education program utilizing the Home Safety Self-Assessment Tool (HSSAT) to increase perceived knowledge of home safety, recognition of unsafe activities, ability to safely perform activities, and develop home safety plans of 47 older adults. Focus groups in two senior centers explored social workers' perspectives on use of the HSSAT in community practice. Results for the health education program found significant differences between reported knowledge of home safety (p = .02), ability to recognize unsafe activities (p = .01), safely perform activities (p = .04), and develop a safety plan (p = .002). Social workers identified home safety as a major concern and the HSSAT a promising assessment tool. Research has implications for reducing environmental fall risks.

  14. Factors associated with high job satisfaction among care workers in Swiss nursing homes - a cross sectional survey study.

    Science.gov (United States)

    Schwendimann, René; Dhaini, Suzanne; Ausserhofer, Dietmar; Engberg, Sandra; Zúñiga, Franziska

    2016-01-01

    While the relationship between nurses' job satisfaction and their work in hospital environments is well known, it remains unclear, which factors are most influential in the nursing home setting. The purpose of this study was to describe job satisfaction among care workers in Swiss nursing homes and to examine its associations with work environment factors, work stressors, and health issues. This cross-sectional study used data from a representative national sample of 162 Swiss nursing homes including 4,145 care workers from all educational levels (registered nurses, licensed practical nurses, nursing assistants and aides). Care worker-reported job satisfaction was measured with a single item. Explanatory variables were assessed with established scales, as e.g. the Practice Environment Scale - Nursing Work Index. Generalized Estimating Equation (GEE) models were used to examine factors related to job satisfaction. Overall, 36.2 % of respondents reported high satisfaction with their workplace, while another 50.4 % were rather satisfied. Factors significantly associated with high job satisfaction were supportive leadership (OR = 3.76), better teamwork and resident safety climate (OR = 2.60), a resonant nursing home administrator (OR = 2.30), adequate staffing resources (OR = 1.40), fewer workplace conflicts (OR = .61), less sense of depletion after work (OR = .88), and fewer physical health problems (OR = .91). The quality of nursing home leadership-at both the unit supervisor and the executive administrator level-was strongly associated with care workers' job satisfaction. Therefore, recruitment strategies addressing specific profiles for nursing home leaders are needed, followed by ongoing leadership training. Future studies should examine the effects of interventions designed to improve nursing home leadership and work environments on outcomes both for care staff and for residents.

  15. Our Lady of Fatima Home, Oakpark, Tralee, Kerry.

    LENUS (Irish Health Repository)

    Cowman, Seamus

    2010-01-01

    BACKGROUND: Although stroke is recognised as a major factor in admission to nursing home care, data is lacking on the extent and nature of the disabilities and dependency in nursing homes arising from stroke. A national study conducted in nursing homes can quantify the number of residents with stroke in nursing homes, their disability and levels of dependency. METHODS: A cross-sectional survey research design was used. A total of 572 public and private nursing homes were identified nationally and a stratified random selection of 60 nursing homes with 3,239 residents was made. In half of the nursing homes (n = 30) efforts were made to interview all residents with stroke Survey instruments were used to collect data from residents with stroke and nursing home managers on demography, patient disability, and treatment. RESULTS: Across all nursing homes (n = 60), 18% (n = 570) of the residents had previously had a stroke. In homes (n = 30), where interviews with residents with stroke (n = 257), only 7% (n = 18) residents were capable of answering for themselves and were interviewed. Data on the remaining 93% (n = 239) residents were provided by the nursing home manager. Nurse Managers reported that 73% of residents with stroke had a high level of dependency. One in two residents with stroke was prescribed antidepressants or sedative medication. Only 21% of stroke residents were prescribed anticoagulants, 42% antiplatelets, and 36% cholesterol lowering medications. Stroke rehabilitation guidelines were lacking and 68% reported that there was no formal review process in place. CONCLUSIONS: This study provides seminal findings on stroke and nursing home services in Ireland. We now know that one in six nursing home residents in a national survey are residents with a stroke, and have a wide range of disabilities. There is currently little or no structured care (beyond generic care) for stroke survivors who reside in nursing homes in Ireland.

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

    DEFF Research Database (Denmark)

    Ekmann, A; Vass, M; Avlund, K

    2010-01-01

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

  17. Decision support at home (DS@HOME – system architectures and requirements

    Directory of Open Access Journals (Sweden)

    Marschollek Michael

    2012-05-01

    Full Text Available Abstract Background Demographic change with its consequences of an aging society and an increase in the demand for care in the home environment has triggered intensive research activities in sensor devices and smart home technologies. While many advanced technologies are already available, there is still a lack of decision support systems (DSS for the interpretation of data generated in home environments. The aim of the research for this paper is to present the state-of-the-art in DSS for these data, to define characteristic properties of such systems, and to define the requirements for successful home care DSS implementations. Methods A literature review was performed along with the analysis of cross-references. Characteristic properties are proposed and requirements are derived from the available body of literature. Results 79 papers were identified and analyzed, of which 20 describe implementations of decision components. Most authors mention server-based decision support components, but only few papers provide details about the system architecture or the knowledge base. A list of requirements derived from the analysis is presented. Among the primary drawbacks of current systems are the missing integration of DSS in current health information system architectures including interfaces, the missing agreement among developers with regard to the formalization and customization of medical knowledge and a lack of intelligent algorithms to interpret data from multiple sources including clinical application systems. Conclusions Future research needs to address these issues in order to provide useful information – and not only large amounts of data – for both the patient and the caregiver. Furthermore, there is a need for outcome studies allowing for identifying successful implementation concepts.

  18. Fixing the broken image of care homes, could a 'care home innovation centre' be the answer?

    Science.gov (United States)

    Hockley, Jo; Harrison, Jennifer Kirsty; Watson, Julie; Randall, Marion; Murray, Scott

    2017-03-01

    The UK has many excellent care homes that provide high-quality care for their residents; however, across the care home sector, there is a significant need for improvement. Even though the majority of care homes receive a rating of 'good' from regulators, still significant numbers are identified as requiring 'improvement' or are 'inadequate'. Such findings resonate with the public perceptions of long-term care as a negative choice, to be avoided wherever possible-as well as impacting on the career choices of health and social care students. Projections of current demographics highlight that, within 10 years, the part of our population that will be growing the fastest will be those people older than 80 years old with the suggestion that spending on long-term care provision needs to rise from 0.6% of our Gross Domestic Product in 2002 to 0.96% by 2031. Teaching/research-based care homes have been developed in the USA, Canada, Norway, the Netherlands and Australia in response to scandals about care, and the shortage of trained geriatric healthcare staff. There is increasing evidence that such facilities help to reduce inappropriate hospital admissions, increase staff competency and bring increased enthusiasm about working in care homes and improve the quality of care. Is this something that the UK should think of developing? This commentary details the core goals of a Care Home Innovation Centre for training and research as a radical vision to change the culture and image of care homes, and help address this huge public health issue we face. © The Author 2016. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  19. A Business Case for Home Performance Contracting

    Energy Technology Data Exchange (ETDEWEB)

    Baechler, Michael C.; Antonopoulos, Chrissi A.; Sevigny, Maureen; Gilbride, Theresa L.; Hefty, Marye G.

    2012-10-01

    This report was prepared by PNNL for the DOE Building America program. The report provides information for businesses considering entering the home performance contracting industry. Metrics discussed include industry trends and drivers, specific points of entry, business models, startup costs, and marketing strategies. The report includes detailed analysis of eight businesses around the country that have successfully entered the home performance contracting industry. Data is provided on their financial structures, program participation, marketing efforts, and staff training. This report will be distributed via the DOE Building America website, www.buildingamerica.gov. Individual case studies will also be cleared separately.

  20. Effect of prospective reimbursement on nursing home costs.

    OpenAIRE

    Coburn, A F; Fortinsky, R; McGuire, C; McDonald, T P

    1993-01-01

    OBJECTIVE. This study evaluates the effect of Maine's Medicaid nursing home prospective payment system on nursing home costs and access to care for public patients. DATA SOURCES/STUDY SETTING. The implementation of a facility-specific prospective payment system for nursing homes provided the opportunity for longitudinal study of the effect of that system. Data sources included audited Medicaid nursing home cost reports, quality-of-care data from state facility survey and licensure files, and ...

  1. Modeling users` work activities in a smart home

    NARCIS (Netherlands)

    Allameh, E.; Heidari Jozam, M.; Vries, de B.; Timmermans, H.J.P.; Masoud, M.; Mozaffar, F.

    2014-01-01

    Almost everyone would agree that teleworking is increasingly growing; but beyond this broad statement, we know little about how people behave when they work at home and how they balance their work and life. User comfort and productivity cannot be addressed properly, without a deep understanding of

  2. Malpractice paid losses and financial performance of nursing homes.

    Science.gov (United States)

    Zhao, Mei; Haley, D Rob; Oetjen, Reid M; Carretta, Henry J

    2011-01-01

    Florida's nursing home industry has experienced significant financial pressure over the past decade. One of the primary reasons is the dramatic increase in litigation activity for nursing home providers claiming negligent care and abuse. Although anecdotal reports indicate a higher cost because of malpractice in nursing facilities, few studies have examined the extent of malpractice paid losses and their effect on the financial performance of nursing homes. The purpose of this study was to examine the impact of malpractice paid losses on the financial performance of nursing homes. Medicare Cost Report data and Online Survey, Certification, and Reporting data for Florida skilled nursing facilities over the 6-year period from 2001 to 2006 were used to calculate the malpractice paid losses and the financial performance indicators as well as the nursing home organizational and market factors. Descriptive analysis and multivariate regression analysis were used to examine the effect of paid loss on financial performance. The paid loss for malpractice claims was strongly associated with financial performance. Nursing facilities with malpractice paid losses had consistently lower total margins over the study period. The threat of nursing home litigation may create an incentive for nursing homes to improve quality of care; however, large paid claims can also force nursing homes into a financial situation where the organization no longer has the resources to improve quality. Nursing home managers must assess their malpractice litigation risk and identify tactics to mitigate these risks to better provide a safe and secure environment for the older persons. In addition, this research offers support for local, state, and federal policymakers to revisit the issue of malpractice litigation and the nursing home industry through its insight on the relationship of nursing home margins and litigation.

  3. Higher prices, higher quality? Evidence from German nursing homes.

    Science.gov (United States)

    Herr, Annika; Hottenrott, Hanna

    2016-02-01

    This study investigates the relationship between prices and quality of 7400 German nursing homes. We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, where we instrument prices to explain their effect on quality controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Descriptive analysis shows that prices and quality do not only vary across nursing homes, but also across counties and federal states and that quality and prices correlate positively. Second, the econometric analysis, which accounts for the endogenous relation between negotiated price and reported quality, shows that quality indeed positively depends on prices. In addition, more places in nursing homes per people in need are correlated with both lower prices and higher quality. Finally, unobserved factors at the federal state level capture some of the variation of reported quality across nursing homes. Our results suggest that higher prices increase quality. Furthermore, since reported quality and prices vary substantially across federal states, we conclude that the quality and prices of long-term care facilities may well be compared within federal states but not across. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  4. Interventions to support people with dementia and their caregivers during the transition from home care to nursing home care: A systematic review.

    Science.gov (United States)

    Müller, Christian; Lautenschläger, Sindy; Meyer, Gabriele; Stephan, Astrid

    2017-06-01

    During the transition of people with dementia from home to nursing home family caregivers often feel burdened. We aimed to 1) identify interventions which support people with dementia and their caregivers in the transition from home care to nursing home care, 2) synthesize the evidence for efficacy of these interventions, and 3) examine whether the identified interventions have been systematically developed, evaluated and implemented according to the Medical Research Council guidance on complex interventions. A systematic review of randomised controlled trials was conducted according to the recommendations specified in the Cochrane Handbook for Intervention Reviews. The review protocol was registered in PROSPERO (2015: CRD42015019839). Reporting follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. MEDLINE, CENTRAL, PsycINFO, CINAHL, OTseeker, and PEDro, were searched. Other sources included Google Scholar, and ALOIS. Two reviewers independently assessed the eligibility of the articles. Data extraction was performed by one reviewer and verified independently by another. The Cochrane Risk of Bias tool was used for critical appraisal. Development and evaluation of the identified interventions were assessed, taking the Medical Research Council guidance into account. Review findings were synthesized narratively. The search yielded 1278 records. Five studies were included, all conducted in the United States (4 RCTs and 1 cRCT with a total of 695 participants). The psychosocial interventions were individual and family counseling via telephone or ad hoc all of which addressed only informal caregivers. The intervention components, content and mode of delivery differed widely with inconsistent results. Significant intervention effects were found for the reduction of caregivers' depressive symptoms, burden, feeling of guilt, emotional distress, overload, and interactions with staff. Other outcomes, i.e. stress, placement

  5. Teaching a Course in Abnormal Psychology and Behavior Intervention Skills for Nursing Home Aides.

    Science.gov (United States)

    Glenwick, David S.; Slutzsky, Mitchel R.; Garfinkel, Eric

    2001-01-01

    Describes an 11-week course given at a nursing home to nursing home aides that focused on abnormal psychology and behavior intervention skills. Discusses the course goals, class composition, and course description. Addresses the problems and issues encountered with teaching this course to a nontraditional population in an unconventional setting.…

  6. 12 CFR 222.82 - Duties of users regarding address discrepancies.

    Science.gov (United States)

    2010-01-01

    ... FEDERAL RESERVE SYSTEM FAIR CREDIT REPORTING (REGULATION V) Duties of Users of Consumer Reports Regarding... a user of consumer reports (user) that receives a notice of address discrepancy from a consumer... consumer report and the address(es) in the agency's file for the consumer. (c) Reasonable belief—(1...

  7. Markers of Impaired Decision Making in Nursing Home Residents: Assessment by Nursing Home Staff in a Population-Based Study.

    Science.gov (United States)

    Fain, Kevin M; Rosenberg, Paul B; Pirard, Sandrine; Bogunovic, Olivera; Spira, Adam P

    2015-07-01

    Many nursing home residents have cognitive impairment that affects their decision making. In order to identify potential markers of impaired decision making, we investigated the association between a range of nursing home resident characteristics and impaired decision making in a population-based sample. Participants were 13,013 residents in the 2004 National Nursing Home Survey. We used logistic regression to determine the association between resident characteristics (ie, gender, age, race, mood, recent pain, falls, fractures, or hospitalizations, length of stay, number of activities of daily living (ADL) requiring help, and diagnoses of dementia, anxiety disorders, and depression) and impaired (vs independent) decision making. After controlling for depression and anxiety diagnoses, as well as gender, age, race, and recent hospitalization or pain, characteristics associated with impaired decision making included depressed, sad, or anxious mood ["mild" odds ratio (OR) = 1.39, 95% confidence interval (CI) = 1.23-1.58; "severe" OR = 2.69, 95% CI = 2.27-3.20); diagnosed dementia or living on a dementia hall (OR = 5.07, 95% CI = 4.52-5.67); number of ADL requiring assistance (with 5 ADL, OR = 10.69, 95% CI = 6.82-16.75); length of nursing home stay [101-365 days (OR = 1.60, 95% CI = 1.36-1.89); 366 days-2 years (OR = 1.60, 95% CI = 1.34-1.90); >2 years (OR = 2.25, 95% CI = 1.92-2.63)]; and history of falls or fractures in the last 6 months (OR = 1.19, 95% CI = 1.07-1.32)]. Residents reporting pain in the last week were less likely to have impaired decision making (OR = 0.58, 95% CI = 0.52-0.66). We found several independent markers of impaired decision making in nursing home residents, including depressed, sad, or anxious mood (independent of depression or anxiety diagnosis); dementia; and greater need for ADL assistance. Some of these factors, in particular mood, are modifiable and addressing them may help improve decision making. These markers should be explored

  8. Nursing home quality: a comparative analysis using CMS Nursing Home Compare data to examine differences between rural and nonrural facilities.

    Science.gov (United States)

    Lutfiyya, May Nawal; Gessert, Charles E; Lipsky, Martin S

    2013-08-01

    Advances in medicine and an aging US population suggest that there will be an increasing demand for nursing home services. Although nursing homes are highly regulated and scrutinized, their quality remains a concern and may be a greater issue to those living in rural communities. Despite this, few studies have investigated differences in the quality of nursing home care across the rural-urban continuum. The purpose of this study was to compare the quality of rural and nonrural nursing homes by using aggregated rankings on multiple quality measures calculated by the Centers for Medicare and Medicaid Services and reported on their Nursing Home Compare Web site. Independent-sample t tests were performed to compare the mean ratings on the reported quality measures of rural and nonrural nursing homes. A linear mixed binary logistic regression model controlling for state was performed to determine if the covariates of ownership, number of beds, and geographic locale were associated with a higher overall quality rating. Of the 15,177 nursing homes included in the study sample, 69.2% were located in nonrural areas and 30.8% in rural areas. The t test analysis comparing the overall, health inspection, staffing, and quality measure ratings of rural and nonrural nursing homes yielded statistically significant results for 3 measures, 2 of which (overall ratings and health inspections) favored rural nursing homes. Although a higher percentage of nursing homes (44.8%-42.2%) received a 4-star or higher rating, regression analysis using an overall rating of 4 stars or higher as the dependent variable revealed that when controlling for state and adjusting for size and ownership, rural nursing homes were less likely to have a 4-star or higher rating when compared with nonrural nursing homes (OR = .901, 95% CI 0.824-0.986). Mixed model logistic regression analysis suggested that rural nursing home quality was not comparable to that of nonrural nursing homes. When controlling for

  9. Meaning creation and employee engagement in home health caregivers.

    Science.gov (United States)

    Nielsen, Mette Strange; Jørgensen, Frances

    2016-03-01

    The purpose of this study is to contribute to an understanding on how home health caregivers experience engagement in their work, and specifically, how aspects of home healthcare work create meaning associated with employee engagement. Although much research on engagement has been conducted, little has addressed how individual differences such as worker orientation influence engagement, or how engagement is experienced within a caregiving context. The study is based on a qualitative study in two home homecare organisations in Denmark using a think-aloud data technique, interviews and observations. The analysis suggests caregivers experience meaning in three relatively distinct ways, depending on their work orientation. Specifically, the nature of engagement varies across caregivers oriented towards being 'nurturers', 'professionals', or 'workers', and the sources of engagement differ for each of these types of caregivers. The article contributes by (i) advancing our theoretical understanding of employee engagement by emphasising meaning creation and (ii) identifying factors that influence meaning creation and engagement of home health caregivers, which should consequently affect the quality of services provided home healthcare patients. © 2015 Nordic College of Caring Science.

  10. Family and home in cognitive rehabilitation after brain injury

    DEFF Research Database (Denmark)

    Wulf-Andersen, Camilla; Mogensen, Jesper

    2017-01-01

    Acquired brain injury (ABI) severely affects both the injured patient and her/his family. This fact alone calls for a therapeutic approach addressing not only the individual victim of ABI but also her/his family. Additionally, the optimal outcome of posttraumatic cognitive rehabilitation may...... be best obtained by supplementing the institution-based cognitive training with home-based training. Moving cognitive training and other therapeutic interventions into the home environment does, however, constitute an additional challenge to the family structure and psychological wellbeing of all family...... members. We presently argue in favour of an increased utilization of family-based intervention programs for the families of brain injured patients – in general and especially in case of utilization of home-based rehabilitative training....

  11. Bringing healthcare closer to home: one province's approach to home care.

    Science.gov (United States)

    Witmer, E

    2000-01-01

    Ontario is implementing a number of steps to address the growing need for home care and continuing care. One of these steps is the establishment of Ontario's network of 43 Community Care Access Centres (CCACs). Responsible for aiding Ontario residents who seek community-based long-term healthcare, CCACs coordinate access to home services such as nursing and homemaking, manage placement to long-term care facilities and provide information and referral services. In 2000/01 the Ontario government announced 92.5 million Canadian dollars in new funding for long-term community services. This new funding includes 70.1 million Canadian dollars for CCACs. During this time, the provincial government will spend more than 1.6 billion Canadian dollars for long-term-care community-based services. Of this amount, 1.1 Canadian dollars billion will go to CCACs. Community Care Access Centres served more than 400,000 people in 1998/99 and are estimated to serve more than 420,000 in 2000/01. The administrative funds saved by this province-wide system are reinvested in front-line health services.

  12. An investigation of home advantage in the Summer Paralympic Games.

    Science.gov (United States)

    Wilson, Darryl; Ramchandani, Girish

    2017-01-01

    There is a paucity of home advantage research set in the context of para-sport events. It is this gap in the knowledge that this paper addresses by investigating the prevalence and size of home advantage in the Summer Paralympic Games. Using a standardised measure of success, we compared the performances of nations when competing at home with their own performances away from home in the competition between 1960 and 2016. Both country-level and individual sport-level analyses were conducted for this time frame. A Wilcoxon signed rank test was used to determine whether there was a genuine difference in nations' performance under host and non-host conditions. Spearman's rank-order correlation was run to assess the relationship between nation quality and home advantage. Strong evidence of a home advantage effect in the Summer Paralympic Games was found at country level ( p   0.10). While our results confirm that home advantage is prevalent in the Summer Paralympic Games at an overall country level and within specific sports, they do not explain fully why such an effect does exist. Future studies should investigate the causes of home advantage in the competition and also draw comparisons with the Summer Olympic Games to explore any differences between para-sport events and able-bodied events.

  13. Home or foster home care versus institutional long-term care for functionally dependent older people.

    Science.gov (United States)

    Young, Camilla; Hall, Amanda M; Gonçalves-Bradley, Daniela C; Quinn, Terry J; Hooft, Lotty; van Munster, Barbara C; Stott, David J

    2017-04-03

    Changing population demographics have led to an increasing number of functionally dependent older people who require care and medical treatment. In many countries, government policy aims to shift resources into the community from institutional care settings with the expectation that this will reduce costs and improve the quality of care compared. To assess the effects of long-term home or foster home care versus institutional care for functionally dependent older people. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) via the Cochrane Library, MEDLINE, Embase, CINAHL, and two trials registers to November 2015. We included randomised and non-randomised trials, controlled before-after studies and interrupted time series studies complying with the EPOC study design criteria and comparing the effects of long-term home care versus institutional care for functionally dependent older people. Two reviewers independently extracted data and assessed the risk of bias of each included study. We reported the results narratively, as the substantial heterogeneity across studies meant that meta-analysis was not appropriate. We included 10 studies involving 16,377 participants, all of which were conducted in high income countries. Included studies compared community-based care with institutional care (care homes). The sample size ranged from 98 to 11,803 (median N = 204). There was substantial heterogeneity in the healthcare context, interventions studied, and outcomes assessed. One study was a randomised trial (N = 112); other included studies used designs that had potential for bias, particularly due lack of randomisation, baseline imbalances, and non-blinded outcome assessment. Most studies did not select (or exclude) participants for any specific disease state, with the exception of one study that only included patients if they had a stroke. All studies had methodological limitations, so readers should interpret results with caution.It is uncertain

  14. 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.

  15. Home Quick – Occupational Therapy Home Visits Using mHealth, to Facilitate Discharge from Acute Admission Back to the Community

    Directory of Open Access Journals (Sweden)

    Jacqueline Nix

    2017-06-01

    Full Text Available This article reports upon an initiative to improve the timeliness of occupational therapy home visits for discharge planning by implementing technology solutions while maintaining patient safety. A community hospital in Queensland, Australia, hosted a process evaluation that examined which aspects of home visiting could be replaced or augmented by alternative technologies. Strategies were trialled, implemented and assessed using the number of home visits completed and the time from referral to completion as outcomes. A technology-enhanced solution called “Home Quick” was developed using technology to facilitate pre-discharge home visits. The implementation of Home Quick resulted in an increase in the number of home visits conducted prior to discharge (50% increase from 145 to 223 and significantly increased the number of patients seen earlier following referral (X2=69.3; p<0.001. The substitution of direct home visits with technology-enabled remote visits is suitable for a variety of home visiting scenarios traditionally performed by occupational therapists.

  16. Optimizing medication safety in the home.

    Science.gov (United States)

    LeBlanc, Raeanne Genevieve; Choi, Jeungok

    2015-06-01

    Medication safety among community-dwelling older adults in the United States is an ongoing health issue impacting health outcomes, chronic disease management, and aging in place at home. This article describes a medication safety improvement project that aimed to: (1) Increase the ability of participants to manage medications, (2) Identify and make necessary medication changes, (3) Create an accurate up-to-date medication list to be available in the home, and (4) Provide communication between the primary care provider, participant, and case manager. An in-home medication assessment was completed for 25 participants using an evidence-based medication management software system. This process was used to review medications; identify medication-related problems; create a shared medication list; and convey this information to the primary care provider, case manager, and client while addressing needed medication changes. Educational interventions on management and understanding of medications were provided to participants to emphasize the correct use of medications and use of a personal medication record. Outcome improvements included provision of an accurate medication list, early identification of medication-related problems, identification of drug duplication, and identification of medication self-management challenges that can be useful for optimizing medication safety-related home healthcare and inform future interventions.

  17. WORKING FROM HOME AS ALTERNATIVE FOR ACHEVING WORKE-LIFE BALANCE

    OpenAIRE

    Nevena Krasulja, Milica Vasiljeviæ Blagojeviæ, Ivana Radojeviæ

    2015-01-01

    TIn this paper, the authors are addressing the issue of family – work balance, as well as the connection between this phenomenon and working from home. The basic, initial point is that the desired balance can be achieved if the employees are provided with more flexible work schemes, one of which is having the option to perform their work from home. According to the forecasts regarding the work place of the future, employees from almost all demographic, cultural and social groups decided that ...

  18. "Is there a gun in the home?" Assessing the risks of gun ownership in older adults.

    Science.gov (United States)

    Pinholt, Ellen M; Mitchell, Joshua D; Butler, Jane H; Kumar, Harjinder

    2014-06-01

    An important ethical and safety concern that geriatricians, primary care providers, and home health professionals need to address is gun ownership by elderly adults. Those aged 65 and older now have the highest rate of gun ownership in America, and they also have a high prevalence of depression and suicide. Dementia can add additional layers of risk. Even older gun owners who are otherwise intellectually intact may benefit from information about gun safety with the increasing numbers of children being cared for by grandparents. Health professionals should ask patients, "Is there a gun in the home?" in the clinic and during home visits. Healthcare professionals must have knowledge and skills to address safe gun ownership in elderly adults. The 5 L's (Locked, Loaded, Little children, feeling Low, Learned owner) will assist professionals in addressing all aspects of safe ownership. © 2014, Copyright the Authors Journal compilation © 2014, The American Geriatrics Society.

  19. Home is where the hearth is: grant recipients' views of England's home energy efficiency scheme (Warm Front).

    Science.gov (United States)

    Gilbertson, Jan; Stevens, Maryjane; Stiell, Bernadette; Thorogood, Nicki

    2006-08-01

    This paper reports the results of research carried out as part of the national health impact evaluation of the Warm Front Scheme, a government initiative aimed at alleviating fuel poverty in England. Semi-structured interviews were carried out in a purposive sample of 49 households which received home energy improvements under the Scheme from five urban areas (Birmingham, Liverpool, Manchester, Newcastle, Southampton). Each household had received installation, replacement or refurbishment of the heating system and, in some cases, also insulation of the cavity wall or loft or both, and draught-proofing measures. Most householders reported improved and more controllable warmth and hot water. Many also reported perceptions of improved physical health and comfort, especially of mental health and emotional well-being and, in several cases, the easing of symptoms of chronic illness. There were reports of improved family relations, an expansion of the domestic space used during cold months, greater use of kitchens and improved nutrition, increased privacy, improved social interaction, and an increase in comfort and atmosphere within the home. Greater warmth and comfort also enhanced emotional security, and recipients were more content and at ease in their homes. However there was little evidence of substantially lower heating bills. These results provide evidence that Warm Front home energy improvements are accompanied by appreciable benefits in terms of use of living space, comfort and quality of life, physical and mental well-being, although there is only limited evidence of change in health behaviour.

  20. Sleep concerns in children and young people with cerebral palsy in their home setting.

    Science.gov (United States)

    McCabe, Susan M; Blackmore, A Marie; Abbiss, Chris R; Langdon, Katherine; Elliott, Catherine

    2015-12-01

    The aims were to identify in-home concerns about sleep in children and young people with cerebral palsy (CP) across age and Gross Motor Function Classification Scale (GMFCS) levels. This was a retrospective review of clinical notes of 154 children and young people with CP, aged 1-18 years (M = 7.8; standard deviation = 5.4) who received a home-based sleep service. Reported concerns were synthesised, for analysis according to age groups (1-5, 6-13, 14-18) and GMFCS levels. Sixteen factors of concern were derived from the home-based assessment reports. Most children and young people had multiple factors of concern. These varied across age groups and GMFCS levels. Body position was of concern across all age groups, for over 90% at GMFCS levels IV and V, and for 10% at GMFCS level I. Settling routines were of concern for more than 90% at GMFCS levels I and II, but for less than 50% at GMFCS levels IV and V. Settling routines were of concern to over 65% of those under 6 years but less than 25% of those over 14 years. Conversely, pain and pressure care concerned less than 10% of children under 6, and more than 35% of those over 14 years. Concerns about sleep vary across ages and GMFCS levels of children and young people with CP. Concerns relate to impairment of body structure and function, activity, environment, and personal supports. Multi-disciplinary, home-based assessment and interventions are recommended to address these concerns. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  1. Ethical issues in palliative care for nursing homes: Development and testing of a survey instrument.

    Science.gov (United States)

    Preshaw, Deborah Hl; McLaughlin, Dorry; Brazil, Kevin

    2018-02-01

    To develop and psychometrically assess a survey instrument identifying ethical issues during palliative care provision in nursing homes. Registered nurses and healthcare assistants have reported ethical issues in everyday palliative care provision. Identifying these issues provides evidence to inform practice development to support healthcare workers. Cross-sectional survey of Registered nurses and healthcare assistants in nursing homes in one region of the UK. A survey instrument, "Ethical issues in Palliative Care for Nursing homes", was developed through the findings of qualitative interviews with Registered nurses and healthcare assistants in nursing homes and a literature review. It was reviewed by an expert panel and piloted prior to implementation in a survey in 2015 with a convenience sample of 596 Registered nurses and healthcare assistants. Descriptive and exploratory factor analyses were used to assess the underlying structure of the Frequency and Distress Scales within the instrument. Analysis of 201 responses (response rate = 33.7%) revealed four factors for the Frequency Scale and five factors for the Distress Scale that comprise the Ethical issues in Palliative Care for Nursing homes. Factors common to both scales included "Processes of care," "Resident autonomy" and "Burdensome treatment." Additionally, the Frequency Scale included "Competency," and the Distress Scale included "Quality of care" and "Communication." The Ethical issues in Palliative Care for Nursing homes instrument has added to the palliative care knowledge base by considering the ethical issues experienced specifically by Registered nurses and healthcare assistants within the nursing home. This research offers preliminary evidence of the psychometric properties of the Ethical issues in Palliative Care for Nursing homes survey instrument. The two largest factors highlight the need to address the organisational aspects of caring and provide training in negotiating conflicting

  2. Examining Racial and Ethnic Differences in Nursing Home Quality.

    Science.gov (United States)

    Hefele, Jennifer Gaudet; Ritter, Grant A; Bishop, Christine E; Acevedo, Andrea; Ramos, Candi; Nsiah-Jefferson, Laurie A; Katz, Gabrielle

    2017-11-01

    Identifying racial/ethnic differences in quality is central to identifying, monitoring, and reducing disparities. Although disparities across all individual nursing home residents and disparities associated with between-nursing home differences have been established, little is known about the degree to which quality of care varies by race//ethnicity within nursing homes. A study was conducted to measure within-facility differences for a range of publicly reported nursing home quality measures. Resident assessment data on approximately 15,000 nursing homes and approximately 3 million residents (2009) were used to assess eight commonly used and publicly reported long-stay quality measures: the proportion of residents with weight loss, with high-risk and low-risk pressure ulcers, with incontinence, with depressive symptoms, in restraints daily, and who experienced a urinary tract infection or functional decline. Each measure was stratified by resident race/ethnicity (non-Hispanic white, non-Hispanic black, and Hispanic), and within-facility differences were examined. Small but significant differences in care on average were found, often in an unexpected direction; in many cases, white residents were experiencing poorer outcomes than black and Hispanic residents in the same facility. However, a broad range of differences in care by race/ethnicity within nursing homes was also found. The results suggest that care is delivered equally across all racial/ethnic groups in the same nursing home, on average. The results support the call for publicly reporting stratified nursing home quality measures and suggest that nursing home providers should attempt to identify racial/ethnic within-facility differences in care. Copyright © 2017 The Joint Commission. Published by Elsevier Inc. All rights reserved.

  3. Out-of-Home Care and the Educational Achievement, Attendance, and Suspensions of Maltreated Children: A Propensity-Matched Study.

    Science.gov (United States)

    Maclean, Miriam J; Taylor, Catherine L; O'Donnell, Melissa

    2018-04-30

    To estimate the influence of out-of-home care on reading scores, attendance, and suspensions by comparing a matched sample of maltreated children who entered out-of-home care and maltreated children who remained at home. Linked administrative data for all children born in Western Australia between 1990 and 2010 was used, focusing on those with substantiated maltreatment before year 9 achievement tests (n = 3297). Propensity score modelling was used to address differences in preexisting risk factors (child, family, neighborhood characteristics, maltreatment history, and reading scores) and compare outcomes for children placed in out-of-home care and those remaining in in-home care. Both groups of maltreated children had poor educational outcomes. After accounting for group differences in risk characteristics, there was no difference in year 9 reading achievement for the out-of-home care and in-home care groups. There was no difference in suspensions for the groups. The only significant difference was children in out-of-home care had fewer school absences than children in in-home care. Out-of-home care was not found to be a significant factor in the adverse educational outcomes of these children; however, there is a clear need for further educational support to address poor outcomes for children involved with child protection services. Copyright © 2018 Elsevier Inc. All rights reserved.

  4. Reducing Energy Use in Existing Homes by 30%: Learning From Home Performance with ENERGY STAR

    Energy Technology Data Exchange (ETDEWEB)

    Liaukus, C. [Building America Research Alliance (BARA), Kent, WA (United States)

    2014-12-01

    The improvement of existing homes in the United States can have a much greater impact on overall residential energy use than the construction of highly efficient new homes. There are over 130 million existing housing units in the U.S., while annually new construction represents less than two percent of the total supply (U.S. Census Bureau, 2013). Therefore, the existing housing stock presents a clear opportunity and responsibility for Building America (BA) to guide the remodeling and retrofit market toward higher performance existing homes. There are active programs designed to improve the energy performance of existing homes. Home Performance with ENERGY STAR (HPwES) is a market-rate program among them. BARA's research in this project verified that the New Jersey HPwES program is achieving savings in existing homes that meet or exceed BA's goal of 30%. Among the 17 HPwES projects with utility data included in this report, 15 have actual energy savings ranging from 24% to 46%. Further, two of the homes achieved that level of energy savings without the costly replacement of heating and cooling equipment, which indicates that less costly envelope packages could be offered to consumers unable to invest in more costly mechanical packages, potentially creating broader market impact.

  5. Home Automated Telemanagement (HAT System to Facilitate Self-Care of Patients with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Joseph Finkelstein

    2003-06-01

    Full Text Available Successful patient self-management requires a multidisciplinary approach that includes regular patient assessment, disease-specific education, control of medication adherence, implementation of health behavior change models and social support. Existing systems for computer-assisted disease management do not provide this multidisciplinary patient support and do not address treatment compliance issues. We developed the Home Automated Telemanagement (HAT system for patients with different chronic health conditions to facilitate their self-care. The HAT system consists of a home unit, HAT server, and clinician units. Patients at home use a palmtop or a laptop connected with a disease monitor on a regular basis. Each HAT session consists of self-testing, feedback, and educational components. The self-reported symptom data and objective results obtained from disease-specific sensors are automatically sent from patient homes to the HAT server in the hospital. Any web-enabled device can serve as a clinician unit to review patient results. The HAT system monitors self-testing results and patient compliance. The HAT system has been implemented and tested in patients receiving anticoagulation therapy, patients with asthma, COPD and other health conditions. Evaluation results indicated high level of acceptance of the HAT system by the patients and that the system has a positive impact on main clinical outcomes and patient satisfaction with medical care.

  6. Exploring the concurrent validity of the nationwide assessment of permanent nursing home residence in Denmark

    DEFF Research Database (Denmark)

    Bebe, Anna; Nielsen, Anni Brit Sternhagen; Willadsen, Tora Grauers

    2017-01-01

    Background: Many register studies make use of information about permanent nursing home residents. Statistics Denmark (StatD) identifies nursing home residents by two different indirect methods, one based on reports from the municipalities regarding home care in taken place in a nursing home...... Danish Region, we randomly selected one municipality reporting to Stat D (Method 1) and one not reporting where instead an algorithm created by StatD was used to discover nursing home residents (Method 2). Method 1 means that municipalities reported to Stat D whether home care has taken place......, and the other based on an algorithm created by StatD.The aim of the present study was to validate StatD’s nursing home register using dedicated administrative municipality records on individual nursing home residents as gold standard. Methods: In total, ten Danish municipalities were selected. Within each...

  7. Environmental Assessment Addressing the Privatization of Military Family Housing at Mountain Home Air Force Base, Idaho

    Science.gov (United States)

    2011-10-01

    chemical characteristics for producing food, feed, forage, fiber , and oilseed crops, and is also available for these uses. The soil qualities, growing...evidenced at Mountain Home AFB by basaltic and rhyolitic rock formations and by remnant volcanic features, such as cones, vents, and shield volcanoes...These volcanic deposits form the bedrock underlying the region. The thick basaltic lava flows and interbedded sedimentary units around Mountain

  8. R-2000 home health study : Homeowner health in R-2000 and new conventional homes

    International Nuclear Information System (INIS)

    Parekh, A.

    2002-01-01

    A field study was conducted by Health Canada and Natural Resources Canada (NRCan) to evaluate self-reported health symptoms by residents of R-2000 and conventional homes in Nova Scotia and New Brunswick. It involved 52 energy efficient R-2000 and 50 conventionally built houses. Health Canada collected and analyzed data concerning changes in occupant health after moving into R-2000 houses and similar conventional houses. Definite trends in improvements of respiratory symptoms of occupants in R-2000 houses were revealed, compared to the results obtained for occupants of conventional houses. New occupants of R-2000 houses reported significant improvement in indoor air quality in 94 per cent of cases, while only 77 per cent of conventional homeowners reported similar results. Fifty six per cent of the occupants of R-2000 homes reported a general improvement in their health, compared to 32 per cent in conventional houses. The testing of houses in other regions is being planned by Health Canada. tabs

  9. Home Health Quality Initiative

    Data.gov (United States)

    U.S. Department of Health & Human Services — The instrument-data collection tool used to collect and report performance data by home health agencies is called the Outcome and Assessment Information Set (OASIS)....

  10. Learning to care for older patients: hospitals and nursing homes as learning environments.

    Science.gov (United States)

    Huls, Marije; de Rooij, Sophia E; Diepstraten, Annemie; Koopmans, Raymond; Helmich, Esther

    2015-03-01

    A significant challenge facing health care is the ageing of the population, which calls for a major response in medical education. Most clinical learning takes place within hospitals, but nursing homes may also represent suitable learning environments in which students can gain competencies in geriatric medicine. This study explores what students perceive as the main learning outcomes of a geriatric medicine clerkship in a hospital or a nursing home, and explicitly addresses factors that may stimulate or hamper the learning process. This qualitative study falls within a constructivist paradigm: it draws on socio-cultural learning theory and is guided by the principles of constructivist grounded theory. There were two phases of data collection. Firstly, a maximum variation sample of 68 students completed a worksheet, giving brief written answers on questions regarding their geriatric medicine clerkships. Secondly, focus group discussions were conducted with 19 purposively sampled students. We used template analysis, iteratively cycling between data collection and analysis, using a constant comparative process. Students described a broad range of learning outcomes and formative experiences that were largely distinct from their learning in previous clerkships with regard to specific geriatric knowledge, deliberate decision making, end-of-life care, interprofessional collaboration and communication. According to students, the nursing home differed from the hospital in three aspects: interprofessional collaboration was more prominent; the lower resources available in nursing homes stimulated students to be creative, and students reported having greater autonomy in nursing homes compared with the more extensive educational guidance provided in hospitals. In both hospitals and nursing homes, students not only learn to care for older patients, but also describe various broader learning outcomes necessary to become good doctors. The results of our study, in particular the

  11. Technical aspects of home hemodialysis

    Directory of Open Access Journals (Sweden)

    Alhomayeed B

    2009-01-01

    Full Text Available Home hemodialysis (HHD has proved to be a useful form of renal replacement therapy. The economic advantage of HHD is well established and interest in it is renewed. Once it has been decided to establish a HHD program, a well developed strategic plan is required. This should address financial and logistical issues and establish policies that will address responsi-bilities of both patients and HD centers. The recruitment of patients is facilitated by ensuring that all incident patients have early access to an education program describing all forms of renal replacement therapy that the regional renal program provides. Patients and members of the pre-dialysis education program should understand the selection process criteria in advance. Once the assessment is completed and the patient agrees to the proceedings, a plan of action should be esta-blished for enrolling the patient into the program and initiating training. Patients′ education pro-gram should take into consideration principles of adult learning. When choosing dialysis equip-ment for home use, the needs and preferences of the patients should be respected. As a rule of thumb, the equipment should be simple to use, yet still provide adequate and reliable therapy. De-ciding where to set up and position the HHD equipment is important. Installation of HHD ma-chine at home requires a continuous supply of accessories. Before establishing a HHD program, commitment of the dialysis center to provide and maintain the infrastructure of the program is mandatory. The estimated patients suitable for HHD are less than 15% of all prospective dialysis patients. Generally, those who are have greatly improved quality of life and by using modalities such as nocturnal and daily dialysis can have improved physical well-being with considerable potential cost savings.

  12. Technical aspects of home hemodialysis.

    Science.gov (United States)

    Alhomayeed, B; Lindsay, R M

    2009-03-01

    Home hemodialysis (HHD) has proved to be a useful form of renal replacement therapy. The economic advantage of HHD is well established and interest in it is renewed. Once it has been decided to establish a HHD program, a well developed strategic plan is required. This should address financial and logistical issues and establish policies that will address responsi-bilities of both patients and HD centers. The recruitment of patients is facilitated by ensuring that all incident patients have early access to an education program describing all forms of renal replacement therapy that the regional renal program provides. Patients and members of the pre-dialysis education program should understand the selection process criteria in advance. Once the assessment is completed and the patient agrees to the proceedings, a plan of action should be esta-blished for enrolling the patient into the program and initiating training. Patients' education pro-gram should take into consideration principles of adult learning. When choosing dialysis equip-ment for home use, the needs and preferences of the patients should be respected. As a rule of thumb, the equipment should be simple to use, yet still provide adequate and reliable therapy. De-ciding where to set up and position the HHD equipment is important. Installation of HHD ma-chine at home requires a continuous supply of accessories. Before establishing a HHD program, commitment of the dialysis center to provide and maintain the infrastructure of the program is mandatory. The estimated patients suitable for HHD are less than 15% of all prospective dialysis patients. Generally, those who are have greatly improved quality of life and by using modalities such as nocturnal and daily dialysis can have improved physical well-being with considerable potential cost savings.

  13. Health centre versus home presumptive diagnosis of malaria in southern Ghana: implications for home-based care policy.

    Science.gov (United States)

    Dunyo, S K; Afari, E A; Koram, K A; Ahorlu, C K; Abubakar, I; Nkrumah, F K

    2000-01-01

    A study was conducted in 1997 to compare the accuracy of presumptive diagnosis of malaria in children aged 1-9 years performed by caretakers of the children to that of health centre staff in 2 ecological zones in southern Ghana. Similar symptoms were reported in the children at home and at the health centre. In the home setting, symptoms were reported the same day that they occurred, 77.6% of the children with a report of fever were febrile (axillary temperature > or = 37.5 degrees C) and 64.7% of the reports of malaria were parasitologically confirmed. In the health centre, the median duration of symptoms before a child was seen was 3 days (range 1-14 days), 58.5% of the children with a report of fever were febrile and 62.6% of the clinically diagnosed cases were parasitologically confirmed. In the 2 settings almost all the infections were due to Plasmodium falciparum. Parasite density was 3 times higher in the health centre cases compared to the home-diagnosed cases. Early and appropriate treatment of malaria detected in children by caretakers may prevent complications that arise as a result of persistence of symptoms and attainment of high parasitaemic levels.

  14. Flexible home care automation adapting to the personal and evolving needs and situations of the patient

    NARCIS (Netherlands)

    Zarifi Eslami, Mohammed; van Sinderen, Marten J.

    Health monitoring and healthcare provisioning at home (i.e., outside the hospital) have received increasingly attention as a possible and partial solution for addressing the problems of an aging population. There are still many technological issues that need to be solved before home healthcare

  15. Pilot Study Results from a Brief Intervention to Create Smoke-Free Homes

    Directory of Open Access Journals (Sweden)

    Michelle C. Kegler

    2012-01-01

    Full Text Available Very few community-based intervention studies have examined how to effectively increase the adoption of smoke-free homes. A pilot study was conducted to test the feasibility, acceptability, and short-term outcomes of a brief, four-component intervention for promoting smoke-free home policies among low-income households. We recruited forty participants (20 smokers and 20 nonsmokers to receive the intervention at two-week intervals. The design was a pretest-posttest with follow-up at two weeks after intervention. The primary outcome measure was self-reported presence of a total home smoking ban. At follow-up, 78% of participants reported having tried to establish a smoke-free rule in their home, with significantly more nonsmokers attempting a smoke-free home than smokers (P=.03. These attempts led to increased smoking restrictions, that is, going from no ban to a partial or total ban, or from a partial to a total ban, in 43% of the homes. At follow-up, 33% of the participants reported having made their home totally smoke-free. Additionally, smokers reported smoking fewer cigarettes per day. Results suggest that the intervention is promising and warrants a rigorous efficacy trial.

  16. Adaptation of a nursing home culture change research instrument for frontline staff quality improvement use.

    Science.gov (United States)

    Hartmann, Christine W; Palmer, Jennifer A; Mills, Whitney L; Pimentel, Camilla B; Allen, Rebecca S; Wewiorski, Nancy J; Dillon, Kristen R; Snow, A Lynn

    2017-08-01

    Enhanced interpersonal relationships and meaningful resident engagement in daily life are central to nursing home cultural transformation, yet these critical components of person-centered care may be difficult for frontline staff to measure using traditional research instruments. To address the need for easy-to-use instruments to help nursing home staff members evaluate and improve person-centered care, the psychometric method of cognitive-based interviewing was used to adapt a structured observation instrument originally developed for researchers and nursing home surveyors. Twenty-eight staff members from 2 Veterans Health Administration (VHA) nursing homes participated in 1 of 3 rounds of cognitive-based interviews, using the instrument in real-life situations. Modifications to the original instrument were guided by a cognitive processing model of instrument refinement. Following 2 rounds of cognitive interviews, pretesting of the revised instrument, and another round of cognitive interviews, the resulting set of 3 short instruments mirrored the concepts of the original longer instrument but were significantly easier for frontline staff to understand and use. Final results indicated frontline staff found the revised instruments feasible to use and clinically relevant in measuring and improving the lived experience of a changing culture. This article provides a framework for developing or adapting other measurement tools for frontline culture change efforts in nursing homes, in addition to reporting on a practical set of instruments to measure aspects of person-centered care. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

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

    Directory of Open Access Journals (Sweden)

    Gage Heather

    2012-11-01

    levels of respect for the experience and knowledge of care home staff. Conclusions Care homes are a hub for a wide range of NHS activity, but this is ad hoc with no recognised way to support working together. Integration between care homes and local health services is only really evident at the level of individual working relationships and reflects patterns of collaborative working rather than integration. More integrated working between care homes and primary health services has the potential to improve quality of care in a cost- effective manner, but strategic decisions to create more formal arrangements are required to bring this about. Commissioners of services for older people need to capitalise on good working relationships and address idiosyncratic patterns of provision to care homes.The low response rate is indicative of the difficulty of undertaking research in care homes.

  18. Feasibility of Measuring Tobacco Smoke Air Pollution in Homes: Report from a Pilot Study

    Directory of Open Access Journals (Sweden)

    Laura Rosen

    2015-11-01

    Full Text Available Tobacco smoke air pollution (TSAP measurement may persuade parents to adopt smoke-free homes and thereby reduce harm to children from tobacco smoke in the home. In a pilot study involving 29 smoking families, a Sidepak was used to continuously monitor home PM2.5 during an 8-h period, Sidepak and/or Dylos monitors provided real-time feedback, and passive nicotine monitors were used to measure home air nicotine for one week. Feedback was provided to participants in the context of motivational interviews. Home PM2.5 levels recorded by continuous monitoring were not well-accepted by participants because of the noise level. Also, graphs from continuous monitoring showed unexplained peaks, often associated with sources unrelated to indoor smoking, such as cooking, construction, or outdoor sources. This hampered delivery of a persuasive message about the relationship between home smoking and TSAP. By contrast, immediate real-time PM2.5 feedback (with Sidepak or Dylos monitor was feasible and provided unambiguous information; the Dylos had the additional advantages of being more economical and quieter. Air nicotine sampling was complicated by the time-lag for feedback and questions regarding shelf-life. Improvement in the science of TSAP measurement in the home environment is needed to encourage and help maintain smoke-free homes and protect vulnerable children. Recent advances in the use of mobile devices for real-time feedback are promising and warrant further development, as do accurate methods for real-time air nicotine air monitoring.

  19. The Effects of Environmental Management Systems on Source Separation in the Work and Home Settings

    Directory of Open Access Journals (Sweden)

    Chris von Borgstede

    2012-06-01

    Full Text Available Measures that challenge the generation of waste are needed to address the global problem of the increasing volumes of waste that are generated in both private homes and workplaces. Source separation at the workplace is commonly implemented by environmental management systems (EMS. In the present study, the relationship between source separation at work and at home was investigated. A questionnaire that maps psychological and behavioural predictors of source separation was distributed to employees at different workplaces. The results show that respondents with awareness of EMS report higher levels of source separation at work, stronger environmental concern, personal and social norms, and perceive source separation to be less difficult. Furthermore, the results support the notion that after the adoption of EMS at the workplace, source separation at work spills over into source separation in the household. The potential implications for environmental management systems are discussed.

  20. Obtaining Self-Report Data from Cognitively Impaired Elders: Methodological Issues and Clinical Implications for Nursing Home Pain Assessment

    Science.gov (United States)

    Fisher, Susan E.; Burgio, Louis D.; Thorn, Beverly E.; Hardin, J. Michael

    2006-01-01

    Purpose: We developed and evaluated an explicit procedure for obtaining self-report pain data from nursing home residents across a broad range of cognitive status, and we evaluated the consistency, stability, and concurrent validity of resident responses. Design and Methods: Using a modification of the Geriatric Pain Measure (GPM-M2), we…

  1. Development and Construct Validation of an Inventory for Assessing the Home Environment for Motor Development

    Science.gov (United States)

    Rodrigues, Luis Paulo; Saraiva, Linda; Gabbard, Carl

    2005-01-01

    A contemporary view of early childhood motor development considers environmental influences as critical factors in optimal growth and behavior, with the home being the primary agent. However, there has been minimal research examining the relationship between motor development and the home. The present study addresses this gap with the goal of…

  2. Business Metrics for High-Performance Homes: A Colorado Springs Case Study

    Energy Technology Data Exchange (ETDEWEB)

    Beach, R. [IBACOS, Inc, Pittsburgh, PA (United States); Jones, A. [IBACOS, Inc, Pittsburgh, PA (United States)

    2016-04-26

    This report explores the correlation between energy efficiency and the business success of home builders by examining a data set of builders and homes in the Colorado Springs, Colorado, market between 2006 and 2014. During this time, the Great Recession of 2007 to 2009 occurred, and new-home sales plummeted both nationally and in Colorado Springs. What is evident from an analysis of builders and homes in Colorado Springs is that builders who had Home Energy Rating System (HERS) ratings performed on some or all of their homes during the Recession remained in business during this challenging economic period. Many builders who did not have HERS ratings performed on their homes at that time went out of business or left the area. From the analysis presented in this report, it is evident that a correlation exists between energy efficiency and the business success of home builders, although the reasons for this correlation remain largely anecdotal and not yet clearly understood.

  3. A Novel Addressing Scheme for PMIPv6 Based Global IP-WSNs

    Directory of Open Access Journals (Sweden)

    Md. Motaharul Islam

    2011-08-01

    Full Text Available IP based Wireless Sensor Networks (IP-WSNs are being used in healthcare, home automation, industrial control and agricultural monitoring. In most of these applications global addressing of individual IP-WSN nodes and layer-three routing for mobility enabled IP-WSN with special attention to reliability, energy efficiency and end to end delay minimization are a few of the major issues to be addressed. Most of the routing protocols in WSN are based on layer-two approaches. For reliability and end to end communication enhancement the necessity of layer-three routing for IP-WSNs is generating significant attention among the research community, but due to the hurdle of maintaining routing state and other communication overhead, it was not possible to introduce a layer-three routing protocol for IP-WSNs. To address this issue we propose in this paper a global addressing scheme and layer-three based hierarchical routing protocol. The proposed addressing and routing approach focuses on all the above mentioned issues. Simulation results show that the proposed addressing and routing approach significantly enhances the reliability, energy efficiency and end to end delay minimization. We also present architecture, message formats and different routing scenarios in this paper.

  4. A novel addressing scheme for PMIPv6 based global IP-WSNs.

    Science.gov (United States)

    Islam, Md Motaharul; Huh, Eui-Nam

    2011-01-01

    IP based Wireless Sensor Networks (IP-WSNs) are being used in healthcare, home automation, industrial control and agricultural monitoring. In most of these applications global addressing of individual IP-WSN nodes and layer-three routing for mobility enabled IP-WSN with special attention to reliability, energy efficiency and end to end delay minimization are a few of the major issues to be addressed. Most of the routing protocols in WSN are based on layer-two approaches. For reliability and end to end communication enhancement the necessity of layer-three routing for IP-WSNs is generating significant attention among the research community, but due to the hurdle of maintaining routing state and other communication overhead, it was not possible to introduce a layer-three routing protocol for IP-WSNs. To address this issue we propose in this paper a global addressing scheme and layer-three based hierarchical routing protocol. The proposed addressing and routing approach focuses on all the above mentioned issues. Simulation results show that the proposed addressing and routing approach significantly enhances the reliability, energy efficiency and end to end delay minimization. We also present architecture, message formats and different routing scenarios in this paper.

  5. [For the betterment of home palliative care].

    Science.gov (United States)

    Midorikawa, Yasuhiko; Iiduka, Masashi

    2010-12-01

    The problems we have identified to overcome for a betterment of home palliative care were as follows:(1) Staffs' low level of knowledge and a lack of interest in home care, (2) Lack of cooperation between hospital and clinic, (3) Hard to keep the medical and caregiver staffs employed in the home care settings and a technical training is behind, (4) Insufficient cooperative networks for elderly care and welfare in the region, and (5) Misunderstanding of home palliative care by patient, family and people in the region. It is important to solve these problems one by one for a betterment of home palliative care. In this paper, we reported these problems through actual activities of our hospital and Iwaki city, and we propose to deal with them.

  6. [Care quality: reliability and usefulness of observation data in bench marking nursing homes and homes for the aged in the Netherlands].

    Science.gov (United States)

    Frijters, Dinnus; Gerritsen, Debby; Steverink, Nardi

    2003-02-01

    Before including quality of care indicators in the Benchmark of Nursing Homes and Homes for the Aged in the Netherlands the reliability of the patient data collection, and usefulness had to be established. The patient data items were derived from the Resident Assessment Instruments (RAI) and a questionnaire on social interaction in elderly people. Three nursing homes and three homes for the aged participated in the test with 550 patients. 279 x 2 assessments were collected by independent raters for an inter rater reliability test; 259 x 2 by the same rater for a reliability test-retest; and 24 by a single rater. The scores on paired assessment forms were compared with the weighted Kappa agreement test. The test results allowed 10 of the 13 quality indicators from RAI to be retained. In addition new quality indicators could be defined on 'giving attention' and 'unrespectful addressing'. We estimate on the basis of a questionnaire for the raters that on average 9 to 12 minutes per patient are needed to collect and enter data for the resulting 12 quality indicators.

  7. Building America FY 2016 Annual Report: Building America Is Driving Real Solutions in the Race to Zero Energy Homes -- Appendix

    Energy Technology Data Exchange (ETDEWEB)

    Sara Farrar, Stacey Rothgeb, Ben Polly, Lieko Earle, Tim Merrigan

    2017-01-01

    This document is a set of appendices presenting technical discussion and references as a companion to the 'Building America FY 2016 Annual Report: Building America Is Driving Real Solutions in the Race to Zero Energy Homes' publication.

  8. Whole-Home Dehumidifiers: Field-Monitoring Study

    Energy Technology Data Exchange (ETDEWEB)

    Burke, Tom; Willem, Henry; Ni, Chun Chun; Stratton, Hannah; Whitehead, Camilla Dunham; Johnson, Russell

    2014-09-23

    Lawrence Berkeley National Laboratory (LBNL) initiated a WHD field-metering study to expand current knowledge of and obtain data on WHD operation and energy consumption in real-world applications. The field study collected real-time data on WHD energy consumption, along with information regarding housing characteristics, consumer behavior, and various outdoor conditions expected to affect WHD performance and efficiency. Although the metering study collected similar data regarding air conditioner operation, this report discusses only WHDs. The primary objectives of the LBNL field-metering study are to (1) expand knowledge of the configurations, energy consumption profiles, consumer patterns of use (e.g., relative humidity [RH] settings), and environmental parameters of whole-home dehumidification systems; and (2) develop distributions of hours of dehumidifier operation in four operating modes: off, standby, fan-only, and compressor (also called dehumidification mode). Profiling energy consumption entails documenting the power consumption, duration of power consumption in different modes, condensate generation, and properties of output air of an installed system under field conditions of varying inlet air temperature and RH, as well as system configuration. This profiling provides a more detailed and deeper understanding of WHD operation and its complexities. This report describes LBNL’s whole-home dehumidification field-metering study conducted at four homes in Wisconsin and Florida. The initial phase of the WHD field-metering study was conducted on one home in Madison, Wisconsin, from June to December of 2013. During a second phase, three Florida homes were metered from June to October of 2014. This report presents and examines data from the Wisconsin site and from the three Florida sites.

  9. Telecommuting: The Trade-Offs of Home Work.

    Science.gov (United States)

    Kraut, Robert E.

    1989-01-01

    Reports that relatively few people use their home as a primary work site and that those who do (substitutors, self-employed, and supplementers) balance their needs for employment flexibility against their needs for income. Discusses differing motivations and satisfactions, and the wage gap between home workers and conventional workers. (SR)

  10. How Do The EV Project Participants Feel about Charging Their EV at Home?

    Energy Technology Data Exchange (ETDEWEB)

    Francfort, James E. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-02-01

    Key Observations from the Survey of the EV Project Participants; In June 2013, 72% of EV Project participants were very satisfied with their home charging experience; 21% of participants relied totally on home charging for all of their charging needs; Volt owners relied more on home charging than Leaf owners, who reported more use of away-from-home charging; 74% of participants reported that they plug in their plug-in electric vehicle (PEV) every time they park at home. Others plugged in as they determined necessary to support their driving needs; 40% of participants reported that they would not have or are unsure that in June 2013 whether they would have purchased an alternating current (AC) Level 2 electric vehicle supply equipment (EVSE) for home charging if it had not been provided by The EV Project; and 61% of participants reported that The EV Project incentive was very important or important in their decision to obtain a PEV.

  11. Care Plan Improvement in Nursing Homes: An Integrative Review.

    Science.gov (United States)

    Mariani, Elena; Chattat, Rabih; Vernooij-Dassen, Myrra; Koopmans, Raymond; Engels, Yvonne

    2017-01-01

    Care planning nowadays is a key activity in the provision of services to nursing home residents. A care plan describes the residents' needs and the actions to address them, providing both individualized and standardized interventions and should be updated as changes in the residents' conditions occur. The aim of this review was to identify the core elements of the implementation of changes in nursing homes' care plans, by providing an overview of the type of stakeholders involved, describing the implementation strategies used, and exploring how care plans changed. An integrative literature review was used to evaluate intervention studies taking place in nursing homes. Data were collected from PubMed, CINHAL-EBSCO, and PsycINFO. English language articles published between 1995 and April 2015 were included. Data analysis followed the strategy of Knafl and Whittemore. Twenty-six articles were included. The stakeholders involved were professionals, family caregivers, and patients. Only a few studies directly involved residents and family caregivers in the quality improvement process. The implementation strategies used were technology implementation, audit, training, feedback, and supervision. The majority of interventions changed the residents' care plans in terms of developing a more standardized care documentation that primarily focuses on its quality. Only some interventions developed more tailored care plans that focus on individualized needs. Care plans generally failed in providing both standardized and personalized interventions. Efforts should be made to directly involve residents in care planning and provide professionals with efficient tools to report care goals and actions in care plans.

  12. Validity of self-reported intensity of exposure to second-hand smoke at home against environmental and personal markers.

    Science.gov (United States)

    Martínez-Sánchez, José M; González-Marrón, Adrián; Martín-Sánchez, Juan Carlos; Sureda, Xisca; Fu, Marcela; Pérez-Ortuño, Raúl; Lidón-Moyano, Cristina; Galán, Iñaki; Pascual, José Antonio; Fernández, Esteve

    2017-11-02

    The objective of this study was to assess the validity of two questions about the perception of intensity of exposure to secondhand smoke (SHS) at home using as a reference environmental markers (airborne nicotine and benzene) and biomarkers of exposure (cotinine in saliva and urine). This was a cross-sectional study in a convenience sample of 49 non-smoking volunteers. We found a high correlation between self-reported SHS exposure and airborne nicotine (r sp =0.806, p0.05). In conclusion, the significant correlation of the two questions proposed with environmental markers and personal markers indicates their potential validity to assess exposure to SHS at home. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  13. Hospital information technology in home care.

    Science.gov (United States)

    Zhang, Xiao-Ying; Zhang, Pei-Ying

    2016-10-01

    The utilization of hospital information technology (HIT) as a tool for home care is a recent trend in health science. Subjects gaining benefits from this new endeavor include middle-aged individuals with serious chronic illness living at home. Published data on the utilization of health care information technology especially for home care in chronic illness patients have increased enormously in recent past. The common chronic illnesses reported in these studies were primarily on heart and lung diseases. Furthermore, health professionals have confirmed in these studies that HIT was beneficial in gaining better access to information regarding their patients and they were also able to save that information easily for future use. On the other hand, some health professional also observed that the use of HIT in home care is not suitable for everyone and that individuals cannot be replaced by HIT. On the whole it is clear that the use of HIT could complement communication in home care. The present review aims to shed light on these latest aspects of the health care information technology in home care.

  14. An In-home Advanced Robotic System to Manage Elderly Home-care Patients' Medications: A Pilot Safety and Usability Study.

    Science.gov (United States)

    Rantanen, Pekka; Parkkari, Timo; Leikola, Saija; Airaksinen, Marja; Lyles, Alan

    2017-05-01

    We examined the safety profile and usability of an integrated advanced robotic device and telecare system to promote medication adherence for elderly home-care patients. There were two phases. Phase I aimed to verify under controlled conditions in a single nursing home (n = 17 patients) that no robotic malfunctions would hinder the device's safe use. Phase II involved home-care patients from 3 sites (n = 27) who were on long-term medication. On-time dispensing and missed doses were recorded by the robotic system. Patients' and nurses' experiences were assessed with structured interviews. The 17 nursing home patients had 457 total days using the device (Phase I; mean, 26.9 per patient). On-time sachet retrieval occurred with 97.7% of the alerts, and no medication doses were missed. At baseline, Phase II home-dwelling patients reported difficulty remembering to take their medicines (23%), and 18% missed at least 2 doses per week. Most Phase II patients (78%) lived alone. The device delivered and patients retrieved medicine sachets for 99% of the alerts. All patients and 96% of nurses reported the device was easy to use. This trial demonstrated the safety profile and usability of an in-home advanced robotic device and telecare system and its acceptability to patients and nurses. It supports individualized patient dosing schedules, patient-provider communications, and on-time, in-home medication delivery to promote adherence. Real time dose-by-dose monitoring and communication with providers if a dose is missed provide oversight generally not seen in home care. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Building America Case Study: Whole-House Solutions for Existing Homes: Greenbelt Homes, Inc. Pilot Retrofit Program; Whole-House Solutions for Existing Homes, Energy Efficiency & Renewable Energy (EERE)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-06-01

    In the fall of 2010, a multiyear pilot energy efficiency retrofit project was undertaken by Greenbelt Homes, Inc, (GHI) a 1,566 home cooperative of circa 1930 and 1940 homes in Greenbelt, Maryland. GHI established this pilot project to serve as a basis for decision making for the rollout of a decade-long community-wide upgrade program that will incorporate energy efficiency improvements to the building envelope and mechanical equipment. With the community upgrade fully funded by the cooperative through their membership without outside subsidies, this project presents a unique opportunity to evaluate and prioritize the wide-range of benefits of high-performance retrofits based on member experience with and acceptance of the retrofit measures implemented during the pilot project. Addressing the complex interactions between benefits, trade-offs, construction methods, project management implications, realistic upfront costs, financing, and other considerations, serves as a case study for energy retrofit projects to include high-performance technologies based on the long-term value to the homeowner. The pilot project focused on identifying the added costs and energy savings benefits of improvements. Phase 1: baseline evaluation for a representative set of 28 homes sited in seven buildings; Phase 2: installation of the building envelope improvements and continued monitoring of the energy consumption for the heating season and energy simulations supporting recommendations for HVAC and water heating upgrades to be implemented in Phase 3.

  16. Approaches to quality improvement in nursing homes: Lessons learned from the six-state pilot of CMS's Nursing Home Quality Initiative

    OpenAIRE

    Kissam, Stephanie; Gifford, David; Parks, Peggy; Patry, Gail; Palmer, Laura; Wilkes, Linda; Fitzgerald, Matthew; Petrulis, Alice Stollenwerk; Barnette, Leslie

    2003-01-01

    Abstract Background In November 2002, the Centers for Medicare & Medicaid Services (CMS) launched a Nursing Home Quality Initiative that included publicly reporting a set of Quality Measures for all nursing homes in the country, and providing quality improvement assistance to nursing homes nationwide. A pilot of this initiative occurred in six states for six months prior to the launch. Methods Review and analysis of the lessons learned from the six Quality Improvement Organizations (QIOs) tha...

  17. Energy Consumption Information Services for Smart Home Inhabitants

    Science.gov (United States)

    Schwanzer, Michael; Fensel, Anna

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

  18. Home electrical system safety in Italy

    Energy Technology Data Exchange (ETDEWEB)

    Auditor,

    1990-06-01

    Italy, amongst the industrialized countries, has the highest mortality rate due to accidents associated with the improper use or maintenance of home electrical systems. The increasing use of domestic electrical appliances has raised the risk of accidents, especially in homes equipped with out-dated, low-capacity electrical plants and worn wiring. Within this context, this paper reports on the results of survey to establish the worthiness and type of electrical systems in use in a sample of 1,000 residential buildings. The paper then assesses the efficacy of recent normatives designed to increase the safety and efficiency of home electrical installations.

  19. Taking the Challenge at Singer Village. A Cold Climate Zero Energy Ready Home

    Energy Technology Data Exchange (ETDEWEB)

    Puttagunta, S. [Consortium for Advanced Residential Buildings, Norwalk, CT (United States); Faakye, O. [Consortium for Advanced Residential Buildings, Norwalk, CT (United States)

    2014-10-01

    After progressively incorporating ENERGY STAR® for Homes Versions 1, 2, and 3 into its standard practices over the years, this builder, Brookside Development, was seeking to build an even more sustainable product that would further increase energy efficiency, while also addressing indoor air quality, water conservation, renewable-ready, and resiliency. These objectives align with the framework of the DOE Challenge Home program, which "builds upon the comprehensive building science requirements of ENERGY STAR for Homes Version 3, along with proven Building America innovations and best practices. Other special attribute programs are incorporated to help builders reach unparalleled levels of performance with homes designed to last hundreds of years." Consortium for Advanced Residential Buildings (CARB) partnered with Brookside Development on the design optimization and construction of the first home in a small development of seven planned new homes being built on the old Singer Estate in Derby, CT.

  20. Taking the Challenge at Singer Village--A Cold Climate Zero Energy Ready Home

    Energy Technology Data Exchange (ETDEWEB)

    Puttagunta, S.; Gaakye, O.

    2014-10-01

    After progressively incorporating ENERGY STAR(R) for Homes Versions 1, 2, and 3 into its standard practices over the years, this builder, Brookside Development, was seeking to build an even more sustainable product that would further increase energy efficiency, while also addressing indoor air quality, water conservation, renewable-ready, and resiliency. These objectives align with the framework of the DOE Challenge Home program, which 'builds upon the comprehensive building science requirements of ENERGY STAR for Homes Version 3, along with proven Building America innovations and best practices. Other special attribute programs are incorporated to help builders reach unparalleled levels of performance with homes designed to last hundreds of years.' CARB partnered with Brookside Development on the design optimization and construction of the first home in a small development of seven planned new homes being built on the old Singer Estate in Derby, CT.

  1. Facilitating out-of-home caregiving through health information technology: survey of informal caregivers' current practices, interests, and perceived barriers.

    Science.gov (United States)

    Zulman, Donna M; Piette, John D; Jenchura, Emily C; Asch, Steven M; Rosland, Ann-Marie

    2013-07-10

    Many patients with chronic conditions are supported by out-of-home informal caregivers-family members, friends, and other individuals who provide care and support without pay-who, if armed with effective consumer health information technology, could inexpensively facilitate their care. We sought to understand caregivers' use of, interest in, and perceived barriers to health information technology for out-of-home caregiving. We conducted 2 sequential Web-based surveys with a national sample of individuals who provide out-of-home caregiving to an adult family member or friend with a chronic illness. We queried respondents about their use of health information technology for out-of-home caregiving and used multivariable regression to investigate caregiver and care-recipient characteristics associated with caregivers' technology use for caregiving. Among 316 out-of-home caregiver respondents, 34.5% (109/316) reported using health information technology for caregiving activities. The likelihood of a caregiver using technology increased significantly with intensity of caregiving (as measured by number of out-of-home caregiving activities). Compared with very low intensity caregivers, the adjusted odds ratio (OR) of technology use was 1.88 (95% CI 1.01-3.50) for low intensity caregivers, 2.39 (95% CI 1.11-5.15) for moderate intensity caregivers, and 3.70 (95% CI 1.62-8.45) for high intensity caregivers. Over 70% (149/207) of technology nonusers reported interest in using technology in the future to support caregiving. The most commonly cited barriers to technology use for caregiving were health system privacy rules that restrict access to care-recipients' health information and lack of familiarity with programs or websites that facilitate out-of-home caregiving. Health information technology use for out-of-home caregiving is common, especially among individuals who provide more intense caregiving. Health care systems can address the mismatch between caregivers' interest

  2. Staff assignment practices in nursing homes: review of the literature.

    Science.gov (United States)

    Rahman, Anna; Straker, Jane K; Manning, Lydia

    2009-01-01

    Consistent assignment, whereby nursing home staff members, particularly certified nurse aides, are assigned to the same residents on most shifts, is increasingly viewed as a cornerstone of culture change in nursing homes. It has been advocated as a best-care model that increases residents' quality of life while contributing to a more stable frontline staff. Given these potential benefits, consistent assignment is now widely viewed as superior to rotating assignment, an alternative staffing model that aims to distribute care burden more fairly among staff and ensure that workers are familiar with most residents. Despite favorable anecdotal reports about the benefits of consistent assignment, the research literature reports mixed and sometimes contradictory findings for this staffing practice. This article reviews the research pertaining to staff assignment practices in nursing homes. Reviewed here are 13 reports on experimental trials (6 reports), evaluation research (4 reports), and nursing home surveys (3 reports). The review reveals broad diversity in staffing practices and raises questions that challenge popular assumptions about consistent assignment. The article closes with a discussion of the research, policy, and practice implications of the research findings.

  3. Survey of Home Visiting Programs for Abused and Neglected Children and Their Families.

    Science.gov (United States)

    Wasik, Barbara Hanna; Roberts, Richard N.

    1994-01-01

    This report on a survey of 224 home visitation programs that provide services for abused and neglected children and their families presents data on program characteristics, characteristics of home visits, credentials of home visitors, and program documentation procedures. Programs reported that training in parenting skills and parent coping were…

  4. Using Sensors to Study Home Activities

    Directory of Open Access Journals (Sweden)

    Jie Jiang

    2017-12-01

    Full Text Available Understanding home activities is important in social research to study aspects of home life, e.g., energy-related practices and assisted living arrangements. Common approaches to identifying which activities are being carried out in the home rely on self-reporting, either retrospectively (e.g., interviews, questionnaires, and surveys or at the time of the activity (e.g., time use diaries. The use of digital sensors may provide an alternative means of observing activities in the home. For example, temperature, humidity and light sensors can report on the physical environment where activities occur, while energy monitors can report information on the electrical devices that are used to assist the activities. One may then be able to infer from the sensor data which activities are taking place. However, it is first necessary to calibrate the sensor data by matching it to activities identified from self-reports. The calibration involves identifying the features in the sensor data that correlate best with the self-reported activities. This in turn requires a good measure of the agreement between the activities detected from sensor-generated data and those recorded in self-reported data. To illustrate how this can be done, we conducted a trial in three single-occupancy households from which we collected data from a suite of sensors and from time use diaries completed by the occupants. For sensor-based activity recognition, we demonstrate the application of Hidden Markov Models with features extracted from mean-shift clustering and change points analysis. A correlation-based feature selection is also applied to reduce the computational cost. A method based on Levenshtein distance for measuring the agreement between the activities detected in the sensor data and that reported by the participants is demonstrated. We then discuss how the features derived from sensor data can be used in activity recognition and how they relate to activities recorded in time

  5. St Kieran's Care Home, Rathcabban, Roscrea, Tipperary.

    LENUS (Irish Health Repository)

    O’Neill, MB

    2017-08-01

    In the training process, there is a tension between the work life and home life of trainees. This study explored both the personal impact and the opportunity costs of training from the Specialist Paediatric Registrar (SPR) perspective. The survey explored 1) career progression2) perceived functional effectiveness at work 3) psychological impact of hospital based training and 4) the personal and social cost of training. Fifty-three (71%) SPRs responded of whom 47 (89%)were married or in long term relationships. Seventy-five percent of trainees had a definite career plan with 86% intending to undertake fellowship training. Seventy percent believed they were efficient time managers but 53% had difficulty in making time for academic pursuits and fifty percent experienced negative feelings, which lingered after work and interfered with their relationships at home. Seventy-four percent stated training was undertaken at significant personal cost with only 21% achieving a very satisfactory work\\/life balance. To address these difficulties trainee wellbeing should be addressed at the Basic Specialist Training (BST) level and the career path clearly explained outlining the challenges that are likely to be encountered.

  6. DTU international energy report 2013. Energy storage options for future sustainable energy systems

    Energy Technology Data Exchange (ETDEWEB)

    Hvidtfeldt Larsen, H.; Soenderberg Petersen, L. (eds.)

    2013-11-01

    One of the great challenges in the transition to a non-fossil energy system with a high share of fluctuating renewable energy sources such as solar and wind is to align consumption and production in an economically satisfactory manner. Energy storage could provide the necessary balancing power to make this possible. This energy report addresses energy storage from a broad perspective: It analyses smaller stores that can be used locally in for example heat storage in the individual home or vehicle, such as electric cars or hydrogen cars. The report also addresses decentralized storage as flywheels and batteries linked to decentralized energy systems. In addition it addresses large central storages as pumped hydro storage and compressed air energy storage and analyse this in connection with international transmission and trading over long distances. The report addresses electrical storage, thermal storage and other forms of energy storage, for example conversion of biomass to liquid fuel and conversion of solar energy directly into hydrogen, as well as storage in transmission, grid storage etc. Finally, the report covers research, innovation and the future prospects and addresses the societal challenges and benefits of the use of energy storage. (Author)

  7. [Terminal home care "Ikigai no Yoake--The real aim of our life"--case report].

    Science.gov (United States)

    Funato, T; Funato, H; Kato, A; Matsuoka, Y; Shibuya, R; Usui, Y; Niwa, Y

    1998-12-01

    It is difficult to provide home care especially for terminal cancer patients as their physical conditions deteriorate due to the cancer. It is important to enhance the will of home care providers to make this possible. Although a universal method has been worked out, personal and religious beliefs have made it difficult to create an effective method. We would like to introduce our experience in the paper entitled "Ikigai no Yoake" and subtitled "Influence of scientific study of reincarnation on view of life" by Fumihiko Ida of Fukushima University. It has encouraged home care providers and made it possible to provide home care to terminal patients along with benefits.

  8. Indian adolescents' perceptions of the home food environment.

    Science.gov (United States)

    Rathi, Neha; Riddell, Lynn; Worsley, Anthony

    2018-01-22

    The home food environment has the potential to influence the eating behaviour of adolescents. This investigation aimed to understand Indian adolescents' perspectives of their home food environments. Adolescents aged 14-16 years (n = 1026, 65.3% girls) attending private secondary schools in Kolkata completed a paper-based questionnaire during school time which included questions about family food rules, availability and accessibility of foods at home, and domestic cooking responsibility. Boys' and girls' opinions and experiences were compared through cross-tabulation analyses. Almost all the adolescents reported that fruits (91.6%) and vegetables (95.7%) were always available in their homes. Approximately two-fifths reported that sugar-sweetened beverages (36.2%) and salty snack foods (38.0%) were readily available. In 56.1% households, adolescents were expected to follow certain food rules during mealtimes (e.g. not talking with my mouth full). The majority of the respondents (80.4%) identified mothers as the primary meal providers, only a minority reported that fathers (5.1%) were responsible for preparation of family meals. This understanding of the family-environmental determinants of adolescent dietary habits provides useful directions for nutrition promotion interventions. Health and educational professionals associated with adolescents could communicate about the development of healthy home food environments to provide positive health benefits for adolescents and their families.

  9. Improving the Quality of Home Health Care for Children With Medical Complexity.

    Science.gov (United States)

    Nageswaran, Savithri; Golden, Shannon L

    2017-08-01

    The objectives of this study are to describe the quality of home health care services for children with medical complexity, identify barriers to delivering optimal home health care, and discuss potential solutions to improve home health care delivery. In this qualitative study, we conducted 20 semistructured in-depth interviews with primary caregivers of children with medical complexity, and 4 focus groups with 18 home health nurses. During an iterative analysis process, we identified themes related to quality of home health care. There is substantial variability between home health nurses in the delivery of home health care to children. Lack of skills in nurses is common and has serious negative health consequences for children with medical complexity, including hospitalizations, emergency room visits, and need for medical procedures. Inadequate home health care also contributes to caregiver burden. A major barrier to delivering optimal home health care is the lack of training of home health nurses in pediatric care and technology use. Potential solutions for improving care include home health agencies training nurses in the care of children with medical complexity, support for nurses in clinical problem solving, and reimbursement for training nurses in pediatric home care. Caregiver-level interventions includes preparation of caregivers about: providing medical care for their children at home and addressing problems with home health care services. There are problems in the quality of home health care delivered to children with medical complexity. Training nurses in the care of children with medical complexity and preparing caregivers about home care could improve home health care quality. Copyright © 2017 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  10. Home-mortgage lending trends in New England in 2010

    OpenAIRE

    Ana Patricia Muñoz

    2012-01-01

    This brief analysis of home-mortgage lending trends in New England is based on data collected under the Home Mortgage Disclosure Act (HMDA). HMDA provides information on mortgage lending trends and includes data by loan purpose, type of loan, income, and the race and ethnicity of borrowers. In this report we focus on home-purchase and refinance loans in New England.

  11. At-Home and Away-from-Home Eating Patterns Influencing Preadolescents' Intake of Calcium-Rich Food as Perceived by Asian, Hispanic and Non-Hispanic White Parents

    Science.gov (United States)

    Cluskey, Mary; Edlefsen, Miriam; Olson, Beth; Reicks, Marla; Auld, Garry; Bock, Margaret A.; Boushey, Carol J.; Bruhn, Christine; Goldberg, Dena; Misner, Scottie; Wang, Changzheng; Zaghloul, Sahar

    2008-01-01

    Objective: To explore at-home and away-from-home eating patterns influencing Asian, Hispanic, and non-Hispanic white preadolescents' intake of calcium-rich food from a parental perspective. Design: Individual semistructured interviews. Setting: Home or community site. Participants: Convenience sample (n = 201) of self-reported Asian (n = 54),…

  12. Depression recognition and capacity for self-report among ethnically diverse nursing homes residents: Evidence of disparities in screening.

    Science.gov (United States)

    Chun, Audrey; Reinhardt, Joann P; Ramirez, Mildred; Ellis, Julie M; Silver, Stephanie; Burack, Orah; Eimicke, Joseph P; Cimarolli, Verena; Teresi, Jeanne A

    2017-12-01

    To examine agreement between Minimum Data Set clinician ratings and researcher assessments of depression among ethnically diverse nursing home residents using the 9-item Patient Health Questionnaire. Although depression is common among nursing homes residents, its recognition remains a challenge. Observational baseline data from a longitudinal intervention study. Sample of 155 residents from 12 long-term care units in one US facility; 50 were interviewed in Spanish. Convergence between clinician and researcher ratings was examined for (i) self-report capacity, (ii) suicidal ideation, (iii) at least moderate depression, (iv) Patient Health Questionnaire severity scores. Experiences by clinical raters using the depression assessment were analysed. The intraclass correlation coefficient was used to examine concordance and Cohen's kappa to examine agreement between clinicians and researchers. Moderate agreement (κ = 0.52) was observed in determination of capacity and poor to fair agreement in reporting suicidal ideation (κ = 0.10-0.37) across time intervals. Poor agreement was observed in classification of at least moderate depression (κ = -0.02 to 0.24), lower than the maximum kappa obtainable (0.58-0.85). Eight assessors indicated problems assessing Spanish-speaking residents. Among Spanish speakers, researchers identified 16% with Patient Health Questionnaire scores of 10 or greater, and 14% with thoughts of self-harm whilst clinicians identified 6% and 0%, respectively. This study advances the field of depression recognition in long-term care by identification of possible challenges in assessing Spanish speakers. Use of the Patient Health Questionnaire requires further investigation, particularly among non-English speakers. Depression screening for ethnically diverse nursing home residents is required, as underreporting of depression and suicidal ideation among Spanish speakers may result in lack of depression recognition and referral for evaluation and

  13. Patient Health Goals Elicited During Home Care Admission: A Categorization.

    Science.gov (United States)

    Sockolow, Paulina; Radhakrishnan, Kavita; Chou, Edgar Y; Wojciechowicz, Christine

    2017-11-01

    Home care agencies are initiating "patient health goal elicitation" activities as part of home care admission planning. We categorized elicited goals and identified "clinically informative" goals at a home care agency. We examined patient goals that admitting clinicians documented in the point-of-care electronic health record; conducted content analysis on patient goal data to develop a coding scheme; grouped goal themes into codes; assigned codes to each goal; and identified goals that were in the patient voice. Of the 1,763 patient records, 16% lacked a goal; only 15 goals were in a patient's voice. Nurse and physician experts identified 12 of the 20 codes as clinically important accounting for 82% of goal occurrences. The most frequent goal documented was safety/falls (23%). Training and consistent communication of the intent and operationalization of patient goal elicitation may address the absence of patient voice and the less than universal recording of home care patients' goals.

  14. Palliative home care: A designer′s perspective

    Directory of Open Access Journals (Sweden)

    Tigmanshu Bhatnagar

    2015-01-01

    Full Text Available The purpose for this observational research was to understand how Can Support provides palliative care at home and analyze its strengths and weaknesses in various socioeconomic scenarios for future development. In the period of 2 weeks, patients and their caregivers were silently observed in their natural surroundings during home care visits in order to listen their problems, identify the pattern of questions for the home care team, their natural way of storytelling, organizational techniques for medicines and medical reports, care givers lives, patient journey, etc. Such observations have enabled the understanding of the phenomena of home palliative care and have led to the identification of certain influential variables of the practice.

  15. Elevated corrosion rates and hydrogen sulfide in homes with ‘Chinese Drywall’

    International Nuclear Information System (INIS)

    Allen, Joseph G.; MacIntosh, David L.; Saltzman, Lori E.; Baker, Brian J.; Matheson, Joanna M.; Recht, Joel R.; Minegishi, Taeko; Fragala, Matt A.; Myatt, Theodore A.; Spengler, John D.; Stewart, James H.; McCarthy, John F.

    2012-01-01

    In December 2008, the U.S. Consumer Product Safety Commission (CPSC) began receiving reports about odors, corrosion, and health concerns related to drywall originating from China. In response, a detailed environmental health and engineering evaluation was conducted of 41 complaint and 10 non-complaint homes in the Southeast U.S. Each home investigation included characterization of: 1) drywall composition; 2) indoor and outdoor air quality; 3) temperature, moisture, and building ventilation; and 4) copper and silver corrosion rates. Complaint homes had significantly higher hydrogen sulfide concentrations (mean 0.82 vs. 3 , p 2 S: 476 vs. 2 S: 1472 vs. 389 Å/30 d, p < 0.01). The abundance of carbonate and strontium in drywall was also elevated in complaint homes, and appears to be useful objective marker of problematic drywall in homes that meet other screening criteria (e.g., constructed or renovated in 2006–2007, reports of malodor and accelerated corrosion). This research provides empirical evidence of the direct association between homes constructed with ‘Chinese Drywall’ in 2006–2007 and elevated corrosion rates and hydrogen sulfide concentrations in indoor air. - Highlights: ► Environmental measurements in homes with and without “Chinese Drywall” ► Homes with “Chinese Drywall” had higher hydrogen sulfide concentrations ► Homes with “Chinese Drywall” had elevated corrosion rates ► Study provides empirical evidence of reported associations

  16. A Correlational Study of Telework Frequency, Information Communication Technology, and Job Satisfaction of Home-Based Teleworkers

    Science.gov (United States)

    Webster-Trotman, Shana P.

    2010-01-01

    In 2008, 33.7 million Americans teleworked from home. The Telework Enhancement Act (S. 707) and the Telework Improvements Act (H.R. 1722) of 2009 were designed to increase the number of teleworkers. The research problem addressed was the lack of understanding of factors that influence home-based teleworkers' job satisfaction. Job dissatisfaction…

  17. Working in clients' homes: the impact on the mental health and well-being of visiting home care workers.

    Science.gov (United States)

    Denton, Margaret A; Zeytinoğlu, Işk Urla; Davies, Sharon

    2002-01-01

    The purpose of this paper is to examine the effects of working in clients' homes on the mental health and well-being of visiting home care workers. This paper reports the results of a survey of 674 visiting staff from three non-profit home care agencies in a medium-sized city in Ontario, Canada. Survey results are also complimented by data from 9 focus groups with 50 employees. For purposes of this study, home care workers include visiting therapists, nurses, and home support workers. Mental health and well-being is measured by three dependent variables: stress; job stress; and intrinsic job satisfaction. Multiple least squared regression analyses show several structural, emotional, physical, and organizational working conditions associated with the health and well-being of visiting home care workers. Overall, results show that workload, difficult clients, clients who take advantage of workers, sexual harassment, safety hazards, a repetitious job, and work-related injuries are associated with poorer health. Being fairly paid, having good benefits, emotional labour, organizational support, control over work, and peer support are associated with better health. Results suggest that policy change is needed to encourage healthier work environments for employees who work in clients' homes.

  18. 75 FR 8239 - Federal Home Loan Bank Housing Associates, Core Mission Activities and Standby Letters of Credit

    Science.gov (United States)

    2010-02-24

    ... written appeal to FHFA that includes the Bank's decision resolution and a statement of the basis for the... Parts 1264, 1265 and 1269 RIN 2590-AA33 Federal Home Loan Bank Housing Associates, Core Mission... regulations address, respectively, Federal Home Loan Bank (Bank) housing associates, the Banks' core mission...

  19. 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.

  20. "To Be Without a Home, like a Rolling Stone"

    DEFF Research Database (Denmark)

    Albu, Oana Brindusa

    ” ethnographers lack a stable “at home/abroad,” “here/there” distinction to fall back on, since the field is a contested site, subject to ongoing negotiations among international regimes. Drawing on fieldwork with activist NGOs in Morocco and the Western Sahara, I will reflect on this conundrum by addressing...

  1. Nutrition standards for away-from-home foods in the USA.

    Science.gov (United States)

    Cohen, D A; Bhatia, R

    2012-07-01

    Away-from-home foods are regulated with respect to the prevention of food-borne diseases and potential contaminants, but not for their contribution to dietary-related chronic diseases. Away-from-home foods have more calories, salt, sugar and fat, and include fewer fruits and vegetables than recommended by national nutrition guidelines. Thus, frequent consumption of away-from-home foods contributes to obesity, hypertension, diabetes, heart disease, and cancer. In light of this, many localities are already adopting regulations or sponsoring programs to improve the quality of away-from-home foods. We review the rationale for developing nutritional performance standards for away-from-home foods in light of limited human capacity to regulate intake or physiologically compensate for a poor diet. We offer a set of model performance standards to be considered as a new area of environmental regulation. Models for voluntary implementation of consumer standards exist in the environmental domain and may be useful templates for implementation. Implementing such standards, whether voluntarily or via regulations, will require addressing a number of practical and ideological challenges. Politically, regulatory standards contradict the belief that adults should be able to navigate dietary risks in away-from-home settings unaided. © 2012 The Authors. obesity reviews © 2012 International Association for the Study of Obesity.

  2. From institutionalized birth to home birth

    Directory of Open Access Journals (Sweden)

    Clara Fróes de Oliveira Sanfelice

    2014-06-01

    Full Text Available The study aimed to describe the experiences of a group of nurse-midwives from the city of Campinas, SP, Brasil, regarding the transition process from attending institutionalized births to attending home births, in the period 2011 – 2013. The study is of the experience report type; the reflections, perceptions and challenges experienced in this process were collected using the technique of brainstorming. Content analysis, as proposed by Bardin, was used, which yielded four thematic categories: a the hospital experience; b living with obstetric violence; c returning home and d the challenges of home care. It is concluded that attending home births offers greater satisfaction to the nurses, even in the face of various obstacles, as it is possible to offer a care to the woman and new-born which covers both the concept of comprehensiveness and the current scientific recommendations.

  3. Nutrition Standards for Away-from-home Foods in the United States

    Science.gov (United States)

    Cohen, Deborah A.; Bhatia, Rajiv

    2012-01-01

    Away-from-home foods are regulated with respect to the prevention of food-borne diseases and potential contaminants, but not for their contribution to dietary-related chronic diseases. Away-from-home foods have more calories, salt, sugar, and fat and provide fewer fruits and vegetables than recommended by national nutrition guidelines; thus, frequent consumption of away-from-home foods contributes to obesity, hypertension, diabetes, heart disease, and cancer. In light of this, many localities are already adopting regulations or sponsoring programs to improve the quality of away-from-home foods. We review the rationale for developing nutritional performance standards for away-from-home foods in light of limited human capacity to regulate intake or physiologically compensate for a poor diet. We offer a set of model performance standards to be considered as a new area of environmental regulation. Models for voluntary implementation of consumer standards exist in the environmental domain and may be useful templates for implementation. Implementing such standards, whether voluntarily or via regulations, will require addressing a number of practical and ideological challenges. Politically, regulatory standards contradict the belief that adults should be able to navigate dietary risks in away-from-home settings unaided. PMID:22329431

  4. A universal data access and protocol integration mechanism for smart home

    Science.gov (United States)

    Shao, Pengfei; Yang, Qi; Zhang, Xuan

    2013-03-01

    With the lack of standardized or completely missing communication interfaces in home electronics, there is no perfect solution to address every aspect in smart homes based on existing protocols and technologies. In addition, the central control unit (CCU) of smart home system working point-to-point between the multiple application interfaces and the underlying hardware interfaces leads to its complicated architecture and unpleasant performance. A flexible data access and protocol integration mechanism is required. The current paper offers a universal, comprehensive data access and protocol integration mechanism for a smart home. The universal mechanism works as a middleware adapter with unified agreements of the communication interfaces and protocols, offers an abstraction of the application level from the hardware specific and decoupling the hardware interface modules from the application level. Further abstraction for the application interfaces and the underlying hardware interfaces are executed based on adaption layer to provide unified interfaces for more flexible user applications and hardware protocol integration. This new universal mechanism fundamentally changes the architecture of the smart home and in some way meets the practical requirement of smart homes more flexible and desirable.

  5. Parenting practices toward food and children's behavior: Eating away from home versus at home.

    Science.gov (United States)

    Kasparian, Michelle; Mann, Georgianna; Serrano, Elena L; Farris, Alisha R

    2017-07-01

    Parenting style influences a child's overall diet quality and establishes food preferences. Parenting style and "food rules" for children differ by eating at home or away from home. Eating meals away from home is increasing despite associations with consumption of unhealthy foods and higher weight status. The objective of the current study was to compare parenting practices and decision-making at restaurants versus at home. A mixed methods approach was utilized: facilitated, individual interviews to explore decision-making and parenting practices; written questionnaires for socio-demographic information; and body mass index. Summaries and emergent themes were generated based on examination of tapes and transcripts. Descriptive statistics were computed for questionnaire data. Twenty-five mothers of children of five to eight years who ate at restaurants at least two times per week participated. Mothers reported more permissive food rules at restaurants yet maintained higher behavioral expectations. Mothers were also more likely to make decisions about whether they eat out, where to eat, and children's meal selections than their children. The findings suggest that parenting practices toward overall behavior and food choices may differ at restaurants than at home, highlighting the importance of healthy menu options, further research, and educational strategies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Home births in the United States, 1990-2009.

    Science.gov (United States)

    MacDorman, Marian F; Mathews, T J; Declercq, Eugene

    2012-01-01

    After 14 years of decline, the percentage of home births rose by 29% from 2004 to 2009, to the point where it is at the highest level since data on this item began to be collected in 1989. The overall increase in home births was driven mostly by a 36% increase for non-Hispanic white women. About 1 out of every 90 births to non-Hispanic white women are now home births. The percentage of home births for non-Hispanic white women was three to five times higher than for any other racial or ethnic group. Home births have a lower risk profile than hospital births, with fewer births to teenagers or unmarried women, and with fewer preterm, low birthweight, and multiple births. The lower risk profile of home compared with hospital births suggests that home birth attendants are selecting low-risk women as candidates for home birth. The increase in the percentage of home births from 2004 to 2009 was widespread and involved selected states from every region of the country. The large variations in the percentage of home births by state may be influenced by differences among states in laws pertaining to births are more prevalent among non-Hispanic white women (7). midwifery practice or out-of-hospital birth (8,9), as well as by differences in the racial and ethnic composition of state populations, as home Studies have suggested that most home births are intentional or planned home births, whereas others are unintentional or unplanned, because of an emergency situation (i.e., precipitous labor, labor complications, or unable to get to the hospital in time) (3,6). Although not representative of all U.S. births (see "Data source and methods"), 87% of home births in a 26-state reporting area (comprising 50% of U.S. births) were planned in 2009. For non-Hispanic white women, 93% of home births were planned (10). Women may prefer a home birth over a hospital birth for a variety of reasons, including a desire for a low-intervention birth in a familiar environment surrounded by family

  7. Solar heating and cooling of mobile homes, Phase II. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jacobsen, A.A.

    1976-12-01

    The specific objectives of the Phase II program were: (1) through system testing, confirm the feasibility of a solar heated and cooled mobile home; (2) update system performance analysis and provide solar heating and cooling computer model verification; (3) evaluate the performance of both an absorption and a Rankine air conditioning system; (4) perform a consumer demand analysis through field survey to ascertain the acceptance of solar energy into the mobile home market; and (5) while at field locations to conduct the consumer demand analysis, gather test data from various U.S. climatic zones. Results are presented and discussed. (WHK)

  8. Technology assessment of automation trends in the modular home industry

    Science.gov (United States)

    Phil Mitchell; Robert Russell Hurst

    2009-01-01

    This report provides an assessment of technology used in manufacturing modular homes in the United States, and that used in the German prefabricated wooden home industry. It is the first step toward identifying the research needs in automation and manufacturing methods that will facilitate mass customization in the home manufacturing industry. Within the United States...

  9. "It's Like Moving the Titanic:" Community Organizing to Address Food (In)Security.

    Science.gov (United States)

    Okamoto, Kristen E

    2017-08-01

    Health communication scholars are uniquely positioned to examine the ways in which individuals organize to address current and future exigencies related to social ills. In particular, organizations are key sites in understanding our health decisions related to food choice. From a young age, children develop habits of eating that stay with them throughout their life. More specifically, food insecurity impacts childhood nutrition. Children from low-income homes experience disproportional negative health outcomes. Appalachian Ohio is an area within the United States that experiences severe poverty. In 2013, community members in a small public school district in Appalachian Ohio formed the Appalachian Nutrition Advisory Council to address the nutritional needs of students in schools. This project stories the ways in which community members creatively organized to supplement existing structures in place designed to address school nutrition and food security.

  10. Private equity ownership and nursing home financial performance.

    Science.gov (United States)

    Pradhan, Rohit; Weech-Maldonado, Robert; Harman, Jeffrey S; Laberge, Alex; Hyer, Kathryn

    2013-01-01

    Private equity has acquired multiple large nursing home chains within the last few years; by 2009, it owned nearly 1,900 nursing homes. Private equity is said to improve the financial performance of acquired facilities. However, no study has yet examined the financial performance of private equity nursing homes, ergo this study. The primary purpose of this study is to understand the financial performance of private equity nursing homes and how it compares with other investor-owned facilities. It also seeks to understand the approach favored by private equity to improve financial performance-for instance, whether they prefer to cut costs or maximize revenues or follow a mixed approach. Secondary data from Medicare cost reports, the Online Survey, Certification and Reporting, Area Resource File, and Brown University's Long-term Care Focus data set are combined to construct a longitudinal data set for the study period 2000-2007. The final sample is 2,822 observations after eliminating all not-for-profit, independent, and hospital-based facilities. Dependent financial variables consist of operating revenues and costs, operating and total margins, payer mix (census Medicare, census Medicaid, census other), and acuity index. Independent variables primarily reflect private equity ownership. The study was analyzed using ordinary least squares, gamma distribution with log link, logit with binomial family link, and logistic regression. Private equity nursing homes have higher operating margin as well as total margin; they also report higher operating revenues and costs. No significant differences in payer mix are noted. Results suggest that private equity delivers superior financial performance compared with other investor-owned nursing homes. However, causes for concern remain particularly with the long-term financial sustainability of these facilities.

  11. Children receiving chemotherapy at home: perceptions of children and parents.

    Science.gov (United States)

    Stevens, Bonnie; McKeever, Patricia; Law, Madelyn P; Booth, Marilyn; Greenberg, Mark; Daub, Stacey; Gafni, Amiram; Gammon, Janet; Yamada, Janet; Epstein, Iris

    2006-01-01

    The aim of this descriptive exploratory study was to determine the perspectives of parents and children with cancer on a home chemotherapy program. Qualitative analyses were used to organize data from 24 parents and 14 children into emerging themes. Themes included (1) financial and time costs, (2) disruption to daily routines, (3) psychological and physical effects, (4) recommendations and caveats, and (5) preference for home chemotherapy. When home chemotherapy was compared with hospital clinic-based chemotherapy, parents reported fewer financial and time costs and less disruption to their work and family schedules, and children reported more time to play/study, improved school attendance, and engagement in normal activities. Although some parents felt more secure with hospital chemotherapy, most found it more exhausting and stressful. At home, children selected places for their treatment and some experienced fewer side effects. Although some coordination/communication problems existed, the majority of parents and children preferred home chemo-therapy. Home chemotherapy treatment is a viable, acceptable, and positive health care delivery alternative from the perspective of parents and children with cancer.

  12. Violence exposure and burn-out among Turkish nursing home staff.

    Science.gov (United States)

    Mandiracioglu, Aliye; Cam, Olcay

    2006-10-01

    The aim of this study was to describe the frequency of violence against personnel from residents and to identify the prevalence of burn-out among staff working in nursing homes. The study was performed in two cities in the west of Turkey. A semi-structured questionnaire on violence and Pines' Burnout scale were distributed among all the staff working in six nursing homes, and 214 of them responded. Of the total number of respondents, 56% stated that they had been exposed to violence during the preceding year. More than 20% stated that they had reported violence to their supervisor. Less than 10% had received medical or psychological support following the event. Violent incidents were reported significantly more frequently among staff who reported problems working with elderly residents. There was no relationship between violence towards staff and burn-out. Violence is commonly experienced by care workers in nursing homes for the elderly. Strategies to improve occupational conditions in nursing homes are required.

  13. Campbell Creek Research Homes: FY2013 Annual Performance Report OCT.1, 2012 SEP. 30, 2013

    Energy Technology Data Exchange (ETDEWEB)

    Jackson, Roderick K [ORNL; Boudreaux, Philip R [ORNL; Munk, Jeffrey D [ORNL; Gehl, Anthony C [ORNL; Lyne, Christopher T [ORNL; Odukomaiya, Wale O [ORNL

    2014-05-01

    1.INTRODUCTION AND PROJECT OVERVIEW The Campbell Creek project is funded and managed by the Tennessee Valley Authority (TVA) Technology Innovation, Energy Efficiency, Power Delivery and Utilization Office. Technical support is provided under contract by the Oak Ridge National Laboratory (ORNL) and the Electric Power Research Institute (EPRI). The project was designed to determine the relative energy efficiency of typical new home construction, of retrofitting of existing homes, and of high-performance new homes built from the ground up for energy efficiency. This project was designed to compare three houses that represent current construction practices: a base case (Builder House CC1); a modified house that could represent a major energy-efficient retrofit (Retrofit House CC2); and a house constructed from the ground up to be a high-performance home (High Performance House CC3). To enable a valid comparison, it was necessary to simulate occupancy in all three houses and extensively monitor the structural components and the energy usage by component. In October 2013, the base case was also modified by replacing the builder-grade heating, ventilation, and air-conditioning (HVAC) system with a high-efficiency variable-speed unit. All three houses are two-story, slab-on-grade, framed construction. CC1 and CC2 are approximately 2,400 ft2. CC3 has a pantry option, used primarily as a mechanical equipment room, that adds approximately 100 ft2. All three houses are all-electric (with the exception of a gas log fireplace that is not used during the testing) and use air-source heat pumps for heating and cooling. The three homes are located in Knoxville in the Campbell Creek Subdivision. CC1 and CC2 are next door to each other with a south-facing orientation; CC3 has a north-facing orientation and is located across the street and a couple of houses down. The energy data collected will be used to determine the benefits of retrofit packages and high-performance new home

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

    Science.gov (United States)

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

    2017-02-01

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

  15. The Value of Home Education Including Physical Education

    Directory of Open Access Journals (Sweden)

    Iradge Ahrabi-Fard

    2017-10-01

    detailed items of children healthy growth present requirement for suitable activities to the development of skill learning. Suitably of activities matching the specification of child’s growth is crucial to their development. Expecting school with so many diverse population attend single child’s needs and direct the program to address them is an undue expectation. Home education make a difference in academic progress and proper physical growth and development of children. Being healthy and living healthy is a behavioral development to address potentials that can only be learned at home and may be strengthened at school, not the other way around.

  16. Home versus hospital birth--process and outcome.

    Science.gov (United States)

    Wax, Joseph R; Pinette, Michael G; Cartin, Angelina

    2010-02-01

    A constant small, but clinically important, number of American women choose to deliver at home. Contradictory professional and public policies reflect the polarization and politicization of the controversy surrounding this birth option. Women opting for home birth seek and often attain their goals of a nonmedicalized experience in comfortable, familiar surroundings wherein they maintain situational control. However, home deliveries in developed Western nations are often associated with excess perinatal and neonatal mortality, particularly among nonanomalous term infants. On the other hand, current home birth practices are, especially when birth attendants are highly trained and fully integrated into comprehensive health care delivery systems, associated with fewer cesareans, operative vaginal deliveries, episiotomies, infections, and third and fourth degree lacerations. Newborn benefits include less meconium staining, assisted ventilation, low birth weight, prematurity, and intensive care admissions. Existing data suggest areas of future research regarding the safety of home birth in the United States. Obstetricians & Gynecologists, Family Physicians. After completion of this educational activity, the participant should be better able to assess perinatal outcomes described in the reported literature associated with home births in developed countries, list potential advantages and disadvantages of planned home births, and identify confounders in current literature that impact our thorough knowledge of home birth outcomes.

  17. Boldness traits, not dominance, predict exploratory flight range and homing behaviour in homing pigeons.

    Science.gov (United States)

    Portugal, Steven J; Ricketts, Rhianna L; Chappell, Jackie; White, Craig R; Shepard, Emily L; Biro, Dora

    2017-08-19

    Group living has been proposed to yield benefits that enhance fitness above the level that would be achieved through living as solitary individuals. Dominance hierarchies occur commonly in these social assemblages, and result, by definition, in resources not being evenly distributed between group members. Determinants of rank within a dominance hierarchy can be associated with morphological characteristics, previous experience of the individual, or personality traits such as exploration tendencies. The purpose of this study was to investigate whether greater exploration and positive responses to novel objects in homing pigeons ( Columba livia ) measured under laboratory conditions were associated with (i) greater initial exploration of the local area around the home loft during spontaneous exploration flights (SEF), (ii) faster and more efficient homing flights when released from further afield, and (iii) whether the traits of greater exploration and more positive responses to novel objects were more likely to be exhibited by the more dominant individuals within the group. There was no relationship between laboratory-based novel object exploration and position within the dominance hierarchy. Pigeons that were neophobic under laboratory conditions did not explore the local area during SEF opportunities. When released from sites further from home, neophobic pigeons took longer routes to home compared to those birds that had not exhibited neophobic traits under laboratory conditions, and had spontaneously explored to a greater extent. The lack of exploration in the neophobic birds is likely to have resulted in the increased costs of homing following release: unfamiliarity with the landscape likely led to the greater distances travelled and less efficient routes taken. Birds that demonstrated a lack of neophobia were not the dominant individuals inside the loft, and thus would have less access to resources such as food and potentially mates. However, a lack of

  18. Byggmeister Test Home: Analysis and Initial Results of Cold Climate Wood-Framed Home Retrofit

    Energy Technology Data Exchange (ETDEWEB)

    Gates, C.

    2013-01-01

    BSC seeks to further the energy efficiency market for New England area retrofit projects by supporting projects that are based on solid building science fundamentals and verified implementation. With the high exposure of energy efficiency and retrofit terminology being used in the general media at this time, it is important to have evidence that measures being proposed will in fact benefit the homeowner through a combination of energy savings, improved durability, and occupant comfort. There are several basic areas of research to which the technical report for these test homes can be expected to contribute. These include the combination of measures that is feasible, affordable and acceptable to homeowners as well as expectations versus results. Two Byggmeister multi-family test homes in Massachusetts are examined with the goal of providing case studies that could be applied to other similar New England homes.

  19. Communication between office-based primary care providers and nurses working within patients' homes: an analysis of process data from CAPABLE.

    Science.gov (United States)

    Smith, Patrick D; Boyd, Cynthia; Bellantoni, Julia; Roth, Jill; Becker, Kathleen L; Savage, Jessica; Nkimbeng, Manka; Szanton, Sarah L

    2016-02-01

    To examine themes of communication between office-based primary care providers and nurses working in private residences; to assess which methods of communication elicit fruitful responses to nurses' concerns. Lack of effective communication between home health care nurses and primary care providers contributes to clinical errors, inefficient care delivery and decreased patient safety. Few studies have described best practices related to frequency, methods and reasons for communication between community-based nurses and primary care providers. Secondary analysis of process data from 'Community Aging in Place: Advancing Better Living for Elders (CAPABLE)'. Independent reviewers analysed nurse documentation of communication (phone calls, letters and client coaching) initiated for 70 patients and analysed 45 letters to primary care providers to identify common concerns and recommendations raised by CAPABLE nurses. Primary care providers responded to 86% of phone calls, 56% of letters and 50% of client coaching efforts. Primary care providers addressed 86% of concerns communicated by phone, 34% of concerns communicated by letter and 41% of client-raised concerns. Nurses' letters addressed five key concerns: medication safety, pain, change in activities of daily living, fall safety and mental health. In letters, CAPABLE nurses recommended 58 interventions: medication change; referral to a specialist; patient education; and further diagnostic evaluation. Effective communication between home-based nurses and primary care providers enhances care coordination and improves outcomes for home-dwelling elders. Various methods of contact show promise for addressing specific communication needs. Nurses practicing within patients' homes can improve care coordination by using phone calls to address minor matters and written letters for detailed communication. Future research should explore implementation of Situation, Background, Assessment and Recommendation in home care to promote

  20. Memory Management of Multimedia Services in Smart Homes

    Science.gov (United States)

    Kamel, Ibrahim; Muhaureq, Sanaa A.

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

  1. Assessment of Anxiety in Older Home Care Recipients

    Science.gov (United States)

    Diefenbach, Gretchen J.; Tolin, David F.; Meunier, Suzanne A.; Gilliam, Christina M.

    2009-01-01

    Purpose: This study determined the psychometric properties of a variety of anxiety measures administered to older adults receiving home care services. Design and Methods: Data were collected from 66 adults aged 65 years and older who were receiving home care services. Participants completed self-report and clinician-rated measures of anxiety and…

  2. The role of cognitive stimulation at home in low-income preschoolers' nutrition, physical activity and body mass index.

    Science.gov (United States)

    den Bosch, Saskia Op; Duch, Helena

    2017-08-01

    Early childhood obesity disproportionately affects children of low socioeconomic status. Children attending Head Start are reported to have an obesity rate of 17.9%.This longitudinal study aimed to understand the relationship between cognitive stimulation at home and intake of junk food, physical activity and body size, for a nationally representative sample of 3- and 4-year old children entering Head Start. We used The Family and Child Experiences Survey 2006. Cognitive stimulation at home was measured for 1905 children at preschool entry using items from the Home Observation Measurement of the Environment Short Form. Junk food consumption and physical activity were obtained from parent interviews at kindergarten entry. BMI z scores were based on CDC national standards. We analyzed the association between early cognitive stimulation and junk food consumption, physical activity and BMI, using multinomial and binary logistic regression on a weighted sample. Children who received moderate levels of cognitive stimulation at home had a 1.5 increase in the likelihood of consuming low amounts of junk food compared to children from low cognitive stimulation environments. Children who received moderate and high levels of cognitive stimulation were two and three times, respectively, more likely to be physically active than those in low cognitive stimulation homes. No direct relationship was identified between cognitive stimulation and BMI. Prevention and treatment efforts to address early childhood obesity may consider strategies that support parents in providing cognitively stimulating home environments. Existing evidence-based programs can guide intervention in pediatric primary care.

  3. Self-Report Measures of the Home Learning Environment in Large Scale Research: Measurement Properties and Associations with Key Developmental Outcomes

    Science.gov (United States)

    Niklas, Frank; Nguyen, Cuc; Cloney, Daniel S.; Tayler, Collette; Adams, Raymond

    2016-01-01

    Favourable home learning environments (HLEs) support children's literacy, numeracy and social development. In large-scale research, HLE is typically measured by self-report survey, but there is little consistency between studies and many different items and latent constructs are observed. Little is known about the stability of these items and…

  4. Evaluation of musculoskeletal pain management practices in rural nursing homes compared with evidence-based criteria.

    Science.gov (United States)

    Decker, Sheila A; Culp, Kennith R; Cacchione, Pamela Z

    2009-06-01

    Chronic pain, mainly associated with musculoskeletal diagnoses, is inadequately and often inappropriately treated in nursing home residents. The purpose of this descriptive study is to identify the musculoskeletal diagnoses associated with pain and to compare pain management of a sample of nursing home residents with the 1998 evidence-based guideline proposed by the American Geriatrics Society (AGS). The sample consists of 215 residents from 13 rural Iowa nursing home homes. The residents answered a series of face-to-face questions that addressed the presence/absence of pain and completed the Mini Mental State Examination (MMSE). Data on pain were abstracted from the Minimum Data Set (MDS). Analyses included descriptive statistics, cross tabulations, and one-way analysis of variance. Residents' responses to the face-to-face pain questions yielded higher rates of pain compared with the MDS pain data. Resident records showed that acetaminophen was the most frequently administered analgesic medication (30.9%). Propoxyphene, not an AGS-recommended opioid, was also prescribed for 23 residents (10.7%). Of the 70 residents (32.6%) expressing daily pain, 23 (32.9%) received no scheduled or pro re nata analgesics. There was no significant difference between MMSE scores and number of scheduled analgesics. Additionally, residents' self-reported use of topical agents was not documented in the charts. The findings suggest that the 1998 AGS evidence-based guideline for the management of chronic pain is inconsistently implemented.

  5. Named data networking-based smart home

    OpenAIRE

    Syed Hassan Ahmed; Dongkyun Kim

    2016-01-01

    Named data networking (NDN) treats content/data as a “first class citizen” of the network by giving it a “name”. This content “name” is used to retrieve any information, unlike in device-centric networks (i.e., the current Internet), which depend on physical IP addresses. Meanwhile, the smart home concept has been gaining attention in academia and industries; various low-cost embedded devices are considered that can sense, process, store, and communicate data autonomously. In this paper, we s...

  6. Brief scales to assess physical activity and sedentary equipment in the home

    Directory of Open Access Journals (Sweden)

    Durant Nefertiti

    2010-01-01

    Full Text Available Abstract Background Sedentary behaviors such as TV viewing are associated with childhood obesity, while physical activity promotes healthy weight. The role of the home environment in shaping these behaviors among youth is poorly understood. The study purpose was to examine the reliability of brief parental proxy-report and adolescent self-report measures of electronic equipment and physical activity equipment in the home and to assess the construct validity of these scales by examining their relationship to physical activity, sedentary behavior, and weight status of children and adolescents. Methods Participants were adolescents (n = 189; mean age = 14.6, parents of adolescents (n = 171; mean age = 45.0, and parents of younger children (n = 116; parents mean age = 39.6; children's mean age = 8.3 who completed two surveys approximately one month apart. Measures included a 21-item electronic equipment scale (to assess sedentary behavior facilitators in the home, in the child or adolescent's bedroom, and portable electronics and a 14-item home physical activity equipment scale. Home environment factors were examined as correlates of children's and adolescents' physical activity, sedentary behavior, and weight status after adjusting for child age, sex, race/ethnicity, household income, and number of children in the home. Results Most scales had acceptable test-retest reliability (intraclass correlations were .54 - .92. Parent and adolescent reports were correlated. Electronic equipment in adolescents' bedrooms was positively related to sedentary behavior. Activity equipment in the home was inversely associated with television time in adolescents and children, and positively correlated with adolescents' physical activity. Children's BMI z-score was positively associated with having a television in their bedroom. Conclusions The measures of home electronic equipment and activity equipment were similarly reliable when reported by parents and by

  7. Leadership, staffing and quality of care in nursing homes

    Science.gov (United States)

    2011-01-01

    Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is

  8. Leadership, staffing and quality of care in nursing homes

    Directory of Open Access Journals (Sweden)

    Havig Anders

    2011-11-01

    Full Text Available Abstract Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78. Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses

  9. Smart Home Dashboard. The intelligent energy management; Smart Home Dashboard. Das intelligente Energiemanagement

    Energy Technology Data Exchange (ETDEWEB)

    Stopczynski, Martin; Ghiglieri, Marco [Technische Univ. Darmstadt (Germany). Fachgebiet Sicherheit in der Informationstechnik

    2012-07-01

    Due to an increasingly smarter environment, however smart home components are used in households. A variety of household appliances can be monitored and controlled by smart plugs. An advantage of this development is the individual investigation of devices in terms of individual power consumption. However, the usability of the end user side also increases proportional to the number of existing devices. A possible access of external market participants is not currently implemented without major security problems. The authors of the contribution under consideration report on the Smart Home Dashboard, which provides a comprehensive power management. The smart home dashboard is intuitively operable and meets current safety standards. The aim of this paper is: (1) Adjustment of the handling of the recorded data to the current privacy policy; (2) Enforcement of the privacy of the end user by means of the implementation of smart grid protection objectives; (3) Providing a secure access for remote participants.

  10. What Type of Knowledge Provides Valid Housing Standards Addressing Accessibility?

    DEFF Research Database (Denmark)

    Helle, Tina; Brandt, Åse; Iwarsson, Susanne

    evaluations of task-surface heights in elderly people’s homes. Applied Ergonomics, 31, 109-119. Kohlbacher, F. (2006). The use of qualitative content analysis in case study research. Forum: Qualitative social research sozialforschung (FQS), Open Journal Systems, vol 7, No1. Kozey, J.W. & Das, B. (2004...... accessibility aspects such as either reach, seat height or space requirements • Targeted primarily industrial workstation design and only wheelchair/scooter users • Addressed positions (standing/seated) and sex difference with respect to reach • Was generated in lab-like environments, using methods...... of the validity of housing standards. Therefore, it is reasonable to question what type of knowledge that provides the most valid standards addressing accessibility and explore the consequences of using an alternative approach. The idea was thus to examine the validity of a set of housing standards using a so...

  11. Higher prices, higher quality? Evidence from German nursing homes

    OpenAIRE

    Herr, Annika; Hottenrott, Hanna

    2016-01-01

    Objectives: This study investigates the relationship between prices and quality of 7,400 German nursing homes controlling for income, nursing home density, demographics, labour market characteristics, and infrastructure at the regional level. Method: We use a cross section of public quality reports for all German nursing homes, which had been evaluated between 2010 and 2013 by external institutions. Our analysis is based on multivariate regressions in a two stage least squares framework, wher...

  12. Cooperating with a palliative home-care team

    DEFF Research Database (Denmark)

    Goldschmidt, Dorthe; Groenvold, Mogens; Johnsen, Anna Thit

    2005-01-01

    BACKGROUND: Palliative home-care teams often cooperate with general practitioners (GPs) and district nurses. Our aim was to evaluate a palliative home-care team from the viewpoint of GPs and district nurses. METHODS: GPs and district nurses received questionnaires at the start of home-care and one...... month later. Questions focussed on benefits to patients, training issues for professionals and cooperation between the home-care team and the GP/ district nurse. A combination of closed- and open-ended questions was used. RESULTS: Response rate was 84% (467/553). Benefits to patients were experienced...... by 91 %, mainly due to improvement in symptom management, 'security', and accessibility of specialists in palliative care. After one month, 57% of the participants reported to have learnt aspects of palliative care, primarily symptom control, and 89% of them found cooperation satisfactory...

  13. Work-Related Stressors Among Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Home Visitors: A Qualitative Study.

    Science.gov (United States)

    Alitz, Paige J; Geary, Shana; Birriel, Pamela C; Sayi, Takudzwa; Ramakrishnan, Rema; Balogun, Omotola; Salloum, Alison; Marshall, Jennifer T

    2018-05-31

    Background The Florida Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program delivers evidence-based home visiting services to over 1400 families each year. Home visitors are integral in providing resources for families to promote healthy pregnancy, child development, family wellness, and self-sufficiency. Due to the nature of this work, home visitors experience work-related pressures and stressors that can impact staff well-being and retention. Objectives The purpose of this study was to understand primary sources of work-related stress experienced by home visitors, subsequent effects on their engagement with program participants, and to learn of coping mechanisms used to manage stress. Methods In 2015, Florida MIECHV program evaluators conducted ten focus groups with 49 home visitors during which they ranked and discussed their top sources of work-related stress. Qualitative analysis was conducted to identify emergent themes in work-related stressors and coping/supports. Results Across all sites, the burden of paperwork and data entry were the highest ranked work-related stressors perceived as interfering with home visitors' engagement with participants. The second-highest ranked stressors included caseload management, followed by a lack of resources for families, and dangerous environments. Home visitors reported gratification in their helping relationships families, and relied on coworkers or supervisors as primary sources of workplace support along with self-care (e.g. mini-vacations, recreation, and counseling). Conclusions for practice Florida MIECHV home visitors across all ten focus groups shared similar work-related stressors that they felt diminished engagement with program participants and could impact participant and staff retention. In response, Florida MIECHV increased resources to support home visitor compensation and reduce caseloads, and obtained a competitive award from HRSA to implement a mindfulness-based stress reduction

  14. Factors associated with smoke-free homes in NSW: results from the 1998 NSW Health Survey.

    Science.gov (United States)

    Merom, D; Rissel, C

    2001-08-01

    To examine the sociodemographic characteristics associated with smoke-free homes (SFHs) in NSW and specify high-risk groups with a low prevalence of household smoking restrictions. Data were drawn from the 1998 NSW Health Survey, a computer-assisted telephone interview survey of 17,494 randomly selected respondents aged > or = 16 years across NSW (response rate = 70%). Logistic regression analyses, stratified by smoking status, were used. Overall, 72% of adults reported having a SFH; 87% of never-smokers, 81% of ex- and 35% of current smokers. The highest percentages of SFHs were reported in households with young children (78%) and with older children (72%) or with adults only (72%). For smokers, SFHs were independently associated with the presence of young children (OR=3.8, 95% CI 3.1-4.7) compared with those who lived alone, but the odds of living in a SFH were only slightly increased for smokers living with older children (aged 6-15) and for those living with adults only (OR=1.9, OR=1.8 respectively). Speaking a language other than English at home, having more than 10 years' education, and being homes have restrictions on smoking inside, but more than half the households with children and at least one smoker adult are not smoke free. Interventions to shape parents' smoking behaviour around older children are warranted. Strategies need to address never-smokers in communities with high prevalence of smoking and adults with lower levels of education. A continued commitment to workplace smoking bans is important as they may affect household smoking restrictions.

  15. Composting Begins at Home.

    Science.gov (United States)

    Dreckman, George P.

    1994-01-01

    Reports the results of a year-long home composting pilot program run by the city of Madison, Wisconsin. The study was designed to gather data on the amount and type of materials composted by 300 volunteer households and to determine the feasibility of a full-scale program. (LZ)

  16. Home Performance with ENERGY STAR: Utility Bill Analysis on Homes Participating in Austin Energy's Program

    Energy Technology Data Exchange (ETDEWEB)

    Belzer, D.; Mosey, G.; Plympton, P.; Dagher, L.

    2007-07-01

    Home Performance with ENERGY STAR (HPwES) is a jointly managed program of the U.S. Department of Energy (DOE) and the U.S. Environmental Protection Agency (EPA). This program focuses on improving energy efficiency in existing homes via a whole-house approach to assessing and improving a home's energy performance, and helping to protect the environment. As one of HPwES's local sponsors, Austin Energy's HPwES program offers a complete home energy analysis and a list of recommendations for efficiency improvements, along with cost estimates. To determine the benefits of this program, the National Renewable Energy Laboratory (NREL) collaborated with the Pacific Northwest National Laboratory (PNNL) to conduct a statistical analysis using energy consumption data of HPwES homes provided by Austin Energy. This report provides preliminary estimates of average savings per home from the HPwES Loan Program for the period 1998 through 2006. The results from this preliminary analysis suggest that the HPwES program sponsored by Austin Energy had a very significant impact on reducing average cooling electricity for participating households. Overall, average savings were in the range of 25%-35%, and appear to be robust under various criteria for the number of households included in the analysis.

  17. Practices of depression care in home health care: Home health clinician perspectives

    Science.gov (United States)

    Bao, Yuhua; Eggman, Ashley A.; Richardson, Joshua E.; Sheeran, Thomas; Bruce, Martha L.

    2015-01-01

    Objective To assess any gaps between published best practices and real-world practices of treating depression in home health care (HHC), and barriers to closing any gaps. Methods A qualitative study based on semi-structured interviews with HHC nurses and administrators from five home health agencies in five states (n=20). Audio-recorded interviews were transcribed and analyzed by a multi-disciplinary team using grounded theory method to identify themes. Results Routine home health nursing care overlapped with all functional areas of depression care. However, there were reported gaps between best practices and real-world practices. Gaps were associated with perceived scope of practice by HHC nurses, knowledge gaps and low self-efficacy in depression treatment, stigma attached to depression, poor quality of antidepressant management in primary care, and poor communication between HHC and primary care. Conclusions Strategies to close gaps between typical and best practices need to enhance HHC clinician knowledge and self-efficacy with depression treatment and improve the quality of antidepressant management and communication with primary care. PMID:26423098

  18. Pregnancy and Village Outreach Tibet: a descriptive report of a community- and home-based maternal-newborn outreach program in rural Tibet.

    Science.gov (United States)

    Dickerson, Ty; Crookston, Benjamin; Simonsen, Sara E; Sheng, Xiaoming; Samen, Arlene; Nkoy, Flory

    2010-01-01

    The Pregnancy and Village Outreach Tibet (PAVOT) program, a model for community- and home-based maternal-newborn outreach in rural Tibet, is presented. This article describes PAVOT, including the history, structure, content, and activities of the program, as well as selected program outcome measures and demographic characteristics, health behaviors, and pregnancy outcomes of women who recently participated in the program. The PAVOT program was developed to provide health-related services to pregnant rural Tibetan women at risk of having an unattended home birth. The program involves training local healthcare workers and laypersons to outreach pregnant women and family members. Outreach includes basic maternal-newborn health education and simple obstetric and neonatal life-saving skills training. In addition, the program distributes safe and clean birth kits, newborn hats, blankets, and maternal micronutrient supplements (eg, prenatal vitamins and minerals). More than 980 pregnant women received outreach during the study period. More than 92% of outreach recipients reported receiving safe pregnancy and birth education, clean birthing and uterine massage skills instruction, and clean umbilical cord care training. Nearly 80% reported basic newborn resuscitation skills training. Finally, nearly 100% of outreach recipients received maternal micronutrient supplements and safe and clean birth kits. The PAVOT program is a model program that has been proven to successfully provide outreach to rural-living Tibetans by delivering maternal-newborn health education, skills training, and resources to the home.

  19. Marketing energy conservation options to Northwest manufactured home buyers. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Hendrickson, P.L.; Mohler, B.L.; Taylor, Z.T.; Lee, A.D.; Onisko, S.A.

    1985-10-01

    Manufactured, or HUD-Code, homes comprise a growing share of the housing stock in the Northwest, as well as nationally. Their relatively low cost has made them especially attractive to lower income families, first-time home-buyers, and retired persons. The characteristics of manufactured home (MH) buyers, the unique energy consumption characteristics of the homes, and their increasing market share make this market an especially critical one for energy consumption and conservation planning in the Northwest. This study relies on extensive, existing survey data and new analyses to develop information that can potentially assist the design of a marketing plan to achieve energy conservation in new manufactured homes. This study has the objective of assisting BPA in the development of a regional approach in which numerous organizations and parties would participate to achieve conservation in new manufactured homes. A previous survey and information collected for this study from regional dealers and manufacturers provide an indication of the energy conservation options being sold to manufactured home buyers in the PNW. Manufacturers in the Northwest appear to sell homes that usually exceed the HUD thermal requirements. Manufacturers typically offer efficiency improvements in packages that include fixed improvements in insulation levels, glazing, and infiltration control. Wholesale costs of these packages range from about $100 to $1500. Typical packages include significant upgrades in floor insulation values with modest upgrades in ceilings and walls. This study identifies trends and impacts that a marketing plan should consider to adequately address the financial concerns of manufactured home buyers.

  20. Prospects for rebuilding primary care using the patient-centered medical home.

    Science.gov (United States)

    Landon, Bruce E; Gill, James M; Antonelli, Richard C; Rich, Eugene C

    2010-05-01

    Existing research suggests that models of enhanced primary care lead to health care systems with better performance. What the research does not show is whether such an approach is feasible or likely to be effective within the U.S. health care system. Many commentators have adopted the model of the patient-centered medical home as policy shorthand to address the reinvention of primary care in the United States. We analyze potential barriers to implementing the medical home model for policy makers and practitioners. Among others, these include developing new payment models, as well as the need for up-front funding to assemble the personnel and infrastructure required by an enhanced non-visit-based primary care practice and methods to facilitate transformation of existing practices to functioning medical homes.

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

    Science.gov (United States)

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

    2013-10-01

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

  2. Wellness protocol for smart homes an integrated framework for ambient assisted living

    CERN Document Server

    Ghayvat, Hemant

    2017-01-01

    This book focuses on the development of wellness protocols for smart home monitoring, aiming to forecast the wellness of individuals living in ambient assisted living (AAL) environments. It describes in detail the design and implementation of heterogeneous wireless sensors and networks as applied to data mining and machine learning, which the protocols are based on. Further, it shows how these sensor and actuator nodes are deployed in the home environment, generating real-time data on object usage and other movements inside the home, and therefore demonstrates that the protocols have proven to offer a reliable, efficient, flexible, and economical solution for smart home systems. Documenting the approach from sensor to decision making and information generation, the book addresses various issues concerning interference mitigation, errors, security and large data handling. As such, it offers a valuable resource for researchers, students and practitioners interested in interdisciplinary studies at the intersecti...

  3. Home Water Treatment Habits and Effectiveness in a Rural Arizona Community.

    Science.gov (United States)

    Lothrop, Nathan; Wilkinson, Sarah T; Verhougstraete, Marc; Sugeng, Anastasia; Loh, Miranda M; Klimecki, Walter; Beamer, Paloma I

    Drinking water quality in the United States (US) is among the safest in the world. However, many residents, often in rural areas, rely on unregulated private wells or small municipal utilities for water needs. These utilities may violate the Safe Drinking Water Act contaminant guidelines, often because they lack the required financial resources. Residents may use alternative water sources or install a home water treatment system. Despite increased home water treatment adoption, few studies have examined their use and effectiveness in the US. Our study addresses this knowledge gap by examining home water treatment in a rural Arizona community. Water samples were analyzed for metal(loid)s, and home treatment and demographic data were recorded in 31 homes. Approximately 42% of homes treated their water. Independent of source water quality, residents with higher income (OR = 1.25; 95%CI (1.00 - 1.64)) and education levels (OR = 1.49; 95%CI (1.12 - 2.12)) were more likely to treat their water. Some contaminant concentrations were effectively reduced with treatment, while some were not. We conclude that increased educational outreach on contaminant testing and treatment, especially to rural areas with endemic water contamination, would result in a greater public health impact while reducing rural health disparities.

  4. Does Working from Home Work? Evidence from a Chinese Experiment

    OpenAIRE

    Nicholas Bloom; James Liang; John Roberts; Zhichun Jenny Ying

    2013-01-01

    A rising share of employees now regularly engage in working from home (WFH), but there are concerns this can lead to "shirking from home". We report the results of a WFH experiment at Ctrip, a 16,000-employee, NASDAQ-listed Chinese travel agency. Call center employees who volunteered to WFH were randomly assigned either to work from home or in the office for nine months. Home working led to a 13% performance increase, of which 9% was from working more minutes per shift (fewer breaks and sick ...

  5. Learning situation models in a smart home.

    Science.gov (United States)

    Brdiczka, Oliver; Crowley, James L; Reignier, Patrick

    2009-02-01

    This paper addresses the problem of learning situation models for providing context-aware services. Context for modeling human behavior in a smart environment is represented by a situation model describing environment, users, and their activities. A framework for acquiring and evolving different layers of a situation model in a smart environment is proposed. Different learning methods are presented as part of this framework: role detection per entity, unsupervised extraction of situations from multimodal data, supervised learning of situation representations, and evolution of a predefined situation model with feedback. The situation model serves as frame and support for the different methods, permitting to stay in an intuitive declarative framework. The proposed methods have been integrated into a whole system for smart home environment. The implementation is detailed, and two evaluations are conducted in the smart home environment. The obtained results validate the proposed approach.

  6. 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.

  7. Evaluation of Cellular Shades in the PNNL Lab Homes

    Energy Technology Data Exchange (ETDEWEB)

    Petersen, Joseph M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sullivan, Greg [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Cort, Katherine A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Metzger, Cheryn E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Merzouk, Massine [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-11-01

    This report examines the energy performance of cellular shade window coverings in a matched pair of all-electric, factory-built “Lab Homes” located on the Pacific Northwest National Laboratory (PNNL) campus in Richland, Washington. The 1500-square-foot homes were identical in construction and baseline performance, which allowed any difference in energy and thermal performance between the baseline home and the experimental home to be attributed to the retrofit technology installed in the experimental home. To assess the performance of high efficiency window attachments in a residential retrofit application, the building shell air leakage, energy use, and interior temperatures of each home were compared during the 2015 -2016 winter heating and summer cooling seasons. Hunter Douglas Duette® Architella® Trielle™ opaque honeycomb “cellular” shades were installed over double-pane clear-glass, aluminum-frame primary windows in the experimental home and were compared to identical primary windows with no window coverings and with standard typical white vinyl horizontal blind window coverings in the baseline home.

  8. The Hospital at Home program: no place like home.

    Science.gov (United States)

    Lippert, M; Semmens, S; Tacey, L; Rent, T; Defoe, K; Bucsis, M; Shykula, T; Crysdale, J; Lewis, V; Strother, D; Lafay-Cousin, L

    2017-02-01

    The treatment of children with cancer is associated with significant burden for the entire family. Frequent clinic visits and extended hospital stays can negatively affect quality of life for children and their families. Here, we describe the development of a Hospital at Home program (H@H) that delivers therapy to pediatric hematology, oncology, and blood and marrow transplant (bmt) patients in their homes. The services provided include short infusions of chemotherapy, supportive-care interventions, antibiotics, post-chemotherapy hydration, and teaching. From 2013 to 2015, the H@H program served 136 patients, making 1701 home visits, for patients mainly between the ages of 1 and 4 years. Referrals came from oncology in 82% of cases, from hematology in 11%, and from bmt in 7%. Since inception of the program, no adverse events have been reported. Family surveys suggested less disruption in daily routines and appreciation of specialized care by hematology and oncology nurses. Staff surveys highlighted a perceived benefit of H@H in contributing to early discharge of patients by supporting out-of-hospital monitoring and teaching. The development of a H@H program dedicated to the pediatric hematology, oncology, or bmt patient appears feasible. Our pilot program offers a potential contribution to improvement in patient quality of life and in cost-benefit for parents and the health care system.

  9. Report: Studies Addressing EPA’s Organizational Structure

    Science.gov (United States)

    Report #2006-P-00029, August 16, 2006. The 13 studies, articles, publications, and reports we reviewed identified issues with cross-media management, regional offices, reliable information, and reliable science.

  10. The role of Aboriginal family workers in delivering a child safety focused home visiting program for Aboriginal families in an urban region of NSW.

    Science.gov (United States)

    Clapham, Kathleen; Bennett-Brook, Keziah; Hunter, Kate

    2018-05-09

    Aboriginal Australian children experience higher rates of injury than other Australian children. However few culturally acceptable programs have been developed or evaluated. The Illawarra Aboriginal Medical Service (IAMS) developed the Safe Homes Safe Kids program as an injury prevention program targeting disadvantaged Aboriginal families with children aged 0-5 in an urban region of NSW. Delivered by Aboriginal Family Workers the program aims to reduce childhood injury by raising awareness of safety in the home. A program evaluation was conducted to determine the effectiveness of the home visiting model as an injury prevention program. This paper reports on the qualitative interviews which explored the ways in which clients, IAMS staff, and external service providers experienced the program and assessed its delivery by the Aboriginal Family Workers. A qualitative program evaluation was conducted between January 2014 and June 2015. We report here on the semi-structured interviews undertaken with 34 individuals. The results show increased client engagement in the program; improved child safety knowledge and skills; increased access to services; improved attitudes to home and community safety; and changes in the home safety environment. Safe Homes Safe Kids provides a culturally appropriate child safety program delivered by Aboriginal Family Workers to vulnerable families. Clients, IAMS staff, and external service were satisfied with the family workers' delivery of the program and the holistic model of service provision. SO WHAT?: This promising program could be replicated in other Aboriginal health services to address unintentional injury to vulnerable Aboriginal children. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Living in cold homes after heating improvements: Evidence from Warm-Front, England's Home Energy Efficiency Scheme

    International Nuclear Information System (INIS)

    Critchley, Roger; Gilbertson, Jan; Grimsley, Michael; Green, Geoff

    2007-01-01

    Objective: To investigate explanatory factors for persistent cold temperatures in homes which have received heating improvements. Design: Analysis of data from a national survey of dwellings and households (in England occupied by low-income residents) that had received heating improvements or repairs under the Warm Front Scheme. Methods: Over the winters of 2001-02 and 2002-03, householders recorded living room and main bedroom temperatures in a diary. Entries were examined for 888 households, which had received high level heating interventions. Two hundred and twenty-two households were identified as occupying cold homes, with mean bedroom temperature below 16 deg. C or mean living room temperatures below 18 deg. C. Binary logistic regression was used to model dwelling and household features and then occupants' behaviour and attitudes in the 'cold homes' sub-set compared with the remainder of the high intervention group. Seventy-nine supplementary, structured telephone interviews explored reasons given for lower temperatures. Using graphical and tabular methods, householders preferring cooler homes were distinguished from those who felt constrained in some way. Results: Cold homes predominate in pre-1930 properties where the householder remains dissatisfied with the heating system despite major improvements funded by Warm Front. Residents of cold homes are less likely to have long-standing illness or disability, but more likely to experience anxiety or depression. A small sample of telephone interviews reveals those preferring lower temperatures for health or other reasons, report less anxiety and depression than those with limited control over their home environment. Their 'thermal resistance' to higher temperatures challenges orthodox definitions of comfort and fuel poverty

  12. 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.

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

    Science.gov (United States)

    Pedlar, David; Walker, John

    2004-01-01

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

  14. User interaction concepts in smart caring homes for elderly with chronic conditions

    NARCIS (Netherlands)

    Bara, C.-D.; Cabrita, M.; op den Akker, Harm; Hermens, Hermanus J.

    2015-01-01

    This article addresses the design and implementation of user interaction concepts for smart caring homes. Elderly suffering from age related frailty or chronic diseases, such as chronic obstructive pulmonary disease and mild dementia are the targeted primary users. Their informal and formal

  15. Homing oneself

    DEFF Research Database (Denmark)

    Winther, Ida Wentzel

    2009-01-01

    What is home? A building, a physical and mental phenomenon, or a concept?  There are many homes and ways `to home oneself´. Many of us quite often dwell in other places than at home (as professional commuters between two places, as travellers staying in hotels, as children of divorced parents...

  16. Bringing work home: the emotional experiences of mothers and fathers.

    Science.gov (United States)

    Matjasko, Jennifer L; Feldman, Amy F

    2006-03-01

    Given the salience of work in our society, this study investigated how intrinsic work motivation, work hours, and taking time for self influenced the interplay between the emotional climates of work and home. The authors examined day-to-day emotional transmission between work and home (spillover) for 143 families using the experience sampling method and interview data from the Sloan Center's 500 Family Study (L. J. Waite & B. Schneider, 1997). Intrinsic work motivation, work hours, and taking time for self were used as predictors of spillover. There was evidence of emotional transmission from work to home for mothers' happiness, anger, and anxiety as well as for father's anxiety. Also, fathers scoring higher on intrinsic work motivation tended to report greater overall anxiety at home after the workday. Anxiety from work was less likely to spill over to the home when fathers reported working longer hours. These findings have practice implications for improving worker productivity and the well-being of two-working-parent families. Copyright 2006 APA, all rights reserved.

  17. 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

  18. Family and home characteristics correlate with mold in homes.

    Science.gov (United States)

    Reponen, Tiina; Levin, Linda; Zheng, Shu; Vesper, Stephen; Ryan, Patrick; Grinshpun, Sergey A; LeMasters, Grace

    2013-07-01

    Previously, we demonstrated that infants residing in homes with higher Environmental Relative Moldiness Index were at greater risk for developing asthma by age seven. The purpose of this analysis was to identify the family and home characteristics associated with higher moldiness index values in infants' homes at age one. Univariate linear regression of each characteristic determined that family factors associated with moldiness index were race and income. Home characteristics associated with the moldiness index values were: air conditioning, carpet, age of the home, season of home assessment, and house dust mite allergen. Parental history of asthma, use of dehumidifier, visible mold, dog and cat allergen levels were not associated with moldiness index. Results of multiple linear regression showed that older homes had 2.9 units higher moldiness index (95% confidence interval [CI]=0.4, 5.4), whereas homes with central air conditioning had 2.5 units lower moldiness index (95% CI=-4.7, -0.4). In addition, higher dust mite allergen levels and carpeting were positively and negatively associated with higher moldiness index, respectively. Because older homes and lack of air conditioning were also correlated with race and lower income, whereas carpeting was associated with newer homes, the multivariate analyses suggests that lower overall socioeconomic position is associated with higher moldiness index values. This may lead to increased asthma risk in homes inhabited by susceptible, vulnerable population subgroups. Further, age of the home was a surrogate of income, race and carpeting in our population; thus the use of these factors should carefully be evaluated in future studies. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Exploring the Potential of a Wearable Camera to Examine the Early Obesogenic Home Environment: Comparison of SenseCam Images to the Home Environment Interview

    NARCIS (Netherlands)

    Schrempft, S.; Jaarsveld, C.H.M. van; Fisher, A.

    2017-01-01

    BACKGROUND: The obesogenic home environment is usually examined via self-report, and objective measures are required. OBJECTIVE: This study explored whether the wearable camera SenseCam can be used to examine the early obesogenic home environment and whether it is useful for validation of

  20. Solar home systems in Nepal

    Energy Technology Data Exchange (ETDEWEB)

    Henryson, Jessica; Haakansson, Teresa

    1999-04-01

    Photovoltaic (PV) technology is a clean and environmentally friendly technology that does not require any fuels. The high reliability of operation and little need for maintenance makes it ideally suited for rural areas. Today PV systems are used in Nepal to power telecommunications centres, navigational aids, in pumping systems for irrigation and drinking water, and for household electrification. A solar home system consists of a PV module, a battery, a charge controller and 3-4 fluorescent light bulbs with fixture. The system provides power for lighting and operation of household appliances for several hours. The success of donor supported programs have shown that solar home systems can be a practical solution for many rural households. In 1996 the Government of Nepal launched a subsidy program for solar home systems, which dramatically has increased the demand for solar home systems among rural customers. This report includes a survey of 52 households with solar home systems in two villages. The field-study shows that the villagers are very happy with their systems and the technical performance of the systems in both villages is satisfactory. The study also shows the positive impact electricity has on education, health, income generation and quality of life. The beneficiaries of introducing electricity in remote areas are the children and the women 39 refs, 18 tabs. Examination paper

  1. Making a Home for Social Media

    DEFF Research Database (Denmark)

    Heyer, Clint; Shklovski, Irina; Gorm Jensen, Nanna

    2013-01-01

    In this paper we report on the design and implementation of an initial prototype to explore how to better situate in the home social media content individually generated by family members. We considered whether existing infrastructure and practices of social media might be leveraged to offer new...... of sharing and disclosure based on pre-existing practices and attitudes toward social technologies. The study demonstrated that there are productive design opportunities in home systems that can leverage content via a broad range of social media applications....

  2. Pilot Residential Deep Energy Retrofits and the PNNL Lab Homes

    Energy Technology Data Exchange (ETDEWEB)

    Widder, Sarah H.; Chandra, Subrato; Parker, Graham B.; Sande, Susan; Blanchard, Jeremy; Stroer, Dennis; McIlvaine, Janet; Chasar, David; Beal, David; Sutherland, Karen

    2012-01-01

    This report summarizes research investigating the technical and economic feasibility of several pilot deep energy retrofits, or retrofits that save 30% to 50% or more on a whole-house basis while increasing comfort, durability, combustion safety, and indoor air quality. The work is being conducted for the U.S. Department of Energy Building Technologies Program as part of the Building America Program. As part of the overall program, Pacific Northwest National Laboratory (PNNL) researchers are collecting and analyzing a comprehensive dataset that describes pre- and post-retrofit energy consumption, retrofit measure cost, health and comfort impacts, and other pertinent information for each home participating in the study. The research and data collection protocol includes recruitment of candidate residences, a thorough test-in audit, home energy modeling, and generation of retrofit measure recommendations, implementation of the measures, test-out, and continued evaluation. On some homes, more detailed data will be collected to disaggregate energy-consumption information. This multi-year effort began in October 2010. To date, the PNNL team has performed test-in audits on 51 homes in the marine, cold, and hot-humid climate zones, and completed 3 retrofits in Texas, 10 in Florida, and 2 in the Pacific Northwest. Two of the retrofits are anticipated to save 50% or more in energy bills and the others - savings are in the 30% to 40% range. Fourteen other retrofits are under way in the three climate zones. Metering equipment has been installed in seven of these retrofits - three in Texas, three in Florida, and one in the Pacific Northwest. This report is an interim update, providing information on the research protocol and status of the PNNL deep energy retrofit project as of December, 2011. The report also presents key findings and lessons learned, based on the body of work to date. In addition, the report summarizes the status of the PNNL Lab Homes that are new

  3. Palliative care in home care: perceptions of occupational therapists

    Directory of Open Access Journals (Sweden)

    Séfora Gomez Portela

    2015-03-01

    Full Text Available This research aimed at understanding and reflecting on the perceptions of occupational therapists regarding the implementation of palliative care in home care. This is an exploratory, qualitative study, through semi-structured interviews, conducted in the second semester of 2012 with eight occupational therapists with experience in palliative care in the city of São Paulo. Content analysis identified four themes: characterization and professional trajectory in the field, understanding the concepts of palliative care, home care and palliative care, and occupational therapy and palliative care in home care. The results suggest that the role of the occupational therapist in this field has taken place at different levels of health care, being addressed to people with varying needs. The use of the concept of palliative care by the interviewees exceeds the notion of end of life, following the changes in the epidemiological transition. They understand that professional services follow the trend of national palliative care services with focus on specialized levels, but manifest the importance of its implementation in primary and home care. Among the barriers to practice, they identified the complexity of “being at home “, peculiarities of palliative care with high cost demands, lack of infrastructure and implementation of the current policy. Professional training and scientific roduction in the area were viewed as inadequate, although they identified a call for change. The interviewees recognized palliative care in home care as a strong professional field, but one still requiring study and discussions regarding its limits and conditions of implementation, especially in the Unified Health System.

  4. 24 CFR 982.612 - Group home: State approval of group home.

    Science.gov (United States)

    2010-04-01

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

  5. ThinkHome Energy Efficiency in Future Smart Homes

    OpenAIRE

    Christian Reinisch; Mario J. Kofler; Félix Iglesias; Wolfgang Kastner

    2011-01-01

    Abstract Smart homes have been viewed with increasing interest by both home owners and the research community in the past few years. One reason for this development is that the use of modern automation technology in the home or building promises considerable savings of energy, therefore, simultaneously reducing the operational costs of the building over its whole lifecycle. However, the full potential of smart homes still lies fallow, due to the complexity and diversity of the systems, badly ...

  6. Texas ''Recycled Content''/Advanced Green Builder Demonstration Home Project

    International Nuclear Information System (INIS)

    Fisk, P. III; Vittori, G.

    1993-01-01

    This paper presents an overview of principal issues addressed in the Advanced Green Builder Demonstration Home Project, with units to be constructed in Austin and Laredo. The project's objective is to introduce these distinct communities to a range of ''green'' housing materials and methods, emphasizing opportunities for recycled-content and by-product based construction materials. The project, principally funded by U.S. Department of Energy Oil Overcharge Funds administered by the Texas Governor's Energy Office, also is supported by several state, regional, and municipal agencies. As such, the project reflects a regional process, as open to adaptation to a region's natural resources as it is to its peoples. The design is specifically intended to bridge issues of social and family concerns, such as affordability, expandibility, and economic development. This is a result of a modular-based design framework, coupled with reliance on environmentally-conscious regional manufacture of by-product based materials. Environmental issues are addressed by establishing a user for pollutants considered major contributors to global concerns of acid rain (due to release of sulphur dioxide), global warming (due to release of carbon dioxide), and deforestation. The homes will be built without virgin wood products or portland cement

  7. Technology and medication errors: impact in nursing homes.

    Science.gov (United States)

    Baril, Chantal; Gascon, Viviane; St-Pierre, Liette; Lagacé, Denis

    2014-01-01

    The purpose of this paper is to study a medication distribution technology's (MDT) impact on medication errors reported in public nursing homes in Québec Province. The work was carried out in six nursing homes (800 patients). Medication error data were collected from nursing staff through a voluntary reporting process before and after MDT was implemented. The errors were analysed using: totals errors; medication error type; severity and patient consequences. A statistical analysis verified whether there was a significant difference between the variables before and after introducing MDT. The results show that the MDT detected medication errors. The authors' analysis also indicates that errors are detected more rapidly resulting in less severe consequences for patients. MDT is a step towards safer and more efficient medication processes. Our findings should convince healthcare administrators to implement technology such as electronic prescriber or bar code medication administration systems to improve medication processes and to provide better healthcare to patients. Few studies have been carried out in long-term healthcare facilities such as nursing homes. The authors' study extends what is known about MDT's impact on medication errors in nursing homes.

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

    Science.gov (United States)

    Ekmann, A; Vass, M; Avlund, K

    2010-11-01

    Since 1998 all municipalities in Denmark have been required by law to offer two annual preventive home visits to all home-dwelling citizens aged 75 or over. The influence of invitational procedures on acceptance rates has not been investigated. The aim of this study was to describe and investigate whether different invitational procedures were associated with first preventive home visit acceptance rates. The study was based on secondary analyses of data from the Danish Intervention Study on Preventive Home Visits. Data were collected from 1998 to 2002. Of the 4060 participants in the main study, 3245 reported receiving an offer for an identifiable preventive home visit, of whom 2399 (73.9%) provided complete data for the main analyses in the present study. Invitational procedures were categorised as: (1) a letter with a proposed date and time for the visit, (2) a visitor telephone call, and (3) a letter with encouragement to phone the visitor for appointment (letter without a proposed date). Covariates included sex, age, experience with preventive interventions, functional ability, self rated health, social relations and psychosocial characteristics. Statistical analyses included chi-square tests, and bi- and multivariable logistic regression analyses. Different invitational procedures were associated with first preventive home visit acceptance rates. Significantly more men (75.1%) than women (62.8%) declined the first preventive home visit regardless of the invitational procedure. Compared to 'letter with a proposed date', men had an odds ratio of 1.78 (95% CI: 1.16-2.74) for declining visits when 'telephone call' was used and an odds ratio 2.81 (95% CI: 1.79-4.40) when 'letter without a proposed date' was used as the invitational procedure. In women the odds ratios were 1.23 (95% CI: 0.91-1.68) and 1.87 (95% CI: 1.37-2.55), respectively. © 2010 Blackwell Publishing Ltd.

  9. Living preference modeling of smart homes for different target groups

    NARCIS (Netherlands)

    Allameh, E.; Heidari Jozam, M.; de Vries, B.

    2018-01-01

    The smart home concept has been around for more than 30 years. It is nevertheless fair to say that it has not taken off commercially on a wider basis so far, in spite of many optimistic forecasts over the years. One of the main reasons for this, aiming to be addressed in this paper, is that the

  10. Elevated corrosion rates and hydrogen sulfide in homes with 'Chinese Drywall'

    Energy Technology Data Exchange (ETDEWEB)

    Allen, Joseph G.; MacIntosh, David L. [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States); Harvard School of Public Health, 677 Huntington Avenue, Boston, MA (United States); Saltzman, Lori E. [U.S. Consumer Product Safety Commission, Bethesda, MD (United States); Baker, Brian J. [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States); Matheson, Joanna M.; Recht, Joel R. [U.S. Consumer Product Safety Commission, Bethesda, MD (United States); Minegishi, Taeko; Fragala, Matt A.; Myatt, Theodore A. [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States); Spengler, John D.; Stewart, James H. [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States); Harvard School of Public Health, 677 Huntington Avenue, Boston, MA (United States); McCarthy, John F., E-mail: jmcccarthy@eheinc.com [Environmental Health and Engineering, Inc., 117 Fourth Avenue, Needham, MA (United States)

    2012-06-01

    In December 2008, the U.S. Consumer Product Safety Commission (CPSC) began receiving reports about odors, corrosion, and health concerns related to drywall originating from China. In response, a detailed environmental health and engineering evaluation was conducted of 41 complaint and 10 non-complaint homes in the Southeast U.S. Each home investigation included characterization of: 1) drywall composition; 2) indoor and outdoor air quality; 3) temperature, moisture, and building ventilation; and 4) copper and silver corrosion rates. Complaint homes had significantly higher hydrogen sulfide concentrations (mean 0.82 vs. < LOD {mu}g/m{sup 3}, p < 0.05), and significantly greater rates of copper sulfide and silver sulfide corrosion compared to non-complaint homes (Cu{sub 2}S: 476 vs. < 32 A/30 d, p < 0.01; Ag{sub 2}S: 1472 vs. 389 A/30 d, p < 0.01). The abundance of carbonate and strontium in drywall was also elevated in complaint homes, and appears to be useful objective marker of problematic drywall in homes that meet other screening criteria (e.g., constructed or renovated in 2006-2007, reports of malodor and accelerated corrosion). This research provides empirical evidence of the direct association between homes constructed with 'Chinese Drywall' in 2006-2007 and elevated corrosion rates and hydrogen sulfide concentrations in indoor air. - Highlights: Black-Right-Pointing-Pointer Environmental measurements in homes with and without 'Chinese Drywall' Black-Right-Pointing-Pointer Homes with 'Chinese Drywall' had higher hydrogen sulfide concentrations Black-Right-Pointing-Pointer Homes with 'Chinese Drywall' had elevated corrosion rates Black-Right-Pointing-Pointer Study provides empirical evidence of reported associations.

  11. Learning under uncertainty in smart home environments.

    Science.gov (United States)

    Zhang, Shuai; McClean, Sally; Scotney, Bryan; Nugent, Chris

    2008-01-01

    Technologies and services for the home environment can provide levels of independence for elderly people to support 'ageing in place'. Learning inhabitants' patterns of carrying out daily activities is a crucial component of these technological solutions with sensor technologies being at the core of such smart environments. Nevertheless, identifying high-level activities from low-level sensor events can be a challenge, as information may be unreliable resulting in incomplete data. Our work addresses the issues of learning in the presence of incomplete data along with the identification and the prediction of inhabitants and their activities under such uncertainty. We show via the evaluation results that our approach also offers the ability to assess the impact of various sensors in the activity recognition process. The benefit of this work is that future predictions can be utilised in a proposed intervention mechanism in a real smart home environment.

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

    Science.gov (United States)

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

    2016-01-01

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

  13. Home visitation programs: an untapped opportunity for the delivery of early childhood obesity prevention.

    Science.gov (United States)

    Salvy, S-J; de la Haye, K; Galama, T; Goran, M I

    2017-02-01

    Extant obesity efforts have had limited impact among low-income underserved children, in part because of limitations inherent to existing programs: (i) short duration and low intensity; (ii) late timing of implementation, when children are already overweight or obese; (iii) intervention delivery limiting their accessibility and sustainability; and (iv) failure to address barriers such as a lack of culturally competent services, poverty and housing instability, which interfere with healthy lifestyle changes. This concept paper proposes an innovative model of obesity prevention implemented in infancy and sustained throughout early childhood to address the limitations of current obesity prevention efforts. Specifically, we propose to integrate sustained, weekly, in-home obesity prevention as part of the services already delivered by ongoing Home Visitation Programs, which currently do not target obesity prevention. The home visiting structure represents an ideal model for impactful obesity prevention as home visitation programs: (i) already provide comprehensive services to diverse low-income infants and families who are most at risk for obesity and poor health because of socio-economic and structural conditions; (ii) services are initiated in infancy and sustained throughout critical developmental periods for the formation of healthy/unhealthy behaviors; and (iii) have been in place for more than 40 years, with a widespread presence across the United States and nationwide, which is critical for the scalability and sustainability of obesity prevention. © 2016 World Obesity Federation.

  14. Knock, Knock, May I Come In? An Integrative Perspective on Professional Development Concerns for Home Visits Conducted by Teachers

    Science.gov (United States)

    Jiles, Tywanda

    2015-01-01

    This article address home visits and the professional development needs of teachers who perform visits. The author writes from a practitioner's point of view, focusing on training needs for providers. The author argues that training and preparation for conducting home visits is needed to equip professionals with the skills needed to execute this…

  15. Imprinting Hatchery Reared Salmon and Steelhead Trout for Homing, Volume III of III; Disease and Physiology Supplements, 1978-1983 Final Report.

    Energy Technology Data Exchange (ETDEWEB)

    Slatick, Emil; Gilbreath, Lyle G.; Harmon, Jerrel R. (Northwest and Alaska Fisheries Science Centr, Coastal Zone and Estuarine Studies Division, Seattle, WA)

    1988-02-03

    The main functions of the National Marine Fisheries Service (NMFS) Aquaculture Task biologists and contractual scientists involved in the 1978 homing studies were primarily a surveillance of fish physiology, disease, and relative survival during culture in marine net-pens, to determine if there were any unusual factors that might affect imprinting and homing behavior. The studies were conducted with little background knowledge of the implications of disease and physiology on imprinting and homing in salmonids. The health status of the stocks was quite variable as could be expected. The Dworshak and Wells Hatcheries steelhead suffered from some early stresses in seawater, probably osmoregulatory. The incidences of latent BKD in the Wells and Chelan Hatcheries steelhead and Kooskia Hatchery spring chinook salmon were extremely high, and how these will affect survival in the ocean is not known. Gill enzyme activity in the Dworshak and Chelan Hatcheries steelhead at release was low. Of the steelhead, survival in the Tucannon Hatchery stock will probably be the highest, with Dworshak Hatchery stock the lowest. This report contains five previously published papers.

  16. 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.

  17. Safety factors predictive of job satisfaction and job retention among home healthcare aides.

    Science.gov (United States)

    Sherman, Martin F; Gershon, Robyn R M; Samar, Stephanie M; Pearson, Julie M; Canton, Allison N; Damsky, Marc R

    2008-12-01

    Although many of the well known work characteristics associated with job satisfaction in home health care have been documented, a unique aspect of the home health care aides' (HHA) work environment that might also affect job satisfaction is the fact that their workplace is a household. To obtain a better understanding of the potential impact of the risks/exposures/hazards within the household environment on job satisfaction and job retention in home care, we recently conducted a risk assessment study. Survey data from a convenience sample of 823 New York City HHAs were obtained and analyzed. Household/job-related risks, environmental exposures, transportation issues, threats/verbal and physical abuse, and potential for violence were significantly correlated with HHA job satisfaction and job retention. Addressing the modifiable risk factors in the home health care household may improve job satisfaction and reduce job turnover in this work population.

  18. An examination of interventions to reduce respiratory health and injury hazards in homes of low-income families

    International Nuclear Information System (INIS)

    Dixon, Sherry L.; Fowler, Cecile; Harris, Judy; Moffat, Sally; Martinez, Yolanda; Walton, Heather; Ruiz, Bernice; Jacobs, David E.

    2009-01-01

    We evaluated whether combining asthma trigger reduction with housing structural repairs, device disbursement and education in low-income households with children would improve self-reported respiratory health and reduce housing-related respiratory health and injury hazards (convenience sample of n=67 homes with 63 asthmatic and 121 non-asthmatic children). At baseline, a visual assessment of the home environment and a structured occupant interview were used to examine 29 potential injury hazards and 7 potential respiratory health hazards. A home-specific intervention was designed to provide the children's parents or caretakers with the knowledge, skills, motivation, supplies, equipment, and minimum housing conditions necessary for a healthy and safe home. The enrolled households were primarily Hispanic and owned their homes. On average, 8 injury hazards were observed in the homes at baseline. Four months following intervention, the average declined to 2.2 hazards per home (p<0.001), with 97% of the parents reporting that their homes were safer following the interventions. An average of 3.3 respiratory health hazards were observed in the homes at baseline. Four months following intervention, the average declined to 0.9 hazards per home (p<0.001), with 96% of parents reporting that the respiratory health of their asthmatic children improved. A tailored healthy homes improvement package significantly improves self-reported respiratory health and safety, reduces respiratory health and injury hazards, and can be implemented in concert with a mobile clinical setting

  19. The relationship between advertising, price, and nursing home quality.

    Science.gov (United States)

    Kash, Bita A; Miller, Thomas R

    2009-01-01

    Theoretically, nursing homes should engage in advertising for the following two reasons: (a) to improve awareness of the services offered in a particular market and (b) to signal high-quality services. In this study, we build upon results from prior studies of nursing home advertising activity, market competition, and quality. The purpose of this study was to examine the association between advertising expenses, price, and quality. We focused on answering the question: Do nursing homes use advertising and price to signal superior quality? The Texas Nursing Facilities Medicaid Cost Report, the Texas Quality Reporting System, and the Area Resource File were merged for the year 2003. We used three alternative measures of quality to improve the robustness of this exploratory analysis. Quality measures were examined using Bonferroni correlation coefficient analysis. Associations between advertising expenses and quality were evaluated using three regression models predicting quality. We also examined the association of the price of a private bed per day with quality. Advertising expenses were not associated with better nursing home quality as measured by three quality scales. The average price customers pay for one private bed per day was associated with better quality only in one of the three quality regression models. The price of nursing home care might be a better indicator of quality and necessary to increase as quality of care is improved in the nursing homes sector. Because more advertising expenditures are not necessarily associated with better quality, consumers could be mislead by advertisements and choose poor quality nursing homes. Nursing home administrators should focus on customer relationship management tools instead of expensive advertising. Relationship management tools are proven marketing techniques for the health services sector, usually less expensive than advertising, and help with staff retention and quality outcomes.

  20. 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.

  1. Quality assessment of home births in Denmark.

    Science.gov (United States)

    Jensen, Sabrina; Colmorn, Lotte B; Schroll, Anne-Mette; Krebs, Lone

    2017-05-01

    The safety of home births has been widely debated. Observational studies examining maternal and neonatal outcomes of home births have become more frequent, and the quality of these studies has improved. The aim of the present study was to describe neonatal outcomes of home births compared with hospital births and to discuss which data are needed to evaluate the safety of home births. This was a register-based cohort study. Data on all births in Denmark (2003-2013) were collected from the Danish Medical Birth Registry (DMBR). The cohort included healthy women with uncomplicated pregnancies and no medical interventions during delivery. A total of 6,395 home births and 266,604 hospital births were eligible for analysis. Comparative analyses were performed separately in nulliparous and multiparous women. The outcome measures were neonatal mortality and morbidity. Frequencies of admission to a neonatal intensive care unit and treatment with continuous positive airway pressure were significantly lower in infants born at home than in infants born at a hospital. A slightly, but significantly increased rate of early neonatal death was found among infants delivered by nulliparous at home. This study indicates that home births in Denmark are characterized by a high level of safety owing to low rates of perinatal mortality and morbidity. Missing registration on intrapartum transfers and planned versus unplanned home births in the DMBR are, however, major limitations to the validity and utility of the reported results. Registration of these items of information is necessary to make reasonable assessments of home births in the future. none. not relevant. Articles published in the DMJ are “open access”. This means that the articles are distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits any non-commercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited.

  2. The Home-School Psychological Contract: Implications for Parental Involvement in Middle Schooling.

    Science.gov (United States)

    Renihan, Patrick J.; Renihan, Frederick J.

    1995-01-01

    Contends that social change has created a need for parents and teachers to develop strategies to improve communication, mutual understanding, and effective ways to nurture and educate young adolescents. Addresses the psychological contract between school and home, strategies and stances, and considerations and strategies for strengthening the…

  3. Home care in Europe: a systematic literature review

    Science.gov (United States)

    2011-01-01

    Background Health and social services provided at home are becoming increasingly important. Hence, there is a need for information on home care in Europe. The objective of this literature review was to respond to this need by systematically describing what has been reported on home care in Europe in the scientific literature over the past decade. Methods A systematic literature search was performed for papers on home care published in English, using the following data bases: Cinahl, the Cochrane Library, Embase, Medline, PsycINFO, Sociological Abstracts, Social Services Abstracts, and Social Care Online. Studies were only included if they complied with the definition of home care, were published between January 1998 and October 2009, and dealt with at least one of the 31 specified countries. Clinical interventions, instrument developments, local projects and reviews were excluded. The data extracted included: the characteristics of the study and aspects of home care 'policy & regulation', 'financing', 'organisation & service delivery', and 'clients & informal carers'. Results Seventy-four out of 5,133 potentially relevant studies met the inclusion criteria, providing information on 18 countries. Many focused on the characteristics of home care recipients and on the organisation of home care. Geographical inequalities, market forces, quality and integration of services were also among the issues frequently discussed. Conclusions Home care systems appeared to differ both between and within countries. The papers included, however, provided only a limited picture of home care. Many studies only focused on one aspect of the home care system and international comparative studies were rare. Furthermore, little information emerged on home care financing and on home care in general in Eastern Europe. This review clearly shows the need for more scientific publications on home care, especially studies comparing countries. A comprehensive and more complete insight into the

  4. Context-Specific Associations Between Harsh Parenting and Peer Rejection on Child Conduct Problems at Home and School.

    Science.gov (United States)

    Tung, Irene; Lee, Steve S

    2016-02-06

    Although harsh parenting and peer rejection are independently associated with childhood conduct problems (CP), these patterns are often informant specific, suggesting that their associations across contexts (i.e., home and school) should be considered. In a sample of 142 children with and without attention-deficit/hyperactivity disorder (ADHD; ages 5-10; 66% male), we used structural equation modeling to evaluate the structure of multi-informant (parent, teacher) and multimethod (semi-structured interview, questionnaire) rated aggressive, rule-breaking, and oppositional behavior. Next, we explored context-specific associations by modeling harsh parenting and peer rejection as simultaneous and independent predictors of home and school CP. We observed several key findings: (a) the structure of parent- and teacher-reported CP was best accounted by context-specific CP (i.e., home vs. school) and a second-order general CP factor; (b) harsh punishment and peer rejection each independently predicted the second-order general CP factor; and (c) peer rejection was uniquely associated with school CP, whereas harsh punishment was associated only with the second-order general CP factor and did not exhibit specificity with home CP. Whereas harsh parenting and peer rejection were each independently associated with generalized CP, peer rejection showed an additional, unique context-specific association with CP exclusively expressed at school. We discuss potential explanatory mechanisms underlying context-specific associations of CP, as well as address etiological and clinical implications for understanding informant-discrepancies in CP.

  5. Cost Effectiveness of a Home-Based Intervention That Helps Functionally Vulnerable Older Adults Age in Place at Home

    Directory of Open Access Journals (Sweden)

    Eric Jutkowitz

    2012-01-01

    Full Text Available Evaluating cost effectiveness of interventions for aging in place is essential for adoption in service settings. We present the cost effectiveness of Advancing Better Living for Elders (ABLE, previously shown in a randomized trial to reduce functional difficulties and mortality in 319 community-dwelling elders. ABLE involved occupational and physical therapy sessions and home modifications to address client-identified functional difficulties, performance goals, and home safety. Incremental cost-effectiveness ratio (ICER, expressed as additional cost to bring about one additional year of life, was calculated. Two models were then developed to account for potential cost differences in implementing ABLE. Probabilistic sensitivity analyses were conducted to account for variations in model parameters. By two years, there were 30 deaths (9: ABLE; 21: control. Additional costs for 1 additional year of life was $13,179 for Model 1 and $14,800 for Model 2. Investment in ABLE may be worthwhile depending on society's willingness to pay.

  6. A Buberian approach to the co-construction of relationships between professional caregivers and residents in nursing homes.

    Science.gov (United States)

    Westerhof, Gerben J; van Vuuren, Mark; Brummans, Boris H J M; Custers, Annette F J

    2014-06-01

    This article demonstrates the value of a Buberian approach to relationships between professional caregivers and residents in nursing homes. Extant research on relationships between professional caregivers and residents typically distinguishes between task-centered and person-centered communication yet tends to privilege either the perspective of professionals or residents. To address this issue, we develop an approach that addresses the co-construction of I-It and I-Thou relationships, based on Martin Buber's social existentialist philosophy. In turn, we show the merit of this approach by using it to analyze interactional data from an observational study on morning care in Dutch nursing homes. As these examples illustrate, our analytical perspective is useful because it highlights how different caregiver-resident relationships are co-created and unfold over time. Thus, by revealing how these relationships are worked out in everyday interactions through subtle shifts between task-centered and person-centered communicative practices, this article offers important insights for improving the quality of care in nursing homes.

  7. Nursing Homes

    Science.gov (United States)

    ... Home › Aging & Health A to Z › Nursing Homes Font size A A A Print Share Glossary Basic ... Reason For Living in A Nursing Home Some type of disability with activities of daily living (ADLs) ...

  8. Correlates of Smoke-Free Home Policies in Shanghai, China

    Directory of Open Access Journals (Sweden)

    Pinpin Zheng

    2014-01-01

    Full Text Available Background. Approximately 63.7% of nonsmokers in China are exposed to secondhand smoke (SHS in their homes. The current study documents the prevalence and correlates of smoke-free home policies in Shanghai, as well as reasons for implementing such a policy and places where smoking is most commonly allowed. Methods. We conducted in-person surveys of 500 participants using a multistage proportional random sampling design in an urban and suburban district. Results. Overall, 35.3% had a smoke-free home policy. In the logistic regression, having higher income, not having smokers in the home, having children in the home, having fewer friends/relatives who permit smoking at home, and not being a current smoker were correlates of having a smoke-free home policy P<0.05. Concern about the health impact of SHS was reportedly the most important reason for establishing a smoke-free home. Among participants with no or partial bans, the most common places where smoking was allowed included the living room (64.2%, kitchen (46.1%, and bathroom (33.8%. Conclusions. Smoke-free home policies were in place for a minority of households surveyed. Establishing such a policy was influenced by personal smoking behavior and social factors. These findings suggest an urgent need to promote smoke-free home policies through tobacco control programs.

  9. Proven Performance of Seven Cold Climate Deep Retrofit Homes

    Energy Technology Data Exchange (ETDEWEB)

    Osser, R.; Neuhauser, K.; Ueno, K.

    2012-06-01

    Seven test homes located in Massachusetts are examined within this report. The retrofit strategies of each home are presented along with a comparison of the pre- and post-retrofit airtightness achieved by the group. Pre- and post-retrofit utility bills were collected; energy models were used to estimate pre-retrofit energy use when bills were unavailable.

  10. Making difficult decisions: the role of quality of care in choosing a nursing home.

    Science.gov (United States)

    Pesis-Katz, Irena; Phelps, Charles E; Temkin-Greener, Helena; Spector, William D; Veazie, Peter; Mukamel, Dana B

    2013-05-01

    We investigated how quality of care affects choosing a nursing home. We examined nursing home choice in California, Ohio, New York, and Texas in 2001, a period before the federal Nursing Home Compare report card was published. Thus, consumers were less able to observe clinical quality or clinical quality was masked. We modeled nursing home choice by estimating a conditional multinomial logit model. In all states, consumers were more likely to choose nursing homes of high hotel services quality but not clinical care quality. Nursing home choice was also significantly associated with shorter distance from prior residence, not-for-profit status, and larger facility size. In the absence of quality report cards, consumers choose a nursing home on the basis of the quality dimensions that are easy for them to observe, evaluate, and apply to their situation. Future research should focus on identifying the quality information that offers the most value added to consumers.

  11. Home Care

    Science.gov (United States)

    ... are part of home healthcare agencies. You may benefit from home care if you are dealing with ... it will trigger an emergency response or checkup phone call. Newer technologies ... or mobile testing technology (home diagnostics), including x-rays and ...

  12. Community-Wide Zero Energy Ready Home Standard

    Energy Technology Data Exchange (ETDEWEB)

    Herk, A. [IBACOS, Inc., Pittsburght, PA (United States); Beggs, T. [IBACOS, Inc., Pittsburght, PA (United States)

    2016-02-05

    This report outlines the steps a developer can use when looking to create and implement higher performance standards such as the U.S. Department of Energy (DOE) Zero Energy Ready Home (ZERH) standards in a community. The report also describes the specific examples of how this process was followed by a developer, Forest City, in the Stapleton community in Denver, Colorado. IBACOS described the steps used to begin to bring the DOE ZERH standard to the Forest City Stapleton community based on 15 years of community-scale development work done by IBACOS. As a result of this prior IBACOS work, the team gained an understanding of the various components that a master developer needs to consider and created strategies for incorporating those components in the initial phases of development to achieve higher performance buildings in the community. An automated scoring system can be used to perform an internal audit that provides a detailed and consistent evaluation of how several homes under construction or builders' floor plans compare with the requirements of the DOE Zero Energy Ready Home program. This audit can be performed multiple times at specific milestones during construction to allow the builder to make changes as needed throughout construction for the project to meet Zero Energy Ready Home standards. This scoring system also can be used to analyze a builder's current construction practices and design.

  13. Comparative Analysis of Homebuyer Response to New Zero-Energy Homes: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Farhar, B. C.; Coburn, T. C.; Murphy, M.

    2004-07-01

    In 2004, mail questionnaires were sent to 271 homebuyers in a highly energy-efficient community and 98 homebuyers living in an adjacent conventional community. People surveyed had to have lived in their homes for at least 6 months. The questionnaires addressed perceptions and preferences relative to the new home purchases, and the role, if any, that energy efficiency and solar features might have played in these purchases. Also investigated was the willingness to pay for energy features; preferences on whether energy features should be standard or optional; preferences on energy policies; perceived problems; aesthetics; homebuyer satisfaction and the reasons for it; environmentalism; and experience with the utility company.

  14. Optimizing Antibiotic Use in Nursing Homes Through Antibiotic Stewardship.

    Science.gov (United States)

    Sloane, Philip D; Huslage, Kirk; Kistler, Christine E; Zimmerman, Sheryl

    2016-01-01

    Antibiotic stewardship is becoming a requirement for nursing homes. Programs should be interdisciplinary and multifaceted; should have support from nursing home administrators; and should aim to promote antibiotics only when needed, not just in case. Recommended components include use of evidence-based guidelines; ongoing monitoring of antibiotic prescriptions, cultures, and study results; monitoring of health outcomes; use of nursing home-specific antibiograms; regular reporting and feedback to medical providers and nurses; and education of residents and families. ©2016 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

  15. The contribution of at-home and away-from-home food to dietary intake among 2-13-year-old Mexican children.

    Science.gov (United States)

    Taillie, Lindsey Smith; Afeiche, Myriam C; Eldridge, Alison L; Popkin, Barry M

    2017-10-01

    Away-from-home foods have been shown to have lower nutritional quality and larger portion sizes than many foods prepared at home. We aimed to describe energy and nutrient intakes among 2-13-year-old Mexican children by eating location (at home and away from home), overall, by socio-economic status (SES) and by urbanicity. Dietary intake was collected via one 24 h recall in the 2012 Mexican National Health and Nutrition Survey (ENSANUT). Location was reported for each food consumed. Results were adjusted for sex, day of recall, region, weight status, SES and urbanicity. Mexico (nationally representative). Children aged 2-5 years (n 1905) and 6-13 years (n 2868). Children consumed the majority of daily energy at home (89% of 2-5-year-olds; 82 % of 6-13-year-olds). The most common away-from-home eating location was school (22 % of 2-5-year-olds; 43 % of 6-13-year-olds), followed by the street (14 % of 2-5-year-olds; 13 % of 6-13-year-olds). The most common foods consumed away from home were wheat/rice and corn mixed dishes, sugar-sweetened beverages, pastries/candy/desserts, milk (2-5-year-olds only) and salty snacks (6-13-year-olds). Multivariate models showed that high-SES 2-5-year-olds consumed 14 % of daily energy away from home v. 8 % among low-SES 2-5-year-olds, and high-SES 6-13-year-olds consumed 21 % of daily energy away from home v. 14 % among low-SES 6-13 year-olds. There were no differences by urban residence. Among Mexican children, most foods and beverages were consumed at home. However, the percentage of foods consumed or purchased away from home increased with age and with SES.

  16. The contribution of at-home and away-from-home food to dietary intake among 2–13y Mexican children

    Science.gov (United States)

    Taillie, Lindsey Smith; Afeiche, Myriam C.; Eldridge, Alison L.; Popkin, Barry M.

    2016-01-01

    Objectives Away-from-home foods have been shown to have lower nutritional quality and larger portion sizes as compared to many foods prepared at home. The objective of this study was to describe calorie and nutrient intakes among 2–13y old Mexican children by eating location (at-home and away-from-home), overall, by socio-economic status (SES), and by urbanicity. Design Dietary intake was collected via one 24-hr recall in the 2012 Mexican National Health and Nutrition Survey (ENSANUT). Location was reported for each food consumed. Results were adjusted for age, sex, weight status, socio-economic status and urbanicity. Setting Mexico (nationally representative) Subjects 2–5y (n=1905) and 6–13y (n=2868) children Results Children consumed the majority of daily energy at home (89% and 82%, respectively). The most common away-from-home eating location was the school (22% 2–5y; 43% 6–13y old), followed by street (14% 2–5y; 13% 6–13y old). The most common foods consumed away-from-home were wheat, rice, and corn mixed dishes, and sugar-sweetened beverages (SSBs), pastries/ candy/desserts, milk (2–5y only) and salty snacks (6–13y). Multivariate models showed that high SES 2–5 year-olds consumed 14% of daily energy away-from-home relative to 8% among low SES 2–5 year-olds, and high SES 6–13 year-olds consumed 21% of daily energy away-from-home compared to 14% among low SES 6–13 year-olds. There were no differences by urban residence. Conclusions Among Mexican children, most foods and beverages were consumed at home. However, the percent of foods consumed or purchased away-from-home increased with age and with SES. PMID:27608532

  17. Building America Energy Renovations. A Business Case for Home Performance Contracting

    Energy Technology Data Exchange (ETDEWEB)

    Baechler, Michael C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Antonopoulos, C. A. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sevigny, M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Gilbride, T. L. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hefty, M. G. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2012-10-01

    This research report gives an overview of the needs and opportunities that exist in the U.S. home performance contracting industry. The report discusses industry trends, market drivers, different business models, and points of entry for existing and new businesses hoping to enter the home performance contracting industry. Case studies of eight companies who successfully entered the industry are provided, including business metrics, start-up costs, and marketing approaches.

  18. Relations among work-home culture, the utilization of work-home arrangements, and work-home interference

    NARCIS (Netherlands)

    Dikkers, J.S.E.; Geurts, S.A.E.; Dulk, L. den; Peper, A.B.; Kompier, M.A.J.

    2004-01-01

    In the present study, we examined the associations among work-home culture (WHC), the utilization of work-home arrangements (WHAs), and work-home interference (WHI) among 638 workers from a Dutch financial consultancy firm. We (a) developed a typology of WHC, (b) examined whether the utilization of

  19. Home mechanical ventilation in Canada: a national survey.

    Science.gov (United States)

    Rose, Louise; McKim, Douglas A; Katz, Sherri L; Leasa, David; Nonoyama, Mika; Pedersen, Cheryl; Goldstein, Roger S; Road, Jeremy D

    2015-05-01

    No comprehensive Canadian national data describe the prevalence of and service provision for ventilator-assisted individuals living at home, data critical to health-care system planning for appropriate resourcing. Our objective was to generate national data profiling service providers, users, types of services, criteria for initiation and monitoring, ventilator servicing arrangements, education, and barriers to home transition. Eligible providers delivering services to ventilator-assisted individuals (adult and pediatric) living at home were identified by our national provider inventory and referrals from other providers. The survey was administered via a web link from August 2012 to April 2013. The survey response rate was 152/171 (89%). We identified 4,334 ventilator-assisted individuals: an estimated prevalence of 12.9/100,000 population, with 73% receiving noninvasive ventilation (NIV) and 18% receiving intermittent mandatory ventilation (9% not reported). Services were delivered by 39 institutional providers and 113 community providers. We identified variation in initiation criteria for NIV, with polysomnography demonstrating nocturnal hypoventilation (57%), daytime hypercapnia (38%), and nocturnal hypercapnia (32%) as the most common criteria. Various models of ventilator servicing were reported. Most providers (64%) stated that caregiver competency was a prerequisite for home discharge; however, repeated competency assessment and retraining were offered by only 45%. Important barriers to home transition were: insufficient funding for paid caregivers, equipment, and supplies; a shortage of paid caregivers; and negotiating public funding arrangements. Ventilatory support in the community appears well-established, with most individuals managed with NIV. Although caregiver competency is a prerequisite to discharge, ongoing assessment and retraining were infrequent. Funding and caregiver availability were important barriers to home transition. Copyright © 2015

  20. Home administration of maintenance pemetrexed for patients with advanced non-squamous non-small cell lung cancer: rationale, practicalities and phase II feasibility study design.

    Science.gov (United States)

    Lal, Rohit; Bourayou, Nawel; Hillerdal, Gunnar; Nicolson, Marianne; Vikstrom, Anders; Lorenzo, Maria; D'yachkova, Yulia; Barriga, Susana; Visseren-Grul, Carla

    2013-10-03

    Home-based care in oncology is mainly reserved for patients at the end of life. Regulations regarding home delivery of cytotoxics differ across Europe, with a notable lack of practice guidelines in most countries. This has led to a lack of data addressing the feasibility of home-based administration of cytotoxic chemotherapy. In advanced non-squamous non-small cell lung cancer, pemetrexed is approved as maintenance therapy after first-line chemotherapy. In this setting, patients have the potential to be treated long-term with maintenance therapy, which, in the absence of unacceptable toxicity, is continued until disease progression. The favourable safety profile of pemetrexed and the ease of its administration by 10-minute intravenous infusion every 3 weeks make this drug a suitable candidate for administration in a home setting. Literature and regulations relevant to the home-based delivery of cytotoxic therapy were reviewed, and a phase II feasibility study of home administration of pemetrexed maintenance therapy was designed. At least 50 patients with advanced non-squamous non-small cell lung cancer, Eastern Cooperative Oncology Group performance status 0-1 and no progressive disease after four cycles of platinum-based first-line therapy are required to allow investigation of the feasibility of home-based administration of pemetrexed maintenance therapy (500 mg/m(2) every 3 weeks until progressive disease or unacceptable toxicity). Feasibility is being assessed as adherence to the home-based administration process (primary endpoint), patient safety, impact on patients' quality of life, patient and physician satisfaction with home care, and healthcare resource use and costs. Enrolment of patients from the UK and Sweden, where home-based care is relatively well developed, commenced in December 2011. This feasibility study addresses an important aspect of maintenance therapy, that is, patient comfort during protracted home-based chemotherapy. The study design

  1. Relationship between home fruit and vegetable availability and infant and maternal dietary intake in African-American families: evidence from the exhaustive home food inventory.

    Science.gov (United States)

    Bryant, Maria; Stevens, June; Wang, Lily; Tabak, Rachel; Borja, Judith; Bentley, Margaret E

    2011-10-01

    The availability of foods in the home is likely to be related to consumption. We know of no studies that have reported this association in African-American participants, and few studies have examined home food availability using objective methods. This study aimed to assess the association between objective measures of fruits and vegetables in the home with reported infant and maternal diet in low-income African Americans. A cross-sectional study design was used to compare food availability and dietary intake. The Exhaustive Home Food Availability Inventory used barcode scanning to measure food availability in the home. Maternal and infant diet was assessed by 24-hour recall. Eighty African-American first-time mother/infant dyads were recruited from Wake and Durham counties in North Carolina. Adjusted mean dietary intake of infants and mothers was calculated within tertiles of food and nutrient availability using analysis of variance. The bootstrap method was used to estimate P values and 95% confidence intervals. Models were adjusted for mother's age, household size, shopping and eating-out behavior. Infants and mothers living in homes in the highest tertile of availability of energy, nutrients, and fruits and vegetables tended to have the highest consumption, respectively; however, statistically significant associations were more likely to occur with infant diet than maternal diet. The relationship was strongest for infant consumption of fruit, with an average of 103.3 g consumed by infants who lived in homes in the highest tertile of availability, compared to 42.5 g in those living in homes in the lowest tertile (P<0.05). Availability of fruits and vegetables in the home was associated with intake of those foods in a sample of African-American mothers and infants. Results support making changes in the home environment as a method of promoting changes in fruit and vegetable intake. Copyright © 2011 American Dietetic Association. Published by Elsevier Inc. All

  2. Associations Between Home Death and the Use and Type of Care at Home.

    Science.gov (United States)

    McEwen, Rebecca; Asada, Yukiko; Burge, Frederick; Lawson, Beverley

    2018-01-01

    Despite wishes for and benefits of home deaths, a discrepancy between preferred and actual location of death persists. Provision of home care may be an effective policy response to support home deaths. Using the population-based mortality follow-back study conducted in Nova Scotia, we investigated the associations between home death and formal care at home and between home death and the type of formal care at home. We found (1) the use of formal care at home at the end of life was associated with home death and (2) the use of formal home support services at home was associated with home death among those whose symptoms were well managed.

  3. PRagmatic trial Of Video Education in Nursing homes: The design and rationale for a pragmatic cluster randomized trial in the nursing home setting.

    Science.gov (United States)

    Mor, Vincent; Volandes, Angelo E; Gutman, Roee; Gatsonis, Constantine; Mitchell, Susan L

    2017-04-01

    Background/Aims Nursing homes are complex healthcare systems serving an increasingly sick population. Nursing homes must engage patients in advance care planning, but do so inconsistently. Video decision support tools improved advance care planning in small randomized controlled trials. Pragmatic trials are increasingly employed in health services research, although not commonly in the nursing home setting to which they are well-suited. This report presents the design and rationale for a pragmatic cluster randomized controlled trial that evaluated the "real world" application of an Advance Care Planning Video Program in two large US nursing home healthcare systems. Methods PRagmatic trial Of Video Education in Nursing homes was conducted in 360 nursing homes (N = 119 intervention/N = 241 control) owned by two healthcare systems. Over an 18-month implementation period, intervention facilities were instructed to offer the Advance Care Planning Video Program to all patients. Control facilities employed usual advance care planning practices. Patient characteristics and outcomes were ascertained from Medicare Claims, Minimum Data Set assessments, and facility electronic medical record data. Intervention adherence was measured using a Video Status Report embedded into electronic medical record systems. The primary outcome was the number of hospitalizations/person-day alive among long-stay patients with advanced dementia or cardiopulmonary disease. The rationale for the approaches to facility randomization and recruitment, intervention implementation, population selection, data acquisition, regulatory issues, and statistical analyses are discussed. Results The large number of well-characterized candidate facilities enabled several unique design features including stratification on historical hospitalization rates, randomization prior to recruitment, and 2:1 control to intervention facilities ratio. Strong endorsement from corporate leadership made randomization

  4. Manufactured Home Energy Audit (MHEA)Users Manual (Version 7)

    Energy Technology Data Exchange (ETDEWEB)

    Gettings, M.B.

    2003-01-27

    each of these measures is evaluated separately in order to devise a package of measures that will result in high energy and dollar savings. MHEA stands apart from other building energy analysis tools in many ways. Calculations incorporated into the computer code specifically address manufactured home heating and cooling load trends. The retrofit measures evaluated by MHEA are all applicable to manufactured homes. Help messages describe common manufactured home weatherization practices as well as provide hints on how to install retrofit measures. These and other features help make MHEA easy to use when evaluating energy consumption and the effects of weatherization retrofit measures for manufactured homes. The National Renewable Energy Laboratory originally developed MHEA for the U.S. Department of Energy Weatherization Assistance Program. Conversion to a Windows-based program with additional modifications has been performed by the Oak Ridge National Laboratory. Many energy consumption and economic calculations resemble those found in the Computerized Instrumented Residential Audit written by Lawrence Berkeley National Laboratory and the National Energy Audit written by Oak Ridge National Laboratory. The calculations are similar in structure but have been altered to more accurately represent a manufactured home's unique energy use characteristics. Most importantly, MHEA helps meet the DOE Weatherization Assistance Program goals to increase client comfort and use federal dollars wisely.

  5. Home

    Science.gov (United States)

    Military Commission Seal VWAP Login Home Go ABOUT US Organization Overview Organizational Chart Families VWAP Login CCTV Sites Travel Media MC News CCTV Sites Travel Today at OMC Home Today at OMC Daily

  6. Home hemodialysis

    DEFF Research Database (Denmark)

    Agar, John W; Perkins, Anthony; Heaf, James G

    2015-01-01

    We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use.......We describe the infrastructure that is necessary for hemodialysis in the home focusing on physical requirements, the organization of plumbing and water, and the key features that should guide the selection of machines that are suitable for home use....

  7. Creating a meaningful infection control program: one home healthcare agency's lessons.

    Science.gov (United States)

    Poff, Renee McCoy; Browning, Sarah Via

    2014-03-01

    Creating a meaningful infection control program in the home care setting proved to be challenging for agency leaders of one hospital-based home healthcare agency. Challenges arose when agency leaders provided infection control (IC) data to the hospital's IC Committee. The IC Section Chief asked for national benchmark comparisons to align home healthcare reporting to that of the hospital level. At that point, it was evident that the home healthcare IC program lacked definition and structure. The purpose of this article is to share how one agency built a meaningful IC program.

  8. Implementing a Zero Energy Ready Home Multifamily Project

    Energy Technology Data Exchange (ETDEWEB)

    Springer, David [Alliance for Residential Building Innovation, Davis, CA (United States); German, Alea [Alliance for Residential Building Innovation, Davis, CA (United States)

    2015-08-01

    An objective of this project was to gain a highly visible foothold for residential buildings built to the U.S. Department of Energy's Zero Energy Ready Home (ZERH) specification that can be used to encourage participation by other California builders. This report briefly describes two single family homes that were ZERH-certified, and focuses on the experience of working with developer Mutual Housing on a 62 unit multi-family community at the Spring Lake subdivision in Woodland, CA. The Spring Lake project is expected to be the first ZERH certified multi-family project nationwide. This report discusses challenges encountered, lessons learned, and how obstacles were overcome.

  9. HomePort

    DEFF Research Database (Denmark)

    Madsen, Per Printz

    2009-01-01

    In the last couple of year's computer based home control systems are getting more and more common in modern homes. For instance these systems take care of light control, heat control and security systems.  The latest trend is to use wireless communication like Z-Wave and ZigBee to interconnect...... different components in these systems. One of the characteristics is that each system, like for instance heat and light, has their own specific way of using the communication system.   This paper describes a way to connect different home control systems through an intelligent gateway, called a Home......Port. The HomePort consists of a number of Subsystem communication drivers, a virtual communication layer, an interpreter and a PC- based compiler for a high level control language, called GIL (Gateway intelligence language). The focus in this paper will be on the upper two layers in the Home...

  10. DOE Zero Energy Ready Home Case Study: Thrive Home Builders, Lowry Plan

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest National Laboratory

    2017-09-01

    Thrive Home Builders built this 4,119-ft2 home at the Lowry development in Denver, Colorado, to the high-performance criteria of the U.S. Department of Energy’s Zero Energy Ready Home Program. Despite the dense positioning of the homes, mono-plane roof designs afforded plenty of space for the 8.68 kW of photovoltaic panels. With the PV, the home achieves a Home Energy Rating System (HERS) score of 4 and the home owners should enjoy energy bills of about $-11 a year. Without the PV, the home would score a HERS 38 (far lower than the HERS 80 to 100 of typical new homes).

  11. Multidisciplinary nutritional support for undernutrition in nursing home and home-care

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe

    2016-01-01

    Objective To assess the effect of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care identified with the validated Eating Validation Scheme (EVS). Methods An 11 wk cluster randomized trial with a home-care (3 clusters) or nursing home (3 clusters.......3] versus 1.3 [0.5], P = 0.021) was observed. There was a almost significant difference in mortality (2% versus 13%, P = 0.079). Conclusions Multidisciplinary nutritional support in older adults in nursing home and home-care could have a positive effect on quality of life, muscle strength, and oral care....... means of EuroQol-5D-3L), physical performance (30-seconds chair stand), nutritional status (weight and hand-grip strength), oral care, fall incidents, hospital admissions, rehabilitation stay, moving to nursing homes (participants from home-care), and mortality. Results Respectively, 55 (46 from 2 home...

  12. Zero carbon homes: Perceptions from the UK construction industry

    International Nuclear Information System (INIS)

    Heffernan, Emma; Pan, Wei; Liang, Xi; Wilde, Pieter de

    2015-01-01

    The take-up of the many voluntary energy efficiency standards which exist in the UK and internationally has been limited. As a result, governments have recognised the need to introduce mandatory schemes through legislation, e.g. from 2016 all new build homes in the UK will be required to achieve zero carbon in regulated energy consumption. However, as 2016 approaches, very few zero carbon homes are being delivered. This paper explores the drivers and barriers for zero carbon homebuilding. The perceptions of the wider construction industry were gathered through a series of semi-structured interviews with professionals involved in commissioning, designing, constructing and regulating housing. The results show that, whilst drivers for zero carbon homebuilding exist, the barriers are currently perceived to be greater than the drivers. The barriers are categorised into five groups: economic, skills and knowledge, industry, legislative and cultural. Mechanisms for policy and industry support for the delivery of zero carbon homes are identified to address these barriers. The research findings highlight the need for a clear and robust policy framework for the forthcoming standard. The Government and industry must prioritise raising public awareness of the need for and benefits of zero carbon homes to help develop market demand. - Highlights: • The strongest drivers were perceived to be in the legislative and economic themes. • More barriers were identified than drivers or potential support mechanisms. • Economic and skills and knowledge barriers were perceived as the most significant. • Uncertainty in zero carbon homes policy is a barrier to zero carbon homebuilding. • Proposed support mechanisms include zero carbon champions and self-build homes

  13. The nutritional care of people living with dementia at home: A scoping review.

    Science.gov (United States)

    Mole, Louise; Kent, Bridie; Abbott, Rebecca; Wood, Chloë; Hickson, Mary

    2018-01-24

    There are an increasing number of people with dementia living in their own home for longer, often supported by a family member. The symptoms of dementia can affect an individual's nutritional status, which can lead to a reduced quality of life for the person with dementia and their family members. A scoping review was conducted from July 2016 until September 2016, using a recognised framework, to explore what is currently known, and identify any gaps in the research regarding the nutritional care of people living with dementia at home. This included any interventions that may have been trialled or implemented, and the views of those living with dementia, carers and clinicians. Six electronic databases were searched from inception to July 2016. A review team was involved in screening and data extraction for selected articles. Published qualitative and quantitative studies were included that explored the nutritional care of people living with dementia at home. Methods included data extraction and conventional content analysis. Stakeholders were involved in the development of final categories. Following screening, 61 studies reported in 63 articles were included. Most studies were cross-sectional (n = 24), cohort (n = 15) or qualitative (n = 9). Only three were randomised controlled trials. Three overarching categories represented the results: Timely identification of nutritional risk and subsequent regular monitoring of nutritional status, multi-component tailored interventions and the influence of the care-giving dyad on nutritional status. Many studies identify people living at home with dementia as a vulnerable group prone to malnutrition; however, a lack of interventions exists to address the increased risk. There is a lack of research exploring the role of home care providers and healthcare professionals in the provision of nutritional care. Further research is required to explore how the emotional aspect of the care-giving dyad influences nutritional care

  14. HomePort ZigBee Adapter

    DEFF Research Database (Denmark)

    Pedersen, Thomas; Smedegaard, Jacob Haubach; Hansen, Rene

    the existing tool, Homeport, to act as a middleware and bridge between ConLAN's existing network and the ZigBee network. This report primarily discusses three possible solutions for constructing this bridge and current status on the implementation of a Develco SmartAMM and Zigbee stack for HomePort....

  15. Attractiveness of people-centred and integrated Dutch Home Care: A nationwide survey among nurses.

    Science.gov (United States)

    Maurits, Erica E M; de Veer, Anke J E; Groenewegen, Peter P; Francke, Anneke L

    2018-03-05

    The World Health Organization is calling for a fundamental change in healthcare services delivery, towards people-centred and integrated health services. This includes providing integrated care around people's needs that is effectively co-ordinated across providers and co-produced by professionals, the patient, the family and the community. At the same time, healthcare policies aim to scale back hospital and residential care in favour of home care. This is one reason for the home-care nursing staff shortages in Europe. Therefore, this study aimed to examine whether people-centred, integrated home care appeals to nurses with different levels of education in home care and hospitals. A questionnaire survey was held among registered nurses in Dutch home-care organisations and hospitals in 2015. The questionnaire addressed the perceived attractiveness of different aspects of people-centred, integrated home care. In total 328 nurses filled in the questionnaire (54% response rate). The findings showed that most home-care nurses (70% to 97%) and 36% to 76% of the hospital nurses regard the different aspects of people-centred, integrated home care as attractive. Specific aspects that home-care nurses find attractive are promoting the patient's self-reliance and having a network in the community. Hospital nurses are mainly attracted to health-related prevention and taking control in complex situations. No clear differences between the educational levels were found. It is concluded that most home-care nurses and a minority of hospital nurses feel attracted to people-centred, integrated home care, irrespective of their educational level. The findings are relevant to policy makers and home-care organisations who aim to expand the home-care nursing workforce. © 2018 John Wiley & Sons Ltd.

  16. Challenges and Opportunities To Achieve 50% Energy Savings in Homes: National Laboratory White Papers

    Energy Technology Data Exchange (ETDEWEB)

    Bianchi, M. V. A.

    2011-07-01

    In 2010, researchers from four of the national laboratories involved in residential research (Lawrence Berkeley National Laboratory, National Renewable Energy Laboratory, Oak Ridge National Laboratory, and Pacific Northwest National Laboratory) were asked to prepare papers focusing on the key longer term research challenges, market barriers, and technology gaps that must be addressed to achieve the longer term 50% saving goal for Building America to ensure coordination with the Building America industry teams who are focusing their research on systems to achieve the near-term 30% savings goal. Although new construction was included, the focus of the effort was on deep energy retrofits of existing homes. This report summarizes the key opportunities, gaps, and barriers identified in the national laboratory white papers.

  17. The Medical Home

    Science.gov (United States)

    ... Videos for Educators Search English Español The Medical Home KidsHealth / For Parents / The Medical Home What's in ... for your child. What Does the Term "Medical Home" Mean? A medical home isn't a place ...

  18. Review series: Examples of chronic care model: the home-based chronic care model: redesigning home health for high quality care delivery.

    Science.gov (United States)

    Suter, Paula; Hennessey, Beth; Florez, Donna; Newton Suter, W

    2011-01-01

    Individuals with chronic obstructive pulmonary disease (COPD) face significant challenges due to frequent distressing dyspnea and deficits related to activities of daily living. Individuals with COPD are often hospitalized frequently for disease exacerbations, negatively impacting quality of life and healthcare expenditure burden. The home-based chronic care model (HBCCM) was designed to address the needs of patients with chronic diseases. This model facilitates the re-design of chronic care delivery within the home health sector by ensuring patient-centered evidence-based care. This HBCCM foundation is Dr. Edward Wagner s chronic care model and has four additional areas of focus: high touch delivery, theory-based self management, specialist oversight and the use of technology. This article will describe this model in detail and outline how model use for patients with COPD can bring value to stakeholders across the health care continuum.

  19. A qualitative examination of home and neighborhood environments for obesity prevention in rural adults

    Directory of Open Access Journals (Sweden)

    Ballard Denise

    2008-12-01

    Full Text Available Abstract Background The home and neighborhood environments may be important in obesity prevention by virtue of food availability, food preparation, cues and opportunities for physical activity, and family support. To date, little research has examined how home and neighborhood environments in rural communities may support or hinder healthy eating and physical activity. This paper reports characteristics of rural homes and neighborhoods related to physical activity environments, availability of healthy foods, and family support for physical activity and maintaining an ideal body weight. Methods In-depth interviews were conducted with 60 African American and White adults over 50 years of age in two rural counties in Southwest Georgia. Interviews were transcribed verbatim and coded independently by two members of the research team using standard methods of qualitative analysis. Themes were then identified and data matrices were used to identify patterns by gender or race. Results Neighborhood features that supported physical activity were plenty of land, minimal traffic and living in a safe and friendly neighborhood. The major barrier was lack of recreational facilities. The majority of participants were not physically active with their family members due to schedule conflicts and lack of time. Family member-initiated efforts to encourage physical activity met with mixed results, with refusals, procrastination, and increased activity all reported. Participants generally reported it was easy to get healthy foods, although cost barriers and the need to drive to a larger town for a supermarket with good variety were noted as obstacles. Family conversations about weight had occurred for about half of the participants, with reactions ranging from agreement about the need to lose weight to frustration. Conclusion This study suggests that successful environmental change strategies to promote physical activity and healthy eating in rural neighborhoods may

  20. Utilizing Chair Massage to Address One Woman's Health in Rural Ghana West Africa: a Case Report.

    Science.gov (United States)

    Meryanos, Cathy J

    2016-12-01

    There is limited access to health care in rural Ghana and virtually no rehabilitative services available. This situation presents a unique opportunity to utilize chair massage in addressing women's health in rural Ghana, particularly when it comes to muscle pain and fatigue from heavy labor. The objective of this case report is to determine the results of chair massage as a strategy to reduce neck, shoulder, and back pain, while increasing range of motion. The patient is a 63-year-old Ghanaian female, who was struck by a public transport van while carrying a 30-50 pound load on her head, two years prior. The accident resulted in a broken right humerus and soft tissue pain. A traditional medicine practitioner set the bone, however there was no post-accident rehabilitation available. At the time of referral, she presented complaints of shoulder, elbow, and wrist pain. In addition, she was unable to raise her right hand to her mouth for food intake. The results of this case report include an increase in range of motion, as well as elimination of pain in the right shoulder, elbow, and hand. Visual assessments showed an approximate increase of ROM within the ranges of 45-65 degrees in the right arm, as well as 10-15 degrees in 4th and 5th fingers. There was also a decrease in muscle hypertonicity in the thoracic and cervical areas, and a profound increase in quality of life for the patient. This case report illustrates how therapeutic chair massage was utilized to address a common health concern for one woman in rural Ghana. It also demonstrates that pre-existing musculoskeletal disorders and pain may be eliminated with massage intervention. Massage therapy may be important to ameliorating certain types of health problems in remote rural villages in low income countries.

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

    Science.gov (United States)

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

    2017-12-01

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

  2. 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.

  3. Frameworks for Understanding Challenging Behaviour in Out-of-Home Care

    Science.gov (United States)

    McLean, Sara; Kettler, Lisa; Delfabbro, Paul; Riggs, Damien

    2012-01-01

    Background: Challenging and disruptive behaviour is commonly reported among children placed in the out-of-home care sector. Little is known about how stakeholders in this sector understand or manage challenging behaviour. Method: Ninety-two stakeholders in the South Australian out-of-home care sector were interviewed about their approach to…

  4. Understanding sharps injuries in home healthcare: The Safe Home Care qualitative methods study to identify pathways for injury prevention.

    Science.gov (United States)

    Markkanen, Pia; Galligan, Catherine; Laramie, Angela; Fisher, June; Sama, Susan; Quinn, Margaret

    2015-04-11

    Home healthcare is one of the fastest growing sectors in the United States. Percutaneous injuries from sharp medical devices (sharps) are a source of bloodborne pathogen infections among home healthcare workers and community members. Sharps use and disposal practices in the home are highly variable and there is no comprehensive analysis of the system of sharps procurement, use and disposal in home healthcare. This gap is a barrier to effective public health interventions. The objectives of this study were to i) identify the full range of pathways by which sharps enter and exit the home, stakeholders involved, and barriers for using sharps with injury prevention features; and ii) assess the leverage points for preventive interventions. This study employed qualitative research methods to develop two systems maps of the use of sharps and prevention of sharps injuries in home healthcare. Twenty-six in-depth interview sessions were conducted including home healthcare agency clinicians, public health practitioners, sharps device manufacturers, injury prevention advocates, pharmacists and others. Interview transcripts were audio-recorded and analyzed thematically using NVIVO qualitative research analysis software. Analysis of supporting archival material also was conducted. All findings guided development of the two maps. Sharps enter the home via multiple complex pathways involving home healthcare providers and home users. The providers reported using sharps with injury prevention features. However, home users' sharps seldom had injury prevention features and sharps were commonly re-used for convenience and cost-savings. Improperly discarded sharps present hazards to caregivers, waste handlers, and community members. The most effective intervention potential exists at the beginning of the sharps systems maps where interventions can eliminate or minimize sharps injuries, in particular with needleless treatment methods and sharps with injury prevention features

  5. Home drinking in the UK: trends and causes.

    Science.gov (United States)

    Foster, John H; Ferguson, Colin S

    2012-01-01

    To explore the trend in the UK to consume alcohol at home rather than at licensed premises. A Medline search entering the terms 'home drinking', 'alcohol' and 'adult' covering the period 2000-2011 yielded 48 articles, of which 6 met the criteria to be included in the review. Grey literature including survey and market research data were reviewed. In the UK, since 1970 there has been trend for beer to be consumed at home more often than in licensed premises and that the overall trend towards greater home drinking has increased since 2000. The main reasons given are convenience, cost, safety, autonomy and stress relief. There has also been an increase in the practice known as 'pre-loading' (drinking before going out). Adults who drink mainly at home report that they are aware that they run a risk of higher overall alcohol consumption but tend to play down the possibility that increased consumption may lead to longer-term harm. Home drinking trends may have long-term public health consequences. Greater understanding of the drivers of this trend will help policy-makers to respond to these societal changes.

  6. ThinkHome Energy Efficiency in Future Smart Homes

    Directory of Open Access Journals (Sweden)

    Reinisch Christian

    2011-01-01

    Full Text Available Abstract Smart homes have been viewed with increasing interest by both home owners and the research community in the past few years. One reason for this development is that the use of modern automation technology in the home or building promises considerable savings of energy, therefore, simultaneously reducing the operational costs of the building over its whole lifecycle. However, the full potential of smart homes still lies fallow, due to the complexity and diversity of the systems, badly engineered and configured installations, as well as the frequent problem of suboptimal control strategies. Summarized, these problems converge to two undesirable conditions in the "not-so-smart" home: energy consumption is still higher than actually necessary and users are unable to yield full comfort in their automated homes. This work puts its focus on alleviating the current problems by proposing a comprehensive system concept, that shall ensure that smart homes can keep their promise in the future. The system operates on an extensive knowledge base that stores all information needed to fulfill the goals of energy efficiency and user comfort. Its intelligence is implemented as and within a multiagent system that also caters for the system's openness to the outside world. As a first evaluation, a profile-based control strategy for thermal comfort is developed and verified by means of simulation.

  7. Where should Momma go? Current nursing home performance measurement strategies and a less ambitious approach

    Directory of Open Access Journals (Sweden)

    Lieberman Trudy

    2007-06-01

    Full Text Available Abstract Background Nursing home performance measurement systems are practically ubiquitous. The vast majority of these systems aspire to rank order all nursing homes based on quantitative measures of quality. However, the ability of such systems to identify homes differing in quality is hampered by the multidimensional nature of nursing homes and their residents. As a result, the authors doubt the ability of many nursing home performance systems to truly help consumers differentiate among homes providing different levels of quality. We also argue that, for consumers, performance measurement models are better at identifying problem facilities than potentially good homes. Discussion In response to these concerns we present a proposal for a less ambitious approach to nursing home performance measurement than previously used. We believe consumers can make better informed choice using a simpler system designed to pinpoint poor-quality nursing homes, rather than one designed to rank hundreds of facilities based on differences in quality-of-care indicators that are of questionable importance. The suggested performance model is based on five principles used in the development of the Consumers Union 2006 Nursing Home Quality Monitor. Summary We can best serve policy-makers and consumers by eschewing nursing home reporting systems that present information about all the facilities in a city, a state, or the nation on a website or in a report. We argue for greater modesty in our efforts and a focus on identifying only the potentially poorest or best homes. In the end, however, it is important to remember that information from any performance measurement website or report is no substitute for multiple visits to a home at different times of the day to personally assess quality.

  8. The Disabled Young Adult: Ready to Leave Home?

    OpenAIRE

    Tervo, Raymond; O'Leary, Donal

    1986-01-01

    The disabled young adult strives to be independent when preparing to leave home and family. This article provides a checklist that can help the disabled young adult and his/her family to make this transition. In some cases, a transitional rehabilitation program may also be of help. The family physician who is familiar with the issues that pertain to adolescent development can play a central part in addressing patient and family problems that present at this time.

  9. Investigating the Challenges and Opportunities in Home Care to Facilitate Effective Information Technology Adoption.

    Science.gov (United States)

    Koru, Güneş; Alhuwail, Dari; Topaz, Maxim; Norcio, Anthony F; Mills, Mary Etta

    2016-01-01

    As home care utilization increases, information technology (IT) becomes a critical tool for providing quality home care. However, most home health agencies (HHAs) in the United States are in a position to adopt and leverage IT solutions in budget-constrained settings, where it is crucial to address important and pressing challenges and opportunities for achieving effectiveness in IT adoption. (1) Explore HHAs' challenges and opportunities related to delivering home care as well as performing administrative functions and conducting business, (2) learn about current IT implementation levels and activities in home care, and (3) make recommendations to facilitate efforts and initiatives designed for adopting IT in home care effectively. Semistructured interviews were conducted to elicit rich contextual information from the participants recruited from 13 local HHAs in one of the states in the United States. Established systems analysis techniques were used to ask questions during the interviews. Framework, a qualitative research method, was used to analyze the qualitative data obtained from the interviews. Coordinating clinical and administrative workflows was an important challenge. Inadequate access to patients' medical history and difficulties with medication reconciliation detracted from the quality of care. Hiring, training, scheduling, and retaining qualified personnel constituted another important challenge. Training and educating patients, caregivers, and families hold important opportunities for improving the quality of care. All except one HHA adopted electronic health records (EHR) but many continued to struggle considerably in their day-to-day functions. Health information exchange (HIE) seems to be the most needed technology. Telehealth solutions were perceived to be promising but their added value and financial viability in the long run were questioned. The recommendations for effective IT adoption include keeping a quality improvement focus, keeping a

  10. Children who run away from home: risks for suicidal behavior and substance misuse.

    Science.gov (United States)

    Meltzer, Howard; Ford, Tamsin; Bebbington, Paul; Vostanis, Panos

    2012-11-01

    The primary aim of this study is to examine the extent to which running away from home as a child is associated with behavioral problems and victimization during childhood and with suicidal behavior and substance abuse during early adulthood. A random probability sample comprising 7,461 respondents was interviewed for the 2007 survey of psychiatric morbidity of adults in England. A subsample of 16- to 34-year-old individuals was selected for secondary analysis (N = 2,247). All survey respondents were asked whether they had run away from home and asked specific questions on being physically, emotionally and sexually abused as children. They were also asked about suicidal behavior and alcohol and drug dependence in early adulthood. Approximately 7% of 16- to 34-year-old individuals reported running away from home before the age of 16 years, with higher rates in women than in men (9.8% compared with 5.3%). Overall, 45.3% reported being bullied, 25.3% experienced violence at home, and 8.8% reported unwanted sexual intercourse. Runaways were far more likely than other children to have suffered victimization and family difficulties and to exhibit behavioral problems. Adults who reported running away from home were three times more likely than other adults to have thought about or attempted suicide, but the relationship with substance abuse was far less pronounced. Sexual, physical, and emotional abuse, along with family difficulties, can all impact children who run away from home. Running away from home was strongly associated with suicidal behavior in adulthood, regardless of other childhood adversities. Copyright © 2012 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  11. On Developing a Novel Versatile Framework for Heterogeneous Home Monitoring WSN networks

    Directory of Open Access Journals (Sweden)

    Ch. P. Antonopoulos

    2015-05-01

    Full Text Available The ability to deploy efficient and versatile WSN networks in the home environment is and will remain in the years to come a cornerstone objective in wireless networking. Respective services are continuously expanding requiring novel design and implementation approaches able to cover all relative present and even more importantly future requirements. This paper aims to present and convey knowledge and experience gained from such an effort in the context of home monitoring. Respective discussion covers all relative aspects and analyzes all critical challenges addressed ranging from identification and specification of the main requirements, to possible implementation approaches considered and finally the actual development undertaken. The final outcome considering the WSN home monitoring infrastructure as well as extracted knowledge and practical conclusions can be proven useful for further extending such an endeavour or even pursuing a different approach.

  12. Workplace Stress and Ethical Challenges Experienced by Nursing Staff in a Nursing Home

    Science.gov (United States)

    Vondras, Dean D.; Flittner, Diane; Malcore, Sylvia A.; Pouliot, Gregory

    2009-01-01

    This research explores the workplace stress and ethical challenges reported by healthcare staff in a nursing home. A brief self-report survey was administered to 44 members of the nursing staff in a not-for-profit nursing home. The survey included items that elicited identification of specific workplace stressors and ethical challenges and global…

  13. Unimaginable homes

    DEFF Research Database (Denmark)

    Møller, Kristian; Klausen, Maja

    2018-01-01

    The chapter draw from critical mediatization theory, critical intimacy theory, and cultural gerontology and asks: How do elderly people practice their mediatized homes? Which roles do media play in constituting and disturbing the flows of bodies into the home? Moreover: how do dominant...... in the making of the mediatized home space. We conclude by returning to the research questions and making explicit how researching flows of bodies that in many ways inhabit homes of the in-between contributes to both gerontological and geomediatization research agendas....

  14. Counting addressing method: Command addressable element and extinguishing module

    Directory of Open Access Journals (Sweden)

    Ristić Jovan D.

    2009-01-01

    Full Text Available The specific requirements that appear in addressable fire detection and alarm systems and the shortcomings of the existing addressing methods were discussed. A new method of addressing of detectors was proposed. The basic principles of addressing and responding of a called element are stated. Extinguishing module is specific subsystem in classic fire detection and alarm systems. Appearing of addressable fire detection and alarm systems didn't caused essential change in the concept of extinguishing module because of long calling period of such systems. Addressable fire security system based on counting addressing method reaches high calling rates and enables integrating of the extinguishing module in addressable system. Solutions for command addressable element and integrated extinguishing module are given in this paper. The counting addressing method was developed for specific requirements in fire detection and alarm systems, yet its speed and reliability justifies its use in the acquisition of data on slowly variable parameters under industrial conditions. .

  15. Mass balances and life cycle inventory of home composting of organic waste

    DEFF Research Database (Denmark)

    Andersen, Jacob Kragh; Boldrin, Alessio; Christensen, Thomas Højlund

    2011-01-01

    A comprehensive experimental setup with six single-family home composting units was monitored during 1year. The composting units were fed with 2.6–3.5kg organic household waste (OHW) per unit per week. All relevant consumptions and emissions of environmental relevance were addressed and a full li...

  16. The Return Home: Transitioning from a 28-Day Remote Outdoor Education Programme

    Science.gov (United States)

    McNatty, Shannon

    2016-01-01

    This article addresses the challenges for students transitioning from the remote Te Kahu (pseudonym) outdoor education programme back into their home and school city environments. Students must develop methods of coping and readjust to society to continue the personal growth and process the learning affected through the 28-day programme. The…

  17. Work–home interference: Examining socio-demographic predictors in the South African context

    Directory of Open Access Journals (Sweden)

    Marissa de Klerk

    2010-04-01

    Research purpose: The main research aim of the study was to investigate the socio-demographic predictors of negative and positive work–home interaction of South African employees. Motivation for the study: Little information is known about the prevalence of work–home interaction within groups. This study is aimed at enabling the researcher and organisations to identify those groups that are at risk of negative interference and which are prone to positive interaction, to allow for the development of appropriate strategies and intervention programmes. Research design, approach and method: A cross-sectional survey design was used in the study. A sample (N = 2040 was taken from four South African industries (i.e. the police service, the earthmoving equipment industry, mining and nursing. A socio-demographic questionnaire and the Survey Work–Home Interaction-Nijmegen (SWING were used. Main findings: The results indicated that robust predictors included occupation, gender and language for negative work–home interference; occupation, age and language for positive work–home interference; occupation and language for negative home–work interference; and occupation, age, education and language for positive home–work interference. Practical/managerial implications: The implications of the study are that negative and positive work–home interaction is uniquely associated with socio-demographic characteristics. Work–life balance initiatives should, therefore, be carefully tailored to address the needs of each socio-demographic group. Contribution/value-add: The findings of the study suggest answers to the management of the work–home interaction among various socio-demographic groups in organisations.

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

    Directory of Open Access Journals (Sweden)

    Helena Walz

    2015-08-01

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

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

    CERN Document Server

    Barranco, Javier; Cameron, David; Crouch, Matthew; De Maria, Riccardo; 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; Van der Veken, Frederik; Zacharov, Igor

    2017-01-01

    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 i...

  20. Medical staff organization in nursing homes: scale development and validation.

    Science.gov (United States)

    Katz, Paul R; Karuza, Jurgis; Intrator, Orna; Zinn, Jacqueline; Mor, Vincent; Caprio, Thomas; Caprio, Anthony; Dauenhauer, Jason; Lima, Julie

    2009-09-01

    To construct a multidimensional self-report scale to measure nursing home (NH) medical staff organization (NHMSO) dimensions and then pilot the scale using a national survey of medical directors to provide data on its psychometric properties. Instrument development process consisting of the proceedings from the Nursing Home Physician Workforce Conference and focus groups followed by cognitive interviews, which culminated in a survey of a random sample of American Medical Directors Association (AMDA) affiliated medical directors. Analyses were conducted on surveys matched to Online Survey Certification and Reporting (OSCAR) data from freestanding nonpediatric nursing homes. A total of 202 surveys were available for analysis and comprised the final sample. Dimensions were identified that measured the extent of medical staff organization in nursing homes and included staff composition, appointment process, commitment (physiciancohesion; leadership turnover/capability), departmentalization (physician supervision, autonomy and interdisciplinary involvement), documentation, and informal dynamics. The items developed to measure each dimension were reliable (Cronbach's alpha ranged from 0.81 to 0.65).Intercorrelations among the scale dimensions provided preliminary evidence of the construct validity of the scale. This report, for the first time ever, defines and validates NH medical staff organization dimensions, a critical first step in determining the relationship between physician practice and the quality of care delivered in the NH.

  1. Home Automation : Smart home technology and template house design

    OpenAIRE

    Zheng, Zeya

    2013-01-01

    In this thesis, home automation’s general knowledge, technology information and each component will be introduced to the reader in the first half of the whole thesis. In the second half, thesis includes the Home Automation template design and market competitiveness analysis. The author assumes that the reader is going to spend lots of money to have a smart home. In this situation, the author introduces the home automation to the reader at each component. So the reader in this thesis actu...

  2. Introduction of assistive devices: home nurses' practices and beliefs.

    Science.gov (United States)

    Roelands, Marc; Van Oost, Paulette; Depoorter, Anne Marie; Buysse, Ann; Stevens, Veerle

    2006-04-01

    This paper reports a study describing home nurses' intention and current practices regarding introducing assistive devices, and investigating whether their practice is related to social cognitive factors (attitudes, subjective norms and self-efficacy). Home nurses not only care for patients in particular medical domains, but also educate and guide them towards more independence. Patients with age-related disabilities in mobility and self-care might benefit from the use of assistive devices. A home nurse might be the first and only person to discuss the disability and use of an assistive device. Therefore, home nurses' beliefs about the introduction of assistive devices could affect their daily practices. A cross-sectional study was conducted with a convenience sample of 64 home nurses chosen from a random sample of home nursing departments. The home nurses completed a self-administered questionnaire. The Theory of Planned Behaviour framework was used to develop the social cognitive measures regarding each of the six steps distinguished in the introduction of assistive devices. Home nurses had positive attitudes and high levels of intention, subjective norm and self-efficacy towards most steps of the decision process to introduce assistive devices. In a multiple linear regression analysis, attitude and self-efficacy predicted intention to introduce assistive devices to older clients with disabilities. Intention was correlated to home nurses' current practices. The findings suggest that conditions are present to involve home nurses more explicitly in the introduction of assistive devices to their patients. Social cognitive factors should be taken into account when developing interventions that aim to support home nurses to do this.

  3. Consumption of foods away from home in Brazil.

    Science.gov (United States)

    Bezerra, Ilana Nogueira; Souza, Amanda de Moura; Pereira, Rosangela Alves; Sichieri, Rosely

    2013-02-01

    To describe foods consumed away from home and associated factors in Brazil. The study was based on the National Dietary Survey which was conducted among residents aged over 10 years old in 24% of households participating in the Household Budget Survey in 2008-2009 (n = 34,003). The consumption of food and beverages was collected through records of foods consumed, type of preparation, quantity, time and food source (inside or outside home). The frequency with which individuals consumed food away from home was calculated according to age, gender, income, household area location, family size, presence of children at home and age of head of household in Brazil and in each Brazilian region. Specific sampling weight and effect of the sampling design were considered in the analyses. Consumption of food away from home in Brazil was reported by 40% of respondents, varying from 13% among the elderly in the Midwest Region to 51% among adolescents in the Southeast. This percentage decreased with age and increased with income in all regions of Brazil and was higher among men and in urban areas. Foods with the highest percentage of consumption outside home were alcoholic beverages, baked and fried snacks, pizza, soft drinks and sandwiches. Foods consumed away from home showed a predominance of high energy content and poor nutritional content, indicating that the consumption of foods away from home should be considered in public health campaigns aimed at improving Brazilians' diet.

  4. Registered report: Tumour micro-environment elicits innate resistance to RAF inhibitors through HGF secretion

    OpenAIRE

    sprotocols

    2015-01-01

    Authors: David Blum, Samuel LaBarge, The Reproducibility Project: Cancer Biology†* ### Abstract The [Reproducibility Project: Cancer Biology](https://osf.io/e81xl/wiki/home/) seeks to address growing concerns about reproducibility in scientific research by conducting replications of 50 papers in the field of cancer biology published between 2010 and 2012. This Registered Report describes the proposed replication plan of key experiments from “Tumour micro-environment elicits innate res...

  5. Registered report: Widespread potential for growth-factor-driven resistance to anticancer kinase inhibitors2

    OpenAIRE

    sprotocols

    2015-01-01

    Authors: Edward Greenfield, Erin Griner, The Reproducibility Project: Cancer Biology† ### Abstract The [Reproducibility Project: Cancer Biology](https://osf.io/e81xl/wiki/home/) seeks to address growing concerns about reproducibility in scientific research by conducting replications of 50 papers in the field of cancer biology published between 2010 and 2012. This Registered Report describes the proposed replication plan of key experiments from “Widespread potential for growth-factor-d...

  6. Obesity and intensive staffing needs of nursing home residents.

    Science.gov (United States)

    Harris, John Alexander; Engberg, John; Castle, Nicholas George

    2018-06-05

    The objective of this study is to examine how increasing body mass index (BMI) among nursing home residents affects the amount of staffing assistance needed for activities of daily living (ADL). We analyzed 1,627,141 US nursing home residents reported in the 2013 Minimum Data Set in seven BMI categories, from underweight (BMI < 18.5 kg/m 2 ) to obesity Class IIIB (≥50 kg/m 2 ). Logistic regression models estimated the odds of nursing home-reported need for extensive (≥2 staff member) assistance needed for ADLs. The adjusted odds increased from 1.07 (95% Confidence Interval (95%CI) 1.06-1.08) for Class I, 1.16 (95%CI 1.14-1.17) for Class II, 1.33 (95%CI 1.31-1.35) for Class IIIA, and 1.90 (95%CI 1.86-1.95) for Class IIIB obesity residents compared to residents of normal weight. As a nursing home resident's BMI increases, especially for BMI ≥40 kg/m 2 , the need for extensive staffing assistance with ADLs also increases substantially. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Comparing Catheter-associated Urinary Tract Infection Prevention Programs Between VA and Non-VA Nursing Homes

    Science.gov (United States)

    Mody, Lona; Greene, M. Todd; Saint, Sanjay; Meddings, Jennifer; Trautner, Barbara W.; Wald, Heidi L.; Crnich, Christopher; Banaszak-Holl, Jane; McNamara, Sara E.; King, Beth J.; Hogikyan, Robert; Edson, Barbara; Krein, Sarah L.

    2018-01-01

    OBJECTIVE The impact of healthcare system integration on infection prevention programs is unknown. Using catheter-associated urinary tract infection (CAUTI) prevention as an example, we hypothesize that U.S. Department of Veterans Affairs (VA) nursing homes have a more robust infection prevention infrastructure due to integration and centralization compared with non-VA nursing homes. SETTING VA and non-VA nursing homes participating in the “AHRQ Safety Program for Long-term Care” collaborative. METHODS Nursing homes provided baseline information about their infection prevention programs to assess strengths and gaps related to CAUTI prevention. RESULTS A total of 353 (71%; 47 VA, 306 non-VA) of 494 nursing homes from 41 states responded. VA nursing homes reported more hours/week devoted to infection prevention-related activities (31 vs. 12 hours, P<.001), and were more likely to have committees that reviewed healthcare-associated infections. Compared with non-VA facilities, a higher percentage of VA nursing homes reported tracking CAUTI rates (94% vs. 66%, P<.001), sharing CAUTI data with leadership (94% vs. 70%, P=.014) and nursing personnel (85% vs. 56%, P=.003). However, fewer VA nursing homes reported having policies for appropriate catheter use (64% vs. 81%, P=.004) and catheter insertion (83% vs. 94%, P=.004). CONCLUSIONS Among nursing homes participating in an AHRQ-funded collaborative, VA and non-VA nursing homes differed in their approach to CAUTI prevention. Best practices from both settings should be applied universally to create an optimal infection prevention program within emerging integrated healthcare systems. PMID:27917728

  8. The Medical Home Model and Pediatric Asthma Symptom Severity: Evidence from a National Health Survey.

    Science.gov (United States)

    Rojanasarot, Sirikan; Carlson, Angeline M

    2018-04-01

    The objective was to investigate the association between receiving care under the medical home model and parental assessment of the severity of asthma symptoms. It was hypothesized that parents of children who received care under the medical home model reported less severe asthma symptoms compared with their counterparts, whose care did not meet the medical home criteria. Secondary analyses were conducted using cross-sectional data from the 2011-2012 National Survey of Children's Health. Children with asthma aged 0-17 years were included and classified as receiving care from the medical home if their care contained 5 components: a personal doctor, a usual source of sick care, family-centered care, no problems getting referrals, and effective care coordination. Ordinal logistic regression was used to examine the relationship between parent-rated severity of asthma symptoms (mild, moderate, and severe symptoms) and the medical home. Approximately 52% of 8229 children who reported having asthma received care from the medical home. Only 30.8% of children with severe asthma symptoms received care that met the medical home criteria, compared to 55.7% of children with mild symptoms. After accounting for confounding factors, obtaining care under the medical home model decreased the odds of parent-reported severe asthma symptoms by 31% (adjusted odds ratio 0.69; 95% CI, 0.56-0.85). Study results suggest that the medical home model can reduce parent-rated severity of asthma symptoms. The findings highlight the importance of providing medical home care to children with asthma to improve the outcomes that matter most to children and their families.

  9. Purple urine bag syndrome in nursing homes: Ten elderly case reports and a literature review

    Directory of Open Access Journals (Sweden)

    Chi-Hung Lin

    2008-12-01

    Full Text Available Chi-Hung Lin1, Hsien-Te Huang1, Chia-Chang Chien1, Dong-Sheng Tzeng1,2, For-Wey Lung1,3–51Department of Psychiatry, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan; 2Graduate Institute of Occupational Safety and Health; 3Graduate Institute of Behavioral Sciences, Kaohsiung Medical University, Kaohsiung, Taiwan; 4Department of Psychiatry, National Defense Medical Center, Taipei, Taiwan; 5Calo Psychiatric Center, Pingtung County, TaiwanAbstract: Purple urine bag syndrome (PUBS is a rare occurrence, in which the patient has a purple-colored urine bag following urinary catheterization for hours to days. Most of authors believe it is a mixture of indigo (blue and indirubin (red that becomes purple. Previous study showed that PUBS occurred predominantly in chronically catheterized, constipated women. We collected 10 elderly patients with PUBS in two nursing homes. The first two cases were identified by chart review in 1987 and 2003, and then later eight cases (42.1% were collected among 19 urinary catheterized elderly in the period between January 2007 and June 2007. In the present report, PUBS probably can occur in any patients with the right elements, namely urinary tract infection (UTI with bacteria possessing these enzymes, diet with enough tryptophan, and being catheterized. Associations with bed-bound state, Alzheimer’s, or dementia from other causes are reflections of the state of such patients who are at higher risk for UTI, and hence PUBS occurred. Although we presented PUBS as a harmless problem, prevention and control of the nosocomial catheter-associated UTIs (CAUTIs has become very important in the new patient-centered medical era. Thus, we should decrease the duration of catheterization, improve catheter care, and deploy technological advances designed for prevention, especially in the elderly cared for in nursing homes.Keyword: purple urine bag syndrome, indigo, indirubin, nursing home, bacteriuria, indoxyl sulphatase

  10. Personalized gesture interactions for cyber-physical smart-home environments

    Institute of Scientific and Technical Information of China (English)

    Yihua LOU; Wenjun WU; Radu-Daniel VATAVU; Wei-Tek TSAI

    2017-01-01

    A gesture-based interaction system for smart homes is a part of a complex cyber-physical environment,for which researchers and developers need to address major challenges in providing personalized gesture interactions.However,current research efforts have not tackled the problem of personalized gesture recognition that often involves user identification.To address this problem,we propose in this work a new event-driven service-oriented framework called gesture services for cyber-physical environments (GS-CPE) that extends the architecture of our previous work gesture profile for web services (GPWS).To provide user identification functionality,GS-CPE introduces a two-phase cascading gesture password recognition algorithm for gesture-based user identification using a two-phase cascading classifier with the hidden Markov model and the Golden Section Search,which achieves an accuracy rate of 96.2% with a small training dataset.To support personalized gesture interaction,an enhanced version of the Dynamic Time Warping algorithm with multiple gestural input sources and dynamic template adaptation support is implemented.Our experimental results demonstrate the performance of the algorithm can achieve an average accuracy rate of 98.5% in practical scenarios.Comparison results reveal that GS-CPE has faster response time and higher accuracy rate than other gesture interaction systems designed for smart-home environments.

  11. Second-hand smoke exposure and mitigation strategies among home visitation workers.

    Science.gov (United States)

    Keske, Robyn R; Rees, Vaughan W; Behm, Ilan; Wadler, Brianna M; Geller, Alan C

    2013-07-01

    Protection of workers from second-hand smoke (SHS) in occupational settings is an important policy priority, yet little attention has been given to SHS protection for home visitation health workers, who number almost 2 million in the USA. Self-reported SHS exposure, SHS mitigation strategies and suggestions for further SHS exposure reduction approaches were obtained from home visitation health workers in Massachusetts. A cross-sectional survey was conducted among Massachusetts Early Intervention workers (N=316) at their state-wide conference in April 2010. Eighty-three per cent of respondents reported at least 1 hour per month of SHS exposure, and 16% reported at least 11 hours per month. Nevertheless, only 22% of workers counselled clients on maintaining a smoke-free home. Fewer than 30% of workers had ever voiced concerns to their employing agency, and just 12% had raised their concerns directly with clients. Only 14% stated that their agency had rules designed to protect workers from SHS. SHS exposure occurs frequently among home visitation health workers. The data point to a substantial population who are not protected from SHS exposure by formal policies.

  12. 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 ...

  13. Smart Home Hacking

    OpenAIRE

    Kodra, Suela

    2016-01-01

    Smart Home is an intelligent home equipped with devices and communications systems that enables the residents to connect and control their home appliances and systems. This technology has changed the way a consumer interacts with his home, enabling more control and convenience. Another advantage of this technology is the positive impact it has on savings on energy and other resources. However, despite the consumer's excitement about smart home, security and privacy have shown to be the strong...

  14. Analysis of Home Safety of the Elderly Living in City and Rural Areas

    Directory of Open Access Journals (Sweden)

    Nihal Buker

    2008-08-01

    Full Text Available BACKGROUND: Physiological changes and chronic diseases arising during aging process increase risk of accident of the elderly, especially the elderly living alone at their homes. Home accidents are the most commonly health problem in the elderly. This study was carried out to describe home safety of the elderly living in a city or rural area using a home safety checklist. MEDHODS: 512 living in Turkey (330 in city; 182 in rural area were evaluated via face-to-face interview using a home safety checklist during a period between December and March in 2007. In addition to sociodemographics, a questionnaire including home characteristics and life style of participants was applied. To describe home safety level, Home Safety Checklist was used. RESULTS: 51.8% of the participants living in a city and 42.8% living in rural area were aged 65-69 years. Of the participants living in a city, 59.4% were living with their partners (61.5% of the participants living in rural area. While 63.9% of the participants living in a city reported that they had a private room in their homes, 53.8% of the participants living in rural area reported that they had a private room in their homes. 2.1% of participants living in a city had an excellent home safety score. Percentage for participants living in rural area was 0.5. CONCLUSION: The results obtained from this study show that majority of houses of the elderly living in Turkey were unsafe and hazardous. Therefore, health providers and architects should work together to prevent home accidents. [TAF Prev Med Bull 2008; 7(4.000: 297-300

  15. Medication errors in home care: a qualitative focus group study.

    Science.gov (United States)

    Berland, Astrid; Bentsen, Signe Berit

    2017-11-01

    To explore registered nurses' experiences of medication errors and patient safety in home care. The focus of care for older patients has shifted from institutional care towards a model of home care. Medication errors are common in this situation and can result in patient morbidity and mortality. An exploratory qualitative design with focus group interviews was used. Four focus group interviews were conducted with 20 registered nurses in home care. The data were analysed using content analysis. Five categories were identified as follows: lack of information, lack of competence, reporting medication errors, trade name products vs. generic name products, and improving routines. Medication errors occur frequently in home care and can threaten the safety of patients. Insufficient exchange of information and poor communication between the specialist and home-care health services, and between general practitioners and healthcare workers can lead to medication errors. A lack of competence in healthcare workers can also lead to medication errors. To prevent these, it is important that there should be up-to-date information and communication between healthcare workers during the transfer of patients from specialist to home care. Ensuring competence among healthcare workers with regard to medication is also important. In addition, there should be openness and accurate reporting of medication errors, as well as in setting routines for the preparation, alteration and administration of medicines. To prevent medication errors in home care, up-to-date information and communication between healthcare workers is important when patients are transferred from specialist to home care. It is also important to ensure adequate competence with regard to medication, and that there should be openness when medication errors occur, as well as in setting routines for the preparation, alteration and administration of medications. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Donoso Brown, Elena V; Fichter, Renae

    2017-12-01

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

  17. Challenges in Gaining Large Scale Carbon Reductions through Wireless Home Automation Systems

    DEFF Research Database (Denmark)

    Larsen, Peter Gorm; Rovsing, Poul Ejnar; Toftegaard, Thomas Skjødeberg

    2010-01-01

    Buildings account for more than a 35 % of the energy consumption in Europe. Therefore a step towards more sustainable lifestile is to use home automation to optimize the energy consumption “automatically”. This paper reports about the usage and some of the remaining challenges of especially...... wireless but also powerline communication in a home automation setting. For many years, home automation has been visible to many, but accessible to only a few, because of inadequate integration of systems. A vast number of both standard and proprietary communication protocols are used, and systems...... are often difficult to install and configure so professional assistance is needed. In this paper we report about our experience in constructing an open universal home automation framework enabling interoperability of multiple communication protocols. The framework can easily be expanded in order to support...

  18. A qualitative study exploring visible components of organizational culture: what influences the use of psychotropic medicines in nursing homes?

    Science.gov (United States)

    Sawan, Mouna J; Jeon, Yun-Hee; Fois, Romano J; Chen, Timothy F

    2016-10-01

    The influence of organizational culture on how psychotropic medicines are used in nursing homes has not been extensively studied. Schein's theory provides a framework for examining organizational culture which begins with the exploration of visible components of an organization such as behaviors, structures, and processes. This study aimed to identify key visible components related to the use of psychotropic medicines in nursing homes. A qualitative study was conducted in eight nursing homes in Sydney, Australia. Purposive sampling was used to conduct semi-structured interviews with 40 participants representing a broad range of health disciplines. Thematic analysis was used to derive concepts. Three visible components were related to psychotropic medicine use. These were drugs and therapeutics committee meetings, pharmacist led medication management reviews and formal and informal meetings with residents and their families. We found that only a few nursing homes utilized drugs and therapeutics committee meetings to address the overuse of psychotropic medicines. Pharmacist led medication management reviews provided a lever to minimize inappropriate psychotropic prescribing for a number of nursing homes; however, in others it was used as a box-ticking exercise. We also found that some nursing homes used meetings with residents and their families to review the use of psychotropic medicines. This study was the first to illustrate that visible components of organizational culture do influence the use of psychotropic medicines and explains in detail what of the culture needs to be addressed to reduce inappropriate psychotropic prescribing.

  19. Smartphone home monitoring of ECG

    Science.gov (United States)

    Szu, Harold; Hsu, Charles; Moon, Gyu; Landa, Joseph; Nakajima, Hiroshi; Hata, Yutaka

    2012-06-01

    A system of ambulatory, halter, electrocardiography (ECG) monitoring system has already been commercially available for recording and transmitting heartbeats data by the Internet. However, it enjoys the confidence with a reservation and thus a limited market penetration, our system was targeting at aging global villagers having an increasingly biomedical wellness (BMW) homecare needs, not hospital related BMI (biomedical illness). It was designed within SWaP-C (Size, Weight, and Power, Cost) using 3 innovative modules: (i) Smart Electrode (lowpower mixed signal embedded with modern compressive sensing and nanotechnology to improve the electrodes' contact impedance); (ii) Learnable Database (in terms of adaptive wavelets transform QRST feature extraction, Sequential Query Relational database allowing home care monitoring retrievable Aided Target Recognition); (iii) Smartphone (touch screen interface, powerful computation capability, caretaker reporting with GPI, ID, and patient panic button for programmable emergence procedure). It can provide a supplementary home screening system for the post or the pre-diagnosis care at home with a build-in database searchable with the time, the place, and the degree of urgency happened, using in-situ screening.

  20. Factors influencing women's decision to have a home birth in rural Turkey.

    Science.gov (United States)

    Kukulu, Kamile; Oncel, Selma

    2009-02-01

    to ascertain the reasons why mothers choose to have a home birth and the factors that influence these reasons. this cross-sectional study involved 392 women and was conducted between June and September 2003 in a rural setting in Turkey. The data were collected using a questionnaire developed by the authors. The questionnaire included demographic information, obstetric background, the reasons for deciding to give birth at home as well as questions on who encouraged the decision to give birth at home and who assisted in the home births. the decision to have a home birth is related to economic difficulties and the desire to benefit from the assistance of neighbours. Women who had experienced both planned and unplanned home births reported that home birth was unsafe. preliminary information is provided about women having home births that may inform practitioners' educational efforts and future research.