WorldWideScience

Sample records for research home risk

  1. Benefits and risks of smart home technologies

    International Nuclear Information System (INIS)

    Wilson, Charlie; Hargreaves, Tom; Hauxwell-Baldwin, Richard

    2017-01-01

    Smart homes are a priority area of strategic energy planning and national policy. The market adoption of smart home technologies (SHTs) relies on prospective users perceiving clear benefits with acceptable levels of risk. This paper characterises the perceived benefits and risks of SHTs from multiple perspectives. A representative national survey of UK homeowners (n=1025) finds prospective users have positive perceptions of the multiple functionality of SHTs including energy management. Ceding autonomy and independence in the home for increased technological control are the main perceived risks. An additional survey of actual SHT users (n=42) participating in a smart home field trial identifies the key role of early adopters in lowering perceived SHT risks for the mass market. Content analysis of SHT marketing material (n=62) finds the SHT industry are insufficiently emphasising measures to build consumer confidence on data security and privacy. Policymakers can play an important role in mitigating perceived risks, and supporting the energy-management potential of a smart-home future. Policy measures to support SHT market development include design and operating standards, guidelines on data and privacy, quality control, and in situ research programmes. Policy experiences with domestic energy efficiency technologies and with national smart meter roll-outs offer useful precedents. - Highlights: • Representative national survey of prospective smart home users. • Comparative analysis of three datasets to analyse perceived benefits and risks of smart home technologies. • Distinctive characteristics identified of early adopters who seed market growth. • Comparison of user perceptions with industry marketing. • Detailed policy recommendations to support energy benefits of smart home technologies.

  2. Action research in nursing homes

    DEFF Research Database (Denmark)

    Andersen, John; Bilfeldt, Annette

    2016-01-01

    quality in a joint effort between care workers, residents at the nursing home, and researchers. It concludes that the project led to empowerment of the residents and staff and played an important role in the development of democratic knowledge building about better quality and ethics in elder care....

  3. Research on the model of home networking

    Science.gov (United States)

    Yun, Xiang; Feng, Xiancheng

    2007-11-01

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

  4. 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)

  5. Research Toward Zero Energy Homes

    Energy Technology Data Exchange (ETDEWEB)

    Robert Hammon

    2010-12-31

    This final report was compiled from the detailed annual reports that were submitted for efforts in 2008 and 2009, and from individual task reports from 2010. Reports, case studies, and presentations derived from this work are available through the Building America website. The BIRA team is led by ConSol, a leading provider of energy solutions for builders since 1983. In partnership with over fifty builders, developers, architects, manufactures, researchers, utilities, and agencies, research work was performed in California, Colorado, Utah, New Mexico, Washington, Oregon, and Hawaii and five (5) climate regions (Hot-Dry, Marine, Hot-Humid, Cold, and Hot/Mixed Dry). In addition to research work, the team provided technical assistance to our partners whose interests span the entire building process. During the three year budget period, the BIRA team performed analyses of several emerging technologies, prototype homes, and high performance communities through detailed computer simulations and extensive field monitoring to meet the required climate joule milestone targets.

  6. Benefits and risks of smart home technologies

    OpenAIRE

    Wilson, Charlie; Hargreaves, Tom; Hauxwell-Baldwin, Richard

    2017-01-01

    Smart homes are a priority area of strategic energy planning and national policy. The market adoption of smart home technologies (SHTs) relies on prospective users perceiving clear benefits with acceptable levels of risk. This paper characterises the perceived benefits and risks of SHTs from multiple perspectives. A representative national survey of UK homeowners (n=1025) finds prospective users have positive perceptions of the multiple functionality of SHTs including energy management. Cedin...

  7. Risk Factors of Entry in Out-of-Home Care

    DEFF Research Database (Denmark)

    Ejrnæs, Mette; Ejrnæs, Niels Morten; Frederiksen, Signe

    2011-01-01

    . The mother’s characteristics are more important risk factors than the corresponding risk factors of the father. The results, the applied method and the epidemiological inspired analysis make an opportunity to discuss the central concepts and methods of calculation of statistical association, risk, prediction......This paper presents the results of research on children’s risk of being placed in out-of-home care. The purpose is: firstly, to compare children placed in out-of-home care with non-placed children, secondly, to estimate the children’s risk of entry into care and finally, to compare the results...... of this study with the results from similar studies. The study is based on register data from the Statistics Denmark. The sample includes all children with Danish citizenship who were born 1981–2003. In order to estimate the risk of being placed in out-of-home care, we use information about the child...

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

    Science.gov (United States)

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

    2011-01-01

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

  9. Broken Homes: Stable Risk, Changing Reasons, Changing Forms.

    Science.gov (United States)

    Sweetser, Dorrian Apple

    1985-01-01

    Cohort membership and two measures of social disadvantage were used as explanatory variables in analysis of the risk of growing up in a broken home and of the living arrangements of children with broken homes. The risk of a broken home by age 16 proved to be stable across cohorts and greater for those from disadvantaged homes. (Author/BL)

  10. Home economics in development through action research

    DEFF Research Database (Denmark)

    Benn, Jette

    2010-01-01

    This research study aimed at describing and developing home economics education through an action research approach in 2 schools and classes grade 6. The study went through 3 phases, an explorative phase with preliminary observations, interviews and discussions with teachers and pupils. Next...... in discursive phase changes have been implemented and conducted in accordance with findings. Third phase the explicative phase results were translated into text books for pupil's grade 4 to7 and to a teachers' guide. The subject is analysed theoretical through a model of the subject and research field. Findings...... and suggestions were discussed in relation to theories of learning, education and home economics. The overall perspectives were to involve pupils, to make them responsible by active and critical participation, and lastly to evaluate education in different ways....

  11. Index to Research in Home Economics: 1972-1986.

    Science.gov (United States)

    Fetterman, Nelma I.; Lefebvre, Verna M.

    This index lists 945 research articles from 4 English-language journals in the field of home economics: the "Canadian Home Economics Journal," volumes 23-30; the "Home Economics Research Journal" (United States), volumes 1-14; the "Journal of Consumer Studies and Home Economics" (United Kingdom), volumes 1-10; and the…

  12. The incidence of depression and its risk factors in Dutch nursing homes and residential care homes

    NARCIS (Netherlands)

    Boorsma, M.; Joling, K.J.; Dussel, M.; Ribbe, M.W.; Frijters, D.H.M.; van Marwijk, H.W.J.; Nijpels, G.; van Hout, H.P.J.

    2012-01-01

    Objective: Although it is known that depression is highly prevalent in institutionalized older adults, little is known about its incidence and risk factors in nursing homes and residential care homes. The aim of this study was to investigate and compare the incidence and associated risk factors for

  13. Home Economics Archive: Research, Tradition and History (HEARTH)

    Science.gov (United States)

    Click here to go to the Mann Library Home Page Click here to return to the HEARTH Home Page Click , Tradition and History HEARTH is a core electronic collection of books and journals in Home Economics and Archive: Research, Tradition and History (HEARTH). Ithaca, NY: Albert R. Mann Library, Cornell University

  14. Muslims, Home Education and Risk in British Society

    Science.gov (United States)

    Myers, Martin; Bhopal, Kalwant

    2018-01-01

    The number of families who choose to home educate has significantly increased in the last decade. This article explores the experiences of British Muslims who home educate using data from a larger study exploring the views of a diverse range of families. Drawing on the work of Beck, we discuss how 'risk' is understood in relation to Muslim home…

  15. Identifying nursing home residents at risk for falling.

    Science.gov (United States)

    Kiely, D K; Kiel, D P; Burrows, A B; Lipsitz, L A

    1998-05-01

    To develop a fall risk model that can be used to identify prospectively nursing home residents at risk for falling. The secondary objective was to determine whether the nursing home environment independently influenced the development of falls. A prospective study involving 1 year of follow-up. Two hundred seventy-two nursing homes in the state of Washington. A total of 18,855 residents who had a baseline assessment in 1991 and a follow-up assessment within the subsequent year. Baseline Minimum Data Set items that could be potential risk factors for falling were considered as independent variables. The dependent variable was whether the resident fell as reported at the follow-up assessment. We estimated the extrinsic risk attributable to particular nursing home environments by calculating the annual fall rate in each nursing home and grouping them into tertiles of fall risk according to these rates. Factors associated independently with falling were fall history, wandering behavior, use of a cane or walker, deterioration of activities of daily living performance, age greater than 87 years, unsteady gait, transfer independence, wheelchair independence, and male gender. Nursing home residents with a fall history were more than three times as likely to fall during the follow-up period than residents without a fall history. Residents in homes with the highest tertile of fall rates were more than twice as likely to fall compared with residents of homes in the lowest tertile, independent of resident-specific risk factors. Fall history was identified as the strongest risk factor associated with subsequent falls and accounted for the vast majority of the predictive strength of the model. We recommend that fall history be used as an initial screener for determining eligibility for fall intervention efforts. Studies are needed to determine the facility characteristics that contribute to fall risk, independent of resident-specific risk factors.

  16. Credit Risk Research

    DEFF Research Database (Denmark)

    Zamore, Stephen; Ohene Djan, Kwame; Alon, Ilan

    2018-01-01

    This article provides a comprehensive review of scholarly research on credit risk measurement during the last 57 years applying bibliometric citation analysis and elaborates an agenda for future research. The bibliography is compiled using the Institute for Scientific Information (ISI) Web...... of Science (WOS) database and includes all articles with citations over the period 1960–2016. Specifically, the review is carried out using 1695 articles across 72 countries published in 442 journals by 2928 authors. The findings suggest that credit risk research is multifaceted and can be classified...... into six streams: (1) defaultable security pricing, (2) default intensity modeling, (3) comparative analysis of credit models, (4) comparative analysis of credit markets, (5) credit default swap (CDS) pricing, and (6) loan loss provisions. The article contributes through synthesizing and identifying...

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

    African Journals Online (AJOL)

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

  18. Care home manager attitudes to balancing risk and autonomy for residents with dementia.

    Science.gov (United States)

    Evans, Elizabeth A; Perkins, Elizabeth; Clarke, Pam; Haines, Alina; Baldwin, Ashley; Whittington, Richard

    2018-02-01

    To determine how care home managers negotiate the conflict between maintaining a safe environment while enabling the autonomy of residents with dementia. This is important because there is limited research with care home managers; yet, they are key agents in the implementation of national policies. Semi-structured interviews were conducted with 18 managers from care homes offering dementia care in the Northwest of England. Data were analysed using a thematic analysis approach. There were three areas in which care home staff reported balancing safety and risk against the individual needs of residents. First, the physical environment created a tension between safety and accessibility to the outside world, which meant that care homes provided highly structured or limited access to outdoor space. Second, care home managers reflected a balancing act between an individual's autonomy and the need to protect their residents' dignity. Finally, care home managers highlighted the ways in which an individual's needs were framed by the needs of other residents to the extent that on some occasions an individual's needs were subjugated to the needs of the general population of a home. There was a strong, even dominant, ethos of risk management and keeping people safe. Managing individual needs while maintaining a safe care home environment clearly is a constant dynamic interpersonal process of negotiating and balancing competing interests for care home managers.

  19. Perinatal risks of planned home births in the United States.

    Science.gov (United States)

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

    2015-03-01

    We analyzed the perinatal risks of midwife-attended planned home births in the United States from 2010 through 2012 and compared them with recommendations from the American College of Obstetricians and Gynecologists (ACOG) and the American Academy of Pediatrics (AAP) for planned home births. Data from the US Centers for Disease Control and Prevention's National Center for Health Statistics birth certificate data files from 2010 through 2012 were utilized to analyze the frequency of certain perinatal risk factors that were associated with planned midwife-attended home births in the United States and compare them with deliveries performed in the hospital by certified nurse midwives. Home birth deliveries attended by others were excluded; only planned home births attended by midwives were included. Hospital deliveries attended by certified nurse midwives served as the reference. Perinatal risk factors were those established by ACOG and AAP. Midwife-attended planned home births in the United States had the following risk factors: breech presentation, 0.74% (odds ratio [OR], 3.19; 95% confidence interval [CI], 2.87-3.56); prior cesarean delivery, 4.4% (OR, 2.08; 95% CI, 2.0-2.17); twins, 0.64% (OR, 2.06; 95% CI, 1.84-2.31); and gestational age 41 weeks or longer, 28.19% (OR, 1.71; 95% CI, 1.68-1.74). All 4 perinatal risk factors were significantly higher among midwife-attended planned home births when compared with certified nurse midwives-attended hospital births, and 3 of 4 perinatal risk factors were significantly higher in planned home births attended by non-American Midwifery Certification Board (AMCB)-certified midwives (other midwives) when compared with home births attended by certified nurse midwives. Among midwife-attended planned home births, 65.7% of midwives did not meet the ACOG and AAP recommendations for certification by the American Midwifery Certification Board. At least 30% of midwife-attended planned home births are not low risk and not within

  20. The incidence of depression and its risk factors in Dutch nursing homes and residential care homes.

    Science.gov (United States)

    Boorsma, Marijke; Joling, Karlijn; Dussel, Martine; Ribbe, Miel; Frijters, Dinnus; van Marwijk, Harm W J; Nijpels, Giel; van Hout, Hein

    2012-11-01

    Although it is known that depression is highly prevalent in institutionalized older adults, little is known about its incidence and risk factors in nursing homes and residential care homes. The aim of this study was to investigate and compare the incidence and associated risk factors for depression in Dutch nursing homes and residential care homes. Data on depression were extracted from the Vrije Universiteit naturalistic cohort on routine care monitoring with the Minimum Data Set of the Resident Assessment Instrument. A total of 1,324 residents in six nursing homes and 1,723 residents in 23 residential care homes with an average follow-up of 1.2 years. Depression was defined as a clinical diagnosis according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria and the use of antidepressants. Residents with prevalent depression at baseline were excluded. The incidence rate was 13.6 per 100 person years in the nursing homes and 10.2 per 100 person years in the residential care homes. The independent risk factors for in-home depression for residents in nursing homes included dementia (OR: 1.7; 95% CI: 1.02-2.95) and a score of 3 or more on the Depression Rating Scale (odds ratio [OR]: 2.1; 95% confidence interval [CI]: 1.23-3.70). A protective effect was seen on the use of a hearing aid (OR: 0.3; 95% CI: 0.12-0.80). In the residential care homes, being male (OR: 2.1; 95% CI: 1.27-3.30), having cancer (OR: 2.9; 95% CI: 1.64-4.95), and a score of 2 or higher on the Cognitive Performance Scale (OR: 1.5; 95% CI: 1.05-2.22) increased the risk to develop depression. Age greater than 85 years (OR: 0.5; 95% CI: 0.31-0.67) and hearing impairment (OR: 0.8; 95% CI: 0.60-1.00) appeared to be protective. The incidence rate for depression in residents of Dutch nursing homes and residential care homes was high and the associated risk factors found may have important implications for staff. 2012 American Association for Geriatric Psychiatry

  1. Climate@Home: Crowdsourcing Climate Change Research

    Science.gov (United States)

    Xu, C.; Yang, C.; Li, J.; Sun, M.; Bambacus, M.

    2011-12-01

    Climate change deeply impacts human wellbeing. Significant amounts of resources have been invested in building super-computers that are capable of running advanced climate models, which help scientists understand climate change mechanisms, and predict its trend. Although climate change influences all human beings, the general public is largely excluded from the research. On the other hand, scientists are eagerly seeking communication mediums for effectively enlightening the public on climate change and its consequences. The Climate@Home project is devoted to connect the two ends with an innovative solution: crowdsourcing climate computing to the general public by harvesting volunteered computing resources from the participants. A distributed web-based computing platform will be built to support climate computing, and the general public can 'plug-in' their personal computers to participate in the research. People contribute the spare computing power of their computers to run a computer model, which is used by scientists to predict climate change. Traditionally, only super-computers could handle such a large computing processing load. By orchestrating massive amounts of personal computers to perform atomized data processing tasks, investments on new super-computers, energy consumed by super-computers, and carbon release from super-computers are reduced. Meanwhile, the platform forms a social network of climate researchers and the general public, which may be leveraged to raise climate awareness among the participants. A portal is to be built as the gateway to the climate@home project. Three types of roles and the corresponding functionalities are designed and supported. The end users include the citizen participants, climate scientists, and project managers. Citizen participants connect their computing resources to the platform by downloading and installing a computing engine on their personal computers. Computer climate models are defined at the server side. Climate

  2. Smart homes, private homes? An empirical study of technology researchers' perceptions of ethical issues in developing smart-home health technologies.

    Science.gov (United States)

    Birchley, Giles; Huxtable, Richard; Murtagh, Madeleine; Ter Meulen, Ruud; Flach, Peter; Gooberman-Hill, Rachael

    2017-04-04

    reduce acceptability of smart-home technologies to future end-users. While attention to choice suggests links with privacy, this may misidentify the sources of privacy and risk unjustly burdening end-users with problems that they cannot resolve. Separating considerations of choice and privacy may result in more satisfactory treatment of both. Finally, through our engagement with researchers as participants this study demonstrates the relevance of (bio)ethics as a critical partner to smart-home engineering.

  3. Factors associated with home hazards: Findings from the Malaysian Elders Longitudinal Research study.

    Science.gov (United States)

    Romli, Muhammad H; Tan, Maw P; Mackenzie, Lynette; Lovarini, Meryl; Kamaruzzaman, Shahrul B; Clemson, Lindy

    2018-03-01

    Previous studies have investigated home hazards as a risk factor for falls without considering factors associated with the presence of home hazards. The present study aimed to determine patterns of home hazards among urban community-dwelling older Malaysians, and to identify factors contributing to home hazards. Cross-sectional data from the initial wave of the Malaysian Elders Longitudinal Research study were used. Basic demographics were obtained from the Global Questionnaire. Basic and instrumental activities of daily living were measured using the Katz and Lawton-Brody scales, and home hazards were identified using the Home Falls and Accidents Screening Tool. Participants were also asked if they had fallen in the previous 12 months. Data were analyzed from 1489 participants. Hazards were frequently identified (>30%) in the toilet and bathroom areas (no grab rail, no non-slip mat, distant toilet), slippery floors, no bedside light access and inappropriate footwear. Lower educational attainment, traditional housing, Chinese ethnicity, greater number of home occupants, lower monthly expenditure, poor vision and younger age were the factors independently associated with home hazards. This study provides evidence that home hazards are a product of the interaction of the individual's function within their home environment. Hazards are also influenced by local sociocultural and environmental factors. The relationship between home hazards and falls appears complex and deserves further evaluation. Geriatr Gerontol Int 2018; 18: 387-395. © 2017 Japan Geriatrics Society.

  4. Integrating Depression Care Management into Medicare Home Health Reduces Risk of 30- and 60-Day Hospitalization: The Depression Care for Patients at Home Cluster-Randomized Trial.

    Science.gov (United States)

    Bruce, Martha L; Lohman, Matthew C; Greenberg, Rebecca L; Bao, Yuhua; Raue, Patrick J

    2016-11-01

    To determine whether a depression care management intervention in Medicare home health recipients decreases risk of hospitalization. Cluster-randomized trial. Nurse teams were randomized to intervention (12 teams) or enhanced usual care (EUC; 9 teams). Six home health agencies from distinct geographic regions. Home health recipients were interviewed at home and over the telephone. Individuals aged 65 and older who screened positive for depression on nurse assessments (N = 755) and a subset who consented to interviews (n = 306). The Depression CARE for PATients at Home (CAREPATH) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted telephone conferences with team supervisors every 2 weeks. Hospitalization while receiving home health services was assessed using data from the home health record. Hospitalization within 30 days of starting home health, regardless of how long recipients received home health services, was assessed using data from the home care record and research assessments. The relative hazard of being admitted to the hospital directly from home health was 35% lower within 30 days of starting home health care (hazard ratio (HR) = 0.65, P = .01) and 28% lower within 60 days (HR = 0.72, P = .03) for CAREPATH participants than for participants receiving EUC. In participants referred to home health directly from the hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, P = .001) for CAREPATH participants. Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk in older adults receiving Medicare home health nursing services. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. Risk factors for burnout among caregivers working in nursing homes.

    Science.gov (United States)

    Kandelman, Nadia; Mazars, Thierry; Levy, Antonin

    2018-01-01

    (i) To assess the level of burnout in nursing home caregivers within a unique healthcare network in France and (ii) to evaluate potential risk factors in this population. Burnout syndrome occurs frequently among nursing home caregivers and has strong detrimental effects on the quality of health care for residents. We used an observational survey to study burnout in nursing home caregivers. The survey was used to quantify burnout level (Maslach Burnout Inventory) and potential risk factors and was implemented from October 2013-April 2014. A logistic regression was used to explore the association between burnout and its risk factors. Three hundred and sixty questionnaires were delivered to caregivers in 14 nursing homes within a unique healthcare network. The response rate was 37% (132/360), and 124/132 (94%) surveys were analysed. Caregiver burnout rate was 40% (49/124). Median age was 41 years (range, 20-70) and most caregivers were female. The most common profession (n = 54; 44%) was nurse caregiver and 90% (n = 112) had an antecedent of bullying by a resident. Risk factors identified were as follows: the presence of institutional protocols (death announcement [OR: 3.7] and pain assessment [OR: 2.8]), working in a profit-making establishment (OR: 2.6) and the antecedent of bullying by a resident (OR: 6.2). Factors most negatively associated with burnout included: practising pastimes (OR: 0.4) and working as a nurse (OR: 0.3). The only significant risk factor in the multivariate analysis was the antecedent of bullying by a resident (OR: 5.3). Several specific risk factors for burnout in nursing home caregivers were identified. In high-risk populations of healthcare professionals, screening and management of risk factors is crucial for preventing burnout. © 2017 John Wiley & Sons Ltd.

  6. Risk Factors for Hip Fracture in Older Home Care Clients

    Science.gov (United States)

    Poss, Jeff; Cook, Richard J.; Byrne, Kerry; Hirdes, John P.

    2009-01-01

    Background Little information is available on hip fracture risks among community-dwelling persons receiving home care. Our aim was to identify risk factors for hip fracture from health information routinely collected for older home care clients. Methods This was a cohort study involving secondary analysis of data on 40,279 long-stay (>60 days) home care clients aged 65 and older in Ontario, Canada; occurrence of hip fracture as well as potential risk factor information were measured using the Resident Assessment Instrument (RAI)/Minimum Data Set–Home Care assessment instrument. Results In all, 1,003 clients (2.5%) had hip fracture on follow-up assessment. Older (85+ vs 65–74, relative risk [95% confidence interval]: 0.52 [0.43–0.64]) clients are at increased risk; males are at reduced risk [0.60 (0.51–0.70)]. Other risk factors include osteoporosis (1.19 [1.03–1.36]), falls (1.31 [1.15–1.49]), unsteady gait (1.18 [1.03–1.36]), use of ambulation aide (1.39 [1.21–1.59]), tobacco use (1.42, [1.13–1.80]), severe malnutrition (2.61 [1.67–4.08]), and cognitive impairment (1.30 [1.12–1.51]). Arthritis (0.86 [0.76–0.98]) and morbid obesity (0.34 [0.16–0.72]) were associated with reduced risk. Males and females demonstrated different risk profiles. Conclusions Important risk factors for hip fracture can be identified from routinely collected data; these could be used to identify at-risk clients for further investigation and prevention strategies [22]. PMID:19196903

  7. Home Environmental and Behavioral Risk Indices for Reading Achievement.

    Science.gov (United States)

    Taylor, Jeanette; Ennis, Chelsea R; Hart, Sara A; Mikolajewski, Amy J; Schatschneider, Christopher

    2017-07-01

    The goal of this study was to identify home environmental and temperament/behavior variables that best predict standardized reading comprehension scores among school-aged children. Data from 269 children aged 9-16 ( M = 12.08; SD = 1.62) were used in discriminant function analyses to create the Home and Behavior indices. Family income was controlled in each index. The final Home and Behavior models each classified around 75% of cases correctly (reading comprehension at grade level vs. not). Each index was then used to predict other outcomes related to reading. Results showed that Home and/or Behavior accounted for 4-7% of the variance in reading fluency and spelling and 20-35% of the variance in parent-rated problems in math, social anxiety, and other dimensions. These metrics show promise as environmental and temperament/behavior risk scores that could be used to predict and potentially screen for further assessment of reading related problems.

  8. Cumulative Risk Exposure and Mental Health Symptoms among Maltreated Youth Placed in Out-of-Home Care

    Science.gov (United States)

    Raviv, Tali; Taussig, Heather N.; Culhane, Sara E.; Garrido, Edward F.

    2010-01-01

    Objective: Maltreated children placed in out-of-home care are at high risk for exhibiting symptoms of psychopathology by virtue of their exposure to numerous risk factors. Research examining cumulative risk has consistently found that the accumulation of risk factors increases the likelihood of mental health problems. The goal of the current study…

  9. Prevalence and risk factors of frailty among home care clients.

    Science.gov (United States)

    Miettinen, Minna; Tiihonen, Miia; Hartikainen, Sirpa; Nykänen, Irma

    2017-11-17

    Frailty is a common problem among older people and it is associated with an increased risk of death and long-term institutional care. Early identification of frailty is necessary to prevent a further decline in the health status of home care clients. The aims of the present study were to determine the prevalence of frailty and associated factors among 75-year-old or older home care clients. The study participants were 75-year-old or older home care clients living in three cities in Eastern and Central Finland. Home care clients who had completed the abbreviated Comprehensive Geriatric Assessment (aCGA) for frailty (n = 257) were included in the present study. Baseline data were obtained on functional status, cognitive status, depressive symptoms, self-rated health, ability to walk 400 m, nutritional status, drug use and comorbidities. Most of the home care clients (90%) were screened for frailty using the aCGA. Multivariate analysis showed that the risk of malnutrition or malnutrition (OR = 4.27, 95% CI = 1.56, 11.68) and a low level of education (OR = 1.14, 95% CI = 1.07, 1.23) were associated with frailty. Frailty is a prevalent problem among home care clients. The risk of malnutrition or malnourishment and a lower level of education increase the risk of frailty. Screening for frailty should be done to detect the most vulnerable older people for further intervention to prevent adverse health problems. ClinicalTrials.gov: NCT02214758 .

  10. Radon risk communication research: Practical lessons

    International Nuclear Information System (INIS)

    Fisher, A.; Johnson, F.R.

    1990-01-01

    Those responsible for state and local radon programs often express frustration about the small share of homes that have been tested for radon, and the small share of those with high readings that have been mitigated. There are now a number of completed studies that have examined how well alternative ways of communicating about radon risk have accomplished the goals of motivating appropriate testing and mitigation. This paper summarizes the research results that are most crucial for planning and implementing effective radon risk communication programs. We identify six reasons why people do not respond to radon as a serious threat and provide some remedies suggested by radon studies

  11. Falls risk assessment begins with hello: lessons learned from the use of one home health agency's fall risk tool.

    Science.gov (United States)

    Flemming, Patricia J; Ramsay, Katherine

    2012-10-01

    Identifying older adults at risk for falls is a challenge all home healthcare agencies (HHAs) face. The process of assessing for falls risk begins with the initial home visit. One HHA affiliated with an academic medical center describes its experience in development and use of a Falls Risk Assessment (FRA) tool over a 10-year period. The FRA tool has been modified since initial development to clarify elements of the tool based on research and to reflect changes in the Outcome and Assessment Information Set (OASIS) document. The primary purpose of this article is to share a validated falls risk assessment tool to facilitate identification of fall-related risk factors in the homebound population. A secondary purpose is to share lessons learned by the HHA during the 10 years using the FRA.

  12. Radon source apportionment in the home, dosimetry and risk modeling. Final report, 1993-1997

    International Nuclear Information System (INIS)

    Harley, N.H.

    1998-01-01

    This research covered the following 3 topics in 4 years: (1) the source apportionment of 222 Rn in the home; (2) the internal bronchial dosimetry of inhaled 222 Rn decay products; and (3) the lung cancer risk from inhalation of the short lived decay products of 222 Rn. A 4th year of support was appended to this grant with a switch in research effort to determine a method for long term measurement of the particle size distribution of the short lived decay products in homes

  13. Home and away: Area socioeconomic disadvantage and obesity risk.

    Science.gov (United States)

    Kimbro, Rachel Tolbert; Sharp, Gregory; Denney, Justin T

    2017-03-01

    Although residential context is linked to obesity risk, less is known about how the additional places where we work, shop, play, and worship may influence that risk. We employ longitudinal data from the Los Angeles Family and Neighborhood Survey (LAFANS) to derive time-weighted measures of exposure to home and activity space contexts to ascertain the impacts of each on obesity risk for adults. Results show that increased exposure to socioeconomic disadvantage in the residential neighborhood significantly increases obesity risk, and although activity space disadvantage does not directly influence obesity, it reduces the association between residential disadvantage and obesity. We further explore the ways in which residential and activity space disadvantages may interact to influence obesity and discuss the value of integrating personal exposure and activity space contexts to better understand how places contribute to individual health risks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Safety in home care: A research protocol for studying medication management

    Directory of Open Access Journals (Sweden)

    Easty Anthony

    2010-06-01

    Full Text Available Abstract Background Patient safety is an ongoing global priority, with medication safety considered a prevalent, high-risk area of concern. Yet, we have little understanding of the supports and barriers to safe medication management in the Canadian home care environment. There is a clear need to engage the providers and recipients of care in studying and improving medication safety with collaborative approaches to exploring the nature and safety of medication management in home care. Methods A socio-ecological perspective on health and health systems drives our iterative qualitative study on medication safety with elderly home care clients, family members and other informal caregivers, and home care providers. As we purposively sample across four Canadian provinces: Alberta (AB, Ontario (ON, Quebec (QC and Nova Scotia (NS, we will collect textual and visual data through home-based interviews, participant-led photo walkabouts of the home, and photo elicitation sessions at clients' kitchen tables. Using successive rounds of interpretive description and human factors engineering analyses, we will generate robust descriptions of managing medication at home within each provincial sample and across the four-province group. We will validate our initial interpretations through photo elicitation focus groups with home care providers in each province to develop a refined description of the phenomenon that can inform future decision-making, quality improvement efforts, and research. Discussion The application of interpretive and human factors lenses to the visual and textual data is expected to yield findings that advance our understanding of the issues, challenges, and risk-mitigating strategies related to medication safety in home care. The images are powerful knowledge translation tools for sharing what we learn with participants, decision makers, other healthcare audiences, and the public. In addition, participants engage in knowledge exchange

  15. Away-from-home food intake and risk for obesity: Examining the influence of context

    Science.gov (United States)

    Ayala, Guadalupe X.; Rogers, Morgan; Arredondo, Elva M.; Campbell, Nadia R.; Baquero, Barbara; Duerksen, Susan C.; Elder, John P.

    2013-01-01

    Objective This study examined socio-demographic and cultural determinants of away-from-home food consumption in two contexts and the influence of frequency of away-from-home food consumption on children’s dietary intake and parent and child weight status. Research Methods and Procedures Parents of children (N=708) in grades K-2 were recruited from 13 elementary schools in Southern California. Parents were asked through a questionnaire the frequency with which they eat meals away from home and the restaurant they frequented most often. The height and weight of the parents and their children were measured to calculate body mass index (BMI). Results Consuming foods at least once a week from relatives/neighbors/friends [RNF] homes was associated with children’s dietary intake and children’s risk for obesity. For example, children of parents with weekly or greater RNF food consumption drank more sugar sweetened beverages. Parents of families who ate at restaurants at least weekly reported that their children consumed more sugar sweetened beverages, more sweet/savory snacks and less water compared with families who did not frequent restaurants this often. The type of restaurant visited did not impact diet intake or obesity. More acculturated families exhibited less healthy dietary behaviors than less acculturated families. Discussion Restaurants remain an important setting for preventing child and adult obesity, but other settings outside the home need to be considered in future intervention research. This may especially involve eating in the homes of relatives, neighbors and friends. PMID:18309297

  16. Perceptions of risk and risk management among 735 women who opted for a home birth.

    Science.gov (United States)

    Lindgren, Helena E; Rådestad, Ingela J; Christensson, Kyllike; Wally-Bystrom, Kristina; Hildingsson, Ingegerd M

    2010-04-01

    home birth is not included in the Swedish health-care system and the rate for planned home births is less than one in a thousand. The aim of this study was to describe women's perceptions of risk related to childbirth and the strategies for managing these perceived risks. a nationwide study including all women who had given birth at home in Sweden was conducted between 1 January 1992 and 31 July 2005. a total of 735 women had given birth to 1038 children. Of the 1038 questionnaires sent to the women, 1025 (99%) were returned. two open questions regarding risk related to childbirth and two questions answered using a scale were investigated by content analysis. regarding perceived risks about hospital birth, three categories, all related to loss of autonomy, were identified: (1) being in the hands of strangers; (2) being in the hands of routines and unnecessary interventions; and (3) being in the hands of structural conditions. Perceived risks related to a home birth were associated with a sense of being beyond help: (1) worst-case scenario; and (2) distance to the hospital. The perceived risks were managed by using extrovert activities and introvert behaviour, and by avoiding discussions concerning risks with health-care professionals. women who plan for a home birth in Sweden do consider risks related to childbirth but they avoid talking about the risks with health-care professionals. to understand why women choose to give birth at home, health-care professionals must learn about the perceived beneficial effect of doing so. Copyright 2008 Elsevier Ltd. All rights reserved.

  17. Ideas of home in palliative care research: A concept analysis.

    Science.gov (United States)

    Tryselius, Kristina; Benzein, Eva; Persson, Carina

    2018-04-23

    To explore the concept of home and its' expressed spatialities in current palliative care research. Home is a central environment for living, caring, and dying. However, pure investigations of the sets of ideas linked to the concept seemed missing. Although identified as an important location, spatial perspectives expressed through the concept of home appeared unexplored. Rodgers' evolutionary concept analysis. Scientific articles published between January 2009 and September 2015. Rodgers' evolutionary concept analysis. Resulting attributes were explored from two geographically informed spatial perspectives. As main results, six attributes were identified and explored: Home as actor-capable of acting; emotional environment-something people have feelings for; place-a part of personal identity and a location; space-complex and relational spatial connections and a site for care; setting-passive background and absolute space; becoming-a fluid spatiality constantly folded. Examples of attributes and suggestions for further concept development were identified. The concept reflects various sets of ideas as well as expressing both relational and absolute perspectives of space. The most challenging for nursing research and practice seems to be investigation, operationalization, and testing the implementation of sets of ideas reflecting a relational thinking of space. © 2018 Wiley Periodicals, Inc.

  18. Research Insights About Risk Governance

    Directory of Open Access Journals (Sweden)

    Therese R. Viscelli

    2016-11-01

    Full Text Available In recent years, expectations for increased risk governance have been placed explicitly on boards of directors. In response, boards are being held responsible for not only understanding and approving management’s risk management processes, but they are also being held responsible for assessing the risks identified by those processes as part of overseeing management’s pursuit of value. These increasing responsibilities have led a number of organizations to adopt enterprise risk management (ERM as a holistic approach to risk management that extends beyond traditional silo-based risk management techniques. As boards, often through their audit committee, consider management’s implementation of ERM as part of the board’s risk oversight, a number of questions emerge that can be informed by academic research related to ERM. This article summarizes findings from ERM research to provide insights related to the board’s risk governance responsibilities. We also identify a number of research questions that warrant further analysis by governance scholars. It is our hope that this article will spawn varying types of research about ERM and corporate governance.

  19. Information Technology in the Home Barriers, Opportunities, and Research Directions

    National Research Council Canada - National Science Library

    Lewis, Rosalind

    2000-01-01

    ...; but what are the implications of increased Information Technology (IT) in the home? Can increased in-home IT create opportunities that will change the way we live and function within our homes and communities and facilitate greater societal benefits...

  20. Can the care transitions measure predict rehospitalization risk or home health nursing use of home healthcare patients?

    Science.gov (United States)

    Ryvicker, Miriam; McDonald, Margaret V; Trachtenberg, Melissa; Peng, Timothy R; Sridharan, Sridevi; Feldman, Penny H

    2013-01-01

    The Care Transitions Measure (CTM) was designed to assess the quality of patient transitions from the hospital. Many hospitals are using the measure to inform their efforts to improve transitional care. We sought to determine if the measure would have utility for home healthcare providers by predicting newly admitted patients at heightened risk for emergency department use, rehospitalization, or increased home health nursing visits. The CTM was administered to 495 home healthcare patients shortly after hospital discharge and home healthcare admission. Follow-up interviews were completed 30 and 60 days post hospital discharge. Interview data were supplemented with agency assessment and service use data. We did not find evidence that the CTM could predict home healthcare patients having an elevated risk for emergent care, rehospitalization, or higher home health nursing use. Because Medicare/Medicaid-certified home healthcare providers already use a comprehensive, mandated start of care assessment, the CTM may not provide them additional crucial information. Process and outcome measurement is increasingly becoming part of usual care. Selection of measures appropriate for each service setting requires thorough site-specific evaluation. In light of our findings, we cannot recommend the CTM as an additional measure in the home healthcare setting. © 2013 National Association for Healthcare Quality.

  1. Prevalence and risk indicators of depression in elderly nursing home patients : the AGED study

    NARCIS (Netherlands)

    Jongenelis, K; Eisses, AMH; Beekman, ATF; Kluiter, H; Ribbe, MW

    2004-01-01

    Background: Depression is a common and disabling psychiatric disorder in later life. Particular frail nursing home patients seem to be at increased risk. Nursing home-based studies on risk indicators of depression are scarce. Methods: Prevalence and risk indicators of depression were assessed in 333

  2. 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

  3. Telecommuting (Work-At-Home) at NASA Lewis Research Center

    Science.gov (United States)

    Srinidhi, Saragur M.

    1994-01-01

    This report presents a study in evaluating the viability of providing a work-at-home (telecommuting) program for Lewis Research Center's corporate employees using Integrated Services Digital Network (ISDN). Case studies have been presented for a range of applications from casual data access to interactive access. The network performance of telemedia applications were studied against future requirements for such level of remote connectivity. Many of the popular ISDN devices were characterized for network and service functionality. A set of recommendations to develop a telecommuting policy have been proposed.

  4. Helping nursing homes "at risk" for quality problems: a statewide evaluation.

    Science.gov (United States)

    Rantz, Marilyn J; Cheshire, Debra; Flesner, Marcia; Petroski, Gregory F; Hicks, Lanis; Alexander, Greg; Aud, Myra A; Siem, Carol; Nguyen, Katy; Boland, Clara; Thomas, Sharon

    2009-01-01

    The Quality Improvement Program for Missouri (QIPMO), a state school of nursing project to improve quality of care and resident outcomes in nursing homes, has a special focus to help nursing homes identified as "at risk" for quality concerns. In fiscal year 2006, 92 of 492 Medicaid-certified facilities were identified as "at risk" using quality indicators (QIs) derived from Minimum Data Set (MDS) data. Sixty of the 92 facilities accepted offered on-site clinical consultations by gerontological expert nurses with graduate nursing education. Content of consultations include quality improvement, MDS, care planning, evidence-based practice, and effective teamwork. The 60 "at-risk" facilities improved scores 4%-41% for 5 QIs: pressure ulcers (overall and high risk), weight loss, bedfast residents, and falls; other facilities in the state did not. Estimated cost savings (based on prior cost research) for 444 residents who avoided developing these clinical problems in participating "at-risk" facilities was more than $1.5 million for fiscal year 2006. These are similar to estimated savings of $1.6 million for fiscal year 2005 when 439 residents in "at-risk" facilities avoided clinical problems. Estimated savings exceed the total program cost by more than $1 million annually. QI improvements demonstrate the clinical effectiveness of on-site clinical consultation by gerontological expert nurses with graduate nursing education.

  5. Digital media in the home: technical and research challenges

    Science.gov (United States)

    Ribas-Corbera, Jordi

    2005-03-01

    This article attempts to identify some of the technology and research challenges facing the digital media industry in the future. We first discuss several trends in the industry, such as the rapid growth of broadband Internet networks and the emergence of networking and media-capable devices in the home. Next, we present technical challenges that result from these trends, such as effective media interoperability in devices, and provide a brief overview of Windows Media, which is one of the technologies in the market attempting to address these challenges. Finally, given these trends and the state of the art, we argue that further research on data compression, encoder optimization, and multi-format transcoding can potentially make a significant technical and business impact in digital media. We also explore the reasons that research on related techniques such as wavelets or scalable video coding is having a relatively minor impact in today"s practical digital media systems.

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

    Directory of Open Access Journals (Sweden)

    Hirdes John P

    2005-01-01

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

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

    Science.gov (United States)

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

    2005-01-01

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

  8. The absolute power of relative risk in debates on repeat cesareans and home birth in the United States.

    Science.gov (United States)

    Declercq, Eugene

    2013-01-01

    Changes in policies and practices related to repeat cesareans and home birth in the U.S. have been influenced by different interpretations of the risk of poor outcomes. This article examines two cases-vaginal birth after cesarean (VBAC) and home birth to illustrate how an emphasis on relative over absolute risk has been used to characterize outcomes associated with these practices. The case studies will rely on reviews of the research literature and examination of data on birth trends and outcomes. Childbirth involves some unique challenges in assessing health risks, specifically the issues of: (1) timing of risks (lowering health risk in a current birth can increase it in subsequent births); (2) the potential weighing of risks to the mother's versus the infant's health; (3) the fact that birth is a condition of health and many of the feared outcomes (for example, symptomatic uterine rupture) involve very low absolute risk of occurrence; and (4) a malpractice environment that seizes upon those rare poor outcomes in highly publicized lawsuits that receive widespread attention in the clinical community. In the cases of VBAC and home birth, the result has been considerable emphasis on relative risks, typically an adjusted odds ratio, with little consideration of absolute risks. Assessments of the safety of interventions in childbirth should involve careful consideration and communication of the multiple dimensions of risk, particularly a balancing of relative and absolute risks of poor health outcomes.

  9. Health Risks due to Exposure to Radon in Homes in Ireland

    International Nuclear Information System (INIS)

    2005-09-01

    This document summarises the evidence that links exposure to radon in homes with an increase in lung cancer. Using the most recent risk estimates derived from epidemiological studies carried out abroad, the risk associated with radon exposure in homes in Ireland is derived. The relationship between exposure to radon and cigarette smoking is also discussed

  10. Home birth or short-stay hospital birth in a low risk population in The Netherlands.

    NARCIS (Netherlands)

    Wiegers, T.A.; Zee, J. van der; Kerssens, J.J.; Keirse, M.J.N.C.

    1998-01-01

    In the Netherlands women with low risk pregnancies can choose whether they want to give birth at home or in hospital, under the care of their own primary caregiver. The majority of these women prefer to give birth at home, but over the last few decades an increasing number of low risk women have

  11. Relations among Neighborhood Social Networks, Home Literacy Environments, and Children's Expressive Vocabulary in Suburban At-Risk Families

    Science.gov (United States)

    Froiland, John Mark; Powell, Douglas R.; Diamond, Karen E.

    2014-01-01

    In response to increasing research and policy interest in the neighborhood context of early school success, this study examined relations among neighborhood social networks, home literacy practices/resources, and children's expressive vocabulary in a suburban at-risk sample in the USA at the beginning of the school year. In a Structural Equation…

  12. An evaluation of venous thromboembolic risk in acutely ill medical patients immobilized at home: the AT-HOME Study.

    Science.gov (United States)

    Haas, Sylvia K; Hach-Wunderle, Viola; Mader, Frank H; Ruster, Katherine; Paar, Wilhelm D

    2007-01-01

    Many risk factors for venous thromboembolism (VTE) in hospitalized medical patients are also present in medical outpatients. VTE prevention represents an important challenge for physicians treating patients at home. The AT-HOME study was a prospective cross-sectional observational study designed to assess awareness of the risk of VTE in immobilized acutely ill medical outpatients among German physicians, many of whom were participating in a national Continuing Medical Education (CME) program designed to raise awareness of VTE. The study involved 1210 medical patients who were acutely confined to bed at home. Physicians performed a subjective assessment of VTE risk, which was rated on a 10-point scale (1 = very low risk; 10 = very high risk). The risk of VTE was also assessed retrospectively by using a scorecard developed for use in hospitalized medical patients. Of the 1210 patients, 198 (16%) had risk scores of 0-4, 319 (26%) had scores of 5 or 6, and 693 (57%) had scores > or =7. Overall, 966 patients (80%) received thromboprophylaxis. The proportion of patients receiving thromboprophylaxis was 0% to 47% in risk score groups 0-4, 76% to 85% in groups 5 and 6, and 90% to 100% in risk score groups 7-10. In the retrospective assessment of VTE risk, 74% of patients were at high risk, 15% were at intermediate risk, and 11% were at low risk. The proportions of patients receiving thromboprophylaxis in these groups were 87%, 61%, and 55%, respectively. The involvement of physicians in educational activities focusing on VTE awareness appeared to create awareness of the risks of VTE in acutely ill medical outpatients.

  13. Effect of Maternal and Pregnancy Risk Factors on Early Neonatal Death in Planned Home Births Delivering at Home.

    Science.gov (United States)

    Bachilova, Sophia; Czuzoj-Shulman, Nicholas; Abenhaim, Haim Arie

    2018-05-01

    The prevalence of home birth in the United States is increasing, although its safety is undetermined. The objective of this study was to investigate the effects of obstetrical risk factors on early neonatal death in planned home births delivering at home. The authors conducted a retrospective 3-year cohort study consisting of planned home births that delivered at home in the United States between 2011 and 2013. The study excluded infants with congenital and chromosomal anomalies and infants born at ≤34 weeks' gestation. Multivariate logistic regression models were used to estimate the adjusted effects of individual obstetrical variables on early neonatal deaths within 7 days of delivery. During the study period, there were 71 704 planned and delivered home births. The overall early neonatal death rate was 1.5 deaths per 1000 planned home births. The risks of early neonatal death were significantly higher in nulliparous births (OR 2.71; 95% CI 1.71-4.31), women with a previous CS (OR 2.62, 95% CI 1.25-5.52), non-vertex presentations (OR 4.27; 95% CI 1.33-13.75), plural births (OR 9.79; 95% CI 4.25-22.57), preterm births (OR 4.68; 95% CI 2.30-9.51), and births at ≥41 weeks of gestation (OR 1.76; 95% CI 1.09-2.84). Early neonatal deaths occur more commonly in certain obstetrical contexts. Patient selection may reduce adverse neonatal outcomes among planned home births. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  14. 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.

  15. Nursing home research: the first International Association of Gerontology and Geriatrics (IAGG) research conference.

    Science.gov (United States)

    Rolland, Yves; Resnick, Barbara; Katz, Paul R; Little, Milta O; Ouslander, Joseph G; Bonner, Alice; Geary, Carol R; Schumacher, Karen L; Thompson, Sarah; Martin, Finbarr C; Wilbers, Joachim; Zúñiga, Franziska; Ausserhofer, D; Schwendimann, R; Schüssler, S; Dassen, Theo; Lohrmann, Christa; Levy, Cari; Whitfield, Emily; de Souto Barreto, Philipe; Etherton-Beer, Christopher; Dilles, Tinne; Azermai, Majda; Bourgeois, Jolyce; Orrell, Martin; Grossberg, George T; Kergoat, Hélène; Thomas, David R; Visschedijk, Jan; Taylor, Stephanie J C; Handajani, Yvonne S; Widjaja, Nelly T; Turana, Yuda; Rantz, Marilyn J; Skubic, Marjorie; Morley, John E

    2014-05-01

    The International Association of Gerontology and Geriatrics held its first conference on nursing home research in St Louis, MO, in November 2013. This article provides a summary of the presentations. Copyright © 2014 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

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

    Science.gov (United States)

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

    2018-04-01

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

  17. Perinatal outcomes of low-risk planned home and hospital births under midwife-led care in Japan.

    Science.gov (United States)

    Hiraizumi, Yoshie; Suzuki, Shunji

    2013-11-01

    It has not been extensively studied whether planned home and planned hospital births under primary midwife-led care increase risk of adverse events among low-risk women in Japan. A retrospective cohort study was performed to compare perinatal outcome between 291 women who were given primary midwife-led care during labor and 217 women who were given standard obstetric shared care. Among 291 women with primary midwife-led care, 168 and 123 chose home deliver and hospital delivery, respectively. Perinatal outcomes included length of labor of 24 h or more, augmentation of labor pains, delivery mode, severe perineal laceration, postpartum hemorrhage of 1000 mL or more, maternal fever of 38°C or more and neonatal asphyxia (Apgar score, home delivery (34 vs 21%, P = 0.011). There were no significant differences in the incidence of adverse perinatal outcomes between women with obstetric shared care and women with primary midwife-led care (regardless of being hospital delivery or home delivery). Approximately one-quarter of low-risk women with primary midwife-led care required obstetric care during labor or postpartum. However, primary midwife-led care during labor at home and hospital for low-risk pregnant women was not associated with adverse perinatal outcomes in Japan. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  18. Why is housing tenure associated with a lower risk of admission to a nursing or residential home? Wealth, health and the incentive to keep 'my home'.

    Science.gov (United States)

    McCann, Mark; Grundy, Emily; O'Reilly, Dermot

    2012-02-01

    Previous research has shown that home ownership is associated with a reduced risk of admission to institutional care. The extent to which this reflects associations between wealth and health, between wealth and ability to buy in care or increased motivation to avoid admission related to policies on charging is unclear. Taking account of the value of the home, as well as housing tenure, may provide some clarification as to the relative importance of these factors. To analyse the probability of admission to residential and nursing home care according to housing tenure and house value. Cox regression was used to examine the association between home ownership, house value and risk of care home admissions over 6 years of follow-up among a cohort of 51 619 people aged 65 years or older drawn from the Northern Ireland Longitudinal Study, a representative sample of ≈28% of the population of Northern Ireland. Results 4% of the cohort (2138) was admitted during follow-up. Homeowners were less likely than those who rented to be admitted to care homes (HR 0.77, 95% CI 0.70 to 0.85, after adjusting for age, sex, health, living arrangement and urban/rural differences). There was a strong association between house value/tenure and health with those in the highest valued houses having the lowest odds of less than good health or limiting long-term illness. However, there was no difference in probability of admission according to house value; HRs of 0.78 (95% CI 0.67 to 0.90) and 0.81 (95% CI 0.70 to 0.95), respectively, for the lowest and highest value houses compared with renters. The requirement for people in the UK with capital resources to contribute to their care is a significant disincentive to institutional admission. This may place an additional burden on carers.

  19. 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.

  20. Prevalence of risk factors for falls among elderly people living in long-term care homes

    OpenAIRE

    Pradnya Dhargave, PhD; Ragupathy Sendhilkumar, MSc, MPT

    2016-01-01

    Background: Falls are common among the geriatric population, causing frequent morbidity and mortality. There is an increased risk of fall among older people living in long-term care homes. Identifying risk factors for falls among older people living in old-age homes can help in the care and prevention of falls in this population. Aim: To evaluate the prevalence of various risk factors for falls among older people living in long-term care homes. Methods: A total of 163 elderly men and wo...

  1. Nuclear safety research - risk and other risks

    International Nuclear Information System (INIS)

    Rossin, A.D.

    1982-01-01

    The nuclear power industry deals in many kinds of risks, complicated by political stress and communication problems. Power plant design must prepare for the unexpected attack, physical as well as psychological, but a zero-defects technology is not possible. The public has not been made sufficiently aware of the risk the US takes if there is not enough energy because nuclear power has been curtailed. Energy shortages could drive industry and jobs abroad, force the public to turn to government for a solution, drive the country to energy allocation, and cause a nuclear war. Policies that prevent closing the nuclear fuel cycle are ineffective in preventing proliferation and counterproductive to national needs

  2. Home screening for sexually transmitted diseases in high-risk young women: randomised controlled trial

    DEFF Research Database (Denmark)

    Cook, Robert L; Østergaard, Lars; Hillier, Sharon L

    2007-01-01

    OBJECTIVE: Home screening tests could eliminate several barriers to testing sexually transmitted diseases (STDs). AIM: To determine whether offering repeated home screening tests would increase the rate of testing for chlamydia and gonorrhoea in a high-risk sample of young women. METHODS: In this...

  3. Under pressure, out of control, or home alone? Reviewing research and policy debates on the occupational health and safety effects of outsourcing and home-based work.

    Science.gov (United States)

    Quinlan, Michael; Bohle, Philip

    2008-01-01

    The practice of outsourcing or subcontracting of work has grown rapidly in most countries over the past two decades. Outsourcing, de-institutionalization, and a range of other practices have also resulted in a growth of home-based work. Home-based workers, even when not part of a subcontracting process, operate in an isolated situation remote from their employer and other workers. Do such work arrangements expose workers to greater risk of injury, illness, or assault? The authors reviewed international studies of the occupational health and safety (OHS) effects of subcontracting and home-based work undertaken over the past 20 years. Of the 25 studies analyzed, 92 percent found poorer OHS outcomes. The studies were examined for clues about the reasons for these negative outcomes. The authors also identified similarities and differences between subcontracting and home-based work. Despite the evidence of poor OHS outcomes, research into outsourcing has stalled in recent years. With notable exceptions, governments have taken little account of findings on these work arrangements in their laws and policies, in part because neoliberal ideas dominate national and global policy agendas. The authors examine policy challenges and regulatory responses and make suggestions for future research and policy interventions.

  4. Estimated risk from exposure to radon decay products in US homes

    International Nuclear Information System (INIS)

    Nero, A.V. Jr.

    1986-05-01

    Recent analyses now permit direct estimation of the risks of lung cancer from radon decay products in US homes. Analysis of data from indoor monitoring in single-family homes yields a tentative frequency distribution of annual-average 222 Rn concentrations averaging 55 Bq m -3 and having 2% of homes exceeding 300 Bq m -3 . Application of the results of occupational epidemiological studies, either directly or using recent advances in lung dosimetry, to indoor exposures suggests that the average indoor concentration entails a lifetime risk of lung cancer of 0.3% or about 10% of the total risk of lung cancer. The risk to individuals occupying the homes with 300 Bq m -3 or more for their lifetimes is estimated to exceed 2%, with risks from the homes with thousands of Bq m -3 correspondingly higher, even exceeding the total risk of premature death due to cigarette smoking. The potential for such average and high-level risks in ordinary homes forces development of a new perspective on environmental exposures

  5. Favorable Risk Selection in Medicare Advantage: Trends in Mortality and Plan Exits Among Nursing Home Beneficiaries

    Science.gov (United States)

    Goldberg, Elizabeth M.; Trivedi, Amal N.; Mor, Vincent; Jung, Hye-Young; Rahman, Momotazur

    2016-01-01

    The 2003 Medicare Modernization Act (MMA) increased payments to Medicare Advantage plans and instituted a new risk-adjustment payment model to reduce plans' incentives to enroll healthier Medicare beneficiaries and avoid those with higher costs. Whether the MMA reduced risk selection remains debatable. This study uses mortality differences, nursing home utilization, and switch rates to assess whether the MMA successfully decreased risk selection from 2000 to 2012. We found no decrease in the mortality difference or adjusted difference in nursing home use between plan beneficiaries pre- and post the MMA. Among beneficiaries with nursing home use, disenrollment from Medicare Advantage plans declined from 20% to 12%, but it remained 6 times higher than the switch rate from traditional Medicare to Medicare Advantage. These findings suggest that the MMA was not associated with reductions in favorable risk selection, as measured by mortality, nursing home use, and switch rates. PMID:27516452

  6. A proposed programme for energy risk research

    International Nuclear Information System (INIS)

    1979-01-01

    The report consists of two parts. Part I presents an overview of technological risk management, noting major contributions and current research needs. Part II details a proposed program of energy research, including discussions of some seven recommended projects. The proposed energy risk research program addresses two basic problem areas: improving the management of energy risks and energy risk communication and public response. Specific recommended projects are given for each. (Auth.)

  7. Home

    Science.gov (United States)

    AF Branding & Trademark Licensing Join the Air Force Home About Us The Air Force Symbol Display Resources Document Library TM Connect Search AF Branding and Trademark Licensing Program: important links Legal Documents 10 U.S.C. § 2260 15 U.S.C. § 167;167; 1114-1125 DODI 5535.12, DoD Branding and

  8. Home

    Science.gov (United States)

    intersect as Attack Wing leaders change roles The 112th COS postured as cyber shield for Pa. infrastructure 111th Attack Wing 111th Attack Wing 21st Century Guard Airmen Home News Photos Art Video Resources - The Balance Search 111th Attack Wing: COMMUNITY/ENVIRO May 16, 2018; Pa. Department of Health update

  9. A Swedish interview study: parents' assessment of risks in home births.

    Science.gov (United States)

    Lindgren, Helena; Hildingsson, Ingegerd; Rådestad, Ingela

    2006-03-01

    to describe home-birth risk assessment by parents. interviews using a semi-structured interview guide. Data were analysed using a phenomenological approach. independent midwifery practices in Sweden. five couples who had had planned home births. the parents had a fundamental trust that the birth would take place without complications, and they experienced meaningfulness in the event itself. Risks were considered to be part of a complex phenomenon that was not limited to births at home. This attitude seems to be part of a lifestyle that has a bearing on how risks experienced during the birth were handled. Five categories were identified as counterbalancing the risk of possible complications: (1) trust in the woman's ability to give birth; (2) trust in intuition; (3) confidence in the midwife; (4) confidence in the relationship; and (5) physical and intellectual preparation. although the parents were conscious of the risk of complications during childbirth, a fundamental trust in the woman's independent ability to give birth was central to the decision to choose a home birth. Importance was attached to the expected positive effects of having the birth at home. knowledge of parents' assessment can promote an increased understanding of how parents-to-be experience the risks associated with home birth.

  10. Risk - a new field of research?

    International Nuclear Information System (INIS)

    Bechmann, G.

    1993-01-01

    Risk research is a research activity that hitherto has failed to come up with a standard concept of risk, or theory of risk. The contribution explains three major approaches and basic orientations, which represent a formal and law-oriented approach, a psychological and cognitive approach, and the approach starting from cultural and sociological aspects. (DG) [de

  11. Comorbidity and 1-year mortality risks in nursing home residents

    NARCIS (Netherlands)

    van Dijk, P.T.; Mehr, D.R.; Ooms, M.E.; Madsen, R.W.; Petroski, G.; Frijters, D.H.M.; Pot, A.M.; Ribbe, M.W.

    2005-01-01

    OBJECTIVES: To investigate the effect of chronic diseases and disease combinations on 1-year mortality in nursing home residents. DESIGN: Retrospective cohort study using electronically submitted Minimum Data Set (MDS) information and Missouri death certificate data. SETTING: Five hundred twenty-two

  12. Review of Researches on Agricultural Industry Chain at Home and Abroad

    Institute of Scientific and Technical Information of China (English)

    Ge; SONG; Taiyan; YANG; Jianhui; LIU

    2014-01-01

    Management of agricultural industry chain is the main form of modern agricultural industrialization. Integration and optimization of agricultural chain have great significance in deepening the reform in the countryside,quickening the development of agricultural modernization and establishing new system of agricultural management. Based on the theory sources and contents of agricultural chain as well as the current researches at home and abroad,this paper hackles and concludes information technology,logistics management and food safety and quality in foreign agricultural chain as well as the organization model,operation mechanism,integration and optimization,promotion and extension,financing and risk prevention,influencing factors as well as performance evaluation in domestic agricultural chain and offers relevant review in order to provide further reference for future researches.

  13. Drug utilization research and risk management

    NARCIS (Netherlands)

    Mazzaglia, Giampiero; Mol, Peter G. M.; Elseviers, Monique; Wettermark, Björn; Almarsdóttir, Anna Birna; Andersen, Morten; Benko, Ria; Bennie, Marion; Eriksson, Irene; Godman, Brian; Krska, Janet; Poluzzi, Elisabetta; Taxis, Katja; Vlahovic-Palcevski, Vera; Stichele, Robert Vander

    2016-01-01

    Good risk management requires continuous evaluation and improvement of planned activities. The evaluation impact of risk management activities requires robust study designs and carefully selected outcome measures. Key learnings and caveats from drug utilization research should be applied to the

  14. NIH Researchers Identify OCD Risk Gene

    Science.gov (United States)

    ... News From NIH NIH Researchers Identify OCD Risk Gene Past Issues / Summer 2006 Table of Contents For ... and Alcoholism (NIAAA) have identified a previously unknown gene variant that doubles an individual's risk for obsessive- ...

  15. Integrating Depression Care Management into Medicare Home Health Reduces Risk of 30 and 60 Day Hospitalization: The Depression CAREPATH Cluster-Randomized Trial

    Science.gov (United States)

    Bruce, Martha L.; Lohman, Matthew C.; Greenberg, Rebecca L.; Bao, Yuhua; Raue, Patrick J.

    2016-01-01

    OBJECTIVES To determine whether a depression care management intervention among Medicare home health recipients decreases risks of hospitalization. DESIGN Cluster-randomized trial. Nurse teams were randomized to Intervention (12 teams) or Enhanced Usual Care (EUC; 9 teams). SETTING Six home health agencies from distinct geographic regions. Patients were interviewed at home and by telephone. PARTICIPANTS Patients age>65 who screened positive for depression on nurse assessments (N=755), and a subset who consented to interviews (N=306). INTERVENTION The Depression CAREPATH (CARE for PATients at Home) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted biweekly telephone conferences with team supervisors. MEASUREMENTS The study examined acute-care hospitalization and days to hospitalization. H1 used data from the home health record to examine hospitalization over 30-day and 60-day periods while a home health patient. H2 used data from both home care record and research assessments to examine 30-day hospitalization from any setting. RESULTS The adjusted hazard ratio (HR) of being admitted to hospital directly from home health within 30 days of start of home health care was 0.65 (p=.013) for CAREPATH compared to EUC patients, and 0.72 (p=.027) within 60 days. In patients referred to home health directly from hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, p=.001) among CAREPATH patients. CONCLUSION Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk among older adults receiving Medicare home health nursing services. PMID:27739067

  16. Risk Analysis of Typhoid Fever Based on Personal Hygiene and Street Food Consumption Habit at Home

    Directory of Open Access Journals (Sweden)

    Hilda Nuruzzaman

    2016-11-01

    Full Text Available Typhoid fever is disease caused by Salmonella typhi bacteria transmission trought contaminated food and drink. Data from RSUD dr. Abdoer Rahem showing that from 2011–2013 typhoid fever case always increase and often happened to children age 5–14 years old. The objective research to analysis risk factor of typhoid fever according to snacking habit at school and at house of children age 7–12 years old. This research was observasional case control study. Data for case in this research are taken from medical record of ‘Unit Teratai’ for the past 1 year in RSUD dr. Abdoer Rahem Situbondo, whereas for control are case group. There are eighty person taken for this research as sample. This result was the risk of typhoid fever children which has habit of hand washing had after defecation at home OR 3.67 (1.29 < OR < 10.64, children which has habit of hand washing before eating had OR 4.33 (1.54 < OR < 12.44, children with short dirty fingernails had OR 7.79 (1.46 < OR < 46.18 frequent street food consumption OR 3.89 (1.39 < OR < 11.06, buy snack at food street OR 3.95 (1.40 < OR < 11.30, buy some snack with packing had OR 3.5 (1.26 < OR < 9.38. The conclusion is that habit hand washing after defecation, habit hand washing before eating, short dirty fingernail, frequent food street consumption, buy food street and buy some food with sealed packing can secrease the risk of typhoid fever for children age 7–12 years Keywords: typhoid fever, risk factor of typhoid fever, personal hygiene, street food consumption habit

  17. Environmental risk assessment using the Persian version of the Home Falls And Screening Tool (HOME FAST in Iranian elderly

    Directory of Open Access Journals (Sweden)

    Bahareh Maghfouri

    2013-05-01

    Full Text Available Introduction: One of the common problems among older people is falling. Falling inside the houses and streets makes up a large incidence between Iranian elderly, then the effort to identify environmental factors at home and home modification can reduce falls and injury in the elderly. The aim of this study is identifying elderly at risk of fall with using screening tool (HOME FAST and define reliability of this tool.Material and Methods: As a reliability, through the health housing of the town councils in five geographical regions of Tehran, 60 old person were selected. Participants aged 60 to 65 years and the HOME FAST tool was used in the two stages (inter rater and test-retest.Results: Test-retest reliability in the study showed that agreement between the items is over than 0.8, which shows very good reliability. The results showed that the relative of the each item in the Agreement between the domain is 1 - 0.65, which shows moderate to high reliability. And the results in this study showed that agreement between the items in Inter rater reliability is over than 0.8, which shows the level of reliability is very good. Also it showed that the relative of the each item in the agreement between the domain is 1 - 0.01, which shows poor to high reliability.Conclusion: This study shows that the reliability of the HOME FAST is high. The findings of these comments have been expected that the test objectives were appropriate to prevent falls and the tools showed acceptable reliability, then this test can be used as a tool for to professionals.

  18. Dutch home-based pre-reading intervention with children at familial risk of dyslexia

    NARCIS (Netherlands)

    van Otterloo, S.G.; van der Leij, A.

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected

  19. Early home-based intervention in the Netherlands for children at familial risk of dyslexia

    NARCIS (Netherlands)

    van Otterloo, S.G.; van der Leij, A.; Henrichs, L.F.

    2009-01-01

    Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and

  20. Dutch Home-Based Pre-Reading Intervention with Children at Familial Risk of Dyslexia

    Science.gov (United States)

    van Otterloo, Sandra G.; van der Leij, Aryan

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small…

  1. Early Home-Based Intervention in the Netherlands for Children at Familial Risk of Dyslexia

    Science.gov (United States)

    van Otterloo, Sandra G.; van der Leij, Aryan; Henrichs, Lotte F.

    2009-01-01

    Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n = 23) received a specific training in phoneme awareness and letter knowledge. A control group (n = 25) received…

  2. The Nursing Home Culture-Change Movement: Recent Past, Present, and Future Directions for Research

    Science.gov (United States)

    Rahman, Anna N.; Schnelle, John F.

    2008-01-01

    This article uses a retrospective approach to critique the research base underlying the nursing home culture-change movement--an effort to radically transform the nation's nursing homes by delivering resident-directed care and empowering staff. The article traces the development of the movement from its inception 10 years ago to 2005, when the…

  3. Weight loss, Mortality and associated potentially modifiable nutritional risk factors among nursing home residents

    DEFF Research Database (Denmark)

    Beck, Anne Marie

    2015-01-01

    Objectives The objective of this follow-up study is to assess the association between different potentially modifiable nutritional risk factors; weight loss after six and 12 months and mortality. Design and setting A one year follow-up project among Danish nursing home residents. Participants...... A total of 441 nursing home resident living in 11 nursing homes. Measurements Odds ratio was calculated and used to assess the strength of association between different potentially modifiable nutritional risk factors and nutritional status of the participants. The difference in mortality between those who...... at most meals, chewing and swallowing problems. The prevalence of eating dependency; leaves 25% or more of food uneaten at most meals; swallowing problems and enteral nutrition were higher among those who died than among survivors. Conclusion A high percentage of old nursing home residents suffer from...

  4. Research supporting the congruence between rehabilitation principles and home health nursing practice.

    Science.gov (United States)

    Neal, L J

    1999-01-01

    A grounded-theory study of 30 home health nurses conducted in the Washington, DC, metropolitan area used unstructured audiotaped interviews to elicit data as to how home health nurses define their practice. The purpose of the study was to develop a beginning substantive research-based theory of home health nursing practice. The model that emerged consists of three stages by which nurses attain autonomy in their practice. Adaptation was found to be the core category, in that nurses cannot function effectively or successfully in the home health arena unless they are or learn to be adaptable. Data also revealed that home health nurses either knowingly or unknowingly use rehabilitation nursing principles in their practice, thereby lending credence to the supposition that home health nursing practice is congruent with rehabilitation nursing principles.

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

    Science.gov (United States)

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

    2016-10-10

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

  6. Risks from exposure to radon at home or at work

    International Nuclear Information System (INIS)

    Chambers, D.B.; Stager, R.H.

    2010-01-01

    This paper examines the risks associated with exposure to radon decay products through estimation of lifetime excess absolute risks (LEAR) per WLM for selected epidemiological risk projection models from miner studies and pooled residential radon studies applied to the ICRP 103 [6] reference populations. The mSv per WLM was calculated using the total detriment per Sv factor. The effect of smoking was considered based on application to Canadian mortality data by smoking status. There was a large variation in the risk per WLM and dose conversion factor depending on the smoking histories which vary substantially between individuals and over time. (author)

  7. A multivariate fall risk assessment model for VHA nursing homes using the minimum data set.

    Science.gov (United States)

    French, Dustin D; Werner, Dennis C; Campbell, Robert R; Powell-Cope, Gail M; Nelson, Audrey L; Rubenstein, Laurence Z; Bulat, Tatjana; Spehar, Andrea M

    2007-02-01

    The purpose of this study was to develop a multivariate fall risk assessment model beyond the current fall Resident Assessment Protocol (RAP) triggers for nursing home residents using the Minimum Data Set (MDS). Retrospective, clustered secondary data analysis. National Veterans Health Administration (VHA) long-term care nursing homes (N = 136). The study population consisted of 6577 national VHA nursing home residents who had an annual assessment during FY 2005, identified from the MDS, as well as an earlier annual or admission assessment within a 1-year look-back period. A dichotomous multivariate model of nursing home residents coded with a fall on selected fall risk characteristics from the MDS, estimated with general estimation equations (GEE). There were 17 170 assessments corresponding to 6577 long-term care nursing home residents. The increased odds ratio (OR) of being classified as a faller relative to the omitted "dependent" category of activities of daily living (ADL) ranged from OR = 1.35 for "limited" ADL category up to OR = 1.57 for "extensive-2" ADL (P canes, walkers, or crutches, or the use of wheelchairs increases the odds of being a faller (OR = 1.17, P falls in long-term care settings. The model incorporated an ADL index and adjusted for case mix by including only long-term care nursing home residents. The study offers clinicians practical estimates by combining multiple univariate MDS elements in an empirically based, multivariate fall risk assessment model.

  8. Modeling Research Project Risks with Fuzzy Maps

    Science.gov (United States)

    Bodea, Constanta Nicoleta; Dascalu, Mariana Iuliana

    2009-01-01

    The authors propose a risks evaluation model for research projects. The model is based on fuzzy inference. The knowledge base for fuzzy process is built with a causal and cognitive map of risks. The map was especially developed for research projects, taken into account their typical lifecycle. The model was applied to an e-testing research…

  9. Social perception risk : evolution of research

    International Nuclear Information System (INIS)

    Prades, A.; Sola, R.

    2004-01-01

    This article shows an overview of the evolution of a research line: the Social Perception of Risk. It starts with a brief reference to the origin and main results of this research field to focus on the crucial challenges we have to face today. Right now we are witnessing a real turning point which is not exclusive of the radiological risk arena. A genuine social change phenomena is leading us a step forward towards the so called risk Governance. (Author)

  10. House price risk and the hedging benefits of home Ownership

    NARCIS (Netherlands)

    Dröes, M.I.; Hassink, W.H.J.

    2013-01-01

    Using a repeat-sales methodology, this paper finds that estimates of house price risk based on aggregate house price indices substantially underestimate the true size of house price risk. This is the result of the fact that aggregate house price indices average away the idiosyncratic volatility in

  11. Integrating spaceflight human system risk research

    Science.gov (United States)

    Mindock, Jennifer; Lumpkins, Sarah; Anton, Wilma; Havenhill, Maria; Shelhamer, Mark; Canga, Michael

    2017-10-01

    NASA is working to increase the likelihood of exploration mission success and to maintain crew health, both during exploration missions and long term after return to Earth. To manage the risks in achieving these goals, a system modelled after a Continuous Risk Management framework is in place. ;Human System Risks; (Risks) have been identified, and 32 are currently being actively addressed by NASA's Human Research Program (HRP). Research plans for each of HRP's Risks have been developed and are being executed. Inter-disciplinary ties between the research efforts supporting each Risk have been identified; however, efforts to identify and benefit from these connections have been mostly ad hoc. There is growing recognition that solutions developed to address the full set of Risks covering medical, physiological, behavioural, vehicle, and organizational aspects of exploration missions must be integrated across Risks and disciplines. This paper discusses how a framework of factors influencing human health and performance in space is being applied as the backbone for bringing together sometimes disparate information relevant to the individual Risks. The resulting interrelated information enables identification and visualization of connections between Risks and research efforts in a systematic and standardized manner. This paper also discusses the applications of the visualizations and insights into research planning, solicitation, and decision-making processes.

  12. Defining characteristics and risk indicators for diagnosing nursing home-acquired pneumonia and aspiration pneumonia in nursing home residents, using the electronically-modified Delphi Method.

    NARCIS (Netherlands)

    Hollaar, V.; Maarel-Wierink, C. van der; Putten, G.J. van der; Sanden, W. van der; Swart, B.J. de; Baat, C. de

    2016-01-01

    BACKGROUND: In nursing home residents, it is not possible to distinguish pneumonia and aspiration pneumonia clinically. International literature reveals no consensus on which and how many characteristics and risk indicators must be present to diagnose (nursing home-acquired) pneumonia and aspiration

  13. Rehabilitation Risk Management: Enabling Data Analytics with Quantified Self and Smart Home Data.

    Science.gov (United States)

    Hamper, Andreas; Eigner, Isabella; Wickramasinghe, Nilmini; Bodendorf, Freimut

    2017-01-01

    A variety of acute and chronic diseases require rehabilitation at home after treatment. Outpatient rehabilitation is crucial for the quality of the medical outcome but is mainly performed without medical supervision. Non-Compliance can lead to severe health risks and readmission to the hospital. While the patient is closely monitored in the hospital, methods and technologies to identify risks at home have to be developed. We analyze state-of-the-art monitoring systems and technologies and show possibilities to transfer these technologies into rehabilitation monitoring. For this purpose, we analyze sensor technology from the field of Quantified Self and Smart Homes. The available sensor data from this consumer grade technology is summarized to give an overview of the possibilities for medical data analytics. Subsequently, we show a conceptual roadmap to transfer data analytics methods to sensor based rehabilitation risk management.

  14. Home Remodeling and Food Allergy Interact Synergistically to Increase the Risk of Atopic Dermatitis

    Directory of Open Access Journals (Sweden)

    Won Seok Lee

    2017-01-01

    Full Text Available Purpose. The purpose of this study was to investigate the effects of home remodeling and food allergy (FA on the development of atopic dermatitis (AD in children. Methods. The Modified International Study of Asthma and Allergies in Childhood questionnaire was used to survey 4,111 children recruited from 3 kindergartens and 6 elementary schools from Seongnam, Korea. Participants’ parents agreed for them to participate in physical examinations, skin prick tests, and blood tests. Results. Home remodeling in the past 12 months (adjusted odds ratio [aOR] 3.40, P=0.006, lifetime diagnosis of FA (aOR 3.95, P<0.001, parental history of AD (aOR 2.67, P=0.001, and FA (aOR 2.35, P=0.004 were independent risk factors for lifetime diagnosis of AD ever. When history of home remodeling and FA were combined, the risk for moderate-to-severe AD by scoring atopic dermatitis (SCORAD score increased (aOR, 7.19, P=0.011, P for interaction = 0.034. Conclusion. Home remodeling, lifetime diagnosis of FA, parental history of AD, and parental history of FA were independent risk factors for AD. In addition, we observed a synergistic interaction between home remodeling and FA in the risk of moderate-to-severe AD.

  15. Perceptions of health and risk management among home care workers in Sweden.

    Science.gov (United States)

    Larsson, A; Karlqvist, L; Westerberg, M; Gard, G

    2013-10-01

    Municipal home care workers provide high-quality services to an increasing proportion of elderly people living in private homes. The work environments and working conditions of these workers vary to a great extent, implying rapid priority-making among both employers and employees to ensure that the work can be performed in a safe way. This study aims to examine home care workers' perceptions of health, risks, working conditions, and risk management within their organization. The study was based on cross-sectional data collected from home care service staff in a municipality in the north of Sweden. Nursing assistants and care aides ( n  = 133) replied to a self-administered questionnaire. Descriptive statistics and between-group differences were analysed. Home care work was perceived to require high levels of professional skill and ingenuity, a good psychosocial work situation, but required a high physical workload. The general health, the capacity and self-efficacy of the staff in relation to work were good. Difficulty in performing risk assessments and following safety regulations due to lack of time, equipment, and information were identified. There is a need to increase participation in risk assessments among the staff, improve management support, structures, and cooperation with other divisions of the social services and the medical care organizations.

  16. THE NURSE IN THE OCCUPATIONAL RISKS IN HOME-CARE

    Directory of Open Access Journals (Sweden)

    Elaine Antunes Cortez

    2011-07-01

    Full Text Available Objetivos: identificar os riscos ocupacionais e descrever ações e medidas preventivas para minimizar riscos ao enfermeiro que atua em Home-Care. Método: estudo exploratório e descritivo com abordagem qualitativa, do tipo bibliográfico. Os dados foram coletados do acervo da Biblioteca Virtual da Saúde (BVS, através da base de dados da Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS, a base de dados Scientific Electronic Library Online (SciELO na Revista Latino Americana de Enfermagem, selecionados como bibliografia potencial 08 estudos dos quais emergiram 02 categorias temáticas: Enfermagem e Riscos ocupacionais; Enfermagem e Home-Care. Resultados: a equipe de enfermagem é uma das principais categorias ocupacionais sujeita aos riscos ocupacionais. O risco de maior destaque foi o ergonômico, seguido do biológico, químico e de acidentes. Dentre as ações/medidas preventivas pode-se citar: utilização de Equipamento de Proteção Individual, orientação quanto ao uso desses equipamentos, e diminuição da carga horária desses trabalhadores. Em relação aos riscos ergonômicos, orientações quanto à postura inadequada, monotonia, repetitividade e estresse ocupacional. Conclusão: Algumas ações/medidas preventivas devem ser implementadas, através de educação permanente, pausas durante as atividades, proporcionar conforto e melhorias das condições de trabalho, melhor distribuição das tarefas, organização do processo de trabalho e ginástica laboral.

  17. Assessment of risk of falls in elderly living at home

    Directory of Open Access Journals (Sweden)

    Adriana de Azevedo Smith

    Full Text Available ABSTRACT Objective: to assess the risk of falls in elderly, by comparing the sociodemographic and cognitive factors, history of falls and self-reported comorbidities. Method: cross-sectional and quantitative study with 240 elderly. Data were collected based on the social profile, through the instrument of risk of falls and assessment of falls, by univariate analysis, bivariate and multiple logistic regression. The Statistical Package for the Social Sciences (SPSS version 19 was used for statistical analysis. Results: there was a significant association of the risk of falls, as measured by the Fall Risk Score, with sex (<0.001, age (0.054, cognitive status (<0.001 and history of falls (<0.001. All variables were statistically significant and contributed to the occurrence of falls. In logistic regression, the variables that showed association with risk of falls were: fall, with whom they live, hypertension and visual impairment. Conclusion: female gender, older elderly (over 80 years old, with low cognitive status and occurrence of previous falls in the last six months are factors that increase the prevalence of falls. In logistic regression, the variables that were associated with risk of falls were: fall, with whom they live, visual impairment and rheumatologic diseases.

  18. A study of balance, gait and psychotropic drug use in relation to fall risk in nursing home residents with dementia

    NARCIS (Netherlands)

    C.S. Sterke (Carolyn)

    2011-01-01

    textabstractFalls are a major health problem in nursing home residents with dementia. In nursing homes one-third of all falls results in an injury. In order to take tailor-made preventive measures in time, the fall risk profile of each individual nursing home resident should be periodically

  19. 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.

  20. Pilot study to investigate the feasibility of the Home Falls and Accidents Screening Tool (HOME FAST) to identify older Malaysian people at risk of falls.

    Science.gov (United States)

    Romli, Muhammad Hibatullah; Mackenzie, Lynette; Lovarini, Meryl; Tan, Maw Pin

    2016-08-16

    The relationship between home hazards and falls in older Malaysian people is not yet fully understood. No tools to evaluate the Malaysian home environment currently exist. Therefore, this study aimed to pilot the Home Falls and Accidents Screening Tool (HOME FAST) to identify hazards in Malaysian homes, to evaluate the feasibility of using the HOME FAST in the Malaysian Elders Longitudinal Research (MELoR) study and to gather preliminary data about the experience of falls among a small sample of Malaysian older people. A cross-sectional pilot study was conducted. An urban setting in Kuala Lumpur. 26 older people aged 60 and over were recruited from the control group of a related research project in Malaysia, in addition to older people known to the researchers. The HOME FAST was applied with the baseline survey for the MELoR study via a face-to-face interview and observation of the home by research staff. The majority of the participants were female, of Malay or Chinese ethnicity and living with others in a double-storeyed house. Falls were reported in the previous year by 19% and 80% of falls occurred at home. Gender and fear of falling had the strongest associations with home hazards. Most hazards were detected in the bathroom area. A small number of errors were detected in the HOME FAST ratings by researchers. The HOME FAST is feasible as a research and clinical tool for the Malaysian context and is appropriate for use in the MELoR study. Home hazards were prevalent in the homes of older people and further research with the larger MELoR sample is needed to confirm the validity of using the HOME FAST in Malaysia. Training in the use of the HOME FAST is needed to ensure accurate use by researchers. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  1. Living alone, receiving help, helplessness, and inactivity are strongly related to risk of undernutrition among older home-dwelling people

    Directory of Open Access Journals (Sweden)

    Tomstad ST

    2012-03-01

    Full Text Available Solveig T Tomstad1, Ulrika Söderhamn2, Geir Arild Espnes3, Olle Söderhamn21Department of Social Work and Health Science, Faculty of Sciences and Technology Management, NTNU, Trondheim, Norway and Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 2Centre for Caring Research – Southern Norway, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway; 3Research Centre for Health Promotion and Resources HiST-NTNU, Department of Social Work and Health Science, Faculty of Social Sciences and Technology Management, NTNU, Trondheim, NorwayBackground: Being at risk of undernutrition is a global problem among older people. Undernutrition can be considered inadequate nutritional status, characterized by insufficient food intake and weight loss. There is a lack of Norwegian studies focusing on being at risk of undernutrition and self-care ability, sense of coherence, and health-related issues among older home-dwelling people.Aim: To describe the prevalence of being at risk of undernutrition among a group of older home-dwelling individuals in Norway, and to relate the results to reported self-care ability, sense of coherence, perceived health and other health-related issues.Methods: A cross-sectional design was applied. A questionnaire with instruments for nutritional screening, self-care ability, and sense of coherence, and health-related questions was sent to a randomized sample of 450 persons (aged 65+ years in southern Norway. The study group included 158 (35.1% participants. Data were analysed using statistical methods.Results: The results showed that 19% of the participants were at medium risk of undernutrition and 1.3% at high risk. Due to the low response rate it can be expected that the nonparticipants can be at risk of undernutrition. The nutritional at-risk group had lower self-care ability and weaker sense of coherence. Living alone, receiving help

  2. Hospitalization Risk and Potentially Inappropriate Medications among Medicare Home Health Nursing Patients.

    Science.gov (United States)

    Lohman, Matthew C; Cotton, Brandi P; Zagaria, Alexandra B; Bao, Yuhua; Greenberg, Rebecca L; Fortuna, Karen L; Bruce, Martha L

    2017-12-01

    Hospitalizations and potentially inappropriate medication (PIM) use are significant and costly issues among older home health patients, yet little is known about the prevalence of PIM use in home health or the relationship between PIM use and hospitalization risk in this population. To describe the prevalence of PIM use and association with hospitalization among Medicare home health patients. Cross-sectional analysis using data from 132 home health agencies in the US. Medicare beneficiaries starting home health nursing services between 2013 and 2014 (n = 87,780). Prevalence of individual and aggregate PIM use at start of care, measured using the 2012 Beers criteria. Relative risk (RR) of 30-day hospitalization or re-hospitalization associated with individual and aggregate PIM use, compared to no PIM use. In total, 30,168 (34.4%) patients were using at least one PIM, with 5969 (6.8%) taking at least two PIMs according to the Beers list. The most common types of PIMs were those affecting the brain or spinal cord, analgesics, and medications with anticholinergic properties. With the exception of nonsteroidal anti-inflammatory drugs (NSAIDs), PIM use across all classes was associated with elevated risk (10-33%) of hospitalization compared to non-use. Adjusting for demographic and clinical characteristics, patients using at least one PIM (excluding NSAIDs) had a 13% greater risk (RR = 1.13, 95% CI: 1.09, 1.17) of being hospitalized than patients using no PIMs, while patients using at least two PIMs had 21% greater risk (RR = 1.21, 95% CI: 1.12, 1.30). Similar associations were found between PIMs and re-hospitalization risk among patients referred to home health from a hospital. Given the high prevalence of PIM use and the association between PIMs and hospitalization risk, home health episodes represent opportunities to substantially reduce PIM use among older adults and prevent adverse outcomes. Efforts to address medication use during home health episodes

  3. Assessment of risk of falls in elderly living at home.

    Science.gov (United States)

    Smith, Adriana de Azevedo; Silva, Antonia Oliveira; Rodrigues, Rosalina Aparecida Partezani; Moreira, Maria Adelaide Silva Paredes; Nogueira, Jordana de Almeida; Tura, Luiz Fernando Rangel

    2017-04-06

    to assess the risk of falls in elderly, by comparing the sociodemographic and cognitive factors, history of falls and self-reported comorbidities. cross-sectional and quantitative study with 240 elderly. Data were collected based on the social profile, through the instrument of risk of falls and assessment of falls, by univariate analysis, bivariate and multiple logistic regression. The Statistical Package for the Social Sciences (SPSS) version 19 was used for statistical analysis. there was a significant association of the risk of falls, as measured by the Fall Risk Score, with sex (adulto mayor, mediante la comparación de los factores cognitivos y sociodemográficos, antecedentes de caídas y comorbilidades auto-reportadas. estudio transversal y cuantitativo con 240 adultos mayores. Los datos fueron recolectados utilizando instrumento del riesgo de caídas y evaluación de caídas, mediante el análisis univariado, bivariado y regresión logística múltiple. Para el anpalisis estadístico, fue utilizado software Statistical Package for the Social Sciences (SPSS) versión 19, se utilizó en el análisis estadístico. hay una asociación significativa del riesgo de caídas, medido por el Fall Risk Score, con el sexo (adulto mayor de edad más avanzada (más de 80 años de edad), bajo desempeño cognitivo, y antecedentes de caídas en los últimos seis meses son factores que aumentan la prevalencia de caídas. En la regresión logística, las variables que mostraron asociación con el riesgo de caídas fueron: caída, con quien vive, discapacidad visual y enfermedades reumáticas.

  4. The psychology of home environments: a call for research on residential space.

    Science.gov (United States)

    Graham, Lindsay T; Gosling, Samuel D; Travis, Christopher K

    2015-05-01

    Homes are important: People devote much of their thought, time, and resources to selecting, modifying, and decorating their living spaces, and they may be devastated when their homes must be sold or are destroyed. Yet the empirical psychological literature says virtually nothing about the roles that homes might play in people's lives. We argue that homes provide an informative context for a wide variety of studies examining how social, developmental, cognitive, and other psychological processes play out in a consequential real-world setting. The topic of homes is also well suited to collaborations with a diverse array of disciplines ranging from architecture and engineering to sociology and law. We illustrate the potential insights to be gained from studying homes with an exploratory study that maps the psychological ambiances (e.g., romance, comfort, togetherness) that people desire in their homes; we identify six broad ambiance dimensions (restoration, kinship, storage, stimulation, intimacy, productivity) that show mean differences across rooms. We connect these findings to existing work on situation selection in emotion regulation. These ideas provide only an initial foray into the domain of residential space, but they hint at the productive roles that homes and other spaces could play in psychological theorizing and research. © The Author(s) 2015.

  5. Does Child Abuse and Neglect Increase Risk for Perpetration of Violence Inside and Outside the Home?

    Science.gov (United States)

    Milaniak, Izabela; Widom, Cathy Spatz

    2014-01-01

    Objective: To examine the extent to which abused and neglected children perpetrate three different types of violence within and outside the home: criminal, child abuse, and intimate partner violence and determine whether childhood maltreatment leads to an increased risk for poly-violence perpetration. Method: Using data from a prospective cohort design study, children (ages 0-11) with documented histories of physical and sexual abuse and/or neglect (n = 676) were matched with children without such histories (n = 520) and assessed in young adulthood (average age 29). Official criminal records in conjunction with self-report data were used to assess violent outcomes. Results: Compared to the control group, individuals with histories of child abuse and/or neglect were significantly more likely to be poly-violence perpetrators, perpetrating violence in all three domains (relative risk = 1.26). All forms of childhood maltreatment (physical and sexual abuse and neglect) significantly predicted poly-violence perpetration. Conclusions: These findings expand the cycle of violence literature by combining the distinct literatures on criminal violence, child abuse, and partner violence to call attention to the phenomenon of poly-violence perpetration by maltreated children. Future research should examine the characteristics of maltreated children who become poly-violence perpetrators and mechanisms that lead to these outcomes. PMID:26191459

  6. [Work-related stress risk assessment in a home care agency].

    Science.gov (United States)

    Latocca, R; Riva, M A; D'Orso, M; Ploia, P; Rocca, S; De Vito, G; Cesana, G

    2012-01-01

    The workload, the quality of professional relationships and emotional involvement have a significant impact on distress and burnout in health care-workers; this impact has an hight variability among the different environments and different care facilities (hospital, erderly nursing homes, home care). The risk assessment of work-related stress performed in 2010 in a homecare agency highlighted organizational problems related to the content/context of work and risk factors for health and safety. High turn-over is evidenced as critical among the "sentinel events". The level of job-strain was moderate, even if some critical issues were evidenced especially in the group of physiotherapists; nurses were configured as a homogeneous group with a low level of job-strain. In informative meetings the workers identified the discomfort related to the time for transferring patients from their homes in a high-traffic metropolitan area was identified as the most critical aspect.

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

    Science.gov (United States)

    Solis, Guillermina R; Champion, Jane Dimmitt

    2017-03-01

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

  8. Risk as a target of safety research

    International Nuclear Information System (INIS)

    Krueger, W.

    1986-01-01

    Job creation is not the idea behind the demand for risk studies to be intensified in safety research. Risks are not only a target safety research should investigate, they are a subject that actually can be most adequately investigated by safety research. Assuming a neutral position between irrational fears and interest-minded problem minimization, that is the central approach and the ethics of a safety scientist. The Babylonian confusion of terminology experienced after the Chernobyl accident is a good example proving the necessity of fostering the neutral professionalism in safety research. (orig./DG) [de

  9. A diaper bank and home visiting partnership: Initial exploration of research and policy questions.

    Science.gov (United States)

    Sadler, Lois S; Condon, Eileen M; Deng, Shirley Z; Ordway, Monica Roosa; Marchesseault, Crista; Miller, Andrea; Alfano, Janet Stolfi; Weir, Alison M

    2018-03-01

    The cost of diapering an infant can place a significant financial strain on families living in poverty. Partnerships between diaper banks and home visiting programs for young families may offer an innovative solution to expanding the reach and impact of diaper banks in low-income communities. The purpose of this pilot study was to uncover preliminary information about the functions of diaper distribution through home visiting programs, and to inform future research and policy questions regarding diaper distribution to families in need. In this descriptive qualitative pilot study, semi-structured interviews were conducted with 6 home visitors from Minding the Baby ® (MTB), a home visiting intervention for young parents. MTB clinicians routinely distribute diapers in partnership with The Diaper Bank in Connecticut. We used directed content analysis to code and analyze interview transcripts. These preliminary findings indicate that partnerships between home visiting programs and diaper banks may benefit families by improving diaper access, reducing stigma, and fostering trusting relationships with home visitors. Home visiting program benefits including engagement or re-engagement with families may need to be balanced with potential effects on clinical and therapeutic relationships. Recommendations for next steps in research and related policy questions are discussed. © 2017 Wiley Periodicals, Inc.

  10. Public involvement in research within care homes: benefits and challenges in the APPROACH study.

    Science.gov (United States)

    Froggatt, Katherine; Goodman, Claire; Morbey, Hazel; Davies, Sue L; Masey, Helen; Dickinson, Angela; Martin, Wendy; Victor, Christina

    2016-12-01

    Public involvement in research (PIR) can improve research design and recruitment. Less is known about how PIR enhances the experience of participation and enriches the data collection process. In a study to evaluate how UK care homes and primary health-care services achieve integrated working to promote older people's health, PIR was integrated throughout the research processes. This paper aims to present one way in which PIR has been integrated into the design and delivery of a multisite research study based in care homes. A prospective case study design, with an embedded qualitative evaluation of PIR activity. Data collection was undertaken in six care homes in three sites in England. Six PIR members participated: all had prior personal or work experience in care homes. Qualitative data collection involved discussion groups, and site-specific meetings to review experiences of participation, benefits and challenges, and completion of structured fieldwork notes after each care home visit. PIR members supported recruitment, resident and staff interviews and participated in data interpretation. Benefits of PIR work were resident engagement that minimized distress and made best use of limited research resources. Challenges concerned communication and scheduling. Researcher support for PIR involvement was resource intensive. Clearly defined roles with identified training and support facilitated involvement in different aspects of the data collection process. This can also ensure that vulnerable older people who participate in research have a positive experience that reinforces the value of their views. © 2015 The Authors Health Expectations Published by John Wiley & Sons Ltd.

  11. Is compromised oral health associated with a greater risk of mortality among nursing home residents? A controlled clinical study.

    Science.gov (United States)

    Klotz, Anna-Luisa; Hassel, Alexander Jochen; Schröder, Johannes; Rammelsberg, Peter; Zenthöfer, Andreas

    2017-08-30

    The objective of this controlled clinical study was to evaluate the association between oral health and 1-year mortality among nursing home residents with or without oral health intervention. This research was part of a multidisciplinary intervention study (EVI-P) performed in 14 nursing homes in Germany. Two-hundred and nineteen nursing home residents were included in the study and assigned to an intervention group, for which dental health education was offered and ultrasonic baths were used for denture cleaning (n = 144), or to a control group (n = 75). Before the intervention, each participant was examined, and dental status, plaque control record (PCR), Denture Hygiene Index, and results from the Revised Oral Assessment Guide were recorded. Amount of care needed and dementia were also assessed, by use of the Barthel Index and the Mini Mental State Examination, respectively. Participant mortality was determined after 12 months, and bivariate analysis and logistic regression models were used to evaluate possible factors affecting mortality. Bivariate analysis detected a direct association between greater mortality and being in the control group (p = .038). Participants with higher PCR were also more likely to die during the study period (p = .049). For dentate participants, the protective effect of being in the intervention group was confirmed by multivariate analysis in which covariates such as age and gender were considered. Oral hygiene and oral health seem to affect the risk of mortality of nursing home residents. Dental intervention programs seem to reduce the risk of 1-year mortality among nursing home residents having remaining natural teeth. Further studies, with larger sample sizes and evaluation of the causes of death, are necessary to investigate the reasons for these associations.

  12. Bank Risk-Taking Abroad : Does Home-Country Regulation and Supervision Matter

    NARCIS (Netherlands)

    Ongena, S.; Popov, A.; Udell, G.F.

    2011-01-01

    This paper provides the first empirical evidence on how home-country regulation and supervision affects bank risk-tailing in host-country markets. We analyze lending by 136 banks to 8,253 firms in 1,513 different localities across 13 countries. We find strong evidence that laxer regulatory

  13. Bank Risk-Taking Abroad : Does Home-Country Regulation and Supervision Matter

    NARCIS (Netherlands)

    Ongena, S.; Popov, A.; Udell, G.F.

    2011-01-01

    This paper provides the first empirical evidence on how home-country regulation and supervision affects bank risk-tailing in hostr-country markets. We analyze lending by 136 banks to 8,253 firms in 1,513 different localities across 13 countries. We find strong evidence that laxer regulatory

  14. Running Away from Home: A Longitudinal Study of Adolescent Risk Factors and Young Adult Outcomes

    Science.gov (United States)

    Tucker, Joan S.; Edelen, Maria Orlando; Ellickson, Phyllis L.; Klein, David J.

    2011-01-01

    Little is known about the adolescent risk factors and young adult health-related outcomes associated with running away from home. We examined these correlates of running away using longitudinal data from 4,329 youth (48% female, 85% white) who were followed from Grade 9 to age 21. Nearly 14% of the sample reported running away in the past year at…

  15. Identifying fallers with Parkinson's disease using home-based tests: who is at risk?

    NARCIS (Netherlands)

    Lim-de Vries, L.I.I.K.; van Wegen, E.E.; Jones, D.; Rochester, L.; Nieuwboer, A.; Willems, A.M.; Baker, K.; Hetherington, V.; Kwakkel, G.

    2008-01-01

    The objective of this work is to determine risk factors for falling in patients with Parkinson's disease (PD) using home-based assessments and develop a prediction model. Data on falls, balance, gait-related activities, and nonmotor symptoms were obtained from 153 PD patients (Hoehn-Yahr 2-4) in

  16. School- And Home-Based Drug Prevention: Environmental, Parent, and Child Risk Reduction

    Science.gov (United States)

    Hahn, Ellen J.; Hall, Lynne A.; Rayens, Mary Kay; Myers, April V.; Bonnel, Galadriel

    2007-01-01

    The study purpose was to test the effect of a school- and home-based alcohol, tobacco, and other drug (ATOD) prevention program on reducing environmental, parent, and child risk factors for ATOD use. The design was a three-group pretest-posttest with interviews at baseline and 1 and 6 months post-intervention. The sample was 126 parents and their…

  17. Sleep Disruption at Home As an Independent Risk Factor for Postoperative Delirium.

    Science.gov (United States)

    Todd, Oliver M; Gelrich, Lisa; MacLullich, Alasdair M; Driessen, Martin; Thomas, Christine; Kreisel, Stefan H

    2017-05-01

    To determine whether sleep disruption at home or in hospital is an independent risk factor for postoperative delirium in older adults undergoing elective surgery. Prospective cohort study. German teaching hospital. Individuals aged 65 and older undergoing elective arthroplasty (N = 101). Preoperative questionnaires were used to assess sleep disruption at home (Pittsburgh Sleep Quality Index). Actigraphy was used to objectively measure sleep disruption in the hospital before and after surgery. Delirium was assessed daily after surgery using the Confusion Assessment Method and, if there was uncertainty, validated according to International Classification of Diseases, Tenth Revision (ICD-10), criteria. Twenty-seven participants developed postoperative delirium. Those with sleep disruption at home were 3.26 times as likely to develop postoperative delirium as those without (95% confidence interval (CI) = 1.34-7.92, P = .009). Participants with sleep disruption in hospital were 1.21 times as likely to develop postoperative delirium as those without (95% CI = 1.03-1.41, P = .02). When adjusting for other variables, risk remained significant for sleep disruption at home (risk ratio (RR) = 3.90, 95% CI = 2.14-7.11, P delirium than those without. Sleep disruption in the hospital may further heighten this risk. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  18. Outcomes and risk factors for unplanned delivery at home and before arrival to the hospital.

    Science.gov (United States)

    Lazić, Zlatko; Takač, Iztok

    2011-01-01

    The aim of this study was to analyze the outcomes and risk factors for unplanned delivery at home and before arrival to the hospital in Maribor region, Slovenia. We used data from medical records of all deliveries in Maribor region from the year 1997 to the year 2005. We analysed a total of 17,846 births from annual reports of the Maribor University Hospital. Among the total of 17,846 births, there were 58 (3.2‰) unplanned births at home and on the way to the hospital. The study based on the data from medical records on safety of unplanned home birth reveals that hospital delivery is approximately 7 times safer than unplanned home delivery. This conclusion is reached by comparing perinatal mortality, which was 68‰ for unplanned deliveries at home versus 8.8‰ for deliveries at hospital. The prematurity was more common in unplanned home deliveries: 13 (22%) versus 1399 (8%) for hospital deliveries. Unplanned deliveries at home and on the way to the hospital were more common in multiparous women (ratio 4:1 compared to 1:1 for hospital births). When for all hospital deliveries the pregnancies were followed, for one third of unplanned deliveries at home or on the way to the hospital the pregnancies were not monitored. Mothers who gave birth at home or on the way to the hospital were without higher education (i.e. 55.2%) and mothers who gave birth in hospital were with higher education (i.e. 87.4%). There was higher rate of perinatal morbidity for unplanned home deliveries compared to hospital deliveries. Factors that make unplanned home deliveries more common are high parity, absence or inadequacy of antenatal care, marital status and lower education. Some conditions in newborn, such as hypothermia, were clearly the result of unplanned birth at home. Additional effort to improve antenatal care and also identifying social vulnerabilities would possibly decrease the number of unplanned deliveries and improve the perinatal outcomes.

  19. Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003–2011

    Science.gov (United States)

    Lohman, Matthew; Leslie, Marc; Powell, Virginia

    2015-01-01

    Objectives. We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Methods. Data come from the Virginia Violent Death Reporting System (2003–2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. Results. Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. Conclusions. LTC may be an important point of engagement in suicide prevention. PMID:25973805

  20. Suicide Risk in Nursing Homes and Assisted Living Facilities: 2003-2011.

    Science.gov (United States)

    Mezuk, Briana; Lohman, Matthew; Leslie, Marc; Powell, Virginia

    2015-07-01

    We investigated the epidemiology of suicide among adults aged 50 years and older in nursing homes and assisted living facilities and whether anticipating transitioning into long-term care (LTC) is a risk factor for suicide. Data come from the Virginia Violent Death Reporting System (2003-2011). We matched locations of suicides (n = 3453) against publicly available resource registries of nursing homes (n = 285) and assisted living facilities (n = 548). We examined individual and organizational correlates of suicide by logistic regression. We identified decedents anticipating entry into LTC through qualitative text analysis. Incidence of suicide was 14.16 per 100 000 in nursing homes and 15.66 in the community. Better performance on Nursing Home Compare quality metrics was associated with higher odds of suicide in nursing homes (odds ratio [OR] = 1.95; 95% confidence interval [CI] = 1.21, 3.14). Larger facility size was associated with higher suicide risk in assisted living facilities (OR = 1.01; 95% CI = 1.00, 1.01). Text narratives identified 38 decedents anticipating transitioning into LTC and 16 whose loved one recently transitioned or resided in LTC. LTC may be an important point of engagement in suicide prevention.

  1. Reliability and risk analysis methods research plan

    International Nuclear Information System (INIS)

    1984-10-01

    This document presents a plan for reliability and risk analysis methods research to be performed mainly by the Reactor Risk Branch (RRB), Division of Risk Analysis and Operations (DRAO), Office of Nuclear Regulatory Research. It includes those activities of other DRAO branches which are very closely related to those of the RRB. Related or interfacing programs of other divisions, offices and organizations are merely indicated. The primary use of this document is envisioned as an NRC working document, covering about a 3-year period, to foster better coordination in reliability and risk analysis methods development between the offices of Nuclear Regulatory Research and Nuclear Reactor Regulation. It will also serve as an information source for contractors and others to more clearly understand the objectives, needs, programmatic activities and interfaces together with the overall logical structure of the program

  2. Coming Out and Leaving Home: A Policy and Research Agenda for LGBT Homeless Students

    Science.gov (United States)

    Tierney, William G.; Ward, James Dean

    2017-01-01

    Each year, it is estimated between 320,000 and 400,000 LGBT youth encounter homelessness. They are at increased risk of victimization and abuse and face stigmatization for being both homeless and a sexual or gender minority. These youth are more likely than their heterosexual counterparts to become homeless after being forced out of their homes.…

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

    Science.gov (United States)

    Lawrence, Sharmila; Stephens, Samuel A.

    2016-01-01

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

  4. "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.

  5. The Falls In Care Home study: a feasibility randomized controlled trial of the use of a risk assessment and decision support tool to prevent falls in care homes

    Science.gov (United States)

    Walker, Gemma M; Armstrong, Sarah; Gordon, Adam L; Gladman, John; Robertson, Kate; Ward, Marie; Conroy, Simon; Arnold, Gail; Darby, Janet; Frowd, Nadia; Williams, Wynne; Knowles, Sue; Logan, Pip A

    2015-01-01

    Objective: To explore the feasibility of implementing and evaluating the Guide to Action Care Home fall prevention intervention. Design: Two-centre, cluster feasibility randomized controlled trial and process evaluation. Setting: Purposive sample of six diverse old age/learning disability, long stay care homes in Nottinghamshire, UK. Subjects: Residents aged over 50 years, who had fallen at least once in the past year, not bed-bound, hoist-dependent or terminally ill. Interventions: Intervention homes (n = 3) received Guide to Action Care Home fall prevention intervention training and support. Control homes (n = 3) received usual care. Outcomes: Recruitment, attrition, baseline and six-month outcome completion, contamination and intervention fidelity, compliance, tolerability, acceptance and impact. Results: A total of 81 of 145 (56%) care homes expressed participatory interest. Six of 22 letter respondent homes (27%) participated. The expected resident recruitment target was achieved by 76% (52/68). Ten (19%) residents did not complete follow-up (seven died, three moved). In intervention homes 36/114 (32%) staff attended training. Two of three (75%) care homes received protocol compliant training. Staff valued the training, but advised greater management involvement to improve intervention implementation. Fall risks were assessed, actioned and recorded in care records. Of 115 recorded falls, 533/570 (93%) of details were complete. Six-month resident fall rates were 1.9 and 4.0 per year for intervention and control homes, respectively. Conclusions: The Guide to Action Care Home is implementable under trial conditions. Recruitment and follow-up rates indicate that a definitive trial can be completed. Falls (primary outcome) can be ascertained reliably from care records. PMID:26385358

  6. Fall Risk and Its Associated Factors among Older Adults without Home-Help Services in a Swedish Municipality.

    Science.gov (United States)

    Hammarlund, Catharina Sjödahl; Hagell, Peter; Westergren, Albert

    2016-01-01

    During preventive home visits, the purpose of this study was to identify the prevalence of fall risk and any associated factors. Participants (n = 1471) were cognitively sound community-dwelling older adults (≥ 70 years) without home-help service, living in a Swedish municipality. The Downton Fall Risk Index and nine single items were used. Tiredness/fatigue, age ≥ 80, inability to walk 1 hr, inability to climb stairs and worrying were significantly associated with fall risk. Preventive home visits incorporating fall-risk screening proved valuable, providing information for interventions aimed at preventing falls, maintaining independence, and facilitating health among community dwelling participants.

  7. Delirium During Postacute Nursing Home Admission and Risk for Adverse Outcomes.

    Science.gov (United States)

    Kosar, Cyrus M; Thomas, Kali S; Inouye, Sharon K; Mor, Vincent

    2017-07-01

    To identify the rate of delirium present during admission to postacute care (PAC) in the nursing home setting and to determine whether patients with delirium had higher risk for adverse outcomes. Retrospective cohort study. US Medicare- and Medicaid-certified nursing homes, 2011 to 2014. Individuals admitted to all US nursing homes for PAC, aged ≥65 years, and without prior history of nursing home residence (n = 5,588,702). Minimum Data Set (MDS) 3.0 admission assessments identified delirium based upon Confusion Assessment Method (CAM) items. Robust Poisson regression was used to calculate adjusted relative risks (aRRs) with 95% confidence intervals (CIs) for death following PAC admission, and for 30-day discharge outcomes including re-hospitalization from PAC, discharge home, and functional improvement. Delirium was identified in 4.3% of new postacute nursing home admissions. Mortality within 30 days of PAC admission was observed in 16.3% of patients with delirium and 5.8% of patients without delirium (aRR = 2.27, CI = 2.24-2.30). The rate of 30-day readmission from PAC was 21.3% for patients with delirium compared with 15.1% among patients without delirium (aRR = 1.42, 95% CI = 1.40, 1.43). 26.9% of patients with delirium were discharged home within 30 days of admission compared to 52.5% of patients without delirium (aRR = 0.57, 95% CI = 0.57, 0.58). 48.9% of patients with delirium showed functional improvement at discharge compared to 59.9% of patients without delirium (aRR = 0.83, 95% CI = 0.82, 0.83). Patients with delirium present upon PAC admission were at high risk for mortality and 30-day re-hospitalization and were less likely to have timely discharge to home or to improve in physical function at discharge. Early identification and care planning for individuals with delirium at PAC admission may be essential to improve outcomes. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  8. Decision Making about Hospital Arrival among Low-Risk Nulliparous Women after Spontaneous Labor Onset at Home.

    Science.gov (United States)

    Edmonds, Joyce K; Miley, Kathleen; Angelini, Kimberly J; Shah, Neel T

    2018-05-15

    Postponing hospital admission until the active phase of labor is a recommended strategy to safely reduce the incidence of primary cesarean births. Success of this strategy depends on women's decisions about when to transfer from home to the hospital, a process that is largely absent from research about childbirth. This study aimed to determine the decision-making criteria used by women about when to go to the hospital after the self-identification of labor onset at home. A qualitative study was conducted at an academic medical center with a sample of 21 nulliparous women who went into spontaneous labor at home and had term, singleton, and vertex-presentation births. The purposive sample consisted of women who decided to stay at home or go to the hospital in early labor. Birth narratives from in-depth interviews conducted in the postpartum period using a semistructured interview guide were subjected to content analysis. The verbatim transcriptions of the interviews were coded and categorized into a set of decision criteria. Criteria used by women in deciding to go to the hospital or stay at home in early labor included the degree of certainty with the self-identification of labor onset, ability to cope with labor pain, influence of social network members, health care provider advice, and concerns about travel to the hospital. Perception of childbirth risk and the need for reassurance about the normalcy of symptoms and fetal well-being also influenced women's decisions. Women use a common set of criteria in deciding when to arrive at the hospital during labor. Antenatal education and telephone triage interventions that incorporate the considerations of women deciding to seek or delay hospital admission in childbirth may facilitate health seeking in more advanced labor. Symptom recognition education about early labor onset and progression could reduce decisional uncertainty. © 2018 by the American College of Nurse-Midwives.

  9. Disparities in risk communication: a pilot study of asthmatic children, their parents, and home environments.

    Science.gov (United States)

    Biksey, Thomas; Zickmund, Susan; Wu, Felicia

    2011-05-01

    Parents' knowledge and control of asthma triggers in home environments can help reduce risks associated with asthmatic children's respiratory health. This pilot study used both qualitative and quantitative methods to determine parental knowledge of their children's asthma triggers in home environments, control of those triggers, and information received and trusted. Twelve parents of asthmatic children in the greater Pittsburgh area--8 white and 4 African American--participated in one-on-one interviews about home exposures to asthma triggers. All parents described the link between asthma symptoms and both environmental tobacco smoke (ETS) and pet dander exposures. House dust mites and mold were also commonly identified asthma triggers. All 8 white parents reported receiving information from physicians about controlling home environmental triggers of asthma, but the 4 African American parents reported having received no such information. However, all 12 parents reported having greater trust in information received from physicians than from other sources. White parents were significantly more aware of potential asthma triggers and performed significantly more actions to control the triggers in their homes. African American parents noted stressful experiences with primary and secondary care, less recall of information sharing about asthma triggers, and a focus on symptom management vs trigger avoidance.

  10. Challenges to conducting research with older people living in nursing homes

    OpenAIRE

    Hall, Sue; Longhurst, Susan; Higginson, Irene J

    2009-01-01

    Abstract Background Although older people are increasingly cared for in nursing homes towards the end of life, there is a dearth of research exploring the views of residents. There are however, a number of challenges and methodological issues involved in doing this. The aim of this paper is to discuss some of these, along with residents' views on taking part in a study of the perceptions of dignity of older people in care homes and make recommendations for future research in these settings. M...

  11. Ethics and gender issues in palliative care in nursing homes: an Austrian participatory research project.

    Science.gov (United States)

    Reitinger, Elisabeth; Heimerl, Katharina

    2014-06-01

    The development of palliative care in nursing homes in German-speaking countries has gained in importance within the past 15-20 years. Ethical and gender issues are core aspects of a palliative care culture and should therefore be better understood. The aim of this study was to highlight insights regarding ethical and gender issues, based on the experiences of professionals in nursing homes. A 2-year participatory action research study was performed in collaboration with three nursing homes in Austria. The article focusses on 10 group discussions with interdisciplinary professional teams that were conducted to generate ethical narratives. Thematic and narrative analysis was undertaken both individually and within the interdisciplinary research team. Findings and interpretations were validated with practitioners and researchers. A total of 36 narratives were collected and summarised within eight themes concerning the theoretical journey of a nursing home resident with relatives from entry into the house until death. The most burdensome ethical dilemmas are not the ones around death and dying but rather those relating to small-scale everyday work/life issues. Sharing experiences and feelings in ethical discussions provides relief. Emotions are important facilitators of insight into ethical dilemmas. Gender issues can be observed in care situations as well as in the organisational structure of nursing homes. Opportunities to share experiences and perspectives around ethical questions in interdisciplinary group discussions help professionals to better understand difficult issues and find appropriate ways of managing them. There is a need for communication structures such as facilitated ethical discussions that enable nursing home staff to reflect their everyday decisions. Expression of emotions should be encouraged in ethical decision-making processes in nursing homes. Gender-sensitive reflection supports the development of palliative care as organisational culture.

  12. 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.

  13. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

    Science.gov (United States)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-09-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. © 2012 John Wiley & Sons A/S.

  14. Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study.

    Science.gov (United States)

    Kwong, Enid Wy; Hung, Maria Sy; Woo, Kevin

    2016-11-25

    A need exits to develop a protocol for preventing pressure ulcers (PUs) in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes. A total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning), changing (action), and refreezing (results) were carried out. During each cycle, focus group interviews, field observations of the care staff's practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results. The following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the revised risk assessment method, the timely and appropriate

  15. Improvement of pressure ulcer prevention care in private for-profit residential care homes: an action research study

    Directory of Open Access Journals (Sweden)

    Enid WY Kwong

    2016-11-01

    Full Text Available Abstract Background A need exits to develop a protocol for preventing pressure ulcers (PUs in private for-profit nursing homes in Hong Kong, where the incidence of PUs is relatively high and which have high proportion of non-professional care staff. The implementation of such protocol would involve changes in the practice of care, likely evoking feelings of fear and uncertainty that may become a barrier to staff adherence. We thus adopted the Systems Model of Action Research in this study to manage the process of change for improving PU prevention care and to develop a pressure ulcer prevention protocol for private for-profit nursing homes. Methods A total of 474 residents and care staff who were health workers, personal care workers, and/or nurses from four private, for-profit nursing homes in Hong Kong participated in this study. Three cyclic stages and steps, namely, unfreezing (planning, changing (action, and refreezing (results were carried out. During each cycle, focus group interviews, field observations of the care staff’s practices and inspections of the skin of the residents for pressure ulcers were conducted to evaluate the implementation of the protocol. Qualitative content analysis was adopted to analyse the data. The data and methodological triangulation used in this study increased the credibility and validity of the results. Results The following nine themes emerged from this study: prevention practices after the occurrence of PUs, the improper use of pressure ulcer prevention materials, non-compliance with several prevention practices, improper prevention practices, the perception that the preventive care was being performed correctly, inadequate readiness to use the risk assessment tool, an undesirable environment, the supplying of unfavorable resources, and various management styles in the homes with or without nurses. At the end of the third cycle, the changes that were identified included improved compliance with the

  16. Quality of Care and Job Satisfaction in the European Home Care Setting: Research Protocol

    Directory of Open Access Journals (Sweden)

    Liza Van Eenoo

    2016-08-01

    Full Text Available Introduction: Since the European population is ageing, a growing number of elderly will need home care. Consequently, high quality home care for the elderly remains an important challenge. Job satisfaction among care professionals is regarded as an important aspect of the quality of home care. Aim: This paper describes a research protocol to identify elements that have an impact on job satisfaction among care professionals and on quality of care for older people in the home care setting of six European countries. Methods: Data on elements at the macro-level (policy, meso-level (care organisations and micro-level (clients are of importance in determining job satisfaction and quality of care. Macro-level indicators will be identified in a previously published literature review. At meso- and micro-level, data will be collected by means of two questionnaires utilsed with both care organisations and care professionals, and by means of interRAI Home Care assessments of clients. The client assessments will be used to calculate quality of care indicators. Subsequently, data will be analysed by means of linear and stepwise multiple regression analyses, correlations and multilevel techniques. Conclusions and Discussion: These results can guide health care policy makers in their decision making process in order to increase the quality of home care in their organisation, in their country or in Europe.

  17. Quality of Care and Job Satisfaction in the European Home Care Setting: Research Protocol

    Science.gov (United States)

    van der Roest, Henriëtte; van Hout, Hein; Declercq, Anja

    2016-01-01

    Introduction: Since the European population is ageing, a growing number of elderly will need home care. Consequently, high quality home care for the elderly remains an important challenge. Job satisfaction among care professionals is regarded as an important aspect of the quality of home care. Aim: This paper describes a research protocol to identify elements that have an impact on job satisfaction among care professionals and on quality of care for older people in the home care setting of six European countries. Methods: Data on elements at the macro-level (policy), meso-level (care organisations) and micro-level (clients) are of importance in determining job satisfaction and quality of care. Macro-level indicators will be identified in a previously published literature review. At meso- and micro-level, data will be collected by means of two questionnaires utilsed with both care organisations and care professionals, and by means of interRAI Home Care assessments of clients. The client assessments will be used to calculate quality of care indicators. Subsequently, data will be analysed by means of linear and stepwise multiple regression analyses, correlations and multilevel techniques. Conclusions and Discussion: These results can guide health care policy makers in their decision making process in order to increase the quality of home care in their organisation, in their country or in Europe. PMID:28435423

  18. Community Research Contributing to Effective Risk Governance

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Neale; Forsstroem, Hans [European Commission, Brussels (Belgium). DG Research

    2001-07-01

    Research in the field of risk assessment and management has had a prominent role in the Commission's nuclear research programme, especially in the area of radiation protection. In the 1980s, the research had a largely technical focus. Through the 1990s, this focus shifted and greater attention was given to broader, less technical, issues, in particular those concerned with risk perception and communication, risk governance and the role of public participation in the process. This trend will continue within the Commission's 6th Framework Programme (FP6) given the increasing recognition of the importance of these broader socio-economic issues for decision making related to both nuclear and other technologies. The paper summarises the main outcomes of Commission sponsored research in the above areas, how this has influenced research currently being carried out in the Sth Framework Programme (FP5) and that being considered for inclusion in FP6. Two aspects are given particular attention: firstly, research into risk governance (both in the nuclear field in general and the waste management area in particular), especially the importance of social trust and participation of all relevant stakeholders in terms of achieving efficient and acceptable decisions when addressing complex, contentious issues; secondly, research into the social and psychological factors that influenced the efficacy and acceptance of measures taken to mitigate the long term impact of areas in the Former Soviet Union contaminated as a result of the Chernobyl accident. There are important lessons here for the management of any future accident that may affect Europe, especially the need for those affected locally to have a role in the decision process and to be able to exercise at least partial control over their own welfare. While this research was largely carried out in a 'nuclear' context, its findings are more generally applicable.

  19. Community Research Contributing to Effective Risk Governance

    International Nuclear Information System (INIS)

    Kelly, Neale; Forsstroem, Hans

    2001-01-01

    Research in the field of risk assessment and management has had a prominent role in the Commission's nuclear research programme, especially in the area of radiation protection. In the 1980s, the research had a largely technical focus. Through the 1990s, this focus shifted and greater attention was given to broader, less technical, issues, in particular those concerned with risk perception and communication, risk governance and the role of public participation in the process. This trend will continue within the Commission's 6th Framework Programme (FP6) given the increasing recognition of the importance of these broader socio-economic issues for decision making related to both nuclear and other technologies. The paper summarises the main outcomes of Commission sponsored research in the above areas, how this has influenced research currently being carried out in the Sth Framework Programme (FP5) and that being considered for inclusion in FP6. Two aspects are given particular attention: firstly, research into risk governance (both in the nuclear field in general and the waste management area in particular), especially the importance of social trust and participation of all relevant stakeholders in terms of achieving efficient and acceptable decisions when addressing complex, contentious issues; secondly, research into the social and psychological factors that influenced the efficacy and acceptance of measures taken to mitigate the long term impact of areas in the Former Soviet Union contaminated as a result of the Chernobyl accident. There are important lessons here for the management of any future accident that may affect Europe, especially the need for those affected locally to have a role in the decision process and to be able to exercise at least partial control over their own welfare. While this research was largely carried out in a 'nuclear' context, its findings are more generally applicable

  20. Smart homes, private homes? An empirical study of technology researchers? perceptions of ethical issues in developing smart-home health technologies

    OpenAIRE

    Birchley, Giles; Huxtable, Richard; Murtagh, Madeleine; ter Meulen, Ruud; Flach, Peter; Gooberman-Hill, Rachael

    2017-01-01

    Background Smart-home technologies, comprising environmental sensors, wearables and video are attracting interest in home healthcare delivery. Development of such technology is usually justified on the basis of the technology?s potential to increase the autonomy of people living with long-term conditions. Studies of the ethics of smart-homes raise concerns about privacy, consent, social isolation and equity of access. Few studies have investigated the ethical perspectives of smart-home engine...

  1. History of Maltreatment in Childhood and Subsequent Parenting Stress in At-Risk, First-Time Mothers: Identifying Points of Intervention During Home Visiting.

    Science.gov (United States)

    Shenk, Chad E; Ammerman, Robert T; Teeters, Angelique R; Bensman, Heather E; Allen, Elizabeth K; Putnam, Frank W; Van Ginkel, Judith B

    2017-04-01

    Home visiting is an effective preventive intervention that can improve parenting outcomes for at-risk, new mothers, thereby optimizing subsequent child development. A history of maltreatment in childhood is common in mothers participating in home visiting, yet the extent to which such a history is related to parenting outcomes during home visiting is unknown. The current study evaluated whether mothers with a history of maltreatment in childhood respond less favorably to home visiting by examining the direct and indirect pathways to subsequent parenting stress, a key parenting outcome affecting child development. First-time mothers (N = 220; age range = 16-42) participating in one of two home visiting programs, Healthy Families America or Nurse Family Partnership, were evaluated at enrollment and again at 9-and 18-month post-enrollment assessments. Researchers administered measures of maternal history of maltreatment in childhood, depressive symptoms, social support, and parenting stress. Maternal history of maltreatment in childhood predicted worsening parenting stress at the 18-month assessment. Mediation modeling identified two indirect pathways, one involving social support at enrollment and one involving persistent depressive symptoms during home visiting, that explained the relation between a history of maltreatment in childhood and parenting stress at the 18-month assessment. Ways to improve the preventive effects of home visiting for mothers with a history of maltreatment in childhood through the identification of relevant intervention targets and their ideal time of administration are discussed.

  2. A Study to Assess the Knowledge on Risk for Fall among Geriatric People Above 60 Years at Selected Oldage Home at Karaikal

    OpenAIRE

    R.G. Padmapriya; E. Kalaivani

    2017-01-01

    A study to assess the risk for fall among geriatric people above 60 years of age in selected old age home at karaikal. The research approach was adopted for this study was quantitative approach. The research design used for this study is descriptive design. A simple random sampling technique adopted to select the desired sample. Sample size is 50. Donna conley fall risk assessment scale was used to assess the risk for fall among geriatric people above 60 years of age . The collected data was...

  3. Influence of sociodemographic factors on the risk of unintentional childhood home injuries

    DEFF Research Database (Denmark)

    Laursen, Bjarne; Nielsen, Jeppe W

    2008-01-01

    . Risk differences were found for all injury mechanisms; however the risk for burns was 1.9 (1.6-2.3) times higher in the lowest-income group than in the highest-income group, the relative risk for poisoning was 1.7(1.4-2.1). For scalds from hot water, tea or coffee, the relative risk for the lowest......-income group was 2.4(1.8-3.2). Living in a one- or two-parent family and size of the dwelling had little or no effect on risk. CONCLUSION: Childhood injury incidence depended on sociodemographic factors. The effect of the sociodemographic factors varied between injury mechanisms and products involved......BACKGROUND: While social differences in childhood injuries are recognized, less is known about how social and demographic differences relate to injury mechanism. The purpose of the study was to reveal how sociodemographic factors affect the incidence of unintentional home injuries in Danish...

  4. Redefining risk research priorities for nanomaterials

    DEFF Research Database (Denmark)

    Grieger, Khara Deanne; Baun, Anders; Owen, R.

    2010-01-01

    Chemical-based risk assessment underpins the current approach to responsible development of nanomaterials (NM). It is now recognised, however, that this process may take decades, leaving decision makers with little support in the near term. Despite this, current and near future research efforts...

  5. Low Fruit/Vegetable Consumption in the Home: Cumulative Risk Factors in Early Childhood

    Science.gov (United States)

    Ward, Wendy L.; Swindle, Taren M.; Kyzer, Angela L.; Whiteside-Mansell, Leanne

    2015-01-01

    Cumulative risk theory suggests that a variety of social risk factors would have an additive effect on obesity risk. Multiple studies have suggested that obesity is related to basic resources such as transportation and financial resources. Additional research points to parental engagement and parental monitoring as additional sources of risk. This…

  6. 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).

  7. Challenges to conducting research with older people living in nursing homes

    Directory of Open Access Journals (Sweden)

    Higginson Irene J

    2009-08-01

    Full Text Available Abstract Background Although older people are increasingly cared for in nursing homes towards the end of life, there is a dearth of research exploring the views of residents. There are however, a number of challenges and methodological issues involved in doing this. The aim of this paper is to discuss some of these, along with residents' views on taking part in a study of the perceptions of dignity of older people in care homes and make recommendations for future research in these settings. Methods Qualitative interviews were used to obtain the views on maintaining dignity of 18 people aged 75 years and over, living in two private nursing homes in South East London. Detailed field notes on experiences of recruiting and interviewing participants were kept. Results Challenges included taking informed consent (completing reply slips and having a 'reasonable' understanding of their participation; finding opportunities to conduct interviews; involvement of care home staff and residents' families and trying to maintain privacy during the interviews. Most residents were positive about their participation in the study, however, five had concerns either before or during their interviews. Although 15 residents seemed to feel free to air their views, three seemed reluctant to express their opinions on their care in the home. Conclusion Although we experienced many challenges to conducting this study, they were not insurmountable, and once overcome, allowed this often unheard vulnerable group to express their views, with potential long-term benefits for future delivery of care.

  8. Multi-disciplinary communication networks for skin risk assessment in nursing homes with high IT sophistication.

    Science.gov (United States)

    Alexander, Gregory L; Pasupathy, Kalyan S; Steege, Linsey M; Strecker, E Bradley; Carley, Kathleen M

    2014-08-01

    The role of nursing home (NH) information technology (IT) in quality improvement has not been clearly established, and its impacts on communication between care givers and patient outcomes in these settings deserve further attention. In this research, we describe a mixed method approach to explore communication strategies used by healthcare providers for resident skin risk in NH with high IT sophistication (ITS). Sample included NH participating in the statewide survey of ITS. We incorporated rigorous observation of 8- and 12-h shifts, and focus groups to identify how NH IT and a range of synchronous and asynchronous tools are used. Social network analysis tools and qualitative analysis were used to analyze data and identify relationships between ITS dimensions and communication interactions between care providers. Two of the nine ITS dimensions (resident care-technological and administrative activities-technological) and total ITS were significantly negatively correlated with number of unique interactions. As more processes in resident care and administrative activities are supported by technology, the lower the number of observed unique interactions. Additionally, four thematic areas emerged from staff focus groups that demonstrate how important IT is to resident care in these facilities including providing resident-centered care, teamwork and collaboration, maintaining safety and quality, and using standardized information resources. Our findings in this study confirm prior research that as technology support (resident care and administrative activities) and overall ITS increases, observed interactions between staff members decrease. Conversations during staff interviews focused on how technology facilitated resident centered care through enhanced information sharing, greater virtual collaboration between team members, and improved care delivery. These results provide evidence for improving the design and implementation of IT in long term care systems to support

  9. The care unit in nursing home research: evidence in support of a definition.

    Science.gov (United States)

    Estabrooks, Carole A; Morgan, Debra G; Squires, Janet E; Boström, Anne-Marie; Slaughter, Susan E; Cummings, Greta G; Norton, Peter G

    2011-04-14

    Defining what constitutes a resident care unit in nursing home research is both a conceptual and practical challenge. The aim of this paper is to provide evidence in support of a definition of care unit in nursing homes by demonstrating: (1) its feasibility for use in data collection, (2) the acceptability of aggregating individual responses to the unit level, and (3) the benefit of including unit level data in explanatory models. An observational study design was used. Research (project) managers, healthcare aides, care managers, nursing home administrators and directors of care from thirty-six nursing homes in the Canadian prairie provinces of Alberta, Saskatchewan and Manitoba provided data for the study. A definition of care unit was developed and applied in data collection and analyses. A debriefing session was held with research managers to investigate their experiences with using the care unit definition. In addition, survey responses from 1258 healthcare aides in 25 of the 36 nursing homes in the study, that had more than one care unit, were analyzed using a multi-level modeling approach. Trained field workers administered the Alberta Context Tool (ACT), a 58-item self-report survey reflecting 10 organizational context concepts, to healthcare aides using computer assisted personal interviews. To assess the appropriateness of obtaining unit level scores, we assessed aggregation statistics (ICC(1), ICC(2), η², and ω²), and to assess the value of using the definition of unit in explanatory models, we performed multi-level modeling. In 10 of the 36 nursing homes, the care unit definition developed was used to align the survey data (for analytic purposes) to specific care units as designated by our definition, from that reported by the facility administrator. The aggregation statistics supported aggregating the healthcare aide responses on the ACT to the realigned unit level. Findings from the multi-level modeling further supported unit level aggregation. A

  10. Influence of cognitive impairment on fall risk among elderly nursing home residents.

    Science.gov (United States)

    Seijo-Martinez, M; Cancela, J M; Ayán, C; Varela, S; Vila, H

    2016-12-01

    Information relating the severity of cognitive decline to the fall risk in institutionalized older adults is still scarce. This study aims to identify potential fall risk factors (medications, behavior, motor function, and neuropsychological disturbances) depending on the severity of cognitive impairment in nursing home residents. A total of 1,167 nursing home residents (mean age 81.44 ± 8.26 years; 66.4% women) participated in the study. According to the MEC, (the Spanish version of the Mini-Mental State Examination) three levels of cognitive impairment were established: mild (20-24) "MCI", moderate (14-19) "MOCI", and severe (≤14) "SCI". Scores above 24 points indicated the absence cognitive impairment (NCI). Information regarding fall history and fall risk during the previous year was collected using standardized questionnaires and tests. Sixty falls (34%) were registered among NCI participants and 417 (43%) among people with cognitive impairment (MCI: 35%; MOCI: 40%; SCI: 50%). A different fall risk model was observed for MCI, MOCI, SCI, and NCI patients. The results imply that the higher the level of cognitive impairment, the greater the number of falls (F1,481 = 113.852; Sig = 0.015), although the level of significance was not maintained when MOCI and SCI participants were compared. Depression, neuropsychiatric disturbances, autonomy constraints in daily life activity performance, and low functional mobility were factors closely associated with fall risk. This study provides evidence indicating that fall risk factors do not hold a direct correlation with the level of cognitive impairment among elderly nursing home care residents.

  11. Homeless drug users' awareness and risk perception of peer "Take Home Naloxone" use – a qualitative study

    Directory of Open Access Journals (Sweden)

    Oldham Nicola

    2006-10-01

    Full Text Available Abstract Background Peer use of take home naloxone has the potential to reduce drug related deaths. There appears to be a paucity of research amongst homeless drug users on the topic. This study explores the acceptability and potential risk of peer use of naloxone amongst homeless drug users. From the findings the most feasible model for future treatment provision is suggested. Methods In depth face-to-face interviews conducted in one primary care centre and two voluntary organisation centres providing services to homeless drug users in a large UK cosmopolitan city. Interviews recorded, transcribed and analysed thematically by framework techniques. Results Homeless people recognise signs of a heroin overdose and many are prepared to take responsibility to give naloxone, providing prior training and support is provided. Previous reports of the theoretical potential for abuse and malicious use may have been overplayed. Conclusion There is insufficient evidence to recommend providing "over the counter" take home naloxone" to UK homeless injecting drug users. However a programme of peer use of take home naloxone amongst homeless drug users could be feasible providing prior training is provided. Peer education within a health promotion framework will optimise success as current professionally led health promotion initiatives are failing to have a positive impact amongst homeless drug users.

  12. Homeless drug users' awareness and risk perception of peer "Take Home Naloxone" use – a qualitative study

    Science.gov (United States)

    Wright, Nat; Oldham, Nicola; Francis, Katharine; Jones, Lesley

    2006-01-01

    Background Peer use of take home naloxone has the potential to reduce drug related deaths. There appears to be a paucity of research amongst homeless drug users on the topic. This study explores the acceptability and potential risk of peer use of naloxone amongst homeless drug users. From the findings the most feasible model for future treatment provision is suggested. Methods In depth face-to-face interviews conducted in one primary care centre and two voluntary organisation centres providing services to homeless drug users in a large UK cosmopolitan city. Interviews recorded, transcribed and analysed thematically by framework techniques. Results Homeless people recognise signs of a heroin overdose and many are prepared to take responsibility to give naloxone, providing prior training and support is provided. Previous reports of the theoretical potential for abuse and malicious use may have been overplayed. Conclusion There is insufficient evidence to recommend providing "over the counter" take home naloxone" to UK homeless injecting drug users. However a programme of peer use of take home naloxone amongst homeless drug users could be feasible providing prior training is provided. Peer education within a health promotion framework will optimise success as current professionally led health promotion initiatives are failing to have a positive impact amongst homeless drug users. PMID:17014725

  13. Dutch home-based pre-reading intervention with children at familial risk of dyslexia

    OpenAIRE

    van Otterloo, Sandra G.; van der Leij, Aryan

    2009-01-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small effect on a composite score of phoneme awareness (d = 0.29) and a large effect on receptive letter knowledge (d  = 0.88). In first grade, however, t...

  14. Low serum concentrations of 25-hydroxyvitamin D in older persons and the risk of nursing home admission

    NARCIS (Netherlands)

    Visser, Marjolein; Deeg, Dorly J H; Puts, Martine T E; Seidell, Jaap C; Lips, Paul

    BACKGROUND: The prevalence of vitamin D deficiency in nursing home patients is high. OBJECTIVE: We aimed to ascertain whether lower serum 25-hydroxyvitamin D [25(OH)D] concentrations increase the risk of future nursing home admission and early death. DESIGN: We included 1260 independent,

  15. Improving prediction of fall risk among nursing home residents using electronic medical records.

    Science.gov (United States)

    Marier, Allison; Olsho, Lauren E W; Rhodes, William; Spector, William D

    2016-03-01

    Falls are physically and financially costly, but may be preventable with targeted intervention. The Minimum Data Set (MDS) is one potential source of information on fall risk factors among nursing home residents, but its limited breadth and relatively infrequent updates may limit its practical utility. Richer, more frequently updated data from electronic medical records (EMRs) may improve ability to identify individuals at highest risk for falls. The authors applied a repeated events survival model to analyze MDS 3.0 and EMR data for 5129 residents in 13 nursing homes within a single large California chain that uses a centralized EMR system from a leading vendor. Estimated regression parameters were used to project resident fall probability. The authors examined the proportion of observed falls within each projected fall risk decile to assess improvements in predictive power from including EMR data. In a model incorporating fall risk factors from the MDS only, 28.6% of observed falls occurred among residents in the highest projected risk decile. In an alternative specification incorporating more frequently updated measures for the same risk factors from the EMR data, 32.3% of observed falls occurred among residents in the highest projected risk decile, a 13% increase over the base MDS-only specification. Incorporating EMR data improves ability to identify those at highest risk for falls relative to prediction using MDS data alone. These improvements stem chiefly from the greater frequency with which EMR data are updated, with minimal additional gains from availability of additional risk factor variables. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  16. Consent, including advanced consent, of older adults to research in care homes: a qualitative study of stakeholders' views in South Wales.

    Science.gov (United States)

    Wood, Fiona; Prout, Hayley; Bayer, Antony; Duncan, Donna; Nuttall, Jacqueline; Hood, Kerenza; Butler, Christopher C

    2013-08-09

    Care home residents, especially those lacking capacity to provide consent for themselves, are frequently excluded from research, thus limiting generalisability of study findings. We set out to explore stakeholders' views about the ethical and practical challenges associated with recruiting care home residents into research studies. Qualitative individual interviews with care home residents (n = 14), their relatives (n = 14), and general practitioners (GPs) (n = 10), and focus groups (n = 2) with care home staff. Interviews focused on the issues of older adults consenting to research in care homes, including advanced consent, in general and through reference to a particular study on the use of probiotics to prevent Antibiotic Associated Diarrhoea. Data were analysed using a thematic approach incorporating themes that had been identified in advance, and themes derived from the data. Researchers discussed evidence for themes, and reached consensus on the final themes. Respondents were generally accepting of low risk observational studies and slightly less accepting of low risk randomised trials of medicinal products. Although respondents identified some practical barriers to informed consent, consenting arrangements were considered workable. Residents and relatives varied in the amount of detail they wanted included in information sheets and consent discussions, but were generally satisfied that an advanced consent model was acceptable and appropriate. Opinions differed about what should happen should residents lose capacity during a research study. Research staff should be mindful of research guidance and ensure that they have obtained an appropriate level of informed consent without overwhelming the participant with unnecessary detail. For research involving medicinal products, research staff should also be more explicit when recruiting that consent is still valid should an older person lose capacity during a trial provided the individual did not previously state a

  17. Improving quality and safety in nursing homes and home care: the study protocol of a mixed-methods research design to implement a leadership intervention

    Science.gov (United States)

    Wiig, Siri; Ree, Eline; Johannessen, Terese; Strømme, Torunn; Storm, Marianne; Aase, Ingunn; Ullebust, Berit; Holen-Rabbersvik, Elisabeth; Hurup Thomsen, Line; Sandvik Pedersen, Anne Torhild; van de Bovenkamp, Hester; Bal, Roland; Aase, Karina

    2018-01-01

    Introduction Nursing homes and home care face challenges across different countries as people are living longer, often with chronic conditions. There is a lack of knowledge regarding implementation and impact of quality and safety interventions as most research evidence so far is generated in hospitals. Additionally, there is a lack of effective leadership tools for quality and safety improvement work in this context. Methods and analysis The aim of the ‘Improving Quality and Safety in Primary Care—Implementing a Leadership Intervention in Nursing Homes and Homecare’ (SAFE-LEAD) study is to develop and evaluate a research-based leadership guide for managers to increase quality and safety competence. The project applies a mixed-methods design and explores the implications of the leadership guide on managers’ and staffs’ knowledge, attitudes and practices. Four nursing homes and four home care services from different Norwegian municipalities will participate in the intervention. Surveys, process evaluation (interviews, observations) and document analyses will be conducted to evaluate the implementation and impact of the leadership intervention. A comparative study of Norway and the Netherlands will establish knowledge of the context dependency of the intervention. Ethics and dissemination The study is approved by the Norwegian Centre for Research Data (2017/52324 and 54855). The results will be disseminated through scientific articles, two PhD dissertations, an anthology, presentations at national and international conferences, and in social media, newsletters and in the press. The results will generate knowledge to inform leadership practices in nursing homes and home care. Moreover, the study will build new theory on leadership interventions and the role of contextual factors in nursing homes and home care. PMID:29599394

  18. Improving quality and safety in nursing homes and home care: the study protocol of a mixed-methods research design to implement a leadership intervention.

    Science.gov (United States)

    Wiig, Siri; Ree, Eline; Johannessen, Terese; Strømme, Torunn; Storm, Marianne; Aase, Ingunn; Ullebust, Berit; Holen-Rabbersvik, Elisabeth; Hurup Thomsen, Line; Sandvik Pedersen, Anne Torhild; van de Bovenkamp, Hester; Bal, Roland; Aase, Karina

    2018-03-28

    Nursing homes and home care face challenges across different countries as people are living longer, often with chronic conditions. There is a lack of knowledge regarding implementation and impact of quality and safety interventions as most research evidence so far is generated in hospitals. Additionally, there is a lack of effective leadership tools for quality and safety improvement work in this context. The aim of the 'Improving Quality and Safety in Primary Care-Implementing a Leadership Intervention in Nursing Homes and Homecare' (SAFE-LEAD) study is to develop and evaluate a research-based leadership guide for managers to increase quality and safety competence. The project applies a mixed-methods design and explores the implications of the leadership guide on managers' and staffs' knowledge, attitudes and practices. Four nursing homes and four home care services from different Norwegian municipalities will participate in the intervention. Surveys, process evaluation (interviews, observations) and document analyses will be conducted to evaluate the implementation and impact of the leadership intervention. A comparative study of Norway and the Netherlands will establish knowledge of the context dependency of the intervention. The study is approved by the Norwegian Centre for Research Data (2017/52324 and 54855). The results will be disseminated through scientific articles, two PhD dissertations, an anthology, presentations at national and international conferences, and in social media, newsletters and in the press. The results will generate knowledge to inform leadership practices in nursing homes and home care. Moreover, the study will build new theory on leadership interventions and the role of contextual factors in nursing homes and home care. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  19. Data at Risk and Research Libraries

    Science.gov (United States)

    Choudhury, S.

    2017-12-01

    Research libraries have recently engaged in data rescue events amidst growing concerns about access to federal data sets. While these efforts are well intentioned, libraries run the risk of ignoring a long established history of activities and accomplishments by other communities focused on data at risk, many of which are represented at forums such as AGU. Under the auspices of the Data Conservancy, the Sheridan Libraries at Johns Hopkins University hosted an event in July 2017 that convened members of various communities including ESIP, RDA, Data Rescue Boulder, Association of Research Libraries, the Fedora repository platform, the Open Science Framework and the Interplanetary File System or IPFS (via the Data Together Network). This group identified a potential role for research libraries to partner with existing players in the data at risk community by focusing on a distributed preservation network as part of a coordinated collection development program. This session will offer an opportunity to hear about this potential role for research libraries and to provide feedback about its viability and utility.

  20. [The Incidence and Risk Factors of the Home Accidents in the Househoulds with Low Socioeconomic Level in Kocaeli

    Directory of Open Access Journals (Sweden)

    Pervin Sahiner

    2011-06-01

    Full Text Available SUMMARY: AIM: This study aimed to determine the incidence of home accidents in the households with low socioeconomic level who preferred in single flat or duplex and the risk factor related to house and sociodemographic characteristics. METHOD: The prospective cohort study. The universe of the survey composed of 419 households (N=1539 persons both with single flat and duplex house located at the “42 Evler” region of Izmit district of the Kocaeli province. The questionaries included “The Sociodemographic Characteristics of the Households” and “The Characteristics and Reasons of the Home Accidents.” The data were collected with face to face tecniques by home visits of households between November 28, 2008 and April 2, 2009. After the first form were filled, each household was followed up three months for home accidents. RESULTS: Twenty-seven of the households and 13.6% of the participants had home accident. The incidence of the home accident also was 4.2 person per/year. Most of the accidents (89% occurred inside of the houses. The mostly observed home accidents were 39.1% burn, 28.6% incision and 12.8% falling respectively. It was important risk factors heater for burns, knife for incisions and slippery-floor for fallings. The incidence of the home accident was higher among women (22.0% (p0.05, and in those with not house ownership itself (for rent 34.5%, for relatives house 34.8% (p<0.05. CONCLUSIONS: This study has showed that the incidence of home accidents are high, and the characteristics of house and some sociodemographic characteristics are important risk factors in term of the home accidents. The qualified primary health services which are financed by the government have great importance for the preventing of the household accidents, determination of the risk factors and recording the home accidents. [TAF Prev Med Bull 2011; 10(3.000: 257-268

  1. Euratom Research Contributing to Better Risk Governance

    International Nuclear Information System (INIS)

    Kelly, Neale; Forsstroem, Hans

    2003-01-01

    Over the past decade, greater attention has increasingly been given to broader, less technical, issues in determining the scope and content of research carried out under the auspices of the European Atomic Energy Community (Euratom) Framework Programmes. This reflects a more general trend, in particular a need for research to take due account of the ethical, social, legal, regulatory and wider cultural aspects resulting from the development and exploitation of its outcomes. These considerations are fully embedded within the 61 Framework Programme and are matters which must be explicitly addressed by most projects. The increasing importance of these aspects is exemplified by the inclusion in the 6th Framework Programme of 'science and society' and 'citizens and governance in a knowledge based society' as two of its priorities. The paper summarises Euratom research being carried out in the 5th Framework Programme that addresses broader, less technical, issues in particular those that are concerned with better approaches to risk governance and broader stakeholder involvement or participation. This research is mainly being carried out in the areas of radioactive waste management and the management of nuclear emergencies but is complemented by research of a more general nature concerned with risk governance. Further research in these areas will continue in the 61 Frarnework Programme with increasing attention given to how it can be practically exploited

  2. Indoor tanning in businesses and homes and risk of melanoma and nonmelanoma skin cancer in 2 US case-control studies.

    Science.gov (United States)

    Ferrucci, Leah M; Vogel, Rachel Isaksson; Cartmel, Brenda; Lazovich, DeAnn; Mayne, Susan T

    2014-11-01

    Indoor tanning increases skin cancer risk. Beyond early research describing melanoma and sun lamps, few recent reports describe where individuals indoor tan and whether skin cancer risk varies by location (business, home-based). We sought to assess where individuals tanned indoors and skin cancer risk by tanning device location. Multivariate logistic regression was conducted in 2 US case-control studies of melanoma (1161 cases, 1083 controls, ages 25-59 years) and early-onset basal cell carcinoma (375 cases, 382 controls, agetanned exclusively in businesses. Persons who used indoor tanning exclusively in businesses were at increased risk of melanoma (odds ratio 1.82, 95% confidence interval 1.47-2.26) and basal cell carcinoma (odds ratio 1.69, 95% confidence interval 1.15-2.48) compared with non-users. Melanoma risk was also increased in the small number who reported tanning indoors only at home relative to non-users (odds ratio 4.14, 95% confidence interval 1.75-9.78); 67.6% used sun lamps. Self-reported tanning and potential recall bias are limitations. Business-only tanning, despite claims of "safe" tanning, was positively associated with a significant risk of melanoma and basal cell carcinoma. Home tanning was uncommon and mostly from sun lamps, which were rarely used by younger participants. Regardless of location, indoor tanning was associated with increased risk of skin cancer. Copyright © 2014 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  3. Virtual rehabilitation: what are the practical barriers for home-based research?

    OpenAIRE

    Threapleton, Kate; Drummond, Avril E.R.; Standen, Penny

    2016-01-01

    Virtual reality technologies are becoming increasingly accessible and affordable to deliver, and consequently the interest in applying virtual reality within rehabilitation is growing. This has resulted in the emergence of research exploring the utility of virtual reality and interactive video gaming interventions for home use by patients. The aim of this paper is to highlight the practical factors and difficulties that may be encountered in research in this area, and to make recommendations ...

  4. Risk assessment research and technology assessment

    International Nuclear Information System (INIS)

    Albach, H.; Schade, D.; Sinn, H.

    1991-01-01

    The concepts and approaches for technology assessment, the targets and scientific principles, as well as recognizable deficits and recommendations concerning purposeful strategies for the promotion of this research field require a dialog between those concerned. Conception, deficits, and the necessary measures for risk assessment research and technology assessment were discussed as well as ethical aspects. The problematic nature of using organisms altered through genetic engineering in the open land, traffic and transport, site restoration, nuclear energy, and isotope applications were subjects particularly dealt with. (DG) [de

  5. Higher energy efficient homes are associated with increased risk of doctor diagnosed asthma in a UK subpopulation.

    Science.gov (United States)

    Sharpe, Richard A; Thornton, Christopher R; Nikolaou, Vasilis; Osborne, Nicholas J

    2015-02-01

    The United Kingdom (UK) has one of the highest prevalence of asthma in the world, which represents a significant economic and societal burden. Reduced ventilation resulting from increased energy efficiency measures acts as a modifier for mould contamination and risk of allergic diseases. To our knowledge no previous study has combined detailed asset management property and health data together to assess the impact of household energy efficiency (using the UK Government's Standard Assessment Procedure) on asthma outcomes in an adult population residing in social housing. Postal questionnaires were sent to 3867 social housing properties to collect demographic, health and environmental information on all occupants. Detailed property data, residency periods, indices of multiple deprivation (IMD) and household energy efficiency ratings were also investigated. Logistic regression was used to calculate odds ratios and confidence intervals while allowing for clustering of individuals coming from the same location. Eighteen percent of our target social housing population were recruited into our study. Adults had a mean age of 59 (SD±17.3) years and there was a higher percentage of female (59%) and single occupancy (58%) respondents. Housing demographic characteristics were representative of the target homes. A unit increase in household Standard Assessment Procedure (SAP) rating was associated with a 2% increased risk of current asthma, with the greatest risk in homes with SAP >71. We assessed exposure to mould and found that the presence of a mouldy/musty odour was associated with a two-fold increased risk of asthma (OR 2.2 95%; CI 1.3-3.8). A unit increase in SAP led to a 4-5% reduction in the risk of visible mould growth and a mouldy/musty odour. In contrast to previous research, we report that residing in energy efficient homes may increase the risk of adult asthma. We report that mould contamination increased the risk of asthma, which is in agreement with existing

  6. Home-Based Risk of Falling Assessment Test Using a Closed-Loop Balance Model.

    Science.gov (United States)

    Ayena, Johannes C; Zaibi, Helmi; Otis, Martin J-D; Menelas, Bob-Antoine J

    2016-12-01

    The aim of this study is to improve and facilitate the methods used to assess risk of falling at home among older people through the computation of a risk of falling in real time in daily activities. In order to increase a real time computation of the risk of falling, a closed-loop balance model is proposed and compared with One-Leg Standing Test (OLST). This balance model allows studying the postural response of a person having an unpredictable perturbation. Twenty-nine volunteers participated in this study for evaluating the effectiveness of the proposed system which includes seventeen elder participants: ten healthy elderly ( 68.4 ±5.5 years), seven Parkinson's disease (PD) subjects ( 66.28 ±8.9 years), and twelve healthy young adults ( 28.27 ±3.74 years). Our work suggests that there is a relationship between OLST score and the risk of falling based on center of pressure measurement with four low cost force sensors located inside an instrumented insole, which could be predicted using our suggested closed-loop balance model. For long term monitoring at home, this system could be included in a medical electronic record and could be useful as a diagnostic aid tool.

  7. Fall-related injuries in a nursing home setting: is polypharmacy a risk factor?

    Science.gov (United States)

    Baranzini, Federico; Diurni, Marcello; Ceccon, Francesca; Poloni, Nicola; Cazzamalli, Sara; Costantini, Chiara; Colli, Cristiano; Greco, Laura; Callegari, Camilla

    2009-12-11

    Polypharmacy is regarded as an important risk factor for fallingand several studies and meta-analyses have shown an increased fall risk in users of diuretics, type 1a antiarrhythmics, digoxin and psychotropic agents. In particular, recent evidence has shown that fall risk is associated with the use of polypharmacy regimens that include at least one established fall risk-increasing drug, rather than with polypharmacy per se. We studied the role of polypharmacy and the role of well-known fall risk-increasing drugs on the incidence of injurious falls. A retrospective observational study was carried out in a population of elderly nursing home residents. An unmatched, post-stratification design for age class, gender and length of stay was adopted. In all, 695 falls were recorded in 293 residents. 221 residents (75.4%) were female and 72 (24.6%) male, and 133 (45.4%) were recurrent fallers. 152 residents sustained no injuries when they fell, whereas injuries were sustained by 141: minor in 95 (67.4%) and major in 46 (32.6%). Only fall dynamics (p = 0.013) and drugs interaction between antiarrhythmic or antiparkinson class and polypharmacy regimen (> or =7 medications) seem to represent a risk association for injuries (p = 0.024; OR = 4.4; CI 95% 1.21 - 15.36). This work reinforces the importance of routine medication reviews, especially in residents exposed to polypharmacy regimens that include antiarrhythmics or antiparkinson drugs, in order to reduce the risk of fall-related injuries during nursing home stays.

  8. Fall-related injuries in a nursing home setting: is polypharmacy a risk factor?

    Directory of Open Access Journals (Sweden)

    Colli Cristiano

    2009-12-01

    Full Text Available Abstract Background Polypharmacy is regarded as an important risk factor for fallingand several studies and meta-analyses have shown an increased fall risk in users of diuretics, type 1a antiarrhythmics, digoxin and psychotropic agents. In particular, recent evidence has shown that fall risk is associated with the use of polypharmacy regimens that include at least one established fall risk-increasing drug, rather than with polypharmacy per se. We studied the role of polypharmacy and the role of well-known fall risk-increasing drugs on the incidence of injurious falls. Methods A retrospective observational study was carried out in a population of elderly nursing home residents. An unmatched, post-stratification design for age class, gender and length of stay was adopted. In all, 695 falls were recorded in 293 residents. Results 221 residents (75.4% were female and 72 (24.6% male, and 133 (45.4% were recurrent fallers. 152 residents sustained no injuries when they fell, whereas injuries were sustained by 141: minor in 95 (67.4% and major in 46 (32.6%. Only fall dynamics (p = 0.013 and drugs interaction between antiarrhythmic or antiparkinson class and polypharmacy regimen (≥7 medications seem to represent a risk association for injuries (p = 0.024; OR = 4.4; CI 95% 1.21 - 15.36. Conclusion This work reinforces the importance of routine medication reviews, especially in residents exposed to polypharmacy regimens that include antiarrhythmics or antiparkinson drugs, in order to reduce the risk of fall-related injuries during nursing home stays.

  9. Proximity to vacant buildings is associated with increased fire risk in Baltimore, Maryland, homes.

    Science.gov (United States)

    Schachterle, Stephen E; Bishai, David; Shields, Wendy; Stepnitz, Rebecca; Gielen, Andrea C

    2012-04-01

    Fires and burns are a leading cause of unintentional injury death in the USA. Although it has been anecdotally reported that vacant dwellings are at a higher risk for fire, the association between vacancy and fire risk at the individual household level has not been empirically measured. In this cross-sectional study, geocoded residential vacant properties (VP) and fire events are analysed in Baltimore City at the census tract level and the individual household level. On average, a 10% increase in the proportion of vacancies in a census tract was associated with a 9.9% increase in fires (95% CI: 5% to 15%). Random-effects Poisson models, controlling for housing and neighbourhood conditions, found contagion effects. The risk of fire in an occupied dwelling increased by 8% (95% CI: 1% to 10%) for every vacant structure within 10 m, and the risk of fire decreased by half (95% CI: 45% to 62%) for every km between an occupied dwelling and vacant building. Close proximity to VP was associated with trash fires within dwellings (p=0.039) and structure fires (p=0.012). We believe that this is the first study to demonstrate increased risk posed by nearby VP at the household level, confirming earlier ecological analyses of the role of VP as strong correlates of home fires. Measurement of this risk can motivate property owners, policy makers and insurers to invest in risk reduction measures that include building maintenance and trash removal.

  10. Fall Risk, Supports and Services, and Falls Following a Nursing Home Discharge.

    Science.gov (United States)

    Noureldin, Marwa; Hass, Zachary; Abrahamson, Kathleen; Arling, Greg

    2017-09-04

    Falls are a major source of morbidity and mortality among older adults; however, little is known regarding fall occurrence during a nursing home (NH) to community transition. This study sought to examine whether the presence of supports and services impacts the relationship between fall-related risk factors and fall occurrence post NH discharge. Participants in the Minnesota Return to Community Initiative who were assisted in achieving a community discharge (N = 1459) comprised the study sample. The main outcome was fall occurrence within 30 days of discharge. Factor analyses were used to estimate latent models from variables of interest. A structural equation model (SEM) was estimated to determine the relationship between the emerging latent variables and falls. Fifteen percent of participants fell within 30 days of NH discharge. Factor analysis of fall-related risk factors produced three latent variables: fall concerns/history; activities of daily living impairments; and use of high-risk medications. A supports/services latent variable also emerged that included caregiver support frequency, medication management assistance, durable medical equipment use, discharge location, and receipt of home health or skilled nursing services. In the SEM model, high-risk medications use and fall concerns/history had direct positive effects on falling. Receiving supports/services did not affect falling directly; however, it reduced the effect of high-risk medication use on falling (p risk of falling post NH discharge. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  11. Mortality risk amongst nursing home residents evacuated after the Fukushima nuclear accident: a retrospective cohort study.

    Directory of Open Access Journals (Sweden)

    Shuhei Nomura

    Full Text Available BACKGROUND: Safety of evacuation is of paramount importance in disaster planning for elderly people; however, little effort has been made to investigate evacuation-related mortality risks. After the Fukushima Daiichi Nuclear Plant accident we conducted a retrospective cohort survival survey of elderly evacuees. METHODS: A total of 715 residents admitted to five nursing homes in Minamisoma city, Fukushima Prefecture in the five years before 11th March 2011 joined this retrospective cohort study. Demographic and clinical characteristics were drawn from facility medical records. Evacuation histories were tracked until the end of 2011. The evacuation's impact on mortality was assessed using mortality incidence density and hazard ratios in Cox proportional hazards regression. RESULTS: Overall relative mortality risk before and after the earthquake was 2.68 (95% CI: 2.04-3.49. There was a substantial variation in mortality risks across the facilities ranging from 0.77 (95% CI: 0.34-1.76 to 2.88 (95% CI: 1.74-4.76. No meaningful influence of evacuation distance on mortality was observed although the first evacuation from the original facility caused significantly higher mortality than subsequent evacuations, with a hazard ratio of 1.94 (95% CI: 1.07-3.49. CONCLUSION: High mortality, due to initial evacuation, suggests that evacuation of the elderly was not the best life-saving strategy for the Fukushima nuclear disaster. Careful consideration of the relative risks of radiation exposure and the risks and benefits of evacuation is essential. Facility-specific disaster response strategies, including in-site relief and care, may have a strong influence on survival. Where evacuation is necessary, careful planning and coordination with other nursing homes, evacuation sites and government disaster agencies is essential to reduce the risk of mortality.

  12. Consumer contribution to food contamination in Brazil: modelling the food safety risk in the home

    Directory of Open Access Journals (Sweden)

    Sergio Paulo Olinto da Motta

    2014-06-01

    Full Text Available Foodborne diseases are among the most widespread public health issues, killing about 2.2 million people annually, and costing hundreds of billions of US dollars for governments, companies, families and consumers (WHO, 2007. In Brazil, foodborne diseases acquired in the home account for 55% of notified outbreaks (BRASIL, 2012. Several studies have investigated aspects of consumer behaviour concerning food poisoning, mapping practices in the home, but it remains a challenge to obtain a full picture of the consumer contribution to food contamination (REDMOND and GRIFFITH, 2003. This study aimed to assess the risks of food contamination in the home. A questionnaire containing 140 questions concerning food safety knowledge, handling practices, personal hygiene and basic health care, covering the stages when the food is under the control of the consumer, was developed and used to gather data for analysis. Appropriate scores were attributed to the questions (consequences to food safety and answers (likelihood of food contamination. A risk estimate algorithm and an appropriate risk ranking scale were used to assess the results. From August 2011 to March 2012, survey questionnaires were collected from 2,775 consumers in Brazil across 19 out of 27 state capitals. The study found risky practices with the potential to lead to food poisoning occurrences in the domestic environment in the following handling steps: food transportation, food preparation, cooking and the handling of leftovers. The personal hygiene, age, formal education, family income and basic health care habits represented the factors most related to the risky practices of consumers, which could orientate food safety educational campaigns for the Brazilian population.

  13. Utility of home sleep apnea testing in high-risk veterans.

    Science.gov (United States)

    Cairns, Alyssa; Sarmiento, Kathleen; Bogan, Richard

    2017-09-01

    Many Veterans Affairs Medical Centers (VAMCs) have implemented home sleep apnea testing (HSAT) in lieu of traditional in-lab testing to establish a timely and cost-sensitive diagnosis of obstructive sleep apnea (OSA). However, concern remains for the sensitivity and specificity of said technology in this population as many veterans are at increased risk for many of the comorbid conditions that can limit the accuracy of HSAT results. Hence, the purpose of this study is to evaluate rate of incongruent outcomes (e.g., negative HSAT results despite high clinical symptomology) as well as differences in study quality metrics and predictors of OSA between veteran sleep patients and general sleep patients being evaluated by a home sleep test. A random sample of HSAT outcomes from 1500 veterans and 1500 general sleep clinic patients was retrieved from a repository of anonymized HSAT outcomes from 2009 to 2013. General sleep clinic data were from patients referred for home sleep testing from a variety of clinical practices across North America, whereas VAMC patients were tested using a central dissemination process. All patients were tested for OSA using the Apnea Risk and Evaluation System (ARES), an HSAT that simultaneously records airflow, pulse oximetry, snoring, accelerometry, and EEG. Sample differences and rates of comorbidities, HSAT outcomes, predictors of OSA, and pretest OSA risk information were evaluated between groups. The presence of OSA was defined as an apnea-hypopnea index (AHI; using 4% desaturation criterion) of ≥5 and ≥15 events per hour. Sample differences in predictors of OSA were evaluated using logistic multiple regression. Veterans (91.3% male) were more likely to report comorbidities, especially depression, insomnia, hypertension, diabetes, restless legs syndrome (RLS), and use of sleep and pain medications compared to general sleep clinic patients (57.1% male). Despite differences in the rate of medical comorbidities, no differences were

  14. Coordinating resources for prospective medication risk management of older home care clients in primary care: procedure development and RCT study design for demonstrating its effectiveness.

    Science.gov (United States)

    Toivo, Terhi; Dimitrow, Maarit; Puustinen, Juha; Savela, Eeva; Pelkonen, Katariina; Kiuru, Valtteri; Suominen, Tuula; Kinnunen, Sirkka; Uunimäki, Mira; Kivelä, Sirkka-Liisa; Leikola, Saija; Airaksinen, Marja

    2018-03-16

    The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy. System based risk management theory and action research method was applied to construct the collaborative procedure utilizing each profession's existing resources in medication risk management of older home care clients. An inventory of clinical measures in usual clinical practice and systematic review of rigorous study designs was utilized in effectiveness study design. The new coordinated medication management model (CoMM) has the following 5 stages: 1) practical nurses are trained to identify clinically significant drug-related problems (DRPs) during home visits and report those to the clinical pharmacist. Clinical pharmacist prepares the cases for 2) an interprofessional triage meeting (50-70 cases/meeting of 2 h) where decisions are made on further action, e.g., more detailed medication reviews, 3) community pharmacists conduct necessary medication reviews and each patients' physician makes final decisions on medication changes needed. The final stages concern 4) implementation and 5) follow-up of medication changes. Randomized controlled trial (RCT) was developed to demonstrate the effectiveness of the procedure. The developed procedure is feasible for screening and reviewing medications of a high number of older home care clients to identify clients with severe DRPs and provide interventions to solve them utilizing existing primary care resources

  15. Identifying fallers with Parkinson's disease using home-based tests: who is at risk?

    Science.gov (United States)

    Lim, Inge; van Wegen, Erwin; Jones, Diana; Rochester, Lynn; Nieuwboer, Alice; Willems, Anne Marie; Baker, Katherine; Hetherington, Vicki; Kwakkel, Gert

    2008-12-15

    The objective of this work is to determine risk factors for falling in patients with Parkinson's disease (PD) using home-based assessments and develop a prediction model. Data on falls, balance, gait-related activities, and nonmotor symptoms were obtained from 153 PD patients (Hoehn-Yahr 2-4) in their home. Fifty-one candidate determinants for falling were independently tested using bivariate logistic regression analysis. A multivariate logistic regression model was developed to identify patients susceptible to falls. Sixty-six subjects (43%) were classified as fallers. Eighteen determinants for falling were selected. The final multivariate model showed an accuracy of 74% and included: (1) Freezing of Gait Questionnaire, (2) Timed Get Up and Go (TGUG) score, (3) disease duration, (4) item 15 of the Unified Parkinson's Disease Rating Scale. Based on disease duration, freezing symptoms, walking problems, and a prolonged TGUG duration, assessed in the home situation, it was possible to accurately identify 74% of PD patients as fallers. (c) 2008 Movement Disorder Society.

  16. The Impact of a Home-Delivered Meal Program on Nutritional Risk, Dietary Intake, Food Security, Loneliness, and Social Well-Being.

    Science.gov (United States)

    Wright, Lauri; Vance, Lauren; Sudduth, Christina; Epps, James B

    2015-01-01

    Maintaining independence and continuing to live at home is one solution to manage the rising health care costs of aging populations in the United States; furthermore, seniors are at risk of malnutrition and food insecurity. Home-delivered meal programs are a tool to address food, nutrition, and well-being concerns of this population. Few studies have identified outcomes from these programs; this pilot study reviews the nutritional status, dietary intake, well-being, loneliness, and food security levels of seniors participating in a Meals on Wheels delivery service. Clients, new to the meal program, participated in pre- and postphone interviews, and 51 seniors completed the study. The survey was composed of five scales or questionnaires, and statistical analyses were conducted using SPSS. Improvements across all five measures were statistically significant after participating two months in the home-delivered meal program. Implications for further research, practice, and the Older Americans Act are discussed.

  17. Smart Homes for Elderly Healthcare-Recent Advances and Research Challenges.

    Science.gov (United States)

    Majumder, Sumit; Aghayi, Emad; Noferesti, Moein; Memarzadeh-Tehran, Hamidreza; Mondal, Tapas; Pang, Zhibo; Deen, M Jamal

    2017-10-31

    Advancements in medical science and technology, medicine and public health coupled with increased consciousness about nutrition and environmental and personal hygiene have paved the way for the dramatic increase in life expectancy globally in the past several decades. However, increased life expectancy has given rise to an increasing aging population, thus jeopardizing the socio-economic structure of many countries in terms of costs associated with elderly healthcare and wellbeing. In order to cope with the growing need for elderly healthcare services, it is essential to develop affordable, unobtrusive and easy-to-use healthcare solutions. Smart homes, which incorporate environmental and wearable medical sensors, actuators, and modern communication and information technologies, can enable continuous and remote monitoring of elderly health and wellbeing at a low cost. Smart homes may allow the elderly to stay in their comfortable home environments instead of expensive and limited healthcare facilities. Healthcare personnel can also keep track of the overall health condition of the elderly in real-time and provide feedback and support from distant facilities. In this paper, we have presented a comprehensive review on the state-of-the-art research and development in smart home based remote healthcare technologies.

  18. Smart Homes for Elderly Healthcare—Recent Advances and Research Challenges

    Science.gov (United States)

    Aghayi, Emad; Noferesti, Moein; Memarzadeh-Tehran, Hamidreza; Mondal, Tapas; Deen, M. Jamal

    2017-01-01

    Advancements in medical science and technology, medicine and public health coupled with increased consciousness about nutrition and environmental and personal hygiene have paved the way for the dramatic increase in life expectancy globally in the past several decades. However, increased life expectancy has given rise to an increasing aging population, thus jeopardizing the socio-economic structure of many countries in terms of costs associated with elderly healthcare and wellbeing. In order to cope with the growing need for elderly healthcare services, it is essential to develop affordable, unobtrusive and easy-to-use healthcare solutions. Smart homes, which incorporate environmental and wearable medical sensors, actuators, and modern communication and information technologies, can enable continuous and remote monitoring of elderly health and wellbeing at a low cost. Smart homes may allow the elderly to stay in their comfortable home environments instead of expensive and limited healthcare facilities. Healthcare personnel can also keep track of the overall health condition of the elderly in real-time and provide feedback and support from distant facilities. In this paper, we have presented a comprehensive review on the state-of-the-art research and development in smart home based remote healthcare technologies. PMID:29088123

  19. Smart Homes for Elderly Healthcare—Recent Advances and Research Challenges

    Directory of Open Access Journals (Sweden)

    Sumit Majumder

    2017-10-01

    Full Text Available Advancements in medical science and technology, medicine and public health coupled with increased consciousness about nutrition and environmental and personal hygiene have paved the way for the dramatic increase in life expectancy globally in the past several decades. However, increased life expectancy has given rise to an increasing aging population, thus jeopardizing the socio-economic structure of many countries in terms of costs associated with elderly healthcare and wellbeing. In order to cope with the growing need for elderly healthcare services, it is essential to develop affordable, unobtrusive and easy-to-use healthcare solutions. Smart homes, which incorporate environmental and wearable medical sensors, actuators, and modern communication and information technologies, can enable continuous and remote monitoring of elderly health and wellbeing at a low cost. Smart homes may allow the elderly to stay in their comfortable home environments instead of expensive and limited healthcare facilities. Healthcare personnel can also keep track of the overall health condition of the elderly in real-time and provide feedback and support from distant facilities. In this paper, we have presented a comprehensive review on the state-of-the-art research and development in smart home based remote healthcare technologies.

  20. Development of project wings home visits, a mental health intervention for Latino families using community-based participatory research.

    Science.gov (United States)

    Garcia, Carolyn; Hermann, Denise; Bartels, Anna; Matamoros, Pablo; Dick-Olson, Linda; Guerra de Patino, Janeth

    2012-11-01

    As the Latino population in the United States experiences rapid growth, the well-being of Latino adolescents is a growing concern because of their high rates of mental health problems. Latino adolescents have higher rates of mental health problems than their peers, including depressive symptoms, suicide attempts, and violence. Sophisticated, realistic health promotion efforts are needed to reduce these risk behaviors and enhance protective factors. Parents and schools can be key protective factors, or assets, in adolescents' lives. This article details the steps undertaken to develop Project Wings Home Visits, a collaborative school-based, community-linked mental health promotion intervention for Latino adolescents and their families. Core to the intervention is the use of a community health worker model to provide home-based outreach and education to parents of Latino adolescents. The intervention was developed using a community-based participatory research approach that involved the cooperation of a community health care system, a public high school, and a university. Our process demonstrates the benefits, strengths, and challenges of using community-based participatory research in creating and implementing health promotion interventions.

  1. Institutionalized elderly people and malnutrition: research on the patients of a nursing home

    Directory of Open Access Journals (Sweden)

    Francesco Rondoni

    2013-09-01

    Full Text Available Protein-energy malnutrition (PEM is a common finding in hospitalized or institutionalized elderly people. In the literature, PEM is not mentioned as being related to individual ability of the patient to feed him or herself correctly. This study analyzed the 56 patients of a nursing home divided into two groups: self-sufficient and non self-sufficient regarding feeding. Levels of serum albumin, transferrin, prealbumin and hemoglobin (Hb were examined and compared to body mass index (BMI calculated with bioelectrical impedance analysis. Fifty-three percent of patients were self-sufficient, while 47% were not self-sufficient for feeding of which 83.3% were women and 16.7% men. Levels below the average range were 49.1% for lymphocyte count, 52.9% for serum albumin, 13.7% for serum transferrin and 52.9% for serum prealbumin. No significant differences were found in terms of patient age, while the mean values of the parameters examined in the two groups, self-sufficient and not, were lower in the patients who were not self-sufficient, even if statistical significance was not reached. Serum albumin was in inverse proportion to age (P<0.05 and 46.1% of individuals with low levels of transferrin also showed low levels of Hb. Anemia was in direct proportion (P<0.05 to age. Measurement of BMI showed values below 22.5 (cut off for risk for malnutrition in 33.4% of the subjects examined. Of the three hematochemical parameters, analysis of a possible relationship with BMI showed only a significant and directly proportional correlation with prealbumin (P<0.05%. These data should be considered in the context of an epidemiological research study carried out in a conditioned and limited environment, where PEM, detected using hematochemical parameters, amounted to 50% of the patients, whereas BMI identified only approximately one-third of patients at risk of malnutrition. There were no statistically significant differences between men and women. Mean values of the

  2. Medication use and risk of falls among nursing home residents: a retrospective cohort study.

    Science.gov (United States)

    Bor, Andrea; Matuz, Mária; Csatordai, Márta; Szalai, Gábor; Bálint, András; Benkő, Ria; Soós, Gyöngyvér; Doró, Péter

    2017-04-01

    Background Geriatric falls are leading causes of hospital trauma admissions and injury-related deaths. Medication use is a crucial element among extrinsic risk factors for falls. To reduce fall risk and the prevalence of adverse drug reactions, potentially inappropriate medication (PIM) lists are widely used. Objective Our aim was to investigate the possible predictors of geriatric falls annualized over a 5-year-long period, as well as to evaluate the medication use of nursing home residents. Setting Nursing home residents were recruited from the same institution between 2010 and 2015 in Szeged, Hungary. Method A retrospective epidemiological study was performed. Patient data were analysed for the first 12 months of residency. Chi-squared test and Fisher's-test were applied to compare the categorical variables, Student's t test to compare the continuous variables between groups. Binary logistic regression analysis was carried out to determine the association of falls with other variables found significant in univariate analysis. Microsoft Excel, IBM SPSS Statistics (version 23) and R (3.2.2) programs were used for data analysis. Main outcome measure Falls affected by age, gender, number of chronic medications, polypharmacy, PIM meds. Results A total of 197 nursing home residents were included, 150 (76.2%) women and 47 (23.8%) men, 55 fallers (annual fall prevalence rate was 27.9%) and 142 non-fallers. Gender was not a predisposing factor for falls (prevalence in males: 23.4 vs 29.3% in females, p > 0.05). Fallers were older (mean years ± SD; 84.0 ± 7.0) than non-fallers (80.1 ± 9.3, p factor for falls (p factor of falls (p fall risk were taken by 70.9% of fallers and 75.3% of non-fallers (p > 0.05). Taking pantoprazole, vinpocetine or trimetazidine was a significant risk factor for falls. Conclusion Older age, polypharmacy and the independent use of pantoprazole, vinpocetine, and trimetazidine were found to be major risk factors for falls. Further

  3. Dutch home-based pre-reading intervention with children at familial risk of dyslexia.

    Science.gov (United States)

    van Otterloo, Sandra G; van der Leij, Aryan

    2009-12-01

    Children (5 and 6 years old, n = 30) at familial risk of dyslexia received a home-based intervention that focused on phoneme awareness and letter knowledge in the year prior to formal reading instruction. The children were compared to a no-training at-risk control group (n = 27), which was selected a year earlier. After training, we found a small effect on a composite score of phoneme awareness (d = 0.29) and a large effect on receptive letter knowledge (d = 0.88). In first grade, however, this did not result in beneficial effects for the experimental group in word reading and spelling. Results are compared to three former intervention studies in The Netherlands and comparable studies from Denmark and Australia.

  4. Early home-based intervention in the Netherlands for children at familial risk of dyslexia.

    Science.gov (United States)

    van Otterloo, Sandra G; van der Leij, Aryan; Henrichs, Lotte F

    2009-08-01

    Dutch children at higher familial risk of reading disability received a home-based intervention programme before formal reading instruction started to investigate whether this would reduce the risk of dyslexia. The experimental group (n=23) received a specific training in phoneme awareness and letter knowledge. A control group (n=25) received a non-specific training in morphology, syntax, and vocabulary. Both interventions were designed to take 10 min a day, 5 days a week for 10 weeks. Most parents were sufficiently able to work with the programme properly. At post-test the experimental group had gained more on phoneme awareness than the control group. The control group gained more on one of the morphology measures. On average, these specific training results did not lead to significant group differences in first-grade reading and spelling measures. However, fewer experimental children scored below 10th percentile on word recognition. (c) 2008 John Wiley & Sons, Ltd.

  5. Fall risk assessment and early-warning for toddler behaviors at home.

    Science.gov (United States)

    Yang, Mau-Tsuen; Chuang, Min-Wen

    2013-12-10

    Accidental falls are the major cause of serious injuries in toddlers, with most of these falls happening at home. Instead of providing immediate fall detection based on short-term observations, this paper proposes an early-warning childcare system to monitor fall-prone behaviors of toddlers at home. Using 3D human skeleton tracking and floor plane detection based on depth images captured by a Kinect system, eight fall-prone behavioral modules of toddlers are developed and organized according to four essential criteria: posture, motion, balance, and altitude. The final fall risk assessment is generated by a multi-modal fusion using either a weighted mean thresholding or a support vector machine (SVM) classification. Optimizations are performed to determine local parameter in each module and global parameters of the multi-modal fusion. Experimental results show that the proposed system can assess fall risks and trigger alarms with an accuracy rate of 92% at a speed of 20 frames per second.

  6. Fall Risk Assessment and Early-Warning for Toddler Behaviors at Home

    Directory of Open Access Journals (Sweden)

    Mau-Tsuen Yang

    2013-12-01

    Full Text Available Accidental falls are the major cause of serious injuries in toddlers, with most of these falls happening at home. Instead of providing immediate fall detection based on short-term observations, this paper proposes an early-warning childcare system to monitor fall-prone behaviors of toddlers at home. Using 3D human skeleton tracking and floor plane detection based on depth images captured by a Kinect system, eight fall-prone behavioral modules of toddlers are developed and organized according to four essential criteria: posture, motion, balance, and altitude. The final fall risk assessment is generated by a multi-modal fusion using either a weighted mean thresholding or a support vector machine (SVM classification. Optimizations are performed to determine local parameter in each module and global parameters of the multi-modal fusion. Experimental results show that the proposed system can assess fall risks and trigger alarms with an accuracy rate of 92% at a speed of 20 frames per second.

  7. Fall Risk Assessment and Early-Warning for Toddler Behaviors at Home

    Science.gov (United States)

    Yang, Mau-Tsuen; Chuang, Min-Wen

    2013-01-01

    Accidental falls are the major cause of serious injuries in toddlers, with most of these falls happening at home. Instead of providing immediate fall detection based on short-term observations, this paper proposes an early-warning childcare system to monitor fall-prone behaviors of toddlers at home. Using 3D human skeleton tracking and floor plane detection based on depth images captured by a Kinect system, eight fall-prone behavioral modules of toddlers are developed and organized according to four essential criteria: posture, motion, balance, and altitude. The final fall risk assessment is generated by a multi-modal fusion using either a weighted mean thresholding or a support vector machine (SVM) classification. Optimizations are performed to determine local parameter in each module and global parameters of the multi-modal fusion. Experimental results show that the proposed system can assess fall risks and trigger alarms with an accuracy rate of 92% at a speed of 20 frames per second. PMID:24335727

  8. Prevalence of and risk factors for violent disciplinary practices at home in Viet Nam.

    Science.gov (United States)

    Cappa, Claudia; Dam, Hang

    2014-02-01

    Data on parenting practices and the use of violence in child rearing remain scarce worldwide, hindering prevention efforts. This study examines disciplinary methods used on children at home in Viet Nam. It is based on data collected from 2010 to 2011 through the fourth round of the Multiple Indicator Cluster Survey (MICS4)-a household survey program supported by the United Nations Children's Fund (UNICEF) that focuses on women and children in low- and middle-income countries. Respondents in the survey were asked 11 questions relating to disciplinary measures used in the preceding month on one randomly selected child (2-14 years old) in each household. A final question about attitudes probed adults' views on the need for physical punishment in child rearing. Univariate and multivariate analyses were conducted to estimate the prevalence of violent and nonviolent forms of discipline, and to identify risk factors associated with violent punishment. Results showed that three in four children in Viet Nam are disciplined through violent means. The exposure of Vietnamese children to violent forms of discipline was significantly associated with varied characteristics of both children and their caregivers. Moreover, the use of violent disciplinary practices on children was strongly associated with positive attitudes toward corporal punishment. Risk factors for violent child discipline identified in this study can inform future interventions to promote positive practices and to protect Vietnamese children against violence in the home.

  9. Perinatal mortality and morbidity in a nationwide cohort of 529,688 low-risk planned home and hospital births

    NARCIS (Netherlands)

    de jonge, A.; van der Goes, B. Y.; Ravelli, A. C. J.; Amelink-Verburg, M. P.; Mol, B. W.; Nijhuis, J. G.; Bennebroek Gravenhorst, J.; Buitendijk, S. E.

    2009-01-01

    OBJECTIVE: To compare perinatal mortality and severe perinatal morbidity between planned home and planned hospital births, among low-risk women who started their labour in primary care. DESIGN: A nationwide cohort study. SETTING: The entire Netherlands. POPULATION: A total of 529,688 low-risk women

  10. A Research Agenda on Assessing and Remediating Home Dampness and Mold to Reduce Dampness-Related Health Effects

    Energy Technology Data Exchange (ETDEWEB)

    Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Computational Cosmology Center

    2015-05-28

    This report briefly summarizes, based on recent review articles and selected more recent research reports, current scientific knowledge on two topics: assessing unhealthy levels of indoor D/M in homes and remediating home dampness-related problems to protect health. Based on a comparison of current scientific knowledge to that required to support effective, evidence-based, health-protective policies on home D/M, gaps in knowledge are highlighted, prior questions and research questions specified, and necessary research activities and approaches recommended.

  11. A Research Agenda on Assessing and Remediating Home Dampness and Mold to Reduce Dampness-Related Health Effects

    Energy Technology Data Exchange (ETDEWEB)

    Mendell, Mark J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States)

    2015-06-01

    This report briefly summarizes, based on recent review articles and selected more recent research reports, current scientific knowledge on two topics: assessing unhealthy levels of indoor D/M in homes and remediating home dampness-related problems to protect health. Based on a comparison of current scientific knowledge to that required to support effective, evidence-based, health-protective policies on home D/M, gaps in knowledge are highlighted, prior questions and research questions specified, and necessary research activities and approaches recommended.

  12. Considerations and recommendations for conducting qualitative research interviews with palliative and end-of-life care patients in the home setting: a consensus paper.

    Science.gov (United States)

    Sivell, Stephanie; Prout, Hayley; Hopewell-Kelly, Noreen; Baillie, Jessica; Byrne, Anthony; Edwards, Michelle; Harrop, Emily; Noble, Simon; Sampson, Catherine; Nelson, Annmarie

    2015-12-08

    To present and discuss the views of researchers at an academic palliative care research centre on research encounters with terminally ill patients in the home setting and to generate a list of recommendations for qualitative researchers working in palliative and end-of-life care. Eight researchers took part in a consensus meeting to discuss their experiences of undertaking qualitative interviews. The researchers were of varying backgrounds and all reported having experience in interviewing terminally ill patients, and all but one had experience of interviewing patients in their home environment. The main areas discussed by researchers included: whether participation in end-of-life research unintentionally becomes a therapeutic experience or an ethical concern; power relationships between terminally ill patients and researchers; researcher reflexivity and reciprocity; researchers' training needs. Qualitative methods can complement the home environment; however, it can raise ethical and practical challenges, which can be more acute in the case of research undertaken with palliative and patients at the end-of-life. The ethical and practical challenges researchers face in this context has the potential to place both participant and researcher at risk for their physical and psychological well-being. We present a set of recommendations for researchers to consider prior to embarking on qualitative research in this context and advocate researchers in this field carefully consider the issues presented on a study-by-study basis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Research of the tasks on risk communication enforcement (Contract research)

    International Nuclear Information System (INIS)

    Tanaka, Masaru; Aoyama, Isao; Ishizaka, Kaoru; Ohata, Yuki; Fukuike, Iori; Miyagawa, Hiroshi; Ishimori, Yuu

    2017-01-01

    From 1955 to 2001, Japan Atomic Energy Agency (JAEA) carried out research and development projects related to uranium exploration, mining, refining, conversion and enrichment at/around Ningyo-toge in Japan. Subsequently, JAEA has been carrying out remediation of the uranium mine legacy sites and decommissioning of the nuclear fuel cycle facilities. JAEA has many experiences of communication with local stakeholders from these projects. Among such experiences, management of the waste rock sites became local concern in 1988, 27 years after completion of the exploration. The issue was resolved in 2012 after several efforts. From this experience, it was suggested that the lack of information sharing with local stakeholders and that the inadequate support to stakeholder's requests caused the delay of problem solving. Therefore, sustainable relationship with local stakeholders for over decades is important for JAEA Ningyo-toge Environmental Engineering Center. As reference, similar domestic cases were investigated and strategies for risk communication were planned. As follows; (1) Clarify roles and responsibilities of communication staffs for sustainable communicating with local residents. (2) Identify gaps in risk communication knowledge among center and local residents and work toward filling those gaps. (3) Improve the effectiveness of Ningyo-toge center's website and PR-magazines as primary mechanism for communicating with wide stakeholders. (4) Investigate new communication methods for sustainable communicating, such as combination of environmental restoration studies by experts and environmental learning activities by residents. (author)

  14. Early-life home environment and risk of asthma among inner-city children.

    Science.gov (United States)

    O'Connor, George T; Lynch, Susan V; Bloomberg, Gordon R; Kattan, Meyer; Wood, Robert A; Gergen, Peter J; Jaffee, Katy F; Calatroni, Agustin; Bacharier, Leonard B; Beigelman, Avrahman; Sandel, Megan T; Johnson, Christine C; Faruqi, Ali; Santee, Clark; Fujimura, Kei E; Fadrosh, Douglas; Boushey, Homer; Visness, Cynthia M; Gern, James E

    2018-04-01

    Environmental exposures in early life appear to play an important role in the pathogenesis of childhood asthma, but the potentially modifiable exposures that lead to asthma remain uncertain. We sought to identify early-life environmental risk factors for childhood asthma in a birth cohort of high-risk inner-city children. We examined the relationship of prenatal and early-life environmental factors to the occurrence of asthma at 7 years of age among 442 children. Higher house dust concentrations of cockroach, mouse, and cat allergens in the first 3 years of life were associated with lower risk of asthma (for cockroach allergen: odds ratio per interquartile range increase in concentration, 0.55; 95% CI, 0.36-0.86; P < .01). House dust microbiome analysis using 16S ribosomal RNA sequencing identified 202 and 171 bacterial taxa that were significantly (false discovery rate < 0.05) more or less abundant, respectively, in the homes of children with asthma. A majority of these bacteria were significantly correlated with 1 of more allergen concentrations. Other factors associated significantly positively with asthma included umbilical cord plasma cotinine concentration (odds ratio per geometric SD increase in concentration, 1.76; 95% CI, 1.00-3.09; P = .048) and maternal stress and depression scores. Among high-risk inner-city children, higher indoor levels of pet or pest allergens in infancy were associated with lower risk of asthma. The abundance of a number of bacterial taxa in house dust was associated with increased or decreased asthma risk. Prenatal tobacco smoke exposure and higher maternal stress and depression scores in early life were associated with increased asthma risk. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. All rights reserved.

  15. THE EVOLUTION OF RISK MANAGEMENT RESEARCH: CHANGES IN KNOWLEDGE MAPS

    OpenAIRE

    Iwona Gorzeń-Mitka

    2017-01-01

    One of the leading trends in modern academic research is risk management. Over the years, the approach to risk management has changed and affected many different areas. This study aims to investigate changes in risk management and trends of risk management in the past 20 years. Risk management related publications from 1990 to 2016 were retrieved from the Web of Science and Scopus databases. VOS viewer software was used to analyse the research trend. Literature growth related to risk manageme...

  16. Brain Research to Ameliorate Impaired Neurodevelopment - Home-based Intervention Trial (BRAIN-HIT

    Directory of Open Access Journals (Sweden)

    Mahantshetti Niranjana S

    2010-04-01

    Full Text Available Abstract Background This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low- and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low- and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality and morbidity from birth asphyxia disproportionately affect more infants in low- and low-middle-income countries, particularly those from the lowest socioeconomic groups. There is evidence that relatively inexpensive programs of early developmental intervention, delivered during home visit by parent trainers, are capable of improving neurodevelopment in infants following brain insult due to birth asphyxia. Methods/Design This trial is a block-randomized controlled trial that has enrolled 174 children with birth asphyxia and 257 without perinatal complications, comparing early developmental intervention plus health and safety counseling to the control intervention receiving health and safety counseling only, in sites in India, Pakistan, and Zambia. The interventions are delivered in home visits every two weeks by parent trainers from 2 weeks after birth until age 36 months. The primary outcome of the trial is cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and number of home visits completed are evaluated as moderating factors. Discussion The trial is supervised by a trial steering committee, and an independent data monitoring

  17. Brain research to ameliorate impaired neurodevelopment--home-based intervention trial (BRAIN-HIT).

    Science.gov (United States)

    Wallander, Jan L; McClure, Elizabeth; Biasini, Fred; Goudar, Shivaprasad S; Pasha, Omrana; Chomba, Elwyn; Shearer, Darlene; Wright, Linda; Thorsten, Vanessa; Chakraborty, Hrishikesh; Dhaded, Sangappa M; Mahantshetti, Niranjana S; Bellad, Roopa M; Abbasi, Zahid; Carlo, Waldemar

    2010-04-30

    This randomized controlled trial aims to evaluate the effects of an early developmental intervention program on the development of young children in low- and low-middle-income countries who are at risk for neurodevelopmental disability because of birth asphyxia. A group of children without perinatal complications are evaluated in the same protocol to compare the effects of early developmental intervention in healthy infants in the same communities. Birth asphyxia is the leading specific cause of neonatal mortality in low- and low-middle-income countries and is also the main cause of neonatal and long-term morbidity including mental retardation, cerebral palsy, and other neurodevelopmental disorders. Mortality and morbidity from birth asphyxia disproportionately affect more infants in low- and low-middle-income countries, particularly those from the lowest socioeconomic groups. There is evidence that relatively inexpensive programs of early developmental intervention, delivered during home visit by parent trainers, are capable of improving neurodevelopment in infants following brain insult due to birth asphyxia. This trial is a block-randomized controlled trial that has enrolled 174 children with birth asphyxia and 257 without perinatal complications, comparing early developmental intervention plus health and safety counseling to the control intervention receiving health and safety counseling only, in sites in India, Pakistan, and Zambia. The interventions are delivered in home visits every two weeks by parent trainers from 2 weeks after birth until age 36 months. The primary outcome of the trial is cognitive development, and secondary outcomes include social-emotional and motor development. Child, parent, and family characteristics and number of home visits completed are evaluated as moderating factors. The trial is supervised by a trial steering committee, and an independent data monitoring committee monitors the trial. Findings from this trial have the potential

  18. Early Educational Intervention, Early Cumulative Risk, and the Early Home Environment as Predictors of Young Adult Outcomes within a High-Risk Sample

    Science.gov (United States)

    Pungello, Elizabeth P.; Kainz, Kirsten; Burchinal, Margaret; Wasik, Barbara H.; Sparling, Joseph J.; Ramey, Craig T.; Campbell, Frances A.

    2010-01-01

    The extent to which early educational intervention, early cumulative risk, and the early home environment were associated with young adult outcomes was investigated in a sample of 139 young adults (age 21) from high-risk families enrolled in randomized trials of early intervention. Positive effects of treatment were found for education attainment,…

  19. Planned home compared with planned hospital births in the Netherlands: intrapartum and early neonatal death in low-risk pregnancies.

    Science.gov (United States)

    van der Kooy, Jacoba; Poeran, Jashvant; de Graaf, Johanna P; Birnie, Erwin; Denktasş, Semiha; Steegers, Eric A P; Bonsel, Gouke J

    2011-11-01

    The purpose of our study was to compare the intrapartum and early neonatal mortality rate of planned home birth with planned hospital birth in community midwife-led deliveries after case mix adjustment. The perinatal outcome of 679,952 low-risk women was obtained from the Netherlands Perinatal Registry (2000-2007). This group represents all women who had a choice between home and hospital birth. Two different analyses were performed: natural prospective approach (intention-to-treat-like analysis) and perfect guideline approach (per-protocol-like analysis). Unadjusted and adjusted odds ratios (ORs) were calculated. Case mix was based on the presence of at least one of the following: congenital abnormalities, small for gestational age, preterm birth, or low Apgar score. We also investigated the potential risk role of intended place of birth. Multivariate stepwise logistic regression was used to investigate the potential risk role of intended place of birth. Intrapartum and neonatal death at 0-7 days was observed in 0.15% of planned home compared with 0.18% in planned hospital births (crude relative risk 0.80, 95% confidence interval [CI] 0.71-0.91). After case mix adjustment, the relation is reversed, showing nonsignificant increased mortality risk of home birth (OR 1.05, 95% CI 0.91-1.21). In certain subgroups, additional mortality may arise at home if risk conditions emerge at birth (up to 20% increase). Home birth, under routine conditions, is generally not associated with increased intrapartum and early neonatal death, yet in subgroups, additional risk cannot be excluded.

  20. Overview of research work activities in German language in the Home Automation area; Ueberblick deutschsprachiger Forschungsaktivitaeten im Bereich Home Automation. Forschungsinstitute, Themen, Ergebnisse - Schlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Staub, R.

    2010-02-15

    This final report for the Swiss Federal Office of Energy (SFOE) takes a look at research work carried out in Germany and Austria on 'smart homes'. The aim of the project was to determine which work has already been carried out in Germany and Austria so that work in Switzerland can be concentrated on questions that have not been looked at in Germany and Austria. The appropriate research institutions are listed. Concrete projects are briefly described and their relevance for Swiss efforts is examined. Various Home Automation project categories are listed, as are the most important research institutes involved. The particular research projects in Germany and Austria and their relevance to Swiss efforts are listed.

  1. Everything safe? – Risk situations in advanced home care from the point of view of ventilated patients and their relatives

    Science.gov (United States)

    Ewers, Michael; Schaepe, Christiane; Lehmann, Yvonne

    2017-01-01

    Background: The number of home mechanically ventilated (HMV) patients has been growing for years. However, little is known about requirements, processes and effects of advanced home care, provided in distance from clinics and doctors. To date, safety related aspects of the above mentioned issues have scarcely been examined. Aim: Users of advanced home care were asked about their experiences and about situations in which they felt safe or unsafe. The aim was to gain insights into the daily care provision, explore safety risks from the users’ point of view, and to develop new approaches to enhance patient safety in home care for the severely ill. Method: A qualitative explorative study has been carried out, based on semi-structured interviews (ventilated patients N = 21; relatives N = 15). Sampling, data collecting and data analysis were guided by principles of Grounded Theory. Results: Risk situations occur when (non-)verbal communication offers of HMV patients are overseen or misunderstood, patient- or technology related monitoring tasks are neglected, if coordination and collaboration requirements are undervalued and if negotiation processes as well as education and supervision needs are disregarded. Furthermore, nurses’ lack of competence, self-confidence and professionalism may produce risk situations. Conclusion: Listen carefully to patients and relatives can help to identify quality shortcomings in advanced home care, to prevent risk situations and to develop patient-centered safety concepts for this particular setting.

  2. Using alternative or direct anthropometric measurements to assess risk for malnutrition in nursing homes.

    Science.gov (United States)

    Lorini, Chiara; Collini, Francesca; Castagnoli, Mariangela; Di Bari, Mauro; Cavallini, Maria Chiara; Zaffarana, Nicoletta; Pepe, Pasquale; Lucenteforte, Ersilia; Vannacci, Alfredo; Bonaccorsi, Guglielmo

    2014-10-01

    The aim of this study was to use the Malnutrition Universal Screening Tool (MUST) to assess the applicability of alternative versus direct anthropometric measurements for evaluating the risk for malnutrition in older individuals living in nursing homes (NHs). We conducted a cross-sectional survey in 67 NHs in Tuscany, Italy. We measured the weight, standing height (SH), knee height (KH), ulna length (UL), and middle-upper-arm circumference of 641 NH residents. Correlations between the different methods for calculating body mass index (BMI; using direct or alternative measurements) were evaluated by the intraclass correlation coefficient and the Bland-Altman method; agreement in the allocation of participants to the same risk category was assessed by squared weighted kappa statistic and indicators of internal relative validity. The intraclass correlation coefficient for BMI calculated using KH was 0.839 (0.815-0.861), whereas those calculated by UL were 0.890 (0.872-0.905). The limits of agreement were ±6.13 kg/m(2) using KH and ±4.66 kg/m(2) using UL. For BMI calculated using SH, 79.9% of the patients were at low risk, 8.1% at medium risk, and 12.2% at high risk for malnutrition. The agreement between this classification and that obtained using BMI calculated by alternative measurements was "fair-good." When it is not possible to determine risk category by using SH, we suggest using the alternative measurements (primarily UL, due to its highest sensitivity) to predict the height and to compare these evaluations with those obtained by using middle-upper-arm-circumference to predict the BMI. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

  3. Natural ventilation reduces high TB transmission risk in traditional homes in rural KwaZulu-Natal, South Africa.

    Science.gov (United States)

    Lygizos, Melissa; Shenoi, Sheela V; Brooks, Ralph P; Bhushan, Ambika; Brust, James C M; Zelterman, Daniel; Deng, Yanhong; Northrup, Veronika; Moll, Anthony P; Friedland, Gerald H

    2013-07-01

    Transmission of drug susceptible and drug resistant TB occurs in health care facilities, and community and households settings, particularly in highly prevalent TB and HIV areas. There is a paucity of data regarding factors that may affect TB transmission risk in household settings. We evaluated air exchange and the impact of natural ventilation on estimated TB transmission risk in traditional Zulu homes in rural South Africa. We utilized a carbon dioxide decay technique to measure ventilation in air changes per hour (ACH). We evaluated predominant home types to determine factors affecting ACH and used the Wells-Riley equation to estimate TB transmission risk. Two hundred eighteen ventilation measurements were taken in 24 traditional homes. All had low ventilation at baseline when windows were closed (mean ACH = 3, SD = 3.0), with estimated TB transmission risk of 55.4% over a ten hour period of exposure to an infectious TB patient. There was significant improvement with opening windows and door, reaching a mean ACH of 20 (SD = 13.1, p ventilation conditions (windows/doors open) and window to volume ratio. Expanding ventilation increased the odds of achieving ≥12 ACH by 60-fold. There is high estimated risk of TB transmission in traditional homes of infectious TB patients in rural South Africa. Improving natural ventilation may decrease household TB transmission risk and, combined with other strategies, may enhance TB control efforts.

  4. Water requirements and drinking rates of homing pigeons: A consideration for exposure risk of migratory birds.

    Science.gov (United States)

    Perez, Cristina R; Moye, John K; Pritsos, Chris A

    2017-09-01

    Access to water along a bird's migratory flyway is essential during the vital process of migration. Because of the scarcity of water in some environments, there is potential for migratory birds to encounter and drink from contaminated bodies of water. Ingestion of contaminated water may cause injury and compromise flying ability, leading to a disruption of migration. To determine injury to birds from potential exposure, it is essential to know not only the concentration of a given contaminant in the water but also the quantity and rate of water consumption by the birds. Homing pigeons (Columba livia) were used in a series of experiments to determine differences in drinking behavior after various flights and after periods of resting. Results from the present study demonstrate that homing pigeons' water consumption is dramatically different when assessed according to activity, flight distance, and time elapsed after flight. This suggests that the drinking rates of birds during migration are extremely important and much greater than estimated using traditional exposure assessment procedures. Thus, exposure to contaminants via drinking water may be greatly underestimated, and the rate of water consumption should be considered when estimating potential exposure risk to avian species. Integr Environ Assess Manag 2017;13:870-876. © 2017 SETAC. © 2017 SETAC.

  5. Funding a Health Disparities Research Agenda: The Case of Medicare Home Health Care

    Science.gov (United States)

    Davitt, Joan K.

    2014-01-01

    Medicare home health care provides critical skilled nursing and therapy services to patients in their homes, generally after a period in an inpatient facility or nursing home. Disparities in access to, or outcomes of, home health care can result in patient deterioration and increased cost to the Medicare program if patient care needs intensify.…

  6. [Research of controlling of smart home system based on P300 brain-computer interface].

    Science.gov (United States)

    Wang, Jinjia; Yang, Chengjie

    2014-08-01

    Using electroencephalogram (EEG) signal to control external devices has always been the research focus in the field of brain-computer interface (BCI). This is especially significant for those disabilities who have lost capacity of movements. In this paper, the P300-based BCI and the microcontroller-based wireless radio frequency (RF) technology are utilized to design a smart home control system, which can be used to control household appliances, lighting system, and security devices directly. Experiment results showed that the system was simple, reliable and easy to be populirised.

  7. In-Home Display – a Review of Experiences from Research Projects

    Directory of Open Access Journals (Sweden)

    Krzysztof Billewicz

    2014-12-01

    Full Text Available There are many studies on smart metering. The aim of smart metering is not only automated billing and two-way communication with a smart meter. The measure of success of the implementation of smart metering is the level of customer engagement and their cooperation with energy companies, as well as the consequences of such involvement changing electricity-using habits. This article focuses on one device for smart metering – in-home display (IHD. The paper characterizes an IHD’s functions and describes international experiences of research and conclusions of studies.

  8. Examining Maternal Depression and Attachment Insecurity as Moderators of the Impacts of Home Visiting for At-Risk Mothers and Infants

    Science.gov (United States)

    Duggan, Anne K.; Berlin, Lisa J.; Cassidy, Jude; Burrell, Lori; Tandon, S. Darius

    2009-01-01

    Home visiting programs for at-risk mothers and their infants have proliferated nationally in recent years, yet experimental studies of home visiting have yielded mixed findings. One promising strategy for explicating the effects of early home visiting is to examine moderators of program impacts. This study assessed the roles of maternal depression…

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

    Science.gov (United States)

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

    2013-08-09

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

  10. Newborn Care in the Home and Health Facility: Formative Findings for Intervention Research in Cambodia

    Directory of Open Access Journals (Sweden)

    Alessandra N. Bazzano

    2016-12-01

    Full Text Available Global coverage and scale up of interventions to reduce newborn mortality remains low, though progress has been achieved in improving newborn survival in many low-income settings. An important factor in the success of newborn health interventions, and moving to scale, is appropriate design of community-based programs and strategies for local implementation. We report the results of formative research undertaken to inform the design of a newborn health intervention in Cambodia. Information was gathered on newborn care practices over a period of three months using multiple qualitative methods of data collection in the primary health facility and home setting. Analysis of the data indicated important gaps, both at home and facility level, between recommended newborn care practices and those typical in the study area. The results of this formative research have informed strategies for behavior change and improving referral of sick infants in the subsequent implementation study. Collection and dissemination of data on newborn care practices from settings such as these can contribute to efforts to advance survival, growth and development of newborns for intervention research, and for future newborn health programming.

  11. Automation of a high risk medication regime algorithm in a home health care population.

    Science.gov (United States)

    Olson, Catherine H; Dierich, Mary; Westra, Bonnie L

    2014-10-01

    Create an automated algorithm for predicting elderly patients' medication-related risks for readmission and validate it by comparing results with a manual analysis of the same patient population. Outcome and Assessment Information Set (OASIS) and medication data were reused from a previous, manual study of 911 patients from 15 Medicare-certified home health care agencies. The medication data was converted into standardized drug codes using APIs managed by the National Library of Medicine (NLM), and then integrated in an automated algorithm that calculates patients' high risk medication regime scores (HRMRs). A comparison of the results between algorithm and manual process was conducted to determine how frequently the HRMR scores were derived which are predictive of readmission. HRMR scores are composed of polypharmacy (number of drugs), Potentially Inappropriate Medications (PIM) (drugs risky to the elderly), and Medication Regimen Complexity Index (MRCI) (complex dose forms, instructions or administration). The algorithm produced polypharmacy, PIM, and MRCI scores that matched with 99%, 87% and 99% of the scores, respectively, from the manual analysis. Imperfect match rates resulted from discrepancies in how drugs were classified and coded by the manual analysis vs. the automated algorithm. HRMR rules lack clarity, resulting in clinical judgments for manual coding that were difficult to replicate in the automated analysis. The high comparison rates for the three measures suggest that an automated clinical tool could use patients' medication records to predict their risks of avoidable readmissions. Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Governance of Land Use Planning to Reduce Fire Risk to Homes Mediterranean France and California

    Directory of Open Access Journals (Sweden)

    Susan D. Kocher

    2017-03-01

    Full Text Available Wildfire is a natural part of forested Mediterranean systems. As humans continue to live and build housing in these areas, wildfire is a constant threat to homes and lives. The goal of this paper is to describe aspects of land-use planning that are used to reduce wildfire risk in institutionally divergent regions; southern France and California. By reviewing relevant legislation and planning documents and conducting in person interviews with fire and planning professionals, we identify the institutions which participate in land use planning to reduce fire risk and the key laws and regulations that guide planning decisions. Our results indicate that France has a more centralized system for planning for fire, with national level entities heavily involved in local land use planning. California, on the other hand sees almost no federal oversite, and, while state law requires local plans to include wildfire risk, most fine grain decisions are left to local planners and decision makers. In both regions, however, we see a reliance on technical support provided from outside local jurisdictions. Increased coordination between local, regional, and national governments could improve land use planning in both locations.

  13. Impact of long term care and mortality risk in community care and nursing homes populations.

    Science.gov (United States)

    Lopes, Hugo; Mateus, Céu; Rosati, Nicoletta

    To identify the survival time, the mortality risk factors and the individuals' characteristics associated with cognitive and physical status at discharge, among the Portuguese long-term care (LTC) populations. Home-and-Community-Based Services (HCBS) and three types of Nursing Homes (NH). 20,984 individuals admitted and discharged in 2015. The Kaplan-Meier survival analysis and the Cox Proportional Hazards Models were used to study the mortality risk; the Wilcoxon signed-rank test to identify the number of individuals with cognitive and physical changes between admission and discharge; two cumulative odds ordinal logistic regressions to predict the cognitive and physical dependence levels at discharge RESULTS: The mortality rate at HCBS was 30%, and 17% at the NH, with a median survival time of 173 and 200 days, respectively. The main factors associated with higher mortality were older age, male gender, family/neighbour support, neoplasms and cognitive/physical dependence at admission. In NH/HCBS, 26%/18% of individuals improve their cognitive status, while in physical status the proportion was 38%/27%, respectively. Finally, older age, being illiterate and being classified at the lowest cognitive and physical status at admission decrease the likelihood of achieving a higher level of cognitive and physical independence at discharge. The adoption of a robust and complete assessment tool, the definition of guidelines to enable a periodical assessment of individuals' autonomy and the adoption of benchmark metrics allowing the comparison of results between similar units are some of the main goals to be taken into account for future developments of this care in Portugal. Copyright © 2018 Elsevier B.V. All rights reserved.

  14. Indoor tanning in businesses and homes and risk of melanoma and non-melanoma skin cancer in two US case-control studies

    Science.gov (United States)

    Ferrucci, Leah M.; Vogel, Rachel Isaksson; Cartmel, Brenda; Lazovich, DeAnn; Mayne, Susan T.

    2014-01-01

    Background Indoor tanning increases skin cancer risk. Beyond early research describing melanoma and sun lamps, few recent reports describe where individuals indoor tan and whether skin cancer risk varies by location (business, home-based). Objective Assess where individuals tanned indoors and skin cancer risk by tanning device location. Methods Multivariate logistic regression in two US case-control studies of melanoma (1,161 cases, 1,083 controls, ages 25–59) and early-onset basal cell carcinoma (BCC) (375 cases, 382 controls, under age 40) conducted between 2004 and 2010. Results Most indoor tanners (86.4–95.1%), especially younger individuals, tanned exclusively in businesses. Persons who used indoor tanning exclusively in businesses were at increased risk of melanoma (OR=1.82, 95% CI=1.47–2.26) and BCC (OR=1.69, 95% CI=1.15–2.48) compared to non-users. Melanoma risk was also increased in the small number who reported tanning indoors only at home relative to non-users (OR=4.14, 95% CI=1.75–9.78); 67.6% used sun lamps. Limitations Self-reported tanning, potential recall bias. Conclusion Business only tanning, despite claims of “safe" tanning, was positively associated with a significant risk of melanoma and BCC. Home tanning was uncommon and mostly from sun lamps which were rarely used by younger participants. Regardless of location, indoor tanning was associated with increased risk of skin cancer. PMID:25062934

  15. Cognitive and motor abilities of young children and risk of injuries in the home.

    Science.gov (United States)

    Ehrhardt, Jennifer; Xu, Yingying; Khoury, Jane; Yolton, Kimberly; Lanphear, Bruce; Phelan, Kieran

    2017-02-01

    Residential injury is a leading cause of morbidity and mortality in US children. Rates and types of injury vary by child age but little is known about injury risk based on child cognitive and motor abilities. The objective of this study was to determine whether cognitive or motor development in young children is associated with residential injury. We employed data from Health Outcomes and Measures of the Environment (HOME) Study. Parent report of medically attended injury was obtained at regular intervals from 0 to 42 months. Child development was assessed at 12, 24 and 36 months using Bayley Scales of Infant and Toddler Development, 2nd edition, which generates both mental developmental index (MDI) and a psychomotor developmental index (PDI). Injury risk was modelled using multivariable logistic regression as function of child's MDI or PDI. Effects of MDI and PDI on injury risk were examined separately and jointly, adjusting for important covariates. Children with cognitive delay (MDI cognitive delay (OR=3.7, 95% CI 1.4 to 10.5, p=0.012). There was no significant association of PDI with injury. There was, however, significant interaction of MDI and PDI (p=0.02); children with cognitive delay but normal motor development were at significantly higher risk of injury than children with normal cognitive and motor development (OR=9.6, 95% CI 2.6 to 35.8, p=0.001). Children with cognitive delays, especially those with normal motor development, are at elevated risk for residential injuries. Injury prevention efforts should target children with developmental delays. NCT00129324; post-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  16. 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

  17. Research on Risks and Forecasting Countermeasures of Hainan Banana Industry

    OpenAIRE

    Liu, Yan-qun; Zeng, Xiao-hong; Fang, Jia

    2011-01-01

    Based on the overviews of the current conditions of Hainan banana industry, the research makes an analysis of the risks faced by Hainan banana industry. They are respectively marketing risks, natural risks, information risks and production risks. In order to promote a sustainable and rapid development of Hainan banana industry, Countermeasures are proposed in the research. The first is to strengthen the leading organization of forecasting mechanisms on banana industry. The second is to establ...

  18. 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.

  19. The methodology of risk perception research

    International Nuclear Information System (INIS)

    Sjoberg, L.

    1998-01-01

    Risk perception is frequently held to be crucial in the understanding and management of risk in policy contexts. The present paper takes as a starting point the notion that risk perception, of the public, of experts and other special groups, is important and hence the question arises how it should be investigated

  20. Risk factors for out-of-home custody child care among families with alcohol and substance abuse problems.

    Science.gov (United States)

    Sarkola, Taisto; Kahila, Hanna; Gissler, Mika; Halmesmäki, Erja

    2007-11-01

    To study the risk of children to mothers with alcohol and/or substance abuse related problems for early childhood out-of-home care in Finland. A population-based cross-sectional retrospective analysis of 526 pregnant women attending special outpatient clinics during 1992-2001 and their 626 offspring, with out-of-home care data until 2003 provided by the National Child Welfare Register. Fifty percent (95% confidence interval 46-54%) were at some point and 38% (34-42%) by the age of two years, in out-of-home care. Out-of-home care was associated with maternal care for substance abuse after delivery, nonemployment, housing, daily smoking during pregnancy, increasing number of previous births, mother in custody in her childhood, maternal education, previous child in custody, drug in urine during pregnancy, unplanned pregnancy, partner with significant abuse, regular health-care contact for abuse, daily alcohol consumption before and/or during pregnancy, newborn not discharged with mother, neonatal abstinence symptoms (NAS), intensified perinatal surveillance or NICU, and delayed discharge from hospital. There is a substantial risk of children born to mothers with significant alcohol and/or substance abuse related problems for out-of-home care during early childhood. Factors identified during the pre- and perinatal period are associated with this risk.

  1. Evaluating the risks of clinical research: direct comparative analysis.

    Science.gov (United States)

    Rid, Annette; Abdoler, Emily; Roberson-Nay, Roxann; Pine, Daniel S; Wendler, David

    2014-09-01

    Many guidelines and regulations allow children and adolescents to be enrolled in research without the prospect of clinical benefit when it poses minimal risk. However, few systematic methods exist to determine when research risks are minimal. This situation has led to significant variation in minimal risk judgments, raising concern that some children are not being adequately protected. To address this concern, we describe a new method for implementing the widely endorsed "risks of daily life" standard for minimal risk. This standard defines research risks as minimal when they do not exceed the risks posed by daily life activities or routine examinations. This study employed a conceptual and normative analysis, and use of an illustrative example. Different risks are composed of the same basic elements: Type, likelihood, and magnitude of harm. Hence, one can compare the risks of research and the risks of daily life by comparing the respective basic elements with each other. We use this insight to develop a systematic method, direct comparative analysis, for implementing the "risks of daily life" standard for minimal risk. The method offers a way of evaluating research procedures that pose the same types of risk as daily life activities, such as the risk of experiencing anxiety, stress, or other psychological harm. We thus illustrate how direct comparative analysis can be applied in practice by using it to evaluate whether the anxiety induced by a respiratory CO2 challenge poses minimal or greater than minimal risks in children and adolescents. Direct comparative analysis is a systematic method for applying the "risks of daily life" standard for minimal risk to research procedures that pose the same types of risk as daily life activities. It thereby offers a method to protect children and adolescents in research, while ensuring that important studies are not blocked because of unwarranted concerns about research risks.

  2. User preferences and usability of iVitality: optimizing an innovative online research platform for home-based health monitoring

    Directory of Open Access Journals (Sweden)

    van Osch M

    2015-06-01

    Full Text Available Mara van Osch,1 AJM Rövekamp,2 Stephanie N Bergman-Agteres,1 Liselotte W Wijsman,3,4 Sharon J Ooms,5 Simon P Mooijaart,3,4,6 Joan Vermeulen71Netherlands Institute for Health Services Research, Utrecht, 2Netherlands Organization for Applied Scientific Research, 3Department of Gerontology and Geriatrics, Leiden University Medical Centre, 4Netherlands Consortium for Healthy Ageing, Leiden, 5Department of Geriatric Medicine, Radboud Alzheimer Centre, Radboud University Nijmegen Medical Centre, Nijmegen, 6Institute for Evidence-Based Medicine in Old Age, Leiden, 7Research School, CAPHRI, Maastricht University, Maastricht, the NetherlandsBackground: The iVitality online research platform has been developed to gain insight into the relationship between early risk factors (ie, poorly controlled hypertension, physical or mental inactivity and onset and possibly prevention of dementia. iVitality consists of a website, a smartphone application, and sensors that can monitor these indicators at home. Before iVitality can be implemented, it should fit the needs and preferences of users, ie, offspring of patients with dementia. This study aimed to explore users’ motivation to participate in home-based health monitoring research, to formulate requirements based on users’ preferences to optimize iVitality, and to test usability of the smartphone application of iVitality.Methods: We recruited 13 participants (aged 42–64 years, 85% female, who were offspring of patients with dementia. A user-centered methodology consisting of four iterative phases was used. Three semistructured interviews provided insight into motivation and acceptance of using iVitality (phase 1. A focus group with six participants elaborated on expectations and preferences regarding iVitality (phase 2. Findings from phase 1 and 2 were triangulated by two semistructured interviews (phase 3. Four participants assessed the usability of the smartphone application (phase 4 using a think aloud

  3. Older adult perceptions of smart home technologies: implications for research, policy & market innovations in healthcare.

    Science.gov (United States)

    Coughlin, J; D'Ambrosio, L A; Reimer, B; Pratt, M R

    2007-01-01

    Advances in information communications technology and related computational power are providing a wide array of systems and related services that form the basis of smart home technologies to support the health, safety and independence of older adults. While these technologies offer significant benefits to older people and their families, they are also transforming older adults into lead adopters of a new 24/7 lifestyle of being monitored, managed, and, at times, motivated, to maintain their health and wellness. To better understand older adult perceptions of smart home technologies and to inform future research a workshop and focus group was conducted with 30 leaders in aging advocacy and aging services from 10 northeastern states. Participants expressed support of technological advance along with a variety of concerns that included usability, reliability, trust, privacy, stigma, accessibility and affordability. Participants also observed that there is a virtual absence of a comprehensive market and policy environment to support either the consumer or the diffusion of these technologies. Implications for research, policy and market innovation are discussed.

  4. Achieving external validity in home advantage research: generalizing crowd noise effects

    Directory of Open Access Journals (Sweden)

    Tony D Myers

    2014-06-01

    Full Text Available Different factors have been postulated to explain the home advantage phenomenon in sport. One plausible explanation investigated has been the influence of a partisan home crowd on sports officials’ decisions. Different types of studies have tested the crowd influence hypothesis including purposefully designed experiments. However, while experimental studies investigating crowd influences have high levels of internal validity, they suffer from a lack of external validity; decision-making in a laboratory setting bearing little resemblance to decision-making in live sports settings. This focused review initially considers threats to external validity in applied and theoretical experimental research. Discussing how such threats can be addressed using representative design by focusing on a recently published study that arguably provides the first experimental evidence of the impact of live crowd noise on officials in sport. The findings of this controlled experiment conducted in a real tournament setting offer some confirmation of the validity of laboratory experimental studies in the area. Finally directions for future research and the future conduct of crowd noise studies are discussed.

  5. Achieving external validity in home advantage research: generalizing crowd noise effects.

    Science.gov (United States)

    Myers, Tony D

    2014-01-01

    Different factors have been postulated to explain the home advantage phenomenon in sport. One plausible explanation investigated has been the influence of a partisan home crowd on sports officials' decisions. Different types of studies have tested the crowd influence hypothesis including purposefully designed experiments. However, while experimental studies investigating crowd influences have high levels of internal validity, they suffer from a lack of external validity; decision-making in a laboratory setting bearing little resemblance to decision-making in live sports settings. This focused review initially considers threats to external validity in applied and theoretical experimental research. Discussing how such threats can be addressed using representative design by focusing on a recently published study that arguably provides the first experimental evidence of the impact of live crowd noise on officials in sport. The findings of this controlled experiment conducted in a real tournament setting offer a level of confirmation of the findings of laboratory studies in the area. Finally directions for future research and the future conduct of crowd noise studies are discussed.

  6. SpaceScience@Home: Authentic Research Projects that Use Citizen Scientists

    Science.gov (United States)

    Méndez, B. J. H.

    2008-06-01

    In recent years, several space science research projects have enlisted the help of large numbers of non-professional volunteers, ``citizen scientists'', to aid in performing tasks that are critical to a project, but require more person-time (or computing time) than a small professional research team can practically perform themselves. Examples of such projects include SETI@home, which uses time from volunteers computers to process radio-telescope observation looking for signals originating from extra-terrestrial intelligences; Clickworkers, which asks volunteers to review images of the surface of Mars to identify craters; Spacewatch, which used volunteers to review astronomical telescopic images of the sky to identify streaks made by possible Near Earth Asteroids; and Stardust@home, which asks volunteers to review ``focus movies'' taken of the Stardust interstellar dust aerogel collector to search for possible impacts from interstellar dust particles. We shall describe these and other similar projects and discuss lessons learned from carrying out such projects, including the educational opportunities they create.

  7. Risk to researchers in qualitative research on sensitive topics: issues and strategies.

    Science.gov (United States)

    Dickson-Swift, Virginia; James, Erica L; Kippen, Sandra; Liamputtong, Pranee

    2008-01-01

    Traditionally, risk assessments in research have been limited to examining the risks to the research participants. Although doing so is appropriate and important, there is growing recognition that undertaking research can pose risks to researchers as well. A grounded theory study involving a range of researchers who had undertaken qualitative health research on a sensitive topic was completed. Analysis of the in-depth, face-to-face unstructured individual interviews with 30 Australian public health researchers provided evidence that researchers do confront a number of physical and emotional risks when undertaking research. Training, preparation, and supervision must be taken into account so that the risk to researchers can be minimized. Researchers need to consider occupational health and safety issues in designing research projects that deal with physical and emotional risks. Recommendations for professional supervision, policy development, and minimum training standards for researchers are provided.

  8. Medical staff involvement in nursing homes: development of a conceptual model and research agenda.

    Science.gov (United States)

    Shield, Renée; Rosenthal, Marsha; Wetle, Terrie; Tyler, Denise; Clark, Melissa; Intrator, Orna

    2014-02-01

    Medical staff (physicians, nurse practitioners, physicians' assistants) involvement in nursing homes (NH) is limited by professional guidelines, government policies, regulations, and reimbursements, creating bureaucratic burden. The conceptual NH Medical Staff Involvement Model, based on our mixed-methods research, applies the Donabedian "structure-process-outcomes" framework to the NH, identifying measures for a coordinated research agenda. Quantitative surveys and qualitative interviews conducted with medical directors, administrators and directors of nursing, other experts, residents and family members and Minimum Data Set, the Online Certification and Reporting System and Medicare Part B claims data related to NH structure, process, and outcomes were analyzed. NH control of medical staff, or structure, affects medical staff involvement in care processes and is associated with better outcomes (e.g., symptom management, appropriate transitions, satisfaction). The model identifies measures clarifying the impact of NH medical staff involvement on care processes and resident outcomes and has strong potential to inform regulatory policies.

  9. The Home Literacy Environment as a Predictor of the Early Literacy Development of Children at Family-Risk of Dyslexia

    Science.gov (United States)

    Hamilton, Lorna G.; Hayiou-Thomas, Marianna E.; Hulme, Charles; Snowling, Margaret J.

    2016-01-01

    The home literacy environment (HLE) predicts language and reading development in typically developing children; relatively little is known about its association with literacy development in children at family-risk of dyslexia. We assessed the HLE at age 4 years, precursor literacy skills at age 5, and literacy outcomes at age 6, in a sample of…

  10. Measuring the quality of infection control in Dutch nursing homes using a standardized method; the Infection prevention RIsk Scan (IRIS)

    NARCIS (Netherlands)

    Willemsen, I.; Nelson-Melching, J.; Hendriks, Y.; Mulders, A.; Verhoeff, S.; Kluytmans-Vandenbergh, M.; Kluytmans, J.

    2014-01-01

    BACKGROUND: We developed a standardised method to assess the quality of infection control in Dutch Nursing Home (NH), based on a cross-sectional survey that visualises the results. The method was called the Infection control RIsk Infection Scan (IRIS). We tested the applicability of this new tool in

  11. Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study

    NARCIS (Netherlands)

    de Jonge, J.; Mesman, J.A.J.M.; Manniën, J.; Zwart, J.J.; van Dillen, J.; van Roosmalen, J.

    2013-01-01

    Objectives: To test the hypothesis that low risk women at the onset of labour with planned home birth have a higher rate of severe acute maternal morbidity than women with planned hospital birth, and to compare the rate of postpartum haemorrhage and manual removal of placenta. Design: Cohort study

  12. Outcome of planned home and planned hospital births in low risk pregnancies: prospective study in midwifery practices in the Netherlands.

    NARCIS (Netherlands)

    Wiegers, T.A.; Keirse, M.J.N.C.; Zee, J. van der; Berghs, G.A.H.

    1996-01-01

    Objective: To investigate the relation between the intended place of birth (home or hospital) and perinatal outcome in women with low risk pregnancies after controlling for parity and social, medical, and obstetric background. Design: Analysis of prospective data from midwives and their clients.

  13. Prevalence and risk factors of depression in the elderly nursing home residents in Singapore.

    Science.gov (United States)

    Tiong, Wei Wei; Yap, Philip; Huat Koh, Gerald Choon; Phoon Fong, Ngan; Luo, Nan

    2013-01-01

    Depression is a common health problem in elderly nursing home (NH) residents and is often under-recognized and under-treated. This study aimed to determine the prevalence rates of depression and identify the risk factors associated with depression in the elderly NH population in Singapore. A sample of 375 residents in six NHs in Singapore, aged 55 years and above, was assessed with the Structural Clinical Interview (SCID), based on the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. The association of demographic, functional and health-related characteristics with depression was examined using multivariate logistic regression analyses. Overall point prevalence for depression in the elderly NH residents was found to be 21.1% (95% confidence intervals (CI): 17.1%-25.6%). The prevalence rate for minor depression in the elderly NH residents was 14.4% (95% CI: 11.1%-18.5%) and 6.7% (95% CI: 4.5%-9.8%) for major depression. Significant risk factors that were found to be associated with depression were length of stay for more than 2 years, known history of depression, pain, and no or lack of social contact. The prevalence rates for depression were high among NH residents in Singapore. More attention is needed to care for the psychosocial needs of elderly NH residents in Singapore.

  14. 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....

  15. Readily Identifiable Risk Factors of Nursing Home Residents' Oral Hygiene: Dementia, Hospice, and Length of Stay.

    Science.gov (United States)

    Zimmerman, Sheryl; Austin, Sophie; Cohen, Lauren; Reed, David; Poole, Patricia; Ward, Kimberly; Sloane, Philip D

    2017-11-01

    The poor oral hygiene of nursing home (NH) residents is a matter of increasing concern, especially because of its relationship with pneumonia and other health events. Because details and related risk factors in this area are scant and providers need to be able to easily identify those residents at most risk, this study comprehensively examined the plaque, gingival, and denture status of NH residents, as well as readily available correlates of those indicators of oral hygiene, including items from the Minimum Data Set (MDS). Oral hygiene assessment and chart abstract conducted on a cross-section of NH residents. NHs in North Carolina (N = 14). NH residents (N = 506). Descriptive data from the MDS and assessments using three standardized measures: the Plaque Index for Long-Term Care (PI-LTC), the Gingival Index for Long-Term Care (GI-LTC), and the Denture Plaque Index (DPI). Oral hygiene scores averaged 1.7 (of 3) for the PI-LTC, 1.5 (of 4) for the GI-LTC, and 2.2 (of 4) for the DPI. Factors most strongly associated with poor oral hygiene scores included having dementia, being on hospice care, and longer stay. MDS ratings of gingivitis differed significantly from oral hygiene assessments. The findings identify resident subgroups at especially high risk of poor oral health who can be targeted in quality improvement efforts related to oral hygiene; they also indicate need to improve the accuracy of how MDS items are completed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

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

    Science.gov (United States)

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

    2017-07-01

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

  17. Barriers to, and facilitators of, the prevention of unintentional injury in children in the home: a systematic review and synthesis of qualitative research.

    Science.gov (United States)

    Smithson, Janet; Garside, Ruth; Pearson, Mark

    2011-04-01

    This review considers barriers to, and facilitators of, success for interventions to reduce unintentional injury to children in the home through supply and/or installation of home safety equipment, and looks at risk assessments. A systematic review of qualitative research. Bibliographic databases were searched for studies on interventions to reduce unintentional child injury in the home, or on related attitudes and behaviours. Studies were quality appraised, findings extracted, and a conceptual framework was developed to assess factors affecting the success of interventions. Nine peer-reviewed journal articles were included. Barriers and facilitators were highlighted at organisational, environmental and personal levels. Effective provision of safety equipment involves ongoing support with installation and maintenance. Take up and success of interventions depends on adjusting interventions according to practical limitations and parents' cultural expectations. A particular barrier was parents' inability to modify rented or shared accommodation. The review highlights ways in which health inequalities affect the take up and success of home safety interventions, and how health workers can use this knowledge to facilitate future interventions.

  18. Relative risk of home hemodialysis attrition in patients using a telehealth platform.

    Science.gov (United States)

    Weinhandl, Eric D; Collins, Allan J

    2017-12-06

    Home hemodialysis (HHD) facilitates increased treatment frequency, which may improve patient outcomes. However, attrition due to technique failure limits the clinical effectiveness of the modality. Nx2me Connected Health is a telehealth platform that enables ongoing assessment of HHD patients using NxStage equipment, and that may reduce patient burden. We aimed to assess whether use of Nx2me was associated with risk of HHD attrition. We compared risks of all-cause attrition, dialysis cessation (i.e., death or transplant), and technique failure in Nx2me users and matched control patients, using a retrospective cohort study. We also compared the likelihood of HHD training graduation in patients who initiated use of Nx2me during training with the likelihood in matched control patients. Matching factors included date of HHD initiation, NxStage treatment duration at initiation of follow-up, and prescribed treatment frequency. We used stratified Fine-Gray and Cox regression to compare risks, with adjustment for demographic factors and vascular access modality, and stratification by matched cluster. We identified 606 Nx2me users; 49.5% initiated use of Nx2me in NxStage equipment. Adjusted hazard ratios (AHRs) of all-cause attrition, dialysis cessation, and technique failure were 0.80 (95% confidence interval, 0.68-0.95), 1.10 (0.86-1.41), and 0.71 (0.57-0.87), respectively, for Nx2me users vs. matched controls. AHRs were similar in patients who initiated use of Nx2me in <3 months after initiation of HHD. The AHR of HHD training graduation was 1.61 (1.10-2.36) in patients who initiated use of Nx2me within 2 weeks of training initiation vs. matched controls. Use of Nx2me was associated with lower risk of all-cause attrition, lower risk of technique failure, and higher likelihood of HHD training graduation. Further studies are needed to identify the mechanisms by which use of a telehealth platform may improve clinical outcomes and reduce patient burden. © 2017 The Authors

  19. Risk Factors for Malnutrition in Seniors Aged 75+ Living in Home Environment in Selected Regions of the Czech Republic.

    Science.gov (United States)

    Brabcová, Iva; Trešlová, Marie; Bártlová, Sylva; Vacková, Jitka; Tóthová, Valerie; Motlová, Lenka

    2016-09-01

    Nutrition is an important social determinant of health that influences the ageing process. The aim of this study was to evaluate the nutritional condition of a group of seniors and identify the bio-psycho-social factors that increase the risk of malnutrition. The research was conducted using a quantitative method. The standardised scales Mini Nutritional Assessment - Short Form (MNA-SF) and the Geriatric depression scale (GDS-5) were used to evaluate the nutritional condition and tendency towards depression of the tested group. This group consisted of seniors aged 75 and above living in home environment in the České Budějovice region. The group was comprised of 320 seniors, 115 men (35.9%) and 205 women (64.1%), which corresponds to the composition of the population in the chosen region of the Czech Republic. Statistical data analysis was conducted using SASD 1.4.10 and SPSS 15.0 programs. Pearson's chi-squared test (Χ²) and Cramér's V were chosen for statistical testing. The significance level was set at 5%. The average BMI value of the seniors was 26.2 kg/m² (overweight). This value decreased with age. More than one third of the respondents were evaluated as being at risk of malnutrition (36.3%). Unintended weight loss was determined as the strongest risk factor of malnutrition. Seniors who had lowered their food intake stated unintended weight loss 10 times more often than respondents with no noticeable reduction in food intake. Seniors who showed signs of depression indicated weight loss three and a half times more often than respondents without depression. Meanwhile acute illness increased the risk by three times. Depression was found to be the cause and also the consequence of malnutrition. Despite the high prevalence of overweight and obesity, a large proportion of the respondents were running the risk of malnutrition. It was concluded that the strongest risk factors for malnutrition in the respondents were unintended weight loss, depression and

  20. University of Washington Center for Child Environmental Health Risks Research

    Data.gov (United States)

    Federal Laboratory Consortium — The theme of the University of Washington based Center for Child Environmental Health Risks Research (CHC) is understanding the biochemical, molecular and exposure...

  1. Researching family through the everyday lives of children across home and day care in Denmark

    DEFF Research Database (Denmark)

    Kousholt, Dorte

    2011-01-01

    The article investigates family as a conflictual community with a specific starting point in exploring children's lives across day-care institution and home. Children's development is theorised in relation to taking part in different communities across different contexts. The article draws...... on an ethnographically inspired research project with 6 families living in a small town in Denmark. The analysis points to how the children's possibilities of participation are created across their different life contexts and that the social interplay and conflicts between the children in the day-care institution have...... impacts on the relation and interaction between parents and children. Parenting in that way reaches far beyond the family and includes taking into account various issues in the other places where the children spend their time. The children's developmental possibilities are shaped by the relations...

  2. Researching family through the everyday lives of children across home and day care in Denmark

    DEFF Research Database (Denmark)

    Kousholt, Dorte

    2011-01-01

    on an ethnographically inspired research project with 6 families living in a small town in Denmark. The analysis points to how the children's possibilities of participation are created across their different life contexts and that the social interplay and conflicts between the children in the day-care institution have......The article investigates family as a conflictual community with a specific starting point in exploring children's lives across day-care institution and home. Children's development is theorised in relation to taking part in different communities across different contexts. The article draws...... impacts on the relation and interaction between parents and children. Parenting in that way reaches far beyond the family and includes taking into account various issues in the other places where the children spend their time. The children's developmental possibilities are shaped by the relations...

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

    OpenAIRE

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

    2014-01-01

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

  4. Report on a comprehensive research study (home welfare apparatus system - interface); Sogo chosa kenkyu (zaitaku fukushi kiki system - interface) hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-03-01

    In the light of the increasing role of welfare at home with the advance of the aging society, the paper conducted an investigational study on the R and D of the home welfare apparatus system - interface. In the study, making the most of the leading home care apparatus systems (welfare technohouses) installed at seven places in the country, the paper carried out a stay experiment on how the life is in the welfare house into which home welfare apparatus is integrated, and an experiment to assess biological data on aged people. Especially as to the support apparatus used for smooth life motions in houses such as movement, excretion and bathing, examined were the linkage with house bodies, care apparatus used, mutual interface with welfare apparatus, etc. By the experiments to assess these home welfare apparatus, an analytical study was conducted on the points to be improved in welfare apparatus and housing equipment, and at the same time on the course of the research/development. Concerning a system for the research study, a research promotion committee was established in Technology Research Association of Medical and Welfare Apparatus, the members of which are learned persons from the industrial circle, the government and universities. 111 figs., 36 tabs.

  5. Research items regarding seismic residual risk evaluation

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2013-08-15

    After learning the Fukushima Dai-ichi NPP severe accidents in 2011, the government investigation committee proposed the effective use of probabilistic safety assessment (PSA), and now it is required to establish new safety rules reflecting the results of probabilistic risk assessment (PRA) and proposed severe accident measures. Since the Seismic Design Guide has been revised on September 19, 2006, JNES has been discussing seismic PRA (Levels 1-3) methods to review licensees' residual risk assessment while preparing seismic PRA models. Meanwhile, new safety standards for light water reactors are to be issued and enforced on July 2013, which require the residual risk of tsunami, in addition to earthquakes, should be lowered as much as possible. The Fukushima accidents raised the problems related to risk assessment, e.g. approaches based on multi-hazard (earthquake and tsunami), multi-unit, multi-site, and equipment's common cause failure. This fiscal year, while performing seismic and/or tsunami PRA to work on these problems, JNES picked up the equipment whose failure greatly contribute to core damage, surveyed accident management measures on those equipment as well as effectiveness to reduce core damage probability. (author)

  6. Translating research into practice in nursing homes: can we close the gap?

    Science.gov (United States)

    Rahman, Anna N; Applebaum, Robert A; Schnelle, John F; Simmons, Sandra F

    2012-10-01

    A gap between research and practice in many nursing home (NH) care areas persists despite efforts by researchers, policy makers, advocacy groups, and NHs themselves to close it. The reasons are many, but two factors that have received scant attention are the dissemination process itself and the work of the disseminators or change agents. This review article examines these two elements through the conceptual lens of Roger's innovation dissemination model. The application of general principles of innovation dissemination suggests that NHs are characteristically slow to innovate and thus may need more time as well as more contact with outside change agents to adopt improved practices. A review of the translation strategies used by NH change agents to promote adoption of evidence-based practice in NHs suggests that their strategies inconsistently reflect lessons learned from the broader dissemination literature. NH-related research, policy, and practice recommendations for improving dissemination strategies are presented. If we can make better use of the resources currently devoted to disseminating best practices to NHs, we may be able to speed NHs' adoption of these practices.

  7. Risk management in higher education and research in the Netherlands

    NARCIS (Netherlands)

    Helsloot, I.; Jong, W

    2006-01-01

    This study examines risk in higher education and research on the basis of a classification into three domains. The practical utility of this division into three domains is that it makes it easier to see what risks are unique to higher education (custodianship of knowledge), what risks are dependent

  8. Defining moments in risk communication research: 1996-2005.

    Science.gov (United States)

    McComas, Katherine A

    2006-01-01

    Ten years ago, scholars suggested that risk communication was embarking on a new phase that would give increased attention to the social contexts that surround and encroach on public responses to risk information. A decade later, many researchers have answered the call, with several defining studies examining the social and psychological influences on risk communication. This article reviews risk communication research appearing in the published literature since 1996. Among studies, social trust, the social amplification of risk framework, and the affect heuristic figured prominently. Also common were studies examining the influence of risk in the mass media. Among these were content analyses of media coverage of risk, as well as investigations of possible effects resulting from coverage. The use of mental models was a dominant method for developing risk message content. Other studies examined the use of risk comparisons, narratives, and visuals in the production of risk messages. Research also examined how providing information about a risk's severity, social norms, and efficacy influenced communication behaviors and intentions to follow risk reduction measures. Methods for conducting public outreach in health risk communication rounded out the literature.

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

    Directory of Open Access Journals (Sweden)

    Peng Qingchao

    2016-01-01

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

  10. The Impact of a Home-Based Computerized Cognitive Training Intervention on Fall Risk Measure Performance in Community Dwelling Older Adults, a Pilot Study.

    Science.gov (United States)

    Blackwood, J; Shubert, T; Fogarty, K; Chase, C

    2016-02-01

    Cognitive intervention studies have reported improvements in various domains of cognition as well as a transfer effect of improved function post training. Despite the availability of web based cognitive training programs, most intervention studies have been performed under the supervision of researchers. Therefore, the purpose of this study was to first, examine the feasibility of a six week home based computerized cognitive training (CCT) program in a group of community dwelling older adults and, second, to determine if a CCT program which focused on set shifting, attention, and visual spatial ability impacted fall risk measure performance. This pilot study used a pretest/posttest experimental design with randomization by testing site to an intervention or control group. Community dwelling older adults (mean age = 74.6 years) participated in either the control (N=25) or the intervention group (N=19). Intervention group subjects participated in 6 weeks of home based CCT 3x/week for an average of 23 minutes/session, using an online CCT program. Comparisons of mean scores on three measures of physical function (usual gait speed, five times sit to stand, timed up and go) were completed at baseline and week 7. Following the completion of an average of 18 sessions of CCT at home with good adherence (86%) and retention (92%) rates, a statistically significant difference in gait speed was found between groups with an average improvement of 0.14 m/s in the intervention group. A home based CCT program is a feasible approach to targeting cognitive impairments known to influence fall risk and changes in gait in older adults.

  11. Research Award: Risk Management and Internal Audit

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

    Corey Piccioni

    2013-08-07

    Aug 7, 2013 ... pursue their research goals and work in one of IDRC's dynamic program or division teams. ... studying how financial and administrave processes can best support ... idenfying competencies, key success factors or performance ...

  12. Risk Mitigation during Human Electromuscular Incapacitation Research

    Science.gov (United States)

    2015-04-30

    Research Unit-San Antonio NIJ National Institute of Justice O2 Oxygen pCO2 Partial pressure of carbon dioxide PEA Pulseless electrical...Research Findings Muscle injury can occur before symptoms appear. Blood levels of the proteins , creatine kinase (CK) and myoglobin, are used to...Rhabdomyolysis occurs when the protein myoglobin is released from damaged muscle cells. Myoglobin is injurious to the kidneys. CK is another protein

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

    OpenAIRE

    Peng Qingchao

    2016-01-01

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

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

    Science.gov (United States)

    Wei, Qi; Shen, Jiaojiao

    2015-12-01

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

  15. 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.

  16. Risk assessment - a research program aimed at health risks from air pollution in the general environment

    International Nuclear Information System (INIS)

    Lindahl-Kiessling, K.; Ahlborg, U.; Bylin, G.; Ehrenberg, L.; Hemminki, K.; Lindell, B.; Nilsson, Robert; Bostroem, C.E.; Swarn, U.

    1991-01-01

    The paper presents a new research program for assessment of health risks caused by air pollutants. It is important to develop general methods for quantitative risk assessments and to improve the scientific base materials. (KAE)

  17. Fall risk factors in community-dwelling elderly who receive Medicaid-supported home- and community-based care services.

    Science.gov (United States)

    Yamashita, Takashi; Jeon, Haesang; Bailer, A John; Nelson, Ian M; Mehdizadeh, Shahla

    2011-06-01

    This study identifies fall risk factors in an understudied population of older people who receive community-based care services. Data were collected from enrollees of Ohio's Medicaid home- and community-based waiver program (preadmission screening system providing options and resources today [PASSPORT]). A total of 23,182 participants receiving PASSPORT services in 2005/2006 was classified as fallers and nonfallers, and a variety of risk factors for falling was analyzed using logistic regressions. The following factors were identified as risk factors for falling: previous fall history, older age, White race, incontinence, higher number of medications, fewer numbers of activity of daily living limitations, unsteady gait, tremor, grasping strength, and absence of supervision. Identifying risk factors for the participants of a Medicaid home- and community-based waiver program are useful for a fall risk assessment, but it would be most helpful if the community-based care service programs incorporate measurements of known fall risk factors into their regular data collection, if not already included.

  18. Risk for Researchers Studying Social Deviance or Criminal Behavior

    Directory of Open Access Journals (Sweden)

    Patricia L. Brougham

    2017-10-01

    Full Text Available Abstract: Researchers often encounter dangerous situations while conducting social research. The concept of risk to researchers refers to the possible harm that may occur to researchers while in the field or after leaving a research project. This study explores issues experienced by social scientists engaged in research on social deviance or criminal behavior. The goal of this research was to discover the types of risk experienced by social scientists and any mediating factors affecting the experience of risk. An online survey was conducted to gather data on issues experienced by social scientists. This study found that researchers experienced a variety of risks within the categories of physical/health, emotional, legal, and personal/professional. Each of the survey options for risk were reported by at least one respondent; however, the greatest number of risks reported were of an emotional or personal/professional nature. There were no mediating factors found to be significant in relation to the experience of risk. This was a surprising finding especially for the variable of gender as it is suggested that gender plays a role in the experience of difficulties.

  19. ASSOCIATION OF EARLY CHILDHOOD CARIES WITH RISK FACTORS IN COMMUNITY HOMES OF INSTITUTO COLOMBIANO DE BIENESTAR FAMILIAR IN ZIPAQUIRÁ, COLOMBIA

    OpenAIRE

    Macías, Carmenza; Díaz, Diana; Caycedo, Marta; Lamus, Francisco; Rincón, Carlos

    2016-01-01

    ABSTRACT Introduction: the goal of this study was to establish the association of social and biological risk factors with early childhood caries (ECC) in children from community homes of Instituto Colombiano de Bienestar Familiar (ICBF) in Zipaquirá, Colombia. Methods: descriptive cross-sectional study conducted by universities in 546 children aged 24 to 60 months. The following conditions were identified: socio-demographic variables, hygiene habits, O’Leary index and DMFT index, anthropom...

  20. The Prevalence of Child Sexual Abuse in Out-of-Home Care: Increased Risk for Children with a Mild Intellectual Disability

    Science.gov (United States)

    Euser, Saskia; Alink, Lenneke R. A.; Tharner, Anne; van IJzendoorn, Marinus H.; Bakermans-Kranenburg, Marian J.

    2016-01-01

    Background: Children without disabilities in out-of-home care have a higher risk of child sexual abuse [CSA (Euser et al. 2013)]. In this study, we examined the year prevalence of CSA in out-of-home care for children with a mild intellectual disability, and compared it with the prevalence in out-of-home care for non-disabled children and children…

  1. A Dual Perspective on Risks and Security Within Research Assistantships

    Directory of Open Access Journals (Sweden)

    Johannes Petrus Rossouw

    2013-01-01

    Full Text Available Although research assistantships are considered research learning venues in graduate education, there is a scarcity of literature that examines ethical elements attached to the employment of graduate student research assistants or the position of their research supervisors. This article explores the need to implement formal regulations specific to research assistantships in order to increase security and decrease risks for research assistants and research supervisors. Relationships between research assistants and research supervisors have some similarities with regular employment relationships; yet some distinct differences arise due to the educational and developmental nature of research assistantships. The article is written from a dual perspective reflecting the authors’ roles (a research supervisor and a research assistant, respectively and institutional locations (Faculties of Education in South Africa and Canada. The authors draw from existing literature, an analysis of institutional policies and practices at their universities, and their personal and professional experiences to illustrate risks that research assistants and their supervisors may face within research assistantships. They assess the extent to which existing and proposed policies and practices influence working conditions and safeguard experiences within graduate research assistantships. The findings reveal that research assistantships are a unique form of employment focused on educational and professional development that requires specific documentation of expected standards of practice. The authors argue that lack of clear regulations exposes both parties to unnecessary risks and offer recommendations for creating a “Standards of Good Practice” document that will be useful for individuals engaged in research assistantships.

  2. Risk Factors for Pressure Ulcers Including Suspected Deep Tissue Injury in Nursing Home Facility Residents: Analysis of National Minimum Data Set 3.0.

    Science.gov (United States)

    Ahn, Hyochol; Cowan, Linda; Garvan, Cynthia; Lyon, Debra; Stechmiller, Joyce

    2016-04-01

    To provide information on risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home residents in the United States. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Examine the literature related to risk factors for the development of PrUs.2. Compare risk factors associated with the prevalence of PrUs and sDTI from the revised Minimum Data Set 3.0 2012 using a modified Defloor's conceptual model of PrUs as a theoretical framework. This study aims to characterize and compare risk factors associated with pressure ulcers (PrUs), including suspected deep tissue injury (sDTI), in nursing home (NH) residents in the United States. Secondary analysis of the 2012 Minimum Data Set (MDS 3.0). Medicare- or Medicaid-certified NHs in the United States. Nursing home residents (n = 2,936,146) 18 years or older with complete PrU data, who received comprehensive assessments from January to December 2012. Pressure ulcer by stage was the outcome variable. Explanatory variables (age, gender, race and ethnicity, body mass index, skin integrity, system failure, disease, infection, mobility, and cognition) from the MDS 3.0 were aligned with the 4 elements of Defloor's conceptual model: compressive forces, shearing forces, tissue tolerance for pressure, and tissue tolerance for oxygen. Of 2,936,146 NH residents who had complete data for PrU, 89.9% had no PrU; 8.4% had a Stage 2, 3, or 4 or unstagable PrU; and 1.7% had an sDTI. The MDS variables corresponding to the 4 elements of Defloor's model were significantly predictive of both PrU and sDTI. Black residents had the highest risk of any-stage PrU, and Hispanic residents had the highest risk of sDTI. Skin integrity, system failure, infection, and disease risk factors had larger effect sizes for sDTI than for other PrU stages

  3. A Research Review: The Importance of Families and the Home Environment

    Science.gov (United States)

    Cole, Jennifer

    2011-01-01

    Parents are a child's first educator. A child's family and home environment has a strong impact on his/her language and literacy development and educational achievement. This impact is stronger during the child's early years but continues throughout their school years. Many background variables affect the impact of the family and home environment…

  4. Research and implementation of geographic information service mode in digital home

    Science.gov (United States)

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

    2014-04-01

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

  5. Home or hospital birth: a prospective study of midwifery care in the Netherlands: research in progress.

    NARCIS (Netherlands)

    Wiegers, T.A.

    1998-01-01

    In 1965 two-thirds of all births in the Netherlands occurred at home. In the next 25 years, that situation became reversed with more than two-thirds of births occurring in hospital and less than one-third at home. Until the 1970's a woman with an uncomplicated pregnancy was expected to give birth

  6. Airborne protein concentration: a key metric for type 1 allergy risk assessment-in home measurement challenges and considerations.

    Science.gov (United States)

    Tulum, Liz; Deag, Zoë; Brown, Matthew; Furniss, Annette; Meech, Lynn; Lalljie, Anja; Cochrane, Stella

    2018-01-01

    Exposure to airborne proteins can be associated with the development of immediate, IgE-mediated respiratory allergies, with genetic, epigenetic and environmental factors also playing a role in determining the likelihood that sensitisation will be induced. The main objective of this study was to determine whether airborne concentrations of selected common aeroallergens could be quantified in the air of homes using easily deployable, commercially available equipment and analytical methods, at low levels relevant to risk assessment of the potential to develop respiratory allergies. Additionally, air and dust sampling were compared and the influence of factors such as different filter types on allergen quantification explored. Low volume air sampling pumps and DUSTREAM ® dust samplers were used to sample 20 homes and allergen levels were quantified using a MARIA ® immunoassay. It proved possible to detect a range of common aeroallergens in the home with sufficient sensitivity to quantify airborne concentrations in ranges relevant to risk assessment (Limits of Detection of 0.005-0.03 ng/m 3 ). The methodology discriminates between homes related to pet ownership and there were clear advantages to sampling air over dust which are described in this paper. Furthermore, in an adsorption-extraction study, PTFE (polytetrafluoroethylene) filters gave higher and more consistent recovery values than glass fibre (grade A) filters for the range of aeroallergens studied. Very low airborne concentrations of allergenic proteins in home settings can be successfully quantified using commercially available pumps and immunoassays. Considering the greater relevance of air sampling to human exposure of the respiratory tract and its other advantages, wider use of standardised, sensitive techniques to measure low airborne protein concentrations and how they influence development of allergic sensitisation and symptoms could accelerate our understanding of human dose-response relationships

  7. Posterior teeth occlusion and dysphagia risk in older nursing home residents: a cross-sectional observational study.

    Science.gov (United States)

    Okabe, Y; Takeuchi, K; Izumi, M; Furuta, M; Takeshita, T; Shibata, Y; Kageyama, S; Ganaha, S; Yamashita, Y

    2017-02-01

    The total number of natural teeth was related to swallowing function among older adults; however, limited information is available regarding the impact of occluding pairs of teeth on swallowing function. This study aimed to examine the association between posterior teeth occlusion and dysphagia risk in older nursing home residents. This cross-sectional study included 238 residents aged ≥60 years from eight nursing homes in Aso City, Japan. Swallowing function was evaluated using the modified water swallowing test (MWST); the primary outcome was dysphagia risk (MWST score ≤3). Posterior teeth occlusion was assessed using number of functional tooth units (FTUs), determined based on number and location of the remaining natural and artificial teeth on implant-supported, fixed or removable prostheses. Univariate and multivariate logistic regression analyses were performed to examine the association between posterior teeth occlusion and dysphagia risk, adjusted for the covariates of number of natural teeth, demographic characteristics, comorbidities, physical function, body mass index and cognitive function. Of the 238 subjects, 44 (18·5%) were determined to be at risk of dysphagia based on the MWST scores. The odds ratio (OR) of dysphagia risk decreased in subjects with higher total FTUs [OR = 0·92, 95% confidence interval (CI) 0·87-0·98]. After adjusting for covariates, this association remained significant (OR = 0·90, 95% CI 0·84-0·97). Loss of posterior teeth occlusion was independently associated with dysphagia risk in older nursing home residents. Maintaining and restoring posterior teeth occlusion may be an effective measure to prevent dysphagia. © 2016 John Wiley & Sons Ltd.

  8. Unpacking Socio-Economic Risks for Reading and Academic Self-Concept in Primary School: Differential Effects and the Role of the Preschool Home Learning Environment

    Science.gov (United States)

    Crampton, Alexandria; Hall, James

    2017-01-01

    Background: Uncertainty remains concerning how children's reading and academic self-concept are related and how these are differentially affected by social disadvantage and home learning environments. Aims: To contrast the impacts of early socio-economic risks and preschool home learning environments upon British children's reading abilities and…

  9. Pricing Externalities to Balance Public Risks and Benefits of Research.

    Science.gov (United States)

    Farquhar, Sebastian; Cotton-Barratt, Owen; Snyder-Beattie, Andrew

    How should scientific funders evaluate research with public health risks? Some risky work is valuable, but accepting too much risk may be ethically neglectful. Recent controversy over H5N1 influenza experiments has highlighted the difficulty of this problem. Advocates of the research claim the work is needed to understand pandemics, while opponents claim that accidents or misuse could release the very pandemic the work is meant to prevent. In an attempt to resolve the debate, the US government sponsored an independent evaluation that successfully produced a quantitative estimate of the risks involved, but only a qualitative estimate of the benefits. Given the difficulties of this "apples-to-oranges" risk-benefit analysis, what is the best way forward? Here we outline a general approach for balancing risks and benefits of research with public risks. Instead of directly comparing risks and benefits, our approach requires only an estimate of risk, which is then translated into a financial price. This estimate can be obtained either through a centrally commissioned risk assessment or by mandating liability insurance, which allows private markets to estimate the financial burden of risky research. The resulting price can then be included in the cost of the research, enabling funders to evaluate grants as usual-comparing the scientific merits of a project against its full cost to society. This approach has the advantage of aligning incentives by assigning costs to those responsible for risks. It also keeps scientific funding decisions in the hands of scientists, while involving the public on questions of values and risk experts on risk evaluation.

  10. Planned home versus planned hospital births in women at low-risk pregnancy: A systematic review with meta-analysis.

    Science.gov (United States)

    Rossi, A Cristina; Prefumo, Federico

    2018-03-01

    New interest in home birth have recently arisen in women at low risk pregnancy. Maternal and neonatal morbidity of women planning delivery at home has yet to be comprehensively quantified. We aimed to quantify pregnancy outcomes following planned home (PHB) versus planned hospital birth (PHos). We did a systematic review of maternal and neonatal morbidity following planned home (PHB) versus planned hospital birth (PHos). We included prospective, retrospective, cohort and case-control studies of low risk pregnancy outcomes according to planning place of birth, identified from January 2000 to June 2017. We excluded studies in which high-risk pregnancy and composite morbidity were included. Outcomes of interest were: maternal and neonatal morbidity/mortality, medical interventions, and delivery mode. We pooled estimates of the association between outcomes and planning place of birth using meta-analyses. The study protocol is registered with PROSPERO, protocol number CRD42017058016. We included 8 studies of the 4294 records identified, consisting in 14,637 (32.6%) in PHB and 30,177 (67.4%) in PHos group. Spontaneous delivery was significantly higher in PHB than PHos group (OR: 2.075; 95%CI:1.654-2.063) group. Women in PHB group were less likely to undergo cesarean section compared with women in PHos (OR:0.607; 95%CI:0.553-0.667) group. PHB group was less likely to receive medical interventions than PHos group. The risk of fetal dystocia was lower in PHB than PHos group (OR:0.287; 95%CI:0.133-0.618). The risk of post-partum hemorrhage was lower in PHB than PHos group (OR:0.692; 95% CI.0.634-0.755). The two groups were similar with regard to neonatal morbidity and mortality. Births assisted at hospital are more likely to receive medical interventions, fetal monitoring and prompt delivery in case of obstetrical complications. Further studies are needed in order to clarify whether home births are as safe as hospital births. Copyright © 2018 Elsevier B.V. All rights

  11. Report on the comprehensive investigational research (at-home welfare apparatus system); Sogo chosa kenkyu (zaitaku fukushi kiki system) hokokusho

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-03-01

    An investigational study was conducted on the research and development of an at-home welfare apparatus system. In this study, a stay experiment was carried out on whether aged or handicapped people can easily live in welfare houses into which at-home welfare apparatus was integrated, using high-tech at-home nursing apparatus systems (welfare techno house: WTH) which were installed at seven places in Japan based on `the development of a system supporting independent excretion.` In addition, the following were conducted: experiments on at-home welfare apparatus in terms of the evaluation of performance/operability/safety, physical physiology reactions, nursing burden/estimate of independence, two-way communication, examination of housing environments, etc. In WTH Chofu, a test on evaluating welfare apparatus was conducted by people with limbs paralysis and healthy case workers. In WTH Sapporo, by a working group studying biological information, examinations were made on the situation of standing up of healthy adults, old people and people with paralysis of one side of the body from various types of chairs, beds, wheel chairs, portable toilets and sitting down on them. An examination was also made on harmony with psychological function and physically adaptable function by a working group studying at-home nursing apparatus. 75 figs., 15 tabs.

  12. Work-Home Interference, Perceived Total Workload, and the Risk of Future Sickness Absence Due to Stress-Related Mental Diagnoses Among Women and Men: a Prospective Twin Study.

    Science.gov (United States)

    Svedberg, Pia; Mather, Lisa; Bergström, Gunnar; Lindfors, Petra; Blom, Victoria

    2018-02-01

    Work-home interference has been proposed as an important explanation for sickness absence (SA). Previous studies show mixed results, have not accounted for familial factors (genetics and shared everyday environment), or investigated diagnosis specific SA. The aim was to study whether work-home interference and perceived total workload predict SA due to stress-related mental diagnoses, or SA due to other mental diagnoses, among women and men, when adjusting for various confounders and familial factors. This study included 11,916 twins, 19-47 years (49% women). Data on work-to-home and home-to-work conflicts, perceived total workload, and relevant confounders were derived from a 2005 survey, and national register data on SA spells until 2013 were obtained. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated. Discordant twin pair design was applied to adjust for familial factors. Each one unit increase in work-to-home and home-to-work conflicts, and perceived total workload was associated with higher odds for SA due to stress-related mental diagnoses and to SA due to other mental diagnoses among women, when adjusting for sociodemographic factors (ORs 1.15-1.31). Including health or familial factors, no associations remained. For men, each one unit increase in work-to-home conflicts was associated with higher odds for SA due to stress-related diagnoses (ORs 1.23-1.35), independently of confounders. Work-to-home conflict was independently associated with future SA due to stress-related diagnoses among men only. Health- and work-related factors seem to be important confounders when researching work-home interference, perceived total workload, and SA. Not including such confounders involves risking drawing incorrect conclusions. Further studies are needed to confirm sex differences and whether genetic factors are important for the associations studied.

  13. 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.

  14. Home Environment, Self-Concept and Urban Student Achievement: A Bibliography and Review of Research. NJ Urban Education Research Reports No. 5.

    Science.gov (United States)

    Shapiro, Carol; Bloom, Joel S.

    This review analyzes recent research on student personality, social and home environment, and the influence of these factors on academic achievement, particularly among minority and disadvantaged students. Several factors which purportedly affect student achievement and which are examined in the review include: (1) socioeconomic status and its…

  15. Combined use of drugs inhibiting the renin–angiotensin system: prescribing patterns and risk of acute kidney injury in German nursing home residents

    Directory of Open Access Journals (Sweden)

    Dörks M

    2018-05-01

    Full Text Available Michael Dörks,1 Stefan Herget-Rosenthal,2 Falk Hoffmann,1 Kathrin Jobski1 1Department of Health Services Research, Carl von Ossietzky University Oldenburg, Oldenburg, Germany; 2Department of Medicine, Rotes Kreuz Krankenhaus, Bremen, Germany Background/aims: In 2012, the European Medicines Agency reviewed the safety of dual renin–angiotensin system (RAS blockade because of potentially increased risks for inter alia acute kidney injury (AKI. Since residents of nursing homes are particularly vulnerable to adverse drug outcomes, the aims of our study were to describe RAS-inhibiting drug use in German nursing home residents and examine the risk of AKI associated with dual RAS blockade.Methods: Based on claims data, a nested case-control study within a cohort of RAS-inhibiting drug users was conducted. Using conditional logistic regression, confounder-adjusted odds ratios (aORs and 95% confidence intervals (CI were obtained for the risk of AKI associated with dual RAS blockade. Subgroup analyses were performed in patients with diabetes or chronic kidney disease and both comorbidities.Results: Of all 127,227 nursing home residents, the study cohort included 64,567 (50.7% who were treated with at least one RAS-inhibiting drug. More than three quarters of the study population were female (77.1%. Mean age was 86.0 ± 6.8 years. Most residents were treated with angiotensin-converting enzyme inhibitors (77.8%, followed by angiotensin II receptor blockers (21.6% and aliskiren (0.2%. Annual prevalence of dual RAS blockade declined from 9.6 (95% CI 7.8–11.8 in 2010 to 4.7 (95% CI 4.0–5.4 per 1,000 users in 2014. In the overall cohort, AKI was not significantly associated with dual RAS blockade (aOR 1.99; 0.77–5.17. However, significantly increased aORs were observed when considering patients with diabetes (3.47; 1.27–9.47, chronic kidney disease (4.74; 1.24–18.13 or both (11.17; 2.65–47.15.Conclusions: Prescribing of drugs inhibiting the RAS is

  16. Summary of the eighth conference on protection against radon at home and at work and the 13. workshop on the geological aspects of radon risk mapping

    International Nuclear Information System (INIS)

    Navratilova Rovenska, K.; Thinova, L.; Neznal, M.

    2017-01-01

    This paper provides summary of the 8. Conference on Protection against Radon at Home and at Work and 13. Workshop on the Geological Aspects of Radon Risk Mapping held in September 2016 in Prague, Czech Republic. (authors)

  17. Research Award: Risk Management and Internal Audit (RMIA ...

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

    Jean-Claude Dumais

    2012-09-12

    Sep 12, 2012 ... Research Award: Risk Management and Internal Audit (RMIA). Deadline: 12 ... management, internal control, and governance processes. ... identifying competencies, key success factors or performance indicators most critical.

  18. Risk assessment for Argon-41 in RP-10 research reactor

    International Nuclear Information System (INIS)

    Arenas C, J.; Alarcon V, P.

    1987-01-01

    An evaluation of the radiological risk during normal operations of the Peruvian 10 Mw research reactor was performed. The noble gas, Argon-41 produced from activation of Ar-40 from the air contained in the irradiation tubes, thermal column and coolant, is analyzed as the major source of risk

  19. Probing a Proactive Home: Challenges in Researching and Designing Everyday Smart Environments

    Directory of Open Access Journals (Sweden)

    Frans Mäyrä

    2006-01-01

    Full Text Available Based on the results of a 3-year interdisciplinary study, this article presents an approach in which proactive information technology was introduced into homes, and discusses the derived design principles from a human-centered perspective. The application of proactive computing in homes will face particularly sensitive conditions, as familiar and reliable household elements remain strongly preferred. Since there is considerable resistance towards the increase of information technology in homes, both the calm system behaviors and the degree of variety in aesthetic designs will play major roles in the acceptance of proactive technology. If proactive technology will be an embedded part of a home’s structures and furniture, it needs to blend with the normal, cozy standards of a real living environment and aim to enhance the homeyness or the key social and aesthetic qualities of homes.

  20. Formative research on creating smoke-free homes in rural communities

    OpenAIRE

    Escoffery, Cam; Kegler, Michelle Crozier; Butler, Susan

    2008-01-01

    The home is a significant place for exposure to secondhand smoke for children and non-smoking adults. This study explored factors that would convince families to adopt household smoking bans and actions to create and maintain smoke-free homes. Interviews were conducted with adults in 102 households in rural Georgia. Participating families had a young adolescent and included households with a mix of smokers and non-smokers and smoking ban status. Families reported they would consider a total b...

  1. Mental health, stress and risk perception: insights from psychological research

    International Nuclear Information System (INIS)

    Renn, Ortwin

    1997-01-01

    Risk perceptions are only slightly correlated with the expected values of a probability distribution for negative health impacts. Psychometric studies have documented that context variables such as dread or personal control are important predictors for the perceived seriousness of risk. Studies about cultural patterns of risk perceptions emphasize different response set to risk information, depending on cultural priorities such as social justice versus personal freedom. This chapter reports the major psychological research pertaining to the factors that govern individual risk perception and discusses the psychometric effects due to people's risk perception and the experience of severe stress. The relative importance of the psychometric content variables, the signals pertaining to each health risks and symbolic beliefs are explained. (Author)

  2. Individualised dietary counselling for nutritionally at-risk older patients following discharge from acute hospital to home

    DEFF Research Database (Denmark)

    Munk, T; Tolstrup, U; Beck, A M

    2016-01-01

    Background: Many older patients are undernourished after hospitalisation. Undernutrition impacts negatively on physical function and the ability of older patients to perform activities of daily living at home after discharge from acute hospital. The present study aimed to evaluate the evidence...... for an effect of individualised dietary counselling following discharge from acute hospital to home on physical function, and, second, on readmissions, mortality, nutritional status, nutritional intake and quality of life (QoL), in nutritionally at-risk older patients. Methods: A systematic review of randomised......% CI = 0.08-1.95, P = 0.03). Meta-analyses revealed no significant effect on physical function assessed using hand grip strength, and similarly on mortality. Narrative summation of effects on physical function using other instruments revealed inconsistent effects. Meta-analyses were not conducted on Qo...

  3. 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

  4. Evaluation of pet contact as a risk factor for carriage of multidrug-resistant staphylococci in nursing home residents.

    Science.gov (United States)

    Gandolfi-Decristophoris, Paola; De Benedetti, Anna; Petignat, Christiane; Attinger, Monica; Guillaume, Jan; Fiebig, Lena; Hattendorf, Jan; Cernela, Nicole; Regula, Gertraud; Petrini, Orlando; Zinsstag, Jakob; Schelling, Esther

    2012-03-01

    Pets, often used as companionship and for psychological support in the therapy of nursing home residents, have been implicated as reservoirs for antibiotic-resistant bacteria. We investigated the importance of pets as reservoirs of multidrug-resistant (MDR) staphylococci in nursing homes. We assessed the carriage of MDR staphylococci in pets and in 2 groups of residents, those living in nursing homes with pets and those living without pet contacts. We collected demographic, health status, and human-pet contact data by means of questionnaires. We assessed potential bacteria transmission pathways by investigating physical resident-to-pet contact. The observed prevalence of MDR staphylococci carriage was 84/229 (37%) in residents living with pets and 99/216 (46%) in those not living with pets (adjusted odds ratio [aOR], 0.6; 95% confidence interval [CI], 0.4-0.9). Active pet contact was associated with lower carriage of MDR staphylococci (aOR, 0.5; 95% CI, 0.4-0.8). Antibiotic treatment during the previous 3 months was associated with significantly increased risk for MDR carriage in residents (aOR, 3.1; 95% CI, 1.8-5.7). We found no evidence that the previously reported benefits of pet contact are compromised by the increased risk of carriage of MDR staphylococci in residents associated with interaction with these animals in nursing homes. Thus, contact with pets, always under good hygiene standards, should be encouraged in these settings. Copyright © 2012 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  5. Women undergoing aortic surgery are at higher risk for unplanned readmissions compared with men especially when discharged home.

    Science.gov (United States)

    Flink, Benjamin J; Long, Chandler A; Duwayri, Yazan; Brewster, Luke P; Veeraswamy, Ravi; Gallagher, Katherine; Arya, Shipra

    2016-06-01

    Women undergoing vascular surgery have higher morbidity and mortality. Our study explores gender-based differences in patient-centered outcomes such as readmission, length of stay (LOS), and discharge destination (home vs nonhome facility) in aortic aneurysm surgery. Patients were identified from the American College of Surgeons National Surgical Quality Improvement Project database (2011-2013) undergoing abdominal, thoracic, and thoracoabdominal aortic aneurysms (N = 17,763), who were discharged and survived their index hospitalization. The primary outcome was unplanned readmission, and secondary outcomes were discharge to a nonhome facility, LOS, and reasons for unplanned readmission. Univariate, multivariate, and stratified analyses based on gender and discharge destination were used. Overall, 1541 patients (8.7%) experienced an unplanned readmission, with a significantly higher risk in women vs men (10.8% vs 8%; P women compared with men persisted in multivariate analysis after controlling for covariates (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.05-1.4). Similarly, the rate of discharge to a nonhome facility was nearly double in women compared with men (20.6% vs 10.7%; P women compared with men occurred in patients who were discharged home (OR, 1.2; 95% CI, 1.02-1.4) but not in those who were discharged to a nonhome facility (OR, 1.06; 95% CI, 0.8-1.4). Significant differences in LOS were seen in patients who were discharged home. No gender differences were found in reasons for readmission with the three most common reasons being thromboembolic events, wound infections, and pneumonia. Gender disparity exists in the risk of unplanned readmission among aortic aneurysm surgery patients. Women who were discharged home have a higher likelihood of unplanned readmission despite longer LOS than men. These data suggest that further study into the discharge planning processes, social factors, and use of rehabilitation services is needed for women

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

    Science.gov (United States)

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

    2016-01-01

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

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

    Science.gov (United States)

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

    2015-10-01

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

  8. Work Engagement: A Double-Edged Sword? A Study of the Relationship between Work Engagement and the Work-Home Interaction Using the ARK Research Platform

    Directory of Open Access Journals (Sweden)

    Katrine Listau

    2017-07-01

    Full Text Available The aim of the present study was to investigate how being engaged at work affects academics’ work-home interaction. Using the Conservation of Resources theory as a theoretical framework, the study contributes to existing research by examining the relationship between the work engagement subscales (i.e. vigour, dedication, and absorption and both work-home facilitation and work-home conflict. In order to test the hypotheses, a Partial Least Squares-Structural Equation Modelling analysis was conducted using a large sample of academics from the Norwegian university sector (N = 4378. The results indicated that vigour and dedication had a positive relationship with work-home facilitation and a negative relationship with work-home conflict. In contrast, absorption was not significantly related to work-home facilitation, but was positively associated with work-home conflict. Thus, we conclude that work engagement seems to have the potential to create both positive and negative outcomes.

  9. Severe adverse maternal outcomes among low risk women with planned home versus hospital births in the Netherlands: nationwide cohort study.

    Science.gov (United States)

    de Jonge, Ank; Mesman, Jeanette A J M; Manniën, Judith; Zwart, Joost J; van Dillen, Jeroen; van Roosmalen, Jos

    2013-06-13

    To test the hypothesis that low risk women at the onset of labour with planned home birth have a higher rate of severe acute maternal morbidity than women with planned hospital birth, and to compare the rate of postpartum haemorrhage and manual removal of placenta. Cohort study using a linked dataset. Information on all cases of severe acute maternal morbidity in the Netherlands collected by the national study into ethnic determinants of maternal morbidity in the netherlands (LEMMoN study), 1 August 2004 to 1 August 2006, merged with data from the Netherlands perinatal register of all births occurring during the same period. 146 752 low risk women in primary care at the onset of labour. Severe acute maternal morbidity (admission to an intensive care unit, eclampsia, blood transfusion of four or more packed cells, and other serious events), postpartum haemorrhage, and manual removal of placenta. Overall, 92 333 (62.9%) women had a planned home birth and 54 419 (37.1%) a planned hospital birth. The rate of severe acute maternal morbidity among planned primary care births was 2.0 per 1000 births. For nulliparous women the rate for planned home versus planned hospital birth was 2.3 versus 3.1 per 1000 births (adjusted odds ratio 0.77, 95% confidence interval 0.56 to 1.06), relative risk reduction 25.7% (95% confidence interval -0.1% to 53.5%), the rate of postpartum haemorrhage was 43.1 versus 43.3 (0.92, 0.85 to 1.00 and 0.5%, -6.8% to 7.9%), and the rate of manual removal of placenta was 29.0 versus 29.8 (0.91, 0.83 to 1.00 and 2.8%, -6.1% to 11.8%). For parous women the rate of severe acute maternal morbidity for planned home versus planned hospital birth was 1.0 versus 2.3 per 1000 births (0.43, 0.29 to 0.63 and 58.3%, 33.2% to 87.5%), the rate of postpartum haemorrhage was 19.6 versus 37.6 (0.50, 0.46 to 0.55 and 47.9%, 41.2% to 54.7%), and the rate of manual removal of placenta was 8.5 versus 19.6 (0.41, 0.36 to 0.47 and 56.9%, 47.9% to 66.3%). Low risk

  10. Identifying early dehydration risk with home-based sensors during radiation treatment: a feasibility study on patients with head and neck cancer.

    Science.gov (United States)

    Peterson, Susan K; Shinn, Eileen H; Basen-Engquist, Karen; Demark-Wahnefried, Wendy; Prokhorov, Alexander V; Baru, Chaitanya; Krueger, Ingolf H; Farcas, Emilia; Rios, Philip; Garden, Adam S; Beadle, Beth M; Lin, Kai; Yan, Yan; Martch, Stephanie L; Patrick, Kevin

    2013-12-01

    Systems that enable remote monitoring of patients' symptoms and other health-related outcomes may optimize cancer care outside of the clinic setting. CYCORE (CYberinfrastructure for COmparative effectiveness REsearch) is a software-based prototype for a user-friendly cyberinfrastructure supporting the comprehensive collection and analyses of data from multiple domains using a suite of home-based and mobile sensors. This study evaluated the feasibility of using CYCORE to address early at-home identification of dehydration risk in head and neck cancer patients undergoing radiation therapy. Head and neck cancer patients used home-based sensors to capture weight, blood pressure, pulse, and patient-reported outcomes for two 5-day periods during radiation therapy. Data were sent to the radiation oncologist of each head and neck cancer patient, who viewed them online via a Web-based interface. Feasibility outcomes included study completion rate, acceptability and perceived usefulness of the intervention, and adherence to the monitoring protocol. We also evaluated whether sensor data could identify dehydration-related events. Fifty patients consented to participate, and 48 (96%) completed the study. More than 90% of patients rated their ease, self-efficacy, and satisfaction regarding use of the sensor suite as extremely favorable, with minimal concerns expressed regarding data privacy issues. Patients highly valued the ability to have immediate access to objective, self-monitoring data related to personal risk for dehydration. Clinician assessments indicated a high degree of satisfaction with the ease of using the CYCORE system and the resulting ability to monitor their patients remotely. Implementing CYCORE in a clinical oncology care setting is feasible and highly acceptable to both patients and providers.

  11. Radon in homes and risk of lung cancer: 13 collaborative analyses of individual data from European case-control studies

    International Nuclear Information System (INIS)

    Darby, S.; Hill, D.; Doll, R.; Auvinen, A.; Barros Dios, J.M.; Ruano Ravina, A.; Baysson, H.; Tirmarche, M.; Bochicchio, F.; Deo, H.; Falk, R.; Forastiere, F.; Hakama, M.; Heid, I.; Schaffrath Rosario, A.; Wichmann, H.E.; Kreienbrock, L.; Kreuzer, M.; Lagarde, F.; Pershagen, G.; Makelainen, I.; Ruosteenoja, E.; Muirhead, C.; Oberaigner, W.; TomaBek, L.; Whitley, E.

    2007-01-01

    Objective: To determine the risk of lung cancer associated with exposure at home to the radioactive disintegration products of naturally occurring radon gas. Design: Collaborative analysis of individual data from 13 case-control studies of residential radon and lung cancer. Setting: Nine European countries. Subjects: 7148 cases of lung cancer and 14 208 controls. Main outcome measures: Relative risks of lung cancer and radon gas concentrations in homes inhabited during the previous 5-34 years measured in becquerels (radon disintegrations per second) per cubic metre (Bq/m3) of household air. Results: The mean measured radon concentration in homes of people in the control group was 97 Bq/m3, with 11% measuring > 200 and 4% measuring > 400 Bq/m3. For cases of lung cancer the mean concentration was 104 Bq/m3. The risk of lung cancer increased by 8.4% (95% confidence interval 3.0% to 15.8%) per 100 Bq/m3 increase in measured radon (P=0.0007). This corresponds to an increase of 16% (5% to 31%) per 100 Bq/m3 increase in usual radon- that is, after correction for the dilution caused by random uncertainties in measuring radon concentrations. The dose-response relation seemed to be linear with no threshold and remained significant (P = 0.04) in analyses limited to individuals from homes with measured radon < 200 Bq/m3. The proportionate excess risk did not differ significantly with study, age, sex, or smoking. In the absence of other causes of death, the absolute risks of lung cancer by age 75 years at usual radon concentrations of 0, 100, and 400 Bq/m3 would be about 0.4%, 0.5%, and 0.7%, respectively, for lifelong non-smokers, and about 25 times greater (10%, 12%, and 16%) for cigarette smokers. Conclusions: Collectively, though not separately, these studies show appreciable hazards from residential radon, particularly for smokers and recent ex-smokers, and indicate that it is responsible for about 2% of all deaths from cancer in Europe. (author)

  12. Implementation strategies of Systems Medicine in clinical research and home care for cardiovascular disease patients.

    Science.gov (United States)

    Montecucco, Fabrizio; Carbone, Federico; Dini, Frank Lloyd; Fiuza, Manuela; Pinto, Fausto J; Martelli, Antonietta; Palombo, Domenico; Sambuceti, Gianmario; Mach, François; De Caterina, Raffaele

    2014-11-01

    Insights from the "-omics" science have recently emphasized the need to implement an overall strategy in medical research. Here, the development of Systems Medicine has been indicated as a potential tool for clinical translation of basic research discoveries. Systems Medicine also gives the opportunity of improving different steps in medical practice, from diagnosis to healthcare management, including clinical research. The development of Systems Medicine is still hampered however by several challenges, the main one being the development of computational tools adequate to record, analyze and share a large amount of disparate data. In addition, available informatics tools appear not yet fully suitable for the challenge because they are not standardized, not universally available, or with ethical/legal concerns. Cardiovascular diseases (CVD) are a very promising area for translating Systems Medicine into clinical practice. By developing clinically applied technologies, the collection and analysis of data may improve CV risk stratification and prediction. Standardized models for data recording and analysis can also greatly broaden data exchange, thus promoting a uniform management of CVD patients also useful for clinical research. This advance however requires a great organizational effort by both physicians and health institutions, as well as the overcoming of ethical problems. This narrative review aims at providing an update on the state-of-art knowledge in the area of Systems Medicine as applied to CVD, focusing on current critical issues, providing a road map for its practical implementation. Copyright © 2014 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  13. Borrowing risk among young home owners : Prevention, alleviation and the promotion of sustainable alternatives: draft paper

    NARCIS (Netherlands)

    Lawson, J.M.; Parkinson, S.

    2009-01-01

    During the 1990s, amidst spiraling house prices and accessible credit, national governments in the Netherlands, the US, Australia and the UK promoted home ownership in rhetoric and policy as the main stream housing solution for working households, also for those with a low income. Recent instability

  14. Fundamental elements in examining a child’s right to education: A study of home education research and regulation in Australia

    Directory of Open Access Journals (Sweden)

    Glenda JACKSON

    2010-07-01

    Full Text Available Home education provides valuable educational and developmental opportunities for children. An examination of Australia’s research indicates many best educational practices, including more informed mediation, contextualised learning, and opportunities to exercise autonomy. Key features include learning embedded in communities and program modification in response to students’ needs. Current state and territory legal requirements are examined within the context of this research and Australia’s obligations to international human rights treaties. All jurisdictions accept home education as one way to meet compulsory education requirements. The extent to which respective laws then reflect understanding of home education research and practice varies. Most jurisdictions allow for a varietyof educational approaches. Some oversight regulation could however be modified to reflect a better understanding of home education. Consultation with home educators and reference to research would assist the development of more uniform legislation and policy across Australia, and enable better regulatory practice.

  15. The unattached fraction of radon decay products: Potential effects of in-home air cleaners on lung cancer risk

    International Nuclear Information System (INIS)

    Brady, P.A.

    1991-01-01

    Radon decay products are a factor in the development of lung cancer. Because of their efficient deposition within the lung, the fraction of decay products not attached to particulate (i.e., the unattached fraction) is very important in lung dosimetry. This study simulated the use of two in-home air cleaning devices to reduce airborne particulate concentrations, measure the effect on the unattached fraction, and estimate the radon lung cancer risk. Radon was released into a chamber having a volume-to-surface-area ratio similar to a small home. At radon-decay product equilibrium, radon and airborne particle concentrations were measured, and the concentration of the unattached fraction was estimated. The effect of particle concentration on the unattached fraction was then determined. The average unattached fractions corresponding to the particle concentration ranges expected for the air cleaning devices were used to calculate the annual alpha radiation dose and annual radon lung cancer for men, women and children at rest and under light activity. The annual doses and related risks were compared to those used in the models published by the Environmental Protection Agency. For particulate concentrations of a home with no particulate generating activities (e.g., smoking, cooking), the electronic air cleaner is predicted to reduce the unattached fraction from seven percent (the value used by the NCRP and confirmed in this study) to four percent. These conditions represent the maximum reduction in the unattached fraction. The decrease in the unattached fraction is tentatively attributed to an increase in plateout. Based on these results, a reduction of less than ten percent in the calculated annual lung cancer risk is found in all cases

  16. MULTILANGUAGE WEBSITE CONCEPT FOR OPERATIONAL IT RISK RESEARCH

    OpenAIRE

    Romānovs, Andrejs; Lektauers, Arnis; Merkurjevs, Jurijs; Klimovs, Ruslans

    2015-01-01

    The paper presents an approach of researches effective organization in sphere of operational IT risk governance. For this purpose, the application of digital multilanguage research area is advised, which can simplify discussion processes for users/researchers from different countries. The concept of multilanguage website is developed based on performed analysis of following modern IT application trends of website development: Web 2.0., social networks, blogs, wiki, etc. Then, practical soluti...

  17. Outcome of planned home and hospital births among low-risk women in Iceland in 2005-2009: a retrospective cohort study.

    Science.gov (United States)

    Halfdansdottir, Berglind; Smarason, Alexander Kr; Olafsdottir, Olof A; Hildingsson, Ingegerd; Sveinsdottir, Herdis

    2015-03-01

    At 2.2 percent in 2012, the home birth rate in Iceland is the highest in the Nordic countries and has been rising rapidly in the new millennium. The objective of this study was to compare the outcomes of planned home births and planned hospital births in comparable low-risk groups in Iceland. The study is a retrospective cohort study comparing the total population of 307 planned home births in Iceland in 2005-2009 to a matched 1:3 sample of 921 planned hospital births. Regression analysis, adjusted for confounding variables, was performed for the primary outcome variables. The rate of oxytocin augmentation, epidural analgesia, and postpartum hemorrhage was significantly lower when labor started as a planned home birth. Differences in the rates of other primary outcome variables were not significant. The home birth group had lower rates of operative birth and obstetric anal sphincter injury. The rate of 5-minute Apgar score home and hospital birth groups, but the home birth group had a higher rate of neonatal intensive care unit admission. Intervention and adverse outcome rates in both study groups, including transfer rates, were higher among primiparas than multiparas. Oxytocin augmentation, epidural analgesia, and postpartum hemorrhage rates were significantly interrelated. This study adds to the growing body of evidence that suggests that planned home birth for low-risk women is as safe as planned hospital birth. © 2015 Wiley Periodicals, Inc.

  18. Risk and protective factors associated with intentional self-harm among older community-residing home care clients in Ontario, Canada.

    Science.gov (United States)

    Neufeld, Eva; Hirdes, John P; Perlman, Christopher M; Rabinowitz, Terry

    2015-10-01

    We aim to concurrently examine risk and protective factors associated with intentional self-harm among community-residing older adults receiving home care services in Ontario, Canada. Administrative health data from the home care sector were linked to hospital administrative data to carry out the analyses. Home care data are collected in Ontario using the Resident Assessment Instrument-Home Care (RAI-HC), an assessment tool that identifies strengths, preferences and needs of long-stay home care clients. The sample included Ontario home care clients aged 60 years or older assessed with the RAI-HC between 2007 and 2010 (N = 222,149). Multivariable analyses were performed using SAS. Hospital records of intentional self-harm (ISH) were present in 9.3 cases per 1000 home care clients. Risks of ISH included younger age (60-74 years; OR = 3.14, CI: 2.75-3.59), psychiatric diagnosis (OR = 2.29, CI: 2.06-2.54), alcohol use and dependence (OR = 1.69, CI: 1.34-2.14), psychotropic medication (OR = 1.94, CI: 1.75-2.15) and depressive symptoms (OR = 1.58, CI: 1.40-1.78). Protective effects were found for marital status and positive social relationships, yet these effects were more pronounced for men. Cognitive performance measures showed the odds of ISH 1.86 times higher for older adults with moderate to severe cognitive impairment. This study based on provincial data points to tangible areas for preventative assessment by frontline home care professionals. Of interest were the risk and protective factors that differed by sex. As demand for home care in Canada is expected to increase, these findings may inform home care professionals' appraisal and approach to suicide prevention among community-residing older adults. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Comparison of Central, Ambulatory, Home and Office Blood Pressure Measurement as Risk Markers for Mild Cognitive Impairment in Hypertensive Patients

    Directory of Open Access Journals (Sweden)

    Teodora Yaneva-Sirakova

    2017-08-01

    Full Text Available Aims: We compared the role of central blood pressure (BP, ambulatory BP monitoring (ABPM, home-measured BP (HMBP and office BP measurement as risk markers for the development of mild cognitive impairment (MCI. Methods: 70 hypertensive patients on combination medical therapy were studied. Their mean age was 64.97 ± 8.88 years. Eighteen (25.71% were males and 52 (74.28% females. All of the patients underwent full physical examination, laboratory screening, echocardiography, and office, ambulatory, home and central BP measurement. The neuropsychological tests used were: Mini Mental State Examination (MMSE and Montreal Cognitive Assessment (MoCA. SPSS 19 was used for the statistical analysis with a level of significance of 0.05. Results: The mean central pulse pressure values of patients with MCI were significantly (p = 0.016 higher than those of the patients without MCI. There was a weak negative correlation between central pulse pressure and the results from the MoCA and MMSE (r = –0.283, p = 0.017 and r = –0.241, p = 0.044, respectively. There was a correlation between ABPM and MCI as well as between HMBP and MCI. Conclusions: The correlation of central BP with target organ damage (MCI is as good as for the other types of measurements of BP (home and ambulatory. Office BP seems to be the poorest marker for the assessment of target organ damage.

  20. Medication Exposure and Risk of Recurrent Clostridium difficile Infection in Community-Dwelling Older People and Nursing Home Residents.

    Science.gov (United States)

    Haran, John P; Bradley, Evan; Howe, Emily; Wu, Xun; Tjia, Jennifer

    2018-02-01

    It is unclear how medication exposures differ in their association with recurrent Clostridium difficile infection (rCDI) in elderly nursing home (NH) residents and community-dwelling individuals. This study examined these exposures to determine whether the risk of rCDI differs according to living environment. Retrospective. Academic and community healthcare settings. Individuals aged 65 and older with CDI (N = 616). Information on participant characteristics and medications was extracted from the electronic medical record (EMR). We used separate extended Cox models according to living environment to identify the association between medication use and risk of rCDI. Of the 616 elderly adults treated for CDI, 24.1% of those living in the community and 28.1% of NH residents experienced recurrence within 1 year. For community-dwelling participants, the risk of rCDI was 1.6 times as high with antibiotic exposure and 2.5 times as high with acid-reducing medication exposure, but corticosteroid exposure was associated with a 39% lower risk of recurrence. For NH residents, the risk of rCDI was 2.9 times as high with acid-reducing medication exposure and 5.9 times as high with corticosteroid medication exposure. Antibiotic exposure was associated with an increased risk of recurrence only in community-dwelling participants (adjusted hazard ratio = 1.63, 95% confidence interval = 1.00-2.67). Risk of rCDI is greater with acid-reducing medication use than antibiotic use after initial CDI treatment, although the risk varied depending on living environment. Corticosteroid use is associated with greater risk of recurrence in NH residents but lower risk in community-dwelling elderly adults. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  1. Double Jeopardy: Poorer Social-Emotional Outcomes for Children in the NICHD SECCYD Experiencing Home and Child-Care Environments that Confer Risk

    Science.gov (United States)

    Watamura, Sarah Enos; Phillips, Deborah A.; Morrissey, Taryn W.; McCartney, Kathleen; Bub, Kristen

    2011-01-01

    Using data from the National Institute of Child Health and Human Development Early Child Care Research Network (NICHD SECCYD), the authors examined whether interactions between home and child-care quality affect children's social-emotional adjustment at 24, 36, and 54 months (N = 771). Triadic splits on quality of home and child care were used to…

  2. Prospective cohort study of fever incidence and risk in elderly persons living at home

    Science.gov (United States)

    Yokobayashi, Kenichi; Matsushima, Masato; Watanabe, Takamasa; Fujinuma, Yasuki; Tazuma, Susumu

    2014-01-01

    Objective To determine the incidence of fever among elderly persons under home medical management, diagnosis at fever onset and outcomes from a practical standpoint. Design Prospective cohort study. Setting 5 clinics in residential areas of Tokyo that process an average of 50–200 outpatients/day. Participants Patients (n=419) aged ≥65 years who received home medical management from the five clinics between 1 October 2009 and 30 September 2010. Main outcome measures Fever (≥37.5°C or ≥1.5°C above usual body temperature), diagnosis at onset and outcomes (cure at home, hospitalisation and death). Results The incidence of fever was 2.5/1000 patient-days (95% CI 2.2 to 2.8). Fever occurred at least once (229 fever events) among one-third of the participants during the study period. Fever was more likely to arise in the wheelchair users or bedridden than in ambulatory individuals (HR 1.9 (95% CI 1.3 to 2.8; p<0.01); in patients with moderate-to-severe rather than those with none-to-mild cognitive impairment (HR, 1.7 (95% CI 1.1 to 2.6, p=0.01); and in those whose care-need levels were ≥3 rather than ≤2 (HR, 4.5 (95% CI 2.9 to 7.0; p<0.01). The causes of fever were pneumonia/bronchitis (n=103), skin and soft tissue infection (n=26), urinary tract infection (n=22) and the common cold (n=13). Fever was cured in 67% and 23% of patients at home and in hospital, respectively, and 5% of patients each died at home and in hospital. Antimicrobial agents treated 153 (67%) events in the home medical care setting. Conclusions Fever was more likely to occur in those requiring higher care levels and the main cause of fever was pneumonia/bronchitis. Healthcare providers should consider the conditions of elderly residents with lower objective functional status. PMID:25009132

  3. Multidisciplinary European Low Dose Initiative (MELODI). Strategic research agenda for low dose radiation risk research

    Energy Technology Data Exchange (ETDEWEB)

    Kreuzer, M. [Federal Office for Radiation Protection, BfS, Department of Radiation Protection and Health, Neuherberg (Germany); Auvinen, A. [University of Tampere, Tampere (Finland); STUK, Helsinki (Finland); Cardis, E. [ISGlobal, Barcelona Institute for Global Health, Barcelona (Spain); Durante, M. [Institute for Fundamental Physics and Applications, TIFPA, Trento (Italy); Harms-Ringdahl, M. [Stockholm University, Centre for Radiation Protection Research, Stockholm (Sweden); Jourdain, J.R. [Institute for Radiological Protection and Nuclear Safety, IRSN, Fontenay-aux-roses (France); Madas, B.G. [MTA Centre for Energy Research, Environmental Physics Department, Budapest (Hungary); Ottolenghi, A. [University of Pavia, Physics Department, Pavia (Italy); Pazzaglia, S. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development (ENEA), Rome (Italy); Prise, K.M. [Queens University Belfast, Belfast (United Kingdom); Quintens, R. [Belgian Nuclear Research Centre, SCK-CEN, Mol (Belgium); Sabatier, L. [French Atomic Energy Commission, CEA, Paris (France); Bouffler, S. [Public Health England, PHE, Chilton (United Kingdom)

    2018-03-15

    MELODI (Multidisciplinary European Low Dose Initiative) is a European radiation protection research platform with focus on research on health risks after exposure to low-dose ionising radiation. It was founded in 2010 and currently includes 44 members from 18 countries. A major activity of MELODI is the continuous development of a long-term European Strategic Research Agenda (SRA) on low-dose risk for radiation protection. The SRA is intended to identify priorities for national and European radiation protection research programs as a basis for the preparation of competitive calls at the European level. Among those key priorities is the improvement of health risk estimates for exposures close to the dose limits for workers and to reference levels for the population in emergency situations. Another activity of MELODI is to ensure the availability of European key infrastructures for research activities, and the long-term maintenance of competences in radiation research via an integrated European approach for training and education. The MELODI SRA identifies three key research topics in low dose or low dose-rate radiation risk research: (1) dose and dose rate dependence of cancer risk, (2) radiation-induced non-cancer effects and (3) individual radiation sensitivity. The research required to improve the evidence base for each of the three key topics relates to three research lines: (1) research to improve understanding of the mechanisms contributing to radiogenic diseases, (2) epidemiological research to improve health risk evaluation of radiation exposure and (3) research to address the effects and risks associated with internal exposures, differing radiation qualities and inhomogeneous exposures. The full SRA and associated documents can be downloaded from the MELODI website (http://www.melodi-online.eu/sra.html). (orig.)

  4. Identifying risk factors for exposure to culturable allergenic moulds in energy efficient homes by using highly specific monoclonal antibodies

    Energy Technology Data Exchange (ETDEWEB)

    Sharpe, Richard A. [European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD (United Kingdom); Cocq, Kate Le [Rothamsted Research, North Wyke, Okehampton EX20 2SB (United Kingdom); Nikolaou, Vasilis [University of Exeter Medical School, The Veysey Building, Salmon Pool Lane, Exeter EX2 4SG (United Kingdom); Osborne, Nicholas J. [European Centre for Environment and Human Health, University of Exeter Medical School, Truro TR1 3HD (United Kingdom); Clinical Pharmacology and Toxicology Research Group, Discipline of Pharmacology, Sydney Medical School, The University of Sydney, NSW (Australia); Thornton, Christopher R., E-mail: c.r.thornton@exeter.ac.uk [Biosciences, College of Life and Environmental Sciences, University of Exeter, Exeter EX4 4QD (United Kingdom)

    2016-01-15

    The aim of this study was to determine the accuracy of monoclonal antibodies (mAbs) in identifying culturable allergenic fungi present in visible mould growth in energy efficient homes, and to identify risk factors for exposure to these known allergenic fungi. Swabs were taken from fungal contaminated surfaces and culturable yeasts and moulds isolated by using mycological culture. Soluble antigens from cultures were tested by ELISA using mAbs specific to the culturable allergenic fungi Aspergillus and Penicillium spp., Ulocladium, Alternaria, and Epicoccum spp., Cladosporium spp., Fusarium spp., and Trichoderma spp. Diagnostic accuracies of the ELISA tests were determined by sequencing of the internally transcribed spacer 1 (ITS1)-5.8S-ITS2-encoding regions of recovered fungi following ELISA. There was 100% concordance between the two methods, with ELISAs providing genus-level identity and ITS sequencing providing species-level identities (210 out of 210 tested). Species of Aspergillus/Penicillium, Cladosporium, Ulocladium/Alternaria/Epicoccum, Fusarium and Trichoderma were detected in 82% of the samples. The presence of condensation was associated with an increased risk of surfaces being contaminated by Aspergillus/Penicillium spp. and Cladosporium spp., whereas moisture within the building fabric (water ingress/rising damp) was only associated with increased risk of Aspergillus/Penicillium spp. Property type and energy efficiency levels were found to moderate the risk of indoor surfaces becoming contaminated with Aspergillus/Penicillium and Cladosporium which in turn was modified by the presence of condensation, water ingress and rising damp, consistent with previous literature. - Highlights: • Monoclonal antibodies were used to track culturable allergenic moulds in homes. • Allergenic moulds were recovered from 82% of swabs from contaminated surfaces. • The mAbs were highly specific with 100% agreement to PCR of recovered fungi. • Improvements to energy

  5. Identifying risk factors for exposure to culturable allergenic moulds in energy efficient homes by using highly specific monoclonal antibodies

    International Nuclear Information System (INIS)

    Sharpe, Richard A.; Cocq, Kate Le; Nikolaou, Vasilis; Osborne, Nicholas J.; Thornton, Christopher R.

    2016-01-01

    The aim of this study was to determine the accuracy of monoclonal antibodies (mAbs) in identifying culturable allergenic fungi present in visible mould growth in energy efficient homes, and to identify risk factors for exposure to these known allergenic fungi. Swabs were taken from fungal contaminated surfaces and culturable yeasts and moulds isolated by using mycological culture. Soluble antigens from cultures were tested by ELISA using mAbs specific to the culturable allergenic fungi Aspergillus and Penicillium spp., Ulocladium, Alternaria, and Epicoccum spp., Cladosporium spp., Fusarium spp., and Trichoderma spp. Diagnostic accuracies of the ELISA tests were determined by sequencing of the internally transcribed spacer 1 (ITS1)-5.8S-ITS2-encoding regions of recovered fungi following ELISA. There was 100% concordance between the two methods, with ELISAs providing genus-level identity and ITS sequencing providing species-level identities (210 out of 210 tested). Species of Aspergillus/Penicillium, Cladosporium, Ulocladium/Alternaria/Epicoccum, Fusarium and Trichoderma were detected in 82% of the samples. The presence of condensation was associated with an increased risk of surfaces being contaminated by Aspergillus/Penicillium spp. and Cladosporium spp., whereas moisture within the building fabric (water ingress/rising damp) was only associated with increased risk of Aspergillus/Penicillium spp. Property type and energy efficiency levels were found to moderate the risk of indoor surfaces becoming contaminated with Aspergillus/Penicillium and Cladosporium which in turn was modified by the presence of condensation, water ingress and rising damp, consistent with previous literature. - Highlights: • Monoclonal antibodies were used to track culturable allergenic moulds in homes. • Allergenic moulds were recovered from 82% of swabs from contaminated surfaces. • The mAbs were highly specific with 100% agreement to PCR of recovered fungi. • Improvements to energy

  6. Analysis of emergency helpline support for home ventilator dependent patients: risk management and workload

    Directory of Open Access Journals (Sweden)

    M. Chatwin

    2008-04-01

    Full Text Available From a total of 1211 adult & paediatric patients receiving home ventilation (HV supervised by Royal Brompton Hospital between 1/1/06 and 30/6/06 the respiratory support team received an average of 528 daytime calls/month and 14/month out of hours calls to a telephone helpline. Diagnoses included: neuromuscular disease, chest wall disease, COPD, obesity hypoventilation and non-COPD lung disease. 99% received non-invasive ventilation, 1% tracheostomy ventilation. 149 required 2 ventilators for near 24 hour ventilator dependency, the remainder were classified as 1 (17% 2 (33% & 3 (50% night dependency as were able to breathe spontaneously for this period. 50% used bilevel positive pressure ventilators, 48% inspiratory pressure ventilators and 2% volume ventilators. In 188 calls a home visit was carried out because of ventilator or associated equipment-related problems. Despite regular equipment servicing programme, in 188 patients there was a technical problem with the equipment which was solved in the patient's home in 64% or required replacement / parts in 22%. Of the 25 calls in which no fault was found, 13 patients were unwell at home or required hospital admission, 2 patients died within 1 month of identification of no fault. No patient was admitted as a result of technical failure of equipment. Conclusion: There is a significant workload associated with supporting HV patients. Patients / carers all received standard competency training before discharge but other calls may be reduced by a more flexible problem-solving approach. Importantly, reports in which no technical fault is found may indicate deteriorating health in the patient and require close follow-up.

  7. Supply Chain Risk Management: Literature Review and Future Research

    OpenAIRE

    Iwan Vanany; Suhaiza Zailani; Nyoman Pujawan

    2009-01-01

    Supply chain risk management has increasingly becoming a more popular research area recently. Various papers, with different focus and approaches, have been published since a few years ago. This paper aims to survey supply chain risk management (SCRM) literature. Paper published in relevant journals from 2000 to 2007 are analysed and classified into five categories: conceptual, descriptive, empirical, exploratory cross-sectional, and exploratory longitudinal. We also looked at the papers in t...

  8. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F.; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-01-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  9. The Investigation of Research-Based Home Parental Involvement Practices, Parental Style, and Student Achievement

    Science.gov (United States)

    Colson, Myron Jamal

    2010-01-01

    The purpose of the study was to investigate the relationship of home parental involvement practices, parental style and student achievement. Dimensions of parental involvement practices are parental instruction, parental reinforcement, parental modeling, and parental encouragement. Dimensions of parental style are authoritarian, permissive, and…

  10. Towards global consensus on outcome measures for atopic eczema research : Results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  11. Individualism and Collectivism in Business School Pedagogy: A Research Agenda for Internationalising the Home Management Student

    Science.gov (United States)

    Waistell, Jeff

    2011-01-01

    The argument presented in this paper is that today's workplaces and universities both require and promote individual and collective responsibility for work and that students need to be adequately prepared for this. UK national culture has been characterised as highly individualist. Therefore, internationalisation of home management students in the…

  12. Assessing and Comparing Physical Environments for Nursing Home Residents: Using New Tools for Greater Research Specificity

    Science.gov (United States)

    Cutler, Lois J.; Kane, Rosalie A.; Degenholtz, Howard B.; Miller, Michael J.; Grant, Leslie

    2006-01-01

    Purpose: We developed and tested theoretically derived procedures to observe physical environments experienced by nursing home residents at three nested levels: their rooms, the nursing unit, and the overall facility. Illustrating with selected descriptive results, in this article we discuss the development of the approach. Design and Methods: On…

  13. Managing Risks in SMEs: A Literature Review and Research Agenda

    Directory of Open Access Journals (Sweden)

    Chiara Verbano

    2013-09-01

    Full Text Available In times of crisis, companies need to carefully monitor current expenses and forecast potential costs, which could be caused by risky actions. Risk is inherent in all business functions and in every kind of activity. Knowing how to identify risks, attribute a value and a priority scale, design actions and mechanisms to minimize risks, and continuously monitor them, are essential to guarantee companies’ survival and create sustainable value. This is especially true for small- and medium-sized businesses that are most exposed to the harmful effects of the risks, due to limited resources and structural features. The objective of this study is to analyze available literature on the subject of risk management for small- and medium-sized enterprises from 1999 to 2009. The analysis derives interesting characteristics from the scientific studies, highlighting gaps and guidelines for future research.

  14. Enhanced risk prediction model for emergency department use and hospitalizations in patients in a primary care medical home.

    Science.gov (United States)

    Takahashi, Paul Y; Heien, Herbert C; Sangaralingham, Lindsey R; Shah, Nilay D; Naessens, James M

    2016-07-01

    With the advent of healthcare payment reform, identifying high-risk populations has become more important to providers. Existing risk-prediction models often focus on chronic conditions. This study sought to better understand other factors to improve identification of the highest risk population. A retrospective cohort study of a paneled primary care population utilizing 2010 data to calibrate a risk prediction model of hospital and emergency department (ED) use in 2011. Data were randomly split into development and validation data sets. We compared the enhanced model containing the additional risk predictors with the Minnesota medical tiering model. The study was conducted in the primary care practice of an integrated delivery system at an academic medical center in Rochester, Minnesota. The study focus was primary care medical home patients in 2010 and 2011 (n = 84,752), with the primary outcome of subsequent hospitalization or ED visit. A total of 42,384 individuals derived the enhanced risk-prediction model and 42,368 individuals validated the model. Predictors included Adjusted Clinical Groups-based Minnesota medical tiering, patient demographics, insurance status, and prior year healthcare utilization. Additional variables included specific mental and medical conditions, use of high-risk medications, and body mass index. The area under the curve in the enhanced model was 0.705 (95% CI, 0.698-0.712) compared with 0.662 (95% CI, 0.656-0.669) in the Minnesota medical tiering-only model. New high-risk patients in the enhanced model were more likely to have lack of health insurance, presence of Medicaid, diagnosed depression, and prior ED utilization. An enhanced model including additional healthcare-related factors improved the prediction of risk of hospitalization or ED visit.

  15. Fall-related injuries in a nursing home setting: is polypharmacy a risk factor?

    OpenAIRE

    Baranzini, Federico; Diurni, Marcello; Ceccon, Francesca; Poloni, Nicola; Cazzamalli, Sara; Costantini, Chiara; Colli, Cristiano; Greco, Laura; Callegari, Camilla

    2009-01-01

    Abstract Background Polypharmacy is regarded as an important risk factor for fallingand several studies and meta-analyses have shown an increased fall risk in users of diuretics, type 1a antiarrhythmics, digoxin and psychotropic agents. In particular, recent evidence has shown that fall risk is associated with the use of polypharmacy regimens that include at least one established fall risk-increasing drug, rather than with polypharmacy per se. We studied the role of polypharmacy and the role ...

  16. Evolution of natural risk: research framework and perspectives

    Science.gov (United States)

    Hufschmidt, G.; Crozier, M.; Glade, T.

    2005-05-01

    This study presents a conceptual framework for addressing temporal variation in natural risk. Numerous former natural risk analyses and investigations have demonstrated that time and related changes have a crucial influence on risk. For natural hazards, time becomes a factor for a number of reasons. Using the example of landslides to illustrate this point, it is shown that: 1. landslide history is important in determining probability of occurrence, 2. the significance of catchment variables in explaining landslide susceptibility is dependent on the time scale chosen, 3. the observer's perception of the geosystem's state changes with different time spans, and 4. the system's sensitivity varies with time. Natural hazards are not isolated events but complex features that are connected with the social system. Similarly, elements at risk and their vulnerability are highly dynamic through time, an aspect that is not sufficiently acknowledged in research. Since natural risk is an amalgam of hazard and vulnerability, its temporal behaviour has to be considered as well. Identifying these changes and their underlying processes contributes to a better understanding of natural risk today and in the future. However, no dynamic models for natural risks are currently available. Dynamic behaviour of factors affecting risk is likely to create increasing connectivity and complexity. This demands a broad approach to natural risk, since the concept of risk encapsulates aspects of many disciplines and has suffered from single-discipline approaches in the past. In New Zealand, dramatic environmental and social change has occurred in a relatively short period of time, graphically demonstrating the temporal variability of the geosystem and the social system. To understand these changes and subsequent interactions between both systems, a holistic perspective is needed. This contribution reviews available frameworks, demonstrates the need for further concepts, and gives research

  17. Europe at risk (Following EU-Funded Research on Hazard and Risks)

    NARCIS (Netherlands)

    Delmonaco, G.; Atun, F.; Ceudech, A.; Deeming, H.; Roo, A.P.J. de; Lumbroso, D.; Galderisi, A.; Kallache, M.; Kropp, J.P.; Kundak, S.; Molinari, D.; Tweed, F.; Wade, S.; Walker, G.; Dandoulaki, M.; Barredo, J.

    2011-01-01

    This chapter regarding present risk conditions, has been structured using significant “images” of Europe, addressing the hazard, exposure and vulnerability factors recognised as crucial components of any risk assessment. To draw such a picture, results of past research at the European level were

  18. Frequency, risk factors and preventive approach to fall among aged population living in a nursing home in Ankara

    Directory of Open Access Journals (Sweden)

    Evren Kibar

    2015-02-01

    Full Text Available AIM: Increase in aged population in number brings along the risk of falls and fall-related injuries among elderly. It has been reported that almost 60% of falls occur in nursing homes and majority of admissions to emergency departments due to falls consist of elderly. The purpose of this study conducted in a nursing home in Ankara was to determine the frequency of falls and risk factors, and to clear out the opinions and views of the participants on planning and promoting interventions for prevention. METHOD: This cross-sectional study was carried out among 60 years of age and older residents who lived in a nursing home. Data of the study was collected via face to face interviewing technique. The questionnaire consisted of four sections including socio-demographic characteristics, health status of the participants, healthy/risky behavior and fall related characteristics. RESULTS: Mean age of the 75 female and 59 male participants involved in the study was 73.99+/-7.18. Females were found to fall more in frequency than males (p>0.05. It was found that nearly half of the males (47.5% and more than half of the females (56.0% fell at least once within the previous year. Number of falls were higher among 75 years of age and older participants compared to the other age groups (p=0.003. Compared to the participants with fall background, aged people without fall background gave more correct answers in number to the questions which were asked to assess the knowledge on falls. Six out of 20 answers were statistically significantly correct (p <0.05. CONCLUSION: Individual and environmental interventions to be continued both inside and outside the institutions in order to prevent falls. [TAF Prev Med Bull 2015; 14(1.000: 23-32

  19. Usefulness of dietary enrichment on energy and protein intake in elderly patients at risk of malnutrition discharged to home.

    Science.gov (United States)

    Trabal, Joan; Hervas, Sonia; Forga, Maria; Leyes, Pere; Farran-Codina, Andreu

    2014-02-01

    Malnutrition is a cause for concern among many admitted elderly patients, being common at hospital admission and discharge. The objective of this study was to assess if diet enrichment with small servings of energy and protein dense foods, improves energy and nutrient intake in elderly patients at risk of malnutrition discharged to home. This was a retrospective case series study in elderly patients at risk of malnutrition treated with diet enrichment. There was a data review of dietary and health records of elderly patients discharged to home. Forty-one patients, mean age of 83 ± 5 years, met the inclusion criteria; 13 patients had been lost after 4 weeks of treatment and a total of 24 patients after 12 weeks. Records contained food intake data assessed at baseline, and after 4 and 12 weeks of treatment. Mini Nutritional Assessment, anthropometric measurements, routine biochemical parameters and the Barthel Index were assessed at baseline and after 12 weeks. Compared to baseline, patients significantly improved their energy and protein intake after 4 weeks of treatment, fulfilling the mean nutritional requirements. The improvement in energy and protein intake was still manifest at week 12. After 12 weeks of dietary enrichment, a significant weight gain was observed (4.1%, p = 0.011), as well. No significant changes were detected in functional status. Using small servings of energy and protein dense foods to enrich meals seems a feasible nutritional treatment to increase energy and protein intake and meet nutritional goals among elderly patients discharged to home. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  20. Anticholinergic Medication Burden and 5-Year Risk of Hospitalization and Death in Nursing Home Elderly Residents With Coronary Artery Disease.

    Science.gov (United States)

    Vetrano, Davide L; La Carpia, Domenico; Grande, Giulia; Casucci, Paola; Bacelli, Tiziana; Bernabei, Roberto; Onder, Graziano

    2016-11-01

    To assess the association of the anticholinergic medication burden with hospitalization and mortality in nursing home elderly patients and to investigate the role of coronary artery disease (CAD). Longitudinal (5-year) retrospective observational study. Nursing homes in Italy. A total of 3761 nursing home older residents. A comprehensive clinical and functional assessment was carried out through the interRAI long-term care facility instrument. The anticholinergic burden was assessed through the anticholinergic cognitive burden (ACB) scale. Occurrence of hospitalization/all-cause mortality was the primary composite outcome. First hospitalization and all-cause mortality were the secondary outcomes of the study. Hazard ratios (HRs) and subdistribution HRs were obtained through Cox and competing risk (death as competing event for hospitalization) models. Within the sample (mean age 83 ± 7 years; 72% females) the incidence rate of the primary outcome was 10/100 person-year. After adjusting for potential confounders and compared with participants with an ACB of 0, those with an ACB of 1 [HR 1.46; 95% confidence interval (CI) 1.12-1.90] and ABC of 2+ (HR 1.41; 95% CI 1.11-1.79) presented an increased risk of developing the primary outcome. After stratification, the risk for the primary outcome increased along with the anticholinergic burden, only for participants affected by CAD (HR 1.53; 95% CI 0.94-2.50 and HR 1.71; 95% CI 1.09-2.68 for the ACB of 1 and ACB of 2+ groups). An ACB score of 2+ was marginally associated with first hospitalization, considering death as a competing risk, only for those with CAD (subdistribution HR 3.47; 95% CI 0.99-12.3). Anticholinergic medication burden is associated to hospitalization and all-cause mortality in institutionalized older adults. CAD increases such risk. The effectiveness and safety profile of complex drug regimens should be reconsidered in this population. Copyright © 2016 AMDA – The Society for Post-Acute and Long

  1. Lower urinary tract symptoms and falls risk among older women receiving home support: a prospective cohort study.

    Science.gov (United States)

    Hunter, Kathleen F; Voaklander, Donald; Hsu, Zoe Y; Moore, Katherine N

    2013-05-15

    Although lower urinary tract symptoms have been associated with falls, few studies have been undertaken to understand this relationship in vulnerable community dwelling older adults. The purpose of this study was to describe the relationship over time of falls risk and lower urinary tract symptoms among community based older women receiving home support services. A prospective cohort study which took place in an urban setting in western Canada. Participants were 100 older women receiving home care or residing in assisted living with home support services and were followed for six months. Demographic characteristics were collected at baseline, with the Timed Up and Go (TUG), International Consultation on Incontinence Questionnaire Female Lower Urinary Tract Symptoms (ICIQ-FLUTS), and self-report of falls collected at baseline, 3 and 6 months. Descriptive statistics were used to summarize demographic data. Differences between the three visits were analyzed using the Friedman test with post hoc analysis and associations between variables by the Spearman Rank-Order Correlation Coefficient. One hundred women initially enrolled; 88 and 75 remained at three months and six months. Mean age = 84.3 years; 91% reported at least one urinary symptom at baseline and 35% reported falling in the six months prior to enrollment; 15.9% reported falling between the baseline and three months and 14.6% between three and six months. Mean TUG scores at each time point indicated falls risk (27.21, 29.18 and 27.76 seconds). Significant correlations between TUG and ICIQ-FLUTS (r = 0.33, p falls risk in this group of vulnerable community dwelling older women at baseline and three months has potential clinical relevance. Lack of correlation at six months may be due loss of less robust participants, illuminating the difficulty in following frailer groups over time. Further studies are needed to understand the contribution of urinary symptoms to falls risk, and clinicians should

  2. Using research for successful Medicare and Medicaid risk marketing.

    Science.gov (United States)

    Jacobs, S; Nelson, A M; Wood, S D

    1996-01-01

    Medicare/Medicaid risk marketing is a vital business challenge, one that countless managed care organizations are facing right now. Early entry into new markets and aggressive participation in existing markets are essential to meet competitive pressures. Health plans intent on success in government risk programs should conduct research to learn the medical needs, wants, and desires of older persons in the geographic area they serve. Original, market-specific research yields critical marketing and clinical data that can be used to improve care and member satisfaction along with customer loyalty and retention.

  3. 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.

  4. 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.

  5. 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.

  6. Unpacking socio-economic risks for reading and academic self-concept in primary school: Differential effects and the role of the preschool home learning environment.

    Science.gov (United States)

    Crampton, Alexandria; Hall, James

    2017-09-01

    Uncertainty remains concerning how children's reading and academic self-concept are related and how these are differentially affected by social disadvantage and home learning environments. To contrast the impacts of early socio-economic risks and preschool home learning environments upon British children's reading abilities and academic self-concept between 7 and 10 years. n = 3,172 British children aged 3-10 years and their families. A secondary analysis of the nationally representative UK EPPE database. Multilevel structural equation modelling calculated the direct, indirect, and total impacts of early socio-economic risks (0-3 years) and preschool home learning environments (3-5 years) upon children's reading ability and academic self-concept between 7 and 10 years. Early socio-economic risk had different effects upon children's reading ability and academic self-concept. Early socio-economic risks affected children's reading at ages 7 and 10 both directly and indirectly via effects upon preschool home learning environments. By contrast, early socio-economic risks had only indirect effects upon children's academic self-concept via less stimulating home learning environments in the preschool period and by limiting reading abilities early on in primary school. Although the impacts of early socio-economic risks are larger and more easily observed upon reading than upon academic self-concept, they can impact both by making it less likely that children will experience enriching home learning environments during the preschool period. This has implications for social policymakers, early educators, and interventionists. Intervening early and improving preschool home learning environments can do more than raise children's reading abilities; secondary benefits may also be achievable upon children's self-concept. © 2017 The British Psychological Society.

  7. Integrated Risk Research. Case of Study: Motozintla, Chiapas, Mexico

    Science.gov (United States)

    Novelo-Casanova, D. A.; Jaimes, M.

    2015-12-01

    This integrated risk research include the analysis of all components of individual constituents of risk such hazard identification, hazard exposure, and vulnerability. We determined risk to natural hazards in the community of Motozintla located in southern Mexico in the state of Chiapas (15.37ºN, 92.25ºW. Due to its geographical and geological location, this community is continuously exposed mainly to earthquakes, landslides and floods. We developed integrated studies and analysis of seismic zonation, landslides and flood susceptibility using standard methodologies. Vulnerability was quantified from data collected from local families interviews considering five social variables: characteristics of housing construction, availability of basic public services, family economic conditions, existing community plans for disaster preparedness, and risk perception. Local families surveyed were randomly selected considering a sample statistically significant. Our results were spatially represented using a Geographical Information System (GIS). Structural vulnerability curves were generated for typical housing constructions. Our integrated risk analysis demonstrates that the community of Motozintla has a high level of structural and socio-economical risk to floods and earthquakes. More than half of the population does not know any existing Civil Protection Plan and perceive that they are in high risk to landslides and floods. Although the community is located in a high seismic risk zone, most of the local people believe that cannot be impacted by a large earthquake. These natural and social conditions indicate that the community of Motozintla has a very high level of risk to natural hazards. This research will support local decision makers in developing an integrated comprehensive natural hazards mitigation and prevention program.

  8. Community-based distribution of misoprostol to prevent postpartum haemorrhage at home births: results from operations research in rural Ghana.

    Science.gov (United States)

    Geller, S; Carnahan, L; Akosah, E; Asare, G; Agyemang, R; Dickson, R; Kapungu, C; Owusu-Ansah, L; Robinson, N; Mensah-Homiah, J

    2014-02-01

    To report on a rigorous distribution and monitoring plan to track misoprostol for community-based distribution to reduce postpartum haemorrhage (PPH) in rural Ghana. Operations research. Rural Ghana. Women in third trimester of pregnancy presenting to primary health centres (PHCs) for antenatal care (ANC). Ghana Health Service (GHS), Millennium Village Projects, and the University of Illinois at Chicago conducted an operations research study designed to assess the safety, feasibility, and acceptability of community-based distribution of misoprostol to prevent PPH at home deliveries in rural Ghana. One thousand doses (3000 tablets, 200 μg each) were obtained from the Family Health Division of GHS. Three 200-μg tablets of misoprostol (600 μg) in foil packets were packaged together in secured transparent plastic packets labelled with pictorial messages and distributed to midwives at seven PHCs for distribution to pregnant women. Correct use of misoprostol in home deliveries and retrieval of unused misoprostol doses, PPH rates and maternal mortality. Of the 999 doses distributed to midwives, 982 (98.3%) were successfully tracked, with a 1.7% lost to follow-up rate. Midwives distributed 654 doses to women at third-trimester ANC visits. Of women who had misoprostol to use at home, 81% had an institutional delivery and were able to return the misoprostol safely to the midwife. Of the women that used misoprostol, 99% used the misoprostol correctly. This study clearly demonstrates that misoprostol distributed antenatally to pregnant women can be used accurately and reliably by rural Ghanaian women, and should be considered for policy implementation across Ghana and other countries with high home birth rates and maternal mortality ratios. © 2013 Royal College of Obstetricians and Gynaecologists.

  9. The 'ripple effect': Towards researching improvisational music therapy in dementia care homes.

    Science.gov (United States)

    Pavlicevic, Mercédès; Tsiris, Giorgos; Wood, Stuart; Powell, Harriet; Graham, Janet; Sanderson, Richard; Millman, Rachel; Gibson, Jane

    2015-09-01

    Increased interest in, and demand for, music therapy provision for persons with dementia prompted this study's exploration of music therapists' strategies for creating musical communities in dementia care settings, considering the needs and resources of people affected by dementia. Focus group discussions and detailed iterative study of improvisational music therapy work by six experienced practitioners clarify the contextual immediacy and socio-musical complexities of music therapy in dementia care homes. Music therapy's 'ripple effect', with resonances from micro (person-to-person musicking), to meso (musicking beyond 'session time') and macro level (within the care home and beyond), implies that all who are part of the dementia care ecology need opportunities for flourishing, shared participation, and for expanded self-identities; beyond 'staff', 'residents', or 'being in distress'. On such basis, managers and funders might consider an extended brief for music therapists' roles, to include generating and maintaining musical wellbeing throughout residential care settings. © The Author(s) 2013.

  10. Comparative research on decommissioning disposal effect of two uranium mines at home and abroad

    International Nuclear Information System (INIS)

    Shi Yuke; Peng Daofeng; Liu Qingcheng

    2014-01-01

    Taking two typical decommissioned uranium mines at home and abroad for an example, disposal means and effects of two uranium mines were compared and analyzed in three aspects of waste dump disposal, mine sealing treatment, and wastewater disposal. The results showed that two uranium mines were basically identical in the disposal standards and disposal means, but the works in the source survey, wastewater disposal and long-term supervision done by oversea uranium mine were more detailed than domestic uranium mine. (authors)

  11. Prediction of the variation in risks from exposure to radon at home or at work

    International Nuclear Information System (INIS)

    Chambers, D. B.; Stager, R. H.

    2011-01-01

    On the basis of a review of recent epidemiology, the ICRP recently issued a statement outlining a new approach to radon. The ICRP indicates that the Publication 65 dose conversion convention will be replaced using the dosimetric approach currently used for other radionuclides. Moreover, the ICRP indicates that the dose conversion factor is expected to increase by about a factor of 2. This paper independently examines the risks associated with exposure to radon and decay products through estimation of lifetime excess absolute risks per WLM for a variety of epidemiological risk projection models and baseline cancer and mortality rates. This paper suggests that current ICRP dosimetric models do not reflect the effect of smoking and suggest that basic risk estimates and dose conversion factors be based on risks to non-smoking populations with recognition that lifestyle choices, especially smoking, have a large effect on the risk from exposure to radon. (authors)

  12. Formative research on creating smoke-free homes in rural communities.

    Science.gov (United States)

    Escoffery, Cam; Kegler, Michelle Crozier; Butler, Susan

    2009-02-01

    The home is a significant place for exposure to secondhand smoke for children and non-smoking adults. This study explored factors that would convince families to adopt household smoking bans and actions to create and maintain smoke-free homes. Interviews were conducted with adults in 102 households in rural Georgia. Participating families had a young adolescent and included households with a mix of smokers and non-smokers and smoking ban status. Families reported they would consider a total ban to protect children from secondhand smoke and protect family members if they got sick. Few described difficulties in enforcement with over half of smokers accepting the rules. Situations that made it hard to enforce restrictions were if there was a visitor who smoked, a smoker who had cravings, and bad weather outside when the smoker desired to smoke. Smokers explained that family members could assist them in quitting by talking to them, not purchasing cigarettes for them, not smoking around them, and supporting them. Ideas for promoting smoke-free homes were having a no smoking sign, saying no to visitors who want to smoke, removing ashtrays, and creating a place outside for smokers. These findings can inform interventions designed to create and maintain smoke-free households.

  13. A Research into Evaluation of Basketball Athletes' Risk Perception Level

    Science.gov (United States)

    Karatas, Ozgur

    2016-01-01

    The aim of this study is to compare the risk perception levels of Basketball athletes in Turkish League teams according to some variables. In this research the "general screening model," which is one of the descriptive screening methods, was used. While the population of the study consists of athletes actively engaged in the Turkish…

  14. Risk Assessment of Heating, Ventilating, and Air-Conditioning Strategies in Low-Load Homes

    Energy Technology Data Exchange (ETDEWEB)

    Poerschke, Andrew [IBACOS, Inc., Pittsburgh, PA (United States)

    2016-02-17

    "Modern, energy efficient homes conforming to the Zero Energy Ready Home standard face the challenge of meeting high customer expectations for comfort. Traditional heating, ventilation, and air conditioning (HVAC) sizing and control strategies may be insufficient to adequately condition each zone due to unique load patterns in each room caused by a number of factors. These factors include solar heat gains, occupant-related gains, and gains associated with appliances and electronics. Because of shrinking shell loads, these intermittent factors are having an increasingly significant impact on the thermal load in each zone. Consequently, occupant comfort can be compromised. To evaluate the impact of climate and house geometry, as well as HVAC system and control strategies on comfort conditions, IBACOS analyzed the results of 99 TRNSYS multiple-zone simulations. The results of this analysis indicate that for simple-geometry and single-story plans, a single zone and thermostat can adequately condition the entire house. Demanding house geometry and houses with multiple stories require the consideration of multiple thermostats and multiple zones.

  15. Research needs for risk-informed, performance-based regulations

    International Nuclear Information System (INIS)

    Thadani, A.C.

    1997-01-01

    This article summarizes the activities of the Office of Research of the NRC, both from a historical aspect as well as it applies to the application of risk-based decision making. The office has been actively involved in problems related to understanding risks related to core accidents, to understanding the problem of aging of reactor components and materials from years of service, and toward the understanding and analysis of severe accidents. In addition new policy statements regarding the role of risk assessment in regulatory applications has given focus for the need of further work. The NRC has used risk assessment in regulatory questions in the past but in a fairly ad hoc sort of manner. The new policies will clearly require a better defined application of risk assessment, and help for people evaluating applications in judging the applicability of such applications when a component of them is based on risk-based decision making. To address this, standard review plans are being prepared to serve as guides for such questions. In addition, with regulatory decisions being allowed to be based upon risk-based decisions, it is necessary to have an adequate data base prepared, and made publically available, to support such a position

  16. Listening to the community: Using formative research to strengthen maternity waiting homes in Zambia.

    Science.gov (United States)

    Scott, Nancy A; Vian, Taryn; Kaiser, Jeanette L; Ngoma, Thandiwe; Mataka, Kaluba; Henry, Elizabeth G; Biemba, Godfrey; Nambao, Mary; Hamer, Davidson H

    2018-01-01

    The WHO recommends maternity waiting homes (MWH) as one intervention to improve maternal and newborn health. However, persistent structural, cultural and financial barriers in their design and implementation have resulted in mixed success in both their uptake and utilization. Guidance is needed on how to design a MWH intervention that is acceptable and sustainable. Using formative research and guided by a sustainability framework for health programs, we systematically collected data from key stakeholders and potential users in order to design a MWH intervention in Zambia that could overcome multi-dimensional barriers to accessing facility delivery, be acceptable to the community and be financially and operationally sustainable. We used a concurrent triangulation study design and mixed methods. We used free listing to gather input from a total of 167 randomly sampled women who were pregnant or had a child under the age of two (n = 59), men with a child under the age of two (n = 53), and community elders (n = 55) living in the catchment areas of four rural health facilities in Zambia. We conducted 17 focus group discussions (n = 135) among a purposive sample of pregnant women (n = 33), mothers-in-law (n = 32), traditional birth attendants or community maternal health promoters (n = 38), and men with a child under two (n = 32). We administered 38 semi-structured interviews with key informants who were identified by free list respondents as having a stake in the condition and use of MWHs. Lastly, we projected fixed and variable recurrent costs for operating a MWH. Respondents most frequently mentioned distance, roads, transport, and the quality of MWHs and health facilities as the major problems facing pregnant women in their communities. They also cited inadequate advanced planning for delivery and the lack of access to delivery supplies and baby clothes as other problems. Respondents identified the main problems of MWHs specifically as over-crowding, poor

  17. Research and Development of Information and Communication Technology-based Home Blood Pressure Monitoring from Morning to Nocturnal Hypertension.

    Science.gov (United States)

    Kario, Kazuomi; Tomitani, Naoko; Matsumoto, Yuri; Hamasaki, Haruna; Okawara, Yukie; Kondo, Maiko; Nozue, Ryoko; Yamagata, Hiromi; Okura, Ayako; Hoshide, Satoshi

    2016-01-01

    Asians have specific characteristics of hypertension (HTN) and its relationship with cardiovascular disease. The morning surge in blood pressure (BP) in Asians is more extended, and the association slope between higher BP and the risk for cardiovascular events is steeper in this population than in whites. Thus, 24-hour BP control including at night and in the morning is especially important for Asian patients with HTN. There are 3 components of "perfect 24-hour BP control": the 24-hour BP level, adequate dipping of nocturnal BP (dipper type), and adequate BP variability such as the morning BP surge. The morning BP-guided approach using home BP monitoring (HBPM) is the first step toward perfect 24-hour BP control. After controlling morning HTN, nocturnal HTN is the second target. We have been developing HBPM that can measure nocturnal BP. First, we developed a semiautomatic HBPM device with the function of automatic fixed-interval BP measurement during sleep. In the J-HOP (Japan Morning Surge Home Blood Pressure) study, the largest nationwide home BP cohort, we successfully measured nocturnal home BP using this device with data memory, 3 times during sleep (2, 3, and 4 am), and found that nocturnal home BP is significantly correlated with organ damage independently of office and morning BP values. The second advance was the development of trigger nocturnal BP (TNP) monitoring with an added trigger function that initiates BP measurements when oxygen desaturation falls below a variable threshold continuously monitored by pulse oximetry. TNP can detect the specific nocturnal BP surges triggered by hypoxic episodes in patients with sleep apnea syndrome. We also added the lowest heart rate-trigger function to TNP to detect the "basal nocturnal BP," which is determined by the circulating volume and structural cardiovascular system without any increase in sympathetic tonus. This double TNP is a novel concept for evaluating the pathogenic pressor mechanism of nocturnal BP

  18. Outcomes associated with planned home and planned hospital births in low-risk women attended by midwives in Ontario, Canada, 2003-2006: a retrospective cohort study.

    Science.gov (United States)

    Hutton, Eileen K; Reitsma, Angela H; Kaufman, Karyn

    2009-09-01

    Midwives in Ontario, Canada, provide care in the home and hospital and are required to submit data for all births to the Ontario Ministry of Health database. The purpose of this study was to compare maternal and perinatal/neonatal mortality and morbidity and intrapartum intervention rates for women attended by Ontario midwives who planned a home birth compared with similar low-risk women who planned a hospital birth between 2003 and 2006. The database provided outcomes for all women planning a home birth at the onset of labor (n = 6,692) and for a cohort, stratified by parity, of similar low-risk women planning a hospital birth. The rate of perinatal and neonatal mortality was very low (1/1,000) for both groups, and no difference was shown between groups in perinatal and neonatal mortality or serious morbidity (2.4% vs 2.8%; relative risk [RR], 95% confidence intervals [CI]: 0.84 [0.68-1.03]). No maternal deaths were reported. All measures of serious maternal morbidity were lower in the planned home birth group as were rates for all interventions including cesarean section (5.2% vs 8.1%; RR [95% CI]: 0.64 [0.56, 0.73]). Nulliparas were less likely to deliver at home, and had higher rates of ambulance transport from home to hospital than multiparas planning home birth and had rates of intervention and outcomes similar to, or lower than, nulliparas planning hospital births. Midwives who were integrated into the health care system with good access to emergency services, consultation, and transfer of care provided care resulting in favorable outcomes for women planning both home or hospital births.

  19. The Austrian Research Centers activities in energy risks

    International Nuclear Information System (INIS)

    Sdouz, Gert

    1998-01-01

    Among the institutions involved in energy analyses in Austria the risk context is being treated by three different entities: the Energy Consumption Agency, internationally known as EVA, the Federal Environmental Protection Agency, or Urnweltbundesarnt assessing mainly the environmental risks involved and the Austrian Research Centers, working on safety and risk evaluation. The Austrian Research Center Seibersdorf draws form its proficiency in Reactor Safety and Fusion Research, two fields of experience it has been involved in since its foundation, for some 40 years now. Nuclear energy is not well accepted by the Austrian population. Therefore in our country only energy systems with advanced safety level might be accepted in the far future. This means that the development of methods to compare risks is an important task. The characteristics of energy systems featuring advanced safety levels are: A very low hazard potential and a focus on deterministic safety instead of probabilistic safety, meaning to rely on inherently safe physics concepts, confirmed by probabilistic safety evaluation results. This can be achieved by adequate design of fusion reactors, advanced fission reactors and all different renewable sources of energy

  20. People with dementia in nursing home research: a methodological review of the definition and identification of the study population.

    Science.gov (United States)

    Palm, Rebecca; Jünger, Saskia; Reuther, Sven; Schwab, Christian G G; Dichter, Martin N; Holle, Bernhard; Halek, Margareta

    2016-04-05

    There are various definitions and diagnostic criteria for dementia, leading to discrepancies in case ascertainment in both clinical practice and research. We reviewed the different definitions, approaches and measurements used to operationalize dementia in health care studies in German nursing homes with the aim of discussing the implications of different approaches. We conducted a systematic search of the MEDLINE and CINAHL databases to identify pre-2016 studies conducted in German nursing homes that focused on residents with dementia or cognitive impairment. In- or exclusion of studies were consented by all authors; data extraction was independently carried out by 2 authors (RP, SJ). The studies' sampling methods were compared with respect to their inclusion criteria, assessment tools and methods used to identify the study population. We summarized case ascertainment methods from 64 studies. Study participants were identified based on a diagnosis that was evaluated during the study, or a recorded medical dementia diagnosis, or a recorded medical diagnosis either with additional cognitive screenings or using screening tests exclusively. The descriptions of the diagnostics that were applied to assess a diagnosis of dementia were not fully transparent in most of the studies with respect to either a clear reference definition of dementia or applied diagnostic criteria. If reported, various neuropsychological tests were used, mostly without a clear rationale for their selection. Pragmatic considerations often determine the sampling strategy; they also may explain the variances we detected in the different studies. Variations in sampling methods impede the comparability of study results. There is a need to consent case ascertainment strategies in dementia studies in health service research in nursing homes. These strategies should consider resource constraints and ethical issues that are related to the vulnerable population of nursing home residents. Additionally

  1. Comportamiento del riesgo de caídas en el hogar en adultos mayores Behavior of falls risk at home of the elderly persons

    Directory of Open Access Journals (Sweden)

    Arlene Salas Mainegra

    2011-03-01

    Full Text Available Introducción: se realizó un estudio descriptivo, en la población de adultos mayores atendidos por el Consultorio del Médico de Familia # 4, perteneciente al policlínico "Ramón González Coro", del municipio Marianao, durante 2008. Objetivo: se realizó el análisis del comportamiento del riesgo de caídas de los adultos mayores en el hogar. Métodos: estudio de investigación descriptiva, en cuyo desarrollo se utilizó un modelo cualicuantitativo, y en su ejecución se emplearon métodos teóricos, empíricos y procedimientos estadísticos. Resultados: hubo un predomino del sexo femenino, el mayor por ciento de los adultos mayores presentó algún grado de dependencia, y tuvieron un mediano riesgo de sufrir una caída en su hogar.Introduction: a descriptive study was conducted in the elderly person population seen in the # 4 Family Physician Consulting Room of the "Ramón González Coro" polyclinic from the Marianao municipality during 2008. Objective: an analysis of the falls risk behavior of elderly persons at home was made. Methods: a descriptive research study was conducted using the qualitative and quantitative model and in its implementation theoretical, empirical methods as well as statistic procedures were used. Results: there was predominance of female sex, the higher percentage of elderly persons had some degree of dependence and also had a middle risk of suffering a fall at home.

  2. Perceived Fall Risk and Functional Decline: Gender Differences in Patient's Willingness to Discuss Fall Risk, Fall History, or to Have a Home Safety Evaluation.

    Science.gov (United States)

    Greenberg, Marna Rayl; Moore, Elizabeth C; Nguyen, Michael C; Stello, Brian; Goldberg, Arnold; Barraco, Robert D; Porter, Bernadette G; Kurt, Anita; Dusza, Stephen W; Kane, Bryan G

    2016-06-01

    The CDC reports that among older adults, falls are the leading cause of injury-related death and rates of fall-related fractures among older women are twice those of men. We set out to 1) determine patient perceptions (analyzed by gender) about their perceived fall risk compared to their actual risk for functional decline and death and 2) to report their comfort level in discussing their fall history or a home safety plan with their provider. Elders who presented to the Emergency Department (ED†) were surveyed. The survey included demographics, the Falls Efficacy Scale (FES) and the Vulnerable Elders Survey (VES); both validated surveys measuring fall concern and functional decline. Females had higher FES scores (mean 12.3, SD 5.9) than males (mean 9.7, SD 5.9 p = .007) in the 146 surveys analyzed. Females were more likely to report an increased fear of falling, and almost three times more likely to have a VES score of 3 or greater than males (OR = 2.86, 95% CI: 1.17-7.00, p = .02). A strong correlation was observed between FES and VES scores (r = 0.80, p fall risk with a provider; there was no difference between genders (p = .57). In this study, irrespective of gender, there appears to be a high association between subjects' perceived fall risk and risk for functional decline and death. The majority of patients are likely willing to discuss their fall risk with their provider. These findings may suggest a meaningful opportunity for fall risk mitigation in this setting.

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

    Science.gov (United States)

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

    2014-03-10

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

  4. Risk Assessment of Heating, Ventilating, and Air-Conditioning Strategies in Low-Load Homes

    Energy Technology Data Exchange (ETDEWEB)

    Poerschke, Andrew [IBACOS, Inc., Pittsburgh, PA (United States)

    2016-02-01

    These simulations enabled IBACOS to identify which strategies work best for particular climate zones or house geometries and to propose solutions that homebuilders can implement to reduce the risk of occupant discomfort in individual rooms.

  5. Outcomes of planned home births and planned hospital births in low-risk women in Norway between 1990 and 2007: a retrospective cohort study.

    Science.gov (United States)

    Blix, Ellen; Huitfeldt, Anette Schaumburg; Øian, Pål; Straume, Bjørn; Kumle, Merethe

    2012-12-01

    The safety of planned home births remains controversial in Western countries. The aim of the present study was to compare outcomes in women who planned, and were selected to, home birth at the onset of labor with women who planned for a hospital birth. Data from 1631 planned home births between 1990 and 2007 were compared with a random sample of 16,310 low-risk women with planned hospital births. The primary outcomes were intrapartum intervention rates and complications. Secondary outcomes were perinatal and neonatal death rates. Primiparas who planned home births had reduced risks for assisted vaginal delivery (OR 0.32; 95% CI 0.20-0.48), epidural analgesia (OR 0.21; CI 0.14-0.33) and dystocia (OR 0.40; CI 0.27-0.59). Multiparas who planned home births had reduced risks for operative vaginal delivery (OR 0.26; CI 0.12-0.56), epidural analgesia (OR 0.08; CI 0.04-0.16), episiotomy (OR 0.48; CI 0.31-0.75), anal sphincter tears (OR 0.29; CI 0.12-0.70), dystocia (OR 0.10; CI 0.06-0.17) and postpartum hemorrhage (OR 0.27; CI 0.17-0.41). We found no differences in cesarean section rate. Perinatal mortality rate was 0.6/1000 (CI 0-3.4) and neonatal mortality rate 0.6/1000 (CI 0-3.4) in the home birth cohort. In the hospital birth cohort, the rates were 0.6/1000 (CI 0.3-1.1) and 0.9/1000 (CI 0.5-1.5) respectively. Planning for home births was associated with reduced risk of interventions and complications. The study is too small to make statistical comparisons of perinatal and neonatal mortality. Copyright © 2012 Elsevier B.V. All rights reserved.

  6. Perinatal and maternal outcomes in planned home and obstetric unit births in women at 'higher risk' of complications: secondary analysis of the Birthplace national prospective cohort study.

    Science.gov (United States)

    Li, Y; Townend, J; Rowe, R; Brocklehurst, P; Knight, M; Linsell, L; Macfarlane, A; McCourt, C; Newburn, M; Marlow, N; Pasupathy, D; Redshaw, M; Sandall, J; Silverton, L; Hollowell, J

    2015-04-01

    To explore and compare perinatal and maternal outcomes in women at 'higher risk' of complications planning home versus obstetric unit (OU) birth. Prospective cohort study. OUs and planned home births in England. 8180 'higher risk' women in the Birthplace cohort. We used Poisson regression to calculate relative risks adjusted for maternal characteristics. Sensitivity analyses explored possible effects of differences in risk between groups and alternative outcome measures. Composite perinatal outcome measure encompassing 'intrapartum related mortality and morbidity' (intrapartum stillbirth, early neonatal death, neonatal encephalopathy, meconium aspiration syndrome, brachial plexus injury, fractured humerus or clavicle) and neonatal admission within 48 hours for more than 48 hours. Two composite maternal outcome measures capturing intrapartum interventions/adverse maternal outcomes and straightforward birth. The risk of 'intrapartum related mortality and morbidity' or neonatal admission for more than 48 hours was lower in planned home births than planned OU births [adjusted relative risks (RR) 0.50, 95% CI 0.31-0.81]. Adjustment for clinical risk factors did not materially affect this finding. The direction of effect was reversed for the more restricted outcome measure 'intrapartum related mortality and morbidity' (RR adjusted for parity 1.92, 95% CI 0.97-3.80). Maternal interventions were lower in planned home births. The babies of 'higher risk' women who plan birth in an OU appear more likely to be admitted to neonatal care than those whose mothers plan birth at home, but it is unclear if this reflects a real difference in morbidity. Rates of intrapartum related morbidity and mortality did not differ statistically significantly between settings at the 5% level but a larger study would be required to rule out a clinically important difference between the groups. © 2015 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John

  7. MEASUREMENT ISSUES IN HOME-VISITING RESEARCH WITHIN TRIBAL COMMUNITIES: CHALLENGES AND STRATEGIES.

    Science.gov (United States)

    Whitesell, Nancy Rumbaugh; Bolan, Marc; Chomos, Julianna C; Heath, Debra; Miles, Jon; Salvador, Melina; Whitmore, Corrie; Barlow, Allison

    2018-05-04

    In this article, Tribal Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grantees share strategies they have developed and adopted to address the most common barriers to effective measurement (and thus to effective evaluation) encountered in the course of implementation and evaluation of their home-visiting programs. We identify key challenges in measuring outcomes in Tribal MIECHV Programs and provide practical examples of various strategies used to address these challenges within diverse American Indian and Alaska Native cultural and contextual settings. Notably, high-quality community engagement is a consistent thread throughout these strategies and fundamental to successful measurement in these communities. These strategies and practices reflect the experiences and innovative solutions of practitioners working on the ground to deliver and evaluate intervention programs to tribal communities. They may serve as models for getting high-quality data to inform intervention while working within the constraints and requirements of program funding. The utility of these practical solutions extends beyond the Tribal MIECHV grantees and offers the potential to inform a broad array of intervention evaluation efforts in tribal and other community contexts. © 2018 Michigan Association for Infant Mental Health.

  8. Impaired mental well-being and psychosocial risk: a cross-sectional study in female nursing home direct staff

    Science.gov (United States)

    Pélissier, C; Fontana, L; Fort, E; Vohito, M; Sellier, B; Perrier, C; Glerant, V; Couprie, F; Agard, J P; Charbotel, B

    2015-01-01

    Objectives The present study sought to quantify the impaired mental well-being and psychosocial stress experienced by nursing home staff and to determine the relationship between impaired mental well-being assessed on the 12-item General Health Questionnaire (GHQ-12) and exposure to psychosocial stress assessed on Siegrist's effort/reward and overcommitment model. Methods A transverse study was conducted in France on 2471 female employees in 105 nursing homes for the elderly. Personal and occupational data were collected by questionnaire for 668 housekeepers, 1454 nursing assistants and 349 nurses. Results 36.8% of participants (n=896) showed impaired mental well-being, 42.7% (n=1039) overcommitment and 9% (n=224) effort/reward imbalance. Overcommitment (prevalence ratio (PR)=1.27; 95% CI (1.21 to 1.34)) and effort–reward imbalance (PR=1.19; 95% CI (1.12 to 1.27)) were significantly associated with presence of impaired mental well-being after adjustment for personal factors (age and private life events). Taking effort and reward levels into account, the frequency of impaired mental well-being was highest in case of exposure to great extrinsic effort and low rewards of any type: esteem, PR=3.53, 95% CI (3.06 to 4.08); earnings, PR=3.48, 95% CI (2.99 to 4.06); or job security, PR=3.30, 95% CI (2.88 to 3.78). Participants in situations of overcommitment and of effort/reward imbalance were at the highest risk of impaired mental well-being: PR=3.86, 95% CI (3.42 to 4.35). Conclusions Several changes in nursing home organisation can be suggested to reduce staff exposure to factors of psychosocial stress. Qualitative studies of the relation between impaired mental well-being and psychosocial stress in nursing home staff could guide prevention of impaired mental well-being at work. PMID:25829371

  9. Social and behavioral research on risk: uses in risk management decision-making

    International Nuclear Information System (INIS)

    Covello, V.T.

    1984-01-01

    The overall objective of this paper is to describe the principal uses of social and behavioral research in risk management decision-making. Five such uses are identified and discussed, including uses in (1) identifying the nature and extent of public concern; (2) structuring public debate and resolving conflicts; (3) anticipating public responses to new technologies; (4) conducting and informing the public; and (5) designing and implementing risk management policies and systems. (author)

  10. Rutgers Young Horse Teaching and Research Program: sustainability of taking a risk with "at risk" horses.

    Science.gov (United States)

    Ralston, Sarah L; Molnar, Anne

    2012-12-01

    In 1999, the Young Horse Teaching and Research Program (YHTRP) was initiated at Rutgers University. The unique aspect of the program was using horses generally considered "at risk" and in need of rescue, but of relatively low value. The risks of using horses from pregnant mare urine (PMU) ranches and Bureau of Land Management (BLM) mustangs were high, but, ultimately, unrealized. No students or staff members were seriously injured over the course of the next 12 yr, and the horses were sold annually as highly desirable potential athletes or pleasure horses, usually at a profit. The use of "at risk" horses generated a significant amount of positive media attention and attracted substantial funding in the form of donations and sponsorships, averaging over $60,000 (USD)per year. Despite economic downturns, public and industry support provided sustainability for the program with only basic University infrastructural support. Taking the risk of using "at risk" horses paid off, with positive outcomes for all.

  11. Eighteenth annual risk reduction engineering laboratory research symposium

    International Nuclear Information System (INIS)

    Anon.

    1992-01-01

    The Eighteenth Annual Risk Reduction Engineering Laboratory Research Symposium was held in Cincinnati, Ohio, April 14-16, 1992. The purpose of this Symposium was to present the latest significant research findings from ongoing and recently completed projects funded by the Risk Reduction Engineering Laboratory (RREL). These Proceedings are organized into two sections. Sessions A and B, which contain extended abstracts of the paper presentations. A list of poster displays is also included. Subjects include remedial action, treatment, and control technologies for waste disposal, landfill liner and cover systems, underground storage tanks, and demonstration and development of innovative/alternative treatment technologies for hazardous waste. Alternative technology subjects include thermal destruction of hazardous wastes, field evaluations, existing treatment options, emerging treatment processes, waste minimization, and biosystems for hazardous waste destruction

  12. Home kitchen ventilation, cooking fuels, and lung cancer risk in a prospective cohort of never smoking women in Shanghai, China.

    Science.gov (United States)

    Kim, Christopher; Gao, Yu-Tang; Xiang, Yong-Bing; Barone-Adesi, Francesco; Zhang, Yawei; Hosgood, H Dean; Ma, Shuangge; Shu, Xiao-ou; Ji, Bu-Tian; Chow, Wong-Ho; Seow, Wei Jie; Bassig, Bryan; Cai, Qiuyin; Zheng, Wei; Rothman, Nathaniel; Lan, Qing

    2015-02-01

    Indoor air pollution (IAP) caused by cooking has been associated with lung cancer risk in retrospective case-control studies in developing and rural countries. We report the association of cooking conditions, fuel use, oil use, and risk of lung cancer in a developed urban population in a prospective cohort of women in Shanghai. A total of 71,320 never smoking women were followed from 1996 through 2009 and 429 incident lung cancer cases were identified. Questionnaires collected information on household living and cooking practices for the three most recent residences and utilization of cooking fuel and oil, and ventilation conditions. Cox proportional hazards regression estimated the association for kitchen ventilation conditions, cooking fuels, and use of cooking oils for the risk of lung cancer by hazard ratios (HR) with 95% confidence intervals (95% CI). Ever poor kitchen ventilation was associated with a 49% increase in lung cancer risk (HR: 1.49; 95% CI: 1.15-1.95) compared to never poor ventilation. Ever use of coal was not significantly associated. However, ever coal use with poor ventilation (HR: 1.69; 95% CI: 1.22-2.35) and 20 or more years of using coal with poor ventilation (HR: 2.03; 95% CI: 1.35-3.05) was significantly associated compared to no exposure to coal or poor ventilation. Cooking oil use was not significantly associated. These results demonstrate that IAP from poor ventilation of coal combustion increases the risk of lung cancer and is an important public health issue in cities across China where people may have lived in homes with inadequate kitchen ventilation. © 2014 UICC.

  13. Rethinking Risk: Prospect Theory Application in Health Message Framing Research.

    Science.gov (United States)

    Harrington, Nancy Grant; Kerr, Anna M

    2017-02-01

    Although prospect theory conceptualizes risk as uncertainty, health message framing research based on the theory typically conceptualizes risk as severity. This study reports the results of two experiments designed to explore these alternative conceptualizations of risk and their effect on health decision making. Participants (N 1  = 768, N 2  = 532) were randomly assigned to one of four conditions that presented a hypothetical scenario of a sexually transmitted disease (STD) outbreak. The conditions were defined by message prompt (deadly vs. easily curable STD) and response option frame (gain vs. loss). Participants selected which of two programs (certain outcome vs. uncertain outcome) they would prefer to combat the outbreak. Across both experiments, participants expressed strong preferences for certain (low risk) outcomes in the gain-framed conditions and no preferences in the loss-framed conditions. These differences held regardless of the consequence severity of the scenario. We discuss the theoretical and practical implications of these results and offer directions for future research.

  14. [Home births].

    Science.gov (United States)

    Welffens, K; Kirkpatrick, C; Daelemans, C; Derisbourg, S

    In Belgium, very few women give birth outside the delivery room. In the United Kingdom and in the Netherlands, they are more numerous. Several studies evaluated obstetric and neonatal outcomes of home births compared with hospital births. We selected seven recent and large studies (with cohorts of more than 5.000 women) using PubMed, Science Direct and Cochrane Database of Systematic Reviews. Several questions were examined. Is there any difference in maternal and neonatal outcomes depending on the intended place of birth? Does parity affect outcomes ? What are the characteristics of women who choose to deliver at home ? We conclude that giving birth at home improves obstetric outcomes but is riskier for the baby, especially for the first one. The women delivering at home are mainly white Europeans, between 25 and 35 years old, in a relationship, multiparous and wealthier. In order to avoid this increased risk for the baby while preserving the obstetric advantages, alongside birth centers offer an intermediate solution. They combine the reassuring home-like atmosphere with the safety of the hospital. In Belgium, the first alongside birth center " Le Cocon " (a low technicity unit distinct from the delivery room) offers now this type of alternative place of birth for women in Hôpital Erasme in Brussels.

  15. Psychosocial risk factors in home and community settings and their associations with population health and health inequalities: A systematic meta-review

    Directory of Open Access Journals (Sweden)

    Petticrew Mark

    2008-07-01

    Full Text Available Abstract Background The effects of psychosocial risk factors on population health and health inequalities has featured prominently in epidemiological research literature as well as public health policy strategies. We have conducted a meta-review (a review of reviews exploring how psychosocial factors may relate to population health in home and community settings. Methods Systematic review (QUORUM of literature reviews (published in any language or country on the health associations of psychosocial risk factors in community settings. The literature search included electronic and manual searches. Two reviewers appraised included reviews using criteria for assessing systematic reviews. Data from the more robust reviews were extracted, tabulated and synthesised. Results Thirty-one reviews met our inclusion criteria. These explored a variety of psychosocial factors including social support and networks, social capital, social cohesion, collective efficacy, participation in local organisations – and less favourable psychosocial risk factors such as demands, exposure to community violence or anti-social behaviour, exposure to discrimination, and stress related to acculturation to western society. Most of the reviews focused on associations between social networks/support and physical or mental health. We identified some evidence of favourable psychosocial environments associated with better health. Reviews also found evidence of unfavourable psychosocial risk factors linked to poorer health, particularly among socially disadvantaged groups. However, the more robust reviews each identified studies with inconclusive findings, as well as studies finding evidence of associations. We also identified some evidence of apparently favourable psychosocial risk factors associated with poorer health. Conclusion From the review literature we have synthesised, where associations have been identified, they generally support the view that favourable psychosocial

  16. Increased Risk of Vascular Events in Emergency Room Patients Discharged Home with Diagnosis of Dizziness or Vertigo: A 3-Year Follow-Up Study

    Science.gov (United States)

    Lee, Ching-Chih; Ho, Hsu-Chueh; Su, Yu-Chieh; Chiu, Brian C-H; Su, Yung-Cheng; Lee, Yi-Da; Chou, Pesus

    2012-01-01

    Background Dizziness and vertigo symptoms are commonly seen in emergency room (ER). However, these patients are often discharged without a definite diagnosis. Conflicting data regarding the vascular event risk among the dizziness or vertigo patients have been reported. This study aims to determine the risk of developing stroke or cardiovascular events in ER patients discharged home with a diagnosis of dizziness or vertigo. Methodology A total of 25,757 subjects with at least one ER visit in 2004 were identified. Of those, 1,118 patients were discharged home with a diagnosis of vertigo or dizziness. A Cox proportional hazard model was performed to compare the three-year vascular event-free survival rates between the dizziness/vertigo patients and those without dizziness/vertigo after adjusting for confounding and risk factors. Results We identified 52 (4.7%) vascular events in patients with dizziness/vertigo and 454 (1.8%) vascular events in patients without dizziness/vertigo. ER patients discharged home with a diagnosis of vertigo or dizziness had 2-fold (95% confidence interval [CI], 1.35–2.96; pvertigo during the first year. Conclusions ER patients discharged home with a diagnosis of dizziness or vertigo were at a increased risk of developing subsequent vascular events than those without dizziness/vertigo after the onset of dizziness or vertigo. Further studies are warranted for developing better diagnostic and follow-up strategies in increased risk patients. PMID:22558272

  17. RESEARCH ON RISK CLASSIFICATION METHOD OF ASSEMBLY OCCUPANCIES

    Directory of Open Access Journals (Sweden)

    Hao Yu

    2017-10-01

    Full Text Available Due to the densely population and mobility characteristics of the crowd, generally accidents happened in assembly occupancies will trigger a chain reaction, and then bring heavy casualties and property loss, and result disastrous consequences. In the context of safety regulation resources limited, building risk classification system of assembly occupancies is important for "scientific predicting, and hierarchical controlling” In this paper, a software with a graphical user interface is designed using MATLAB GUI to analyze and calculate risks of stampede accident caused by gathered crowds in the video. A velocity extraction method based on cross-correlation algorithm is adopted, and the risk characteristic parameters such as velocity variance is also applied. In this way, real-time analysis and early-warning for risks of stampede accident in time and space can be achieved. Also, the algorithm is applied to the surveillance video of the stampede in Shanghai and its feasibility is proved. Empirical research shows that, the assembly occupancies risk rating model built in this paper has good effectiveness, simplicity and practicability, applies to the government safety regulation and organization safety management, and can improve the safety situation of assembly occupancies effectively.

  18. Unexplained Absences and Risk of Death and Injury Among Nursing Home Residents: A Systematic Review.

    Science.gov (United States)

    Woolford, Marta H; Weller, Carolina; Ibrahim, Joseph E

    2017-04-01

    Unexplained absence of nursing home (NH) residents is one of the most challenging issues related to the care of older people. The aim of this review was to examine the death and injury outcomes of unexplained absence of NH residents. We searched MEDLINE, CINAHL, EMBASE, PsycINFO, AgeLine, and Cochrane Library to identify qualitative and quantitative studies published in the English language. Data on death and injury were collated, and aggregate proportions were calculated where possible. Nine studies were identified; most (n = 6) were conducted in the United States. Persons with dementia formed the study population in all studies. There were 1440 individual unexplained absences reported across the 9 studies. We calculated a rate of 82 deaths and 61 injuries per 1000 incidents of unexplained absence. Extreme temperatures were the most common cause of death. Most individuals left by foot, and were found within a 1-mile radius of place last seen in green vegetation and waterways. This review provides valuable insight into death and injury outcomes. Further studies are recommended to improve understanding and prevent adverse outcomes. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  19. Home gardening may be a risk factor for contact dermatitis to Alstroemeria.

    Science.gov (United States)

    Tavares, Beatriz; Loureiro, Graça; Pereira, Celso; Chieira, Celso

    2006-01-01

    Occupational allergy among florists and people who work in cut flower production of Alstroemeria cultivars (Peruvian lily or Inca lily) has been previously reported. The allergen involved in sensitization is tulipalin A (alpha-methylene-gamma-butyrolactone). We describe the case of a 65-year-old woman who developed severe dermatitis on her right thumb, index and middle fingers and less severe dermatitis on her left palm and front of forearm with occasional itching of the neck and face after taking up home gardening activities, including cutting flowers such as Alstroemeria. The patient and three healthy individuals were submitted to epicutaneous tests with the European standard series, the plant series, and stem portions of three suspected ornamental plants (Alstroemeria, Lilium and Zantedeschia), garlic, and onion. Patch tests performed in our patient, revealed an extreme reaction (+ + +) to Alstroemeria and alpha-methylene-gamma-butyrolactone, a strong reaction (+ +) to propolis and wood tar mix, a weak reaction (+) to balsam of Peru, an irritant reaction to garlic and negative results to diallyl disulfide and the other components investigated. Patch tests performed in the healthy individuals revealed negative. We stress the importance of Alstroemeria as a cause of allergic contact dermatitis not only in workers involved in the flower trade, but also in other people that come into contact with this plant in their leisure activities.

  20. Animal experimental research of the endothelialization of home-made atrial septal defect occluder device

    International Nuclear Information System (INIS)

    Chen Mingwu; Zhou Aiqing; Li Feng; Gao Wei; Yu Zhiqing; Tang Ning; Zhang Lan

    2003-01-01

    Objective: To evaluate the endothelialization of Chinese nitinol atrial septal defect occluder device. Methods: Atrial septal defect with controllable size was created by the Brockenborough needle and Rashkind balloon atrial septostomy, the occluder devices were implanted in six piglets (mean weight 7.5 kg). Two pigs were killed each time after 1 month, 3 months and 6 months after the device implantation and then the explanted devices were examined by scanning electron microscope (SEM). Results: The devices were found covering with collagen fibrosis together with diffuse endothelial cells spreading over the primer 1 month after implantation. The implants were covered mostly by neointima 3 months after implantation and completely covered by confluent endothelial cells 6 months after the implantation. Endothelial cells were not found on the smooth marker band at 3 months, however, did exist by 6 months. Conclusions: Home-made atrial septal defect occluder devices were mostly endothelialised 3 months after the implantation and did completely at 6 months

  1. Emerging Cardiovascular Risk Research: Impact of Pets on Cardiovascular Risk Prevention.

    Science.gov (United States)

    Schreiner, Pamela J

    2016-02-01

    Animals interact with humans in multiple ways, including as therapy and service animals, commercially as livestock, as wildlife, and in zoos. But the most common interaction is as companion animals in our homes, with an estimated 180 million cats and dogs living in US households. While pet ownership has been reported to have many health benefits, the findings are inconsistent. Cardiovascular risk factors such as lipids, glucose, obesity, and heart rate variability have improved, worsened, or remained the same in the limited number of studies considering companion animals. Physical activity increases have more consistently been linked with dog ownership, although whether this reflects antecedent motivation or direct benefit from the dog is unclear. Allergies and asthma also are variably linked to pet ownership and are confounded by family history of atopy and timing of exposure to pet dander. The benefits of companion animals are most likely to be through reduction in depression, anxiety, and social isolation, but these studies have been largely cross-sectional and may depend on degree of bonding of the owner with the animal. Positive relationships show measurably higher oxytocin with lower cortisol and alpha-amylase levels. Finally, pet ownership is also a marker of better socioeconomic status and family stability, and if companion animals are to provide cardiovascular risk benefit, the route should perhaps be through improved education and opportunity for ownership.

  2. Cardiovascular risk factors in cognitively impaired nursing home patients: A relationship with pain?

    NARCIS (Netherlands)

    Achterberg, W.P.; Scherder, E.J.A.; Pot, A.M.; Ribbe, M.W.

    2007-01-01

    Cardiovascular risk factors (CRF) such as hypertension and diabetes mellitus favour the development of both vascular dementia (VaD) and Alzheimer’s disease (AD). The resulting deafferentation may increase the experience of pain in VaD and in AD. The goal of the present study was to examine the

  3. Home Automation

    OpenAIRE

    Ahmed, Zeeshan

    2010-01-01

    In this paper I briefly discuss the importance of home automation system. Going in to the details I briefly present a real time designed and implemented software and hardware oriented house automation research project, capable of automating house's electricity and providing a security system to detect the presence of unexpected behavior.

  4. Center for risk research: A review of work 1988-1991

    International Nuclear Information System (INIS)

    Sjoeberg, L.

    1992-01-01

    This report gives a summary of the research published during the first 4 years of the Center for Risk Research at the Stockholm School of Economics. Risk research carried out so far at the Center has been concerned with mapping of attitudes and risk perceptions with regard to nuclear risks, AIDS, military flight risks, and economic risks. There has also been some methodological work and some work on the relationship between risk perception and interests

  5. Center for risk research: A review of work 1988-1991

    Energy Technology Data Exchange (ETDEWEB)

    Sjoeberg, L

    1992-01-01

    This report gives a summary of the research published during the first 4 years of the Center for Risk Research at the Stockholm School of Economics. Risk research carried out so far at the Center has been concerned with mapping of attitudes and risk perceptions with regard to nuclear risks, AIDS, military flight risks, and economic risks. There has also been some methodological work and some work on the relationship between risk perception and interests.

  6. Home Visiting Processes: Relations with Family Characteristics and Outcomes

    Science.gov (United States)

    Peterson, Carla A.; Roggman, Lori A.; Green, Beth; Chazan-Cohen, Rachel; Korfmacher, Jon; McKelvey, Lorraine; Zhang, Dong; Atwater, Jane B.

    2013-01-01

    Variations in dosage, content, and family engagement with Early Head Start (EHS) home visiting services were examined for families participating in the EHS Research and Evaluation Project. Families were grouped by characteristics of maternal age, maternal ethnicity, and level of family risk. All home visiting variables were related differentially…

  7. Current Research Status of KHNP for Site Risk

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Kyemin; Jeon, Ho-Jun; Bahng, Ki-In; Na, Jang-Hwan [KHNP CRI, Daejeon (Korea, Republic of)

    2016-10-15

    In Korea, by the geographical characteristics, many Nuclear Power Plants (NPPs) have been constructed and operated at a single site. This is above average level or number of plants per site in the world. For this reason, the public concerns for the safety of nuclear facilities increased after Fukushima Daiichi accident. As a result, comprehensive risk assessment and management for the site which have multi-unit NPPs were strongly asked. Currently, to solve it, many researches and projects has carried out by various Korean companies, research centers, and regulatory authorities. In this paper, R and D plans of KHNP for multi-unit risk were summarized. Firstly, the needs of multi-unit PSA were reviewed. R and D activities and plans of KHNP were summarized in the last part. In this paper, we summarized the R and D plans of KHNP for assessing the multi-unit risk. Currently, multi-unit risk or multi-unit PSA are important and practical issues in both nuclear industry and national energy policy. After Fukushima accident, several countries stopped the construction and the operation of NPPs, other countries which is maintaining the NPPs are being strongly asked to assess the risk for multi-unit NPPs at the same site. Because of Korean geographical characteristics, the number of NPPs which are above average level or number of plants per site in the world is being constructed and operated at a single site. The population density nearby each site is considered to be higher than that of other countries.

  8. Current Research Status of KHNP for Site Risk

    International Nuclear Information System (INIS)

    Oh, Kyemin; Jeon, Ho-Jun; Bahng, Ki-In; Na, Jang-Hwan

    2016-01-01

    In Korea, by the geographical characteristics, many Nuclear Power Plants (NPPs) have been constructed and operated at a single site. This is above average level or number of plants per site in the world. For this reason, the public concerns for the safety of nuclear facilities increased after Fukushima Daiichi accident. As a result, comprehensive risk assessment and management for the site which have multi-unit NPPs were strongly asked. Currently, to solve it, many researches and projects has carried out by various Korean companies, research centers, and regulatory authorities. In this paper, R and D plans of KHNP for multi-unit risk were summarized. Firstly, the needs of multi-unit PSA were reviewed. R and D activities and plans of KHNP were summarized in the last part. In this paper, we summarized the R and D plans of KHNP for assessing the multi-unit risk. Currently, multi-unit risk or multi-unit PSA are important and practical issues in both nuclear industry and national energy policy. After Fukushima accident, several countries stopped the construction and the operation of NPPs, other countries which is maintaining the NPPs are being strongly asked to assess the risk for multi-unit NPPs at the same site. Because of Korean geographical characteristics, the number of NPPs which are above average level or number of plants per site in the world is being constructed and operated at a single site. The population density nearby each site is considered to be higher than that of other countries

  9. Flying the Nest: How the Home Department Shapes Researchers' Career Paths

    Science.gov (United States)

    Hottenrott, Hanna; Lawson, Cornelia

    2017-01-01

    This paper studies the importance of the socialization environment--nest--for the career destinations of early career researchers. In a sample of research groups in the fields of science and engineering at universities in Germany, we identify research orientation, output, funding as well as openness to industry and commercialization as relevant…

  10. Review of European research trends of low dose radiation risk

    International Nuclear Information System (INIS)

    Iwasaki, Toshiyasu; Yoshida, Kazuo

    2010-01-01

    Large research projects on low dose radiation effects in Europe and US over the past decade have provided limited scientific knowledge which could underpin the validation of radiation protection systems. Recently in Europe, there have been repeated discussions and dialogues to improve the situation, and as the consequence, the circumstances surrounding low dose radiation risks are changing. In 2009, Multidisciplinary European Low Dose Initiative (MELODI) was established as a trans-national organization capable of ensuring appropriate governance of research in the pursuit of a long term shared vision, and Low Dose Research towards Multidisciplinary Integration (DoReMi) network was launched in 2010 to achieve fairly short term results in order to prove the validity of the MELODI approach. It is expected to be very effective and powerful activities to facilitate the reduction of uncertainties in the understanding of low dose risks, but the regulatory requests rushing the reinforcement of radiological protection regulations based on the precautional principles are more increasing. To develop reasonable radiological protection systems based on scientific evidences, we need to accelerate to collect scientific evidences which could directly underpin more appropriate radiation protection systems even in Japan. For the purpose, we Japan need to develop from an independent standpoint and share as a multidisciplinary vision a long term and holistic research strategy which enables to enhance Japanese advantages such as low dose rate facilities and animal facilities, as soon as possible. (author)

  11. Logistic regression for risk factor modelling in stuttering research.

    Science.gov (United States)

    Reed, Phil; Wu, Yaqionq

    2013-06-01

    To outline the uses of logistic regression and other statistical methods for risk factor analysis in the context of research on stuttering. The principles underlying the application of a logistic regression are illustrated, and the types of questions to which such a technique has been applied in the stuttering field are outlined. The assumptions and limitations of the technique are discussed with respect to existing stuttering research, and with respect to formulating appropriate research strategies to accommodate these considerations. Finally, some alternatives to the approach are briefly discussed. The way the statistical procedures are employed are demonstrated with some hypothetical data. Research into several practical issues concerning stuttering could benefit if risk factor modelling were used. Important examples are early diagnosis, prognosis (whether a child will recover or persist) and assessment of treatment outcome. After reading this article you will: (a) Summarize the situations in which logistic regression can be applied to a range of issues about stuttering; (b) Follow the steps in performing a logistic regression analysis; (c) Describe the assumptions of the logistic regression technique and the precautions that need to be checked when it is employed; (d) Be able to summarize its advantages over other techniques like estimation of group differences and simple regression. Copyright © 2012 Elsevier Inc. All rights reserved.

  12. Identifying risk factors for exposure to culturable allergenic moulds in energy efficient homes by using highly specific monoclonal antibodies.

    Science.gov (United States)

    Sharpe, Richard A; Cocq, Kate Le; Nikolaou, Vasilis; Osborne, Nicholas J; Thornton, Christopher R

    2016-01-01

    The aim of this study was to determine the accuracy of monoclonal antibodies (mAbs) in identifying culturable allergenic fungi present in visible mould growth in energy efficient homes, and to identify risk factors for exposure to these known allergenic fungi. Swabs were taken from fungal contaminated surfaces and culturable yeasts and moulds isolated by using mycological culture. Soluble antigens from cultures were tested by ELISA using mAbs specific to the culturable allergenic fungi Aspergillus and Penicillium spp., Ulocladium, Alternaria, and Epicoccum spp., Cladosporium spp., Fusarium spp., and Trichoderma spp. Diagnostic accuracies of the ELISA tests were determined by sequencing of the internally transcribed spacer 1 (ITS1)-5.8S-ITS2-encoding regions of recovered fungi following ELISA. There was 100% concordance between the two methods, with ELISAs providing genus-level identity and ITS sequencing providing species-level identities (210 out of 210 tested). Species of Aspergillus/Penicillium, Cladosporium, Ulocladium/Alternaria/Epicoccum, Fusarium and Trichoderma were detected in 82% of the samples. The presence of condensation was associated with an increased risk of surfaces being contaminated by Aspergillus/Penicillium spp. and Cladosporium spp., whereas moisture within the building fabric (water ingress/rising damp) was only associated with increased risk of Aspergillus/Penicillium spp. Property type and energy efficiency levels were found to moderate the risk of indoor surfaces becoming contaminated with Aspergillus/Penicillium and Cladosporium which in turn was modified by the presence of condensation, water ingress and rising damp, consistent with previous literature. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Functional measures show improvements after a home exercise program following supervised balance training in older adults with elevated fall risk.

    Science.gov (United States)

    Tisher, Kristen; Mann, Kimberly; VanDyke, Sarah; Johansson, Charity; Vallabhajosula, Srikant

    2018-03-05

    Supervised balance training shows immediate benefit for older adults at fall risk. The long-term effectiveness of such training can be enhanced by implementing a safe and simple home exercise program (HEP). We investigated the effects of a12-week unsupervised HEP following supervised clinic-based balance training on functional mobility, balance, fall risk, and gait. Six older adults with an elevated fall risk obtained an HEP and comprised the HEP group (HEPG) and five older adults who were not given an HEP comprised the no HEP group (NoHEPG). The HEP consisted of three static balance exercises: feet-together, single-leg stance, and tandem. Each exercise was to be performed twice for 30-60 s, once per day, 3 days per week for 12 weeks. Participants were educated on proper form, safety, and progression of exercises. Pre- and post-HEP testing included Berg Balance Scale (BBS), Timed Up and Go, Short Physical Performance Battery (SPPB) assessments, Activities-Balance Confidence, Late-Life Functional Disability Instrument and instrumented assessments of balance and gait (Limits of Stability, modified Clinical Test of Sensory Interaction on Balance, Gait). A healthy control group (HCG; n = 11) was also tested. For most of the measures, the HEPG improved to the level of HCG. Though task-specific improvements like BBS and SPPB components were seen, the results did not carry over to more dynamic assessments. Results provide proof of concept that a simple HEP can be independently implemented and effective for sustaining and/or improving balance in older adults at elevated fall-risk after they have undergone a clinic-based balance intervention.

  14. 2013 Nutrition Risk Research Plan Review Final Report. Research Plan Review for: The Risk Factor of Inadequate Nutrition

    Science.gov (United States)

    2014-01-01

    The 2013 Nutrition Risk Standing Review Panel (from here on referred to as the SRP) was impressed by the degree of progress the nutrition discipline has made with the research plan presented since the 2012 Nutrition Risk SRP WebEx/teleconference. The scientists and staff associated with the nutrition discipline have, in addition, continued their impressive publication track record. Specifically the SRP found that the novel and important progress in the ocular health research area (Gap N7.3) represents an important advance in understanding the etiology and potential countermeasures for this condition and thinks that the work will not only be valuable for vision, but may have implications for cardiovascular health, as well. The SRP also considered the bone countermeasure data presented a potentially valuable tool for investigating bone metabolism under the unique conditions of space travel, specifically the innovation of variable use of stable Ca isotopes for bone synthesis and equal contribution for bone to investigate bone metabolism, as well as, the impact of the advanced resistive exercise device (ARED) on body composition during spaceflight. Finally, the SRP considers the planned Integrated Nutrition task to be an important and necessary strategic part of the research plan. The SRP is concerned that the risks observed in previous research on Low Earth Orbit (LEO) may not capture all the risks of longer duration flight beyond LEO. In particular, the SRP believes that there may be a much greater likelihood of an intensified chronic inflammatory response compared to the very minimal evidence seen to date and that modest effects seen in LEO, such as the reduction in appetite, may not predict an absence in longer duration flight out of LEO. The added complications of longer duration flight, greater bio-behavioral stress, radiation exposure, poorer communication, and inability to respond to unforeseen exigencies may create different risks. Thus, preparation for

  15. Getting sick and falling behind: health and the risk of mortgage default and home foreclosure.

    Science.gov (United States)

    Houle, Jason N; Keene, Danya E

    2015-04-01

    An emerging literature shows that mortgage strain can lead to poor health outcomes, but less work has focused on whether and how health shocks influence mortgage distress. We examine the link between changes in health status and default/foreclosure risk among older middle-aged adults. We used National Longitudinal Study of Youth 1979 data and multivariate logistic regression models to examine the relationship between changes in health limitations and chronic conditions across survey waves and risk of mortgage default and foreclosure. We found that changes in health limitations and chronic conditions increased the risk of default and foreclosure between 2007 and 2010. These associations were partially mediated by changes in family income and loss of health insurance. From a policy perspective, the strong link between the onset of illness and foreclosure suggests a need to re-examine the safety-nets that are available to individuals who become ill or disabled. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. Risk Factors for Nursing Home Placement in Alzheimer's Disease: A Longitudinal Study of Cognition, ADL, Service Utilization, and Cholinesterase Inhibitor Treatment

    Science.gov (United States)

    Wattmo, Carina; Wallin, Asa K.; Londos, Elisabet; Minthon, Lennart

    2011-01-01

    Purpose of the Study: To identify risk factors for early nursing home placement (NHP) in Alzheimer's disease (AD), focusing on the impact of longitudinal change in cognition, activities of daily living (ADL), service utilization, and cholinesterase inhibitor treatment (ChEI). Design and Methods: In an open, 3-year, prospective, multicenter study…

  17. Effect of family-style meals on energy intake and risk of malnutrition in dutch nursing home residents: A randomized controlled trial

    NARCIS (Netherlands)

    Nijs, K.A.N.D.; Graaf, de C.; Siebelink, E.; Blauw, Y.H.; Vanneste, V.; Kok, F.J.; Staveren, van W.A.

    2006-01-01

    Background. Social facilitation and meal ambiance have beneficial effects on food intake in healthy adults. Extrapolation to the nursing home setting may lead to less malnutrition among the residents. Therefore, we investigate the effect of family-style meals on energy intake and the risk of

  18. Mild to moderate cognitive impairment is a major risk factor for mortality and nursing home admission in the first year after hip fracture

    Science.gov (United States)

    It is not well established if and to what extent mild to moderate cognitive impairment predicts mortality and risk of nursing home admission after hip fracture. To investigate prospectively whether and to what extent mild to moderate cognitive impairment, contributes to mortality and admission to nu...

  19. The role of geriatric assessment tests and anthropometric measurements in identifying the risk of falls in elderly nursing home residents

    Science.gov (United States)

    Yardimci, Bulent; Aran, Sinan N.; Ozkaya, Ismail; Aksoy, Sevki M.; Demir, Tarik; Tezcan, Gulsen; Kaptanoglu, Aysegul Y.

    2016-01-01

    Objectives: To determine the relation among the risk of falls, geriatric assessment, and anthropometric measurements, including the mini mental state examination, geriatric depression scale, handgrip test, and key pinch test. Methods: This prospective study included 89 residents hospitalized between May 2014 and September 2015 in the geriatric care unit of the Istanbul Balikli Rum Hospital, Istanbul, Turkey. Patients were followed-up for one year, and their falls were recorded. Medical records of the included patients were retrieved and analyzed. Results: A total of 89 patients, comprising 37 men and 52 women with an average age of 75.8 ± 8.2 years were included in the study. The residents’ annual falling averages were 1.0 ± 1.5. The most significant factors were identified to be predicted muscle mass, skeletal muscle index, whole body bioimpedance, dominant arm muscle strength, dominant arm bioimpedance, and free fat mass. Conclusions: The mini mental test, geriatric depression scale and lawton-brody scale combined with the handgrip, 6-meters walking, and bioimpedance tests are favorable for detecting the risk of falls and recurrent falls in vulnerable elderly nursing home residents. PMID:27652361

  20. Research needs for risk-informed, performance-based regulation

    International Nuclear Information System (INIS)

    Cloninger, T.H.

    1997-01-01

    This presentation was made by an executive in the utility which operates the South Texas Project reactors, and summarizes their perspective on probabilistic safety analysis, risk-based operation, and risk-based regulation. They view it as a tool to help them better apply their resources to maintain the level of safety necessary to protect the public health and safety. South Texas served as one of the pilot plants for the application of risk-based regulation to the maintenance rule. The author feels that the process presents opportunities as well as challenges. Among the opportunities is the involvement of more people in the process, and the sense of investment they take in the decisions, in addition to the insight they can offer. In the area of challenges there is the need for better understanding of how to apply what already is known on problems, rather than essentially reinventing the wheel to address problems. Research is needed to better understand when some events are not truly of a significant safety concern. The demarcation between deterministic decisions and the appropriate application of risk-based decisions must be better defined, for the sake of the operator as well as the public observing plant operation

  1. Regional variations in home canning practices and the risk of foodborne botulism in the Republic of Georgia, 2003.

    Science.gov (United States)

    Tarkhashvili, N; Chokheli, M; Chubinidze, M; Abazashvili, N; Chakvetadze, N; Imnadze, P; Kretsinger, K; Varma, J; Sobel, J

    2015-04-01

    Foodborne botulism is a severe, paralytic illness caused by ingestion of preformed neurotoxins produced by Clostridium botulinum. In 2003, we conducted a population-based household survey of home canning practices to explore marked regional variations in botulism incidence in the Republic of Georgia (ROG). We designed a cluster sampling scheme and subdivided each of the 10 regions of the ROG into a variable number of strata. Households were selected from each stratum using a two-step cluster sampling methodology. We administered a questionnaire about home canning practices to household members responsible for food preparation. Using multivariate logistic regression analysis, we modeled high (eastern ROG) against low (western ROG) incidence areas. Overall, we surveyed 2,742 households nationwide. Home canning with a capping device hermetically sealing the lid covering the jar was practiced by 1,909 households (65.9%; 95% confidence interval [CI]: 59.8 to 72.1%). Canning was more prevalent in regions of low botulism incidence (34 versus 32%; P canning vegetables and consuming them (adjusted odds ratio [aOR] = 2.1; 95% CI: 1.3 to 3.5) and adding any of the following ingredients to the jar at time of preparation: >1 tablespoon of salt per liter (aOR = 5.1; 95% CI: 1.2 to 22.6); vinegar (aOR = 2.2; 95% CI: 1.3 to 3.7), and greens (aOR = 5.6; 95% CI: 1.7 to 18.2). The following practices were associated with a decreased risk in high-botulism areas: >57 jars canned per household annually (aOR = 0.5; 95% CI: 0.3 to 0.9), covering or immersing vegetables in boiling water before placing them into the jar (aOR = 0.3 95% CI: 0.2 to 0.6), covering or immersing vegetables in boiling water after placing them into the jar (aOR = 0.4; 95% CI: 0.2 to 0.9), or adding garlic (aOR = 0.2; 95% CI: 0.1 to 0.5) or aspirin (aOR = 0.1; 95% CI: 0.1 to 0.2) to the jar at the time of preparation.

  2. Supply chain risk management: review, classification and future research directions

    Directory of Open Access Journals (Sweden)

    Mittal, M.L.

    2011-01-01

    Full Text Available In order to be more efficient, firms have adopted strategies such as outsourcing, global partnerships and lean practices. Although such strategies have tremendous abilities to improve the efficiencies but simultaneously they make the firms vulnerable to market uncertainties, dependencies and disruptions. Moreover, natural calamities and manmade crises have also put negative impact on strategic, operational and tactical performance of supply chains. These factors have triggered the interest of academia and industry to consider the risk issues as prime concerns. To capture the more fine-grained elements of diversified risk issues related to the supply chain we employ a multi-layered top town taxonomy to classify and codify the literature and put forward the probable dimensions for future research. We further study the pool of SCRM literature focusing on coordination, decision making and sector-wise SCRM implementation issues and derive relevant propositions.

  3. How did formative research inform the development of a home-based neonatal care intervention in rural Ghana?

    Science.gov (United States)

    Hill, Z; Manu, A; Tawiah-Agyemang, C; Gyan, T; Turner, K; Weobong, B; Ten Asbroek, A H A; Kirkwood, B R

    2008-12-01

    Formative research is often used to inform intervention design, but the design process is rarely reported. This study describes how an integrated home visit intervention for newborns in Ghana was designed. As a first step in the design process, the known intervention parameters were listed, information required to refine the intervention was then identified and a formative research strategy designed. The strategy included synthesizing available data, collecting data on newborn care practices in homes and facilities, on barriers and facilitators to adopting desired behaviors and on practical issues such as whom to include in the intervention. The data were used to develop an intervention plan through workshops with national and international stakeholders and experts. The intervention plan was operationalized by district level committees. This included developing work plans, a creative brief for the materials and completing a community volunteer inventory. The intervention was then piloted and the intervention materials were finalized. The design process took over a year and was iterative. Throughout the process, literature was reviewed to identify the best practice. The intervention focuses on birth preparedness, using treated bednets in pregnancy, early and exclusive breastfeeding, thermal care, special care for small babies and prompt care seeking for newborns with danger signs. The need for a problem-solving approach was identified to help ensure behavior change. A subset of behaviors were already being performed adequately, or were the focus of other interventions, but were important to reinforce in the visits. These include attending antenatal care and care seeking for danger signs in pregnancy. On the basis of the intervention content, the timing of newborn deaths and the acceptability of visits, two antenatal and three visits in the first week of life (days 1, 3 and 7) were planned. Several household members were identified to include in the visits as they

  4. Screening for malnutrition among nursing home residents - a comparative analysis of the mini nutritional assessment, the nutritional risk screening, and the malnutrition universal screening tool.

    Science.gov (United States)

    Diekmann, R; Winning, K; Uter, W; Kaiser, M J; Sieber, C C; Volkert, D; Bauer, J M

    2013-04-01

    The European Society for Clinical Nutrition and Metabolism (ESPEN) has recommended the Mini Nutritional Assessment (MNA®), the Nutritional Risk Screening 2002 (NRS), and the Malnutrition Universal Screening Tool (MUST) for nutritional screening in various settings and age groups. While in recent years all three tools have been applied to nursing home residents, there is still no consensus on the most appropriate screening tool in this specific setting. The present study aims at comparing the MNA, the NRS, and the MUST with regard to applicability, categorization of nutritional status, and predictive value in the nursing home setting. MNA, NRS, and MUST were performed on 200 residents from two municipal nursing homes in Nuremberg, Germany. Follow-up data on infection, hospitalization, and mortality were collected after six and again after twelve months. Among 200 residents (mean age 85.5 ± 7.8 years) the MNA could be completed in 188 (94.0%) and the NRS and MUST in 198 (99.0%) residents. The prevalence of 'malnutrition' according to the MNA was 15.4%. The prevalence of 'risk of malnutrition' (NRS) and 'high risk of malnutrition' (MUST), respectively, was 8.6% for both tools. The individual categorization of nutritional status showed poor agreement between NRS and MUST on the one hand and MNA on the other. For all tools a significant association between nutritional status and mortality was demonstrated during follow-up as classification in 'malnourished', respectively 'high risk of malnutrition' or 'nutritional risk', was significantly associated with increased hazard ratios. However, the MNA showed the best predictive value for survival among well-nourished residents. The evaluation of nutritional status in nursing home residents by MNA, NRS, and MUST shows significant differences. This observation may be of clinical relevance as nutritional intervention is usually based on screening results. As the items of the MNA reflect particularities of the nursing home

  5. 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

  6. Bringing life course home: a pilot to reduce pregnancy risk through housing access and family support.

    Science.gov (United States)

    Allen, Deborah; Feinberg, Emily; Mitchell, Heavenly

    2014-02-01

    Proponents of life course comment that while the theory is persuasive, translating theory to practice is daunting. This paper speaks to the challenges and possibilities of intervention based on life course theory. It describes Healthy Start in Housing (HSiH), a partnership between the Boston Public Health Commission (BPHC) and the Boston Housing Authority (BHA) to reduce stress due to housing insecurity among low-income, pregnant women. HSiH seeks improved birth outcomes and long term health of mothers and infants. BHA goals are improved quality of life for participants, greater public housing stability and enhanced impact of housing on community well-being. HSiH is a 1 year pilot offering 75 housing units to pregnant women at risk of adverse birth outcomes and homelessness. BHA provides housing and expedites processing of HSiH applications; BPHC staff oversee enrollment, guide women through the application process, and provide enhanced, long-term case management. Of 130 women referred to HSiH to date, 53 were ineligible, 59 have submitted applications, 13 are preparing applications and 5 dropped out. Nineteen women have been housed. Among eligible women, 58 % had medical conditions, 56 % mental health conditions, and 14 % prior adverse outcomes; 30 % had multiple risks. Standardized assessments reflected high levels of depressive symptoms; 41 % had symptoms consistent with post-traumatic stress disorder. Life course theory provides both the framework and the rationale for HSiH. HSiH experience confirms the salience of daily social experience to women's health and the importance of addressing stressors and stress in women's lives.

  7. Cholera in the United States, 1965-1991. Risks at home and abroad.

    Science.gov (United States)

    Weber, J T; Levine, W C; Hopkins, D P; Tauxe, R V

    1994-03-14

    To assess risks for cholera in the United States. Review of published reports of cholera outbreaks and sporadic cases and Centers for Disease Control and Prevention (CDC) memoranda and laboratory reports. Persons with symptomatic laboratory-diagnosed cholera treated in the United States and territories. From 1965 through 1991, 136 cases of cholera were reported. Fifty-three percent of the patients were hospitalized and three persons died (case-fatality rate, 0.02). Ninety-three infections were acquired in the United States and 42 overseas; for one case the source was unknown. Domestically acquired cholera was largely related to the endemic Gulf Coast focus of Vibrio cholerae 01 (56 cases). The major domestic food vehicle was shellfish, particularly crabs harvested from the Gulf of Mexico or nearby estuaries. In 1991, 14 (54%) of 26 domestically acquired cases were caused by food from Ecuador (n = 11) and Thailand (n = 3). During 1991, the first cases of cholera in travelers returning from South America were reported. In 1991, the rate of cholera among air travelers returning from South America was estimated as 0.3 per 100,000; among air travelers returning from Ecuador, 2.6 per 100,000. Cholera remains a small but persistent risk in the United States and for travelers. An endemic focus on the Gulf Coast, the continuing global pandemic, and the epidemic in South America make this likely to continue for years to come. Physicians should know how to diagnose and treat cholera and should report all suspected cases to their state health departments.

  8. Home gardening near a mining site in an arsenic-endemic region of Arizona: assessing arsenic exposure dose and risk via ingestion of home garden vegetables, soils, and water.

    Science.gov (United States)

    Ramirez-Andreotta, Monica D; Brusseau, Mark L; Beamer, Paloma; Maier, Raina M

    2013-06-01

    The human-health risk posed by gardening near a legacy mine and smelter in an arsenic-endemic region of Arizona was characterized in this study. Residential soils were used in a greenhouse study to grow common vegetables, and local residents, after training, collected soil, water, and vegetables samples from their home gardens. Concentrations of arsenic measured in water, soil, and vegetable samples were used in conjunction with reported US intake rates to calculate the daily dose, Incremental Excess Lifetime Cancer Risk (IELCR), and Hazard Quotient for arsenic. Relative arsenic intake dose decreased in order: water>garden soils>homegrown vegetables, and on average, each accounted for 77, 16, and 7% of a residential gardener's daily arsenic intake dose. The IELCR ranges for vegetables, garden soils, and water were 10(-8) to 10(-4), 10(-6) to 10(-4), and 10(-5) to 10(-2), respectively. All vegetables (greenhouse and home garden) were grouped by scientific family, and the risk posed decreased as: Asteraceae≫Fabaceae>Amaranthaceae>Liliaceae>Brassicaceae>Solanaceae≫Cucurbitaceae. Correlations observed between concentrations of arsenic in vegetables and soils were used to estimate a maximum allowable level of arsenic in soil to limit the excess cancer risk to 10(-6). The estimated values are 1.56 mg kg(-1), 5.39 mg kg(-1), 11.6 mg kg(-1) and 12.4 mg kg(-1) for the Asteraceae, Brassicaceae, Fabaceae, and Amaranthaceae families, respectively. It is recommended that home gardeners: sample their private wells annually, test their soils prior to gardening, and, if necessary, modify their gardening behavior to reduce incidental soil ingestion. This study highlights the importance of site-specific risk assessment, and the need for species-specific planting guidelines for communities. Copyright © 2013 Elsevier B.V. All rights reserved.

  9. Unpacking socio-economic risks for reading and academic self-concept in primary school: differential effects and the role of the preschool home learning environment

    OpenAIRE

    Crampton, Alexandria; Hall, James

    2017-01-01

    Background: uncertainty remains concerning how children’s reading and academic self-concept are related and how these are differentially affected by social disadvantage and home learning environments. Aims: to contrast the impacts of early socioeconomic risks and preschool home learning environments upon British children’s reading abilities and academic self-concept between 7-10 years.Sample: n=3,172 British children aged 3-10 years and their families.Methods: a secondary analysis of the nati...

  10. Could In-Home Sensors Surpass Human Observation of People with Parkinson’s at High Risk of Falling? An Ethnographic Study

    Directory of Open Access Journals (Sweden)

    Emma Stack

    2016-01-01

    Full Text Available Self-report underpins our understanding of falls among people with Parkinson’s (PwP as they largely happen unwitnessed at home. In this qualitative study, we used an ethnographic approach to investigate which in-home sensors, in which locations, could gather useful data about fall risk. Over six weeks, we observed five independently mobile PwP at high risk of falling, at home. We made field notes about falls (prior events and concerns and recorded movement with video, Kinect, and wearable sensors. The three women and two men (aged 71 to 79 years having moderate or severe Parkinson’s were dependent on others and highly sedentary. We most commonly noted balance protection, loss, and restoration during chair transfers, walks across open spaces and through gaps, turns, steps up and down, and tasks in standing (all evident walking between chair and stairs, e.g.. Our unobtrusive sensors were acceptable to participants: they could detect instability during everyday activity at home and potentially guide intervention. Monitoring the route between chair and stairs is likely to give information without invading the privacy of people at high risk of falling, with very limited mobility, who spend most of the day in their sitting rooms.

  11. Focused Ethnography as Research Method: A Case Study of Techno Music Producers in Home-Recording Studios

    Directory of Open Access Journals (Sweden)

    Jan Michael Kühn

    2013-05-01

    Full Text Available Translator's Introduction: Jan-Michael Kühn's essay introduces the reader to Hubert Knoblauch's focused ethnography [fokussierte Ethnographie] as an ethnographic fieldwork method. More than a decade after Knoblauch's first publications on this method, there are precious few guides to focused ethnography in the English language, save one (Knoblauch 2005. At any rate, there are certainly no introductions to this methodology that also use EDM scenes as a case study. Kühn's article was originally published in German in Soziologie Magazin, a student-run journal published from Martin Luther University in Halle (Saale but operated by an editorial network that spans Germany. As a result, Kühn orients his writing towards an audience of junior researchers, post-docs and graduate students, highlighting the ways in which focused ethnography suits the circumstances of early research careers, where one may have difficulty securing long-term research stays for fieldwork of broader scope. In particular, he notes that Knoblauch's methods require a very narrow scope for the project (i.e., a "field sector" rather than the whole field, a reliance on the researcher's previous knowledge of the field, and short bursts of intense ethnographic activity in order to create work that is tightly focused but still rigorous and generative of fresh knowledge and new concepts.KEYWORDS: qualitative methods; cultural production; music production; home-recording; technoculture

  12. Development of a risk monitor for research reactor

    International Nuclear Information System (INIS)

    Agrawal, Mayank; Mathur, D.; Joshi, N.S.; Varde, P.V.

    2014-01-01

    The traditional approach to engineering asset management, which primarily includes management and operation and maintenance activities, in a nuclear plant is based on engineering judgment. Here, the defence-in-depth and conservative criteria form the basis of decisions. Ideally, it is expected that the decisions should be based on performance of systems, structures and components (SSC), which should also take plant safety margin into consideration. Probabilistic methods are widely used as a compliment to deterministic methods in assessing safety of nuclear reactors. A risk-based operations and maintenance management system has been developed for a research reactor. The results of a level-1 PSA study in terms of minimal cut-set equations along with other engineering plant information forms major input for this system. The system is expected to be operational in plant control room conditions in support of routine decisions. This paper presents one of the main applications of the plant Level-1 Probabilistic Safety Assessment, developed from plant specific data i.e. a risk monitor. The risk monitor has several applications that support in decision making. It is expected that the use of this system in real-time scenario will provide improved understanding of safety on one hand while enabling enhancement of plant economics on the other. Some the case studies are discussed here. (author)

  13. Sick leave among home-care personnel: a longitudinal study of risk factors

    Directory of Open Access Journals (Sweden)

    Holmström Eva B

    2004-11-01

    Full Text Available Abstract Background Sick leave due to neck, shoulder and back disorders (NSBD is higher among health-care workers, especially nursing aides/assistant nurses, compared with employees in other occupations. More information is needed about predictors of sick leave among health care workers. The aim of the study was to assess whether self-reported factors related to health, work and leisure time could predict: 1 future certified sick leave due to any cause, in nursing aides/assistant nurses (Study group I and 2 future self-reported sick leave due to NSBD in nursing aides/assistant nurses (Study group II. Methods Study group I, comprised 443 female nursing aides/assistant nurses, not on sick leave at baseline when a questionnaire was completed. Data on certified sick leave were collected after 18 months. Study group II comprised 274 of the women, who at baseline reported no sick leave during the preceding year due to NSBD and who participated at the 18 month follow-up. Data on sick leave due to NSBD were collected from the questionnaire at 18 months. The associations between future sick leave and factors related to health, work and leisure time were tested by logistic regression analyses. Results Health-related factors such as previous low back disorders (OR: 1.89; 95% CI 1.20–2.97 and previous sick leave (OR 6.40; 95%CI 3.97–10.31, were associated with a higher risk of future sick leave due to any cause. Factors related to health, work and leisure time, i.e. previous low back disorders (OR: 4.45; 95% CI 1.27–15.77 previous sick leave, not due to NSBD (OR 3.30; 95%CI 1.33–8.17, high strain work (OR 2.34; 95%CI 1.05–5.23 and high perceived physical exertion in domestic work (OR 2.56; 95%CI 1.12–5.86 were associated with a higher risk of future sick leave due to NSBD. In the final analyses, previous low back disorders and previous sick leave remained significant in both study groups. Conclusion The results suggest a focus on previous low

  14. One exhibition, many goals. Combining scientific research and risk communication

    Science.gov (United States)

    Charrière, Marie; Bogaard, Thom; Junier, Sandra; Malet, Jean-Philippe; Mostert, Erik

    2015-04-01

    How effective is visual communication to increase awareness of natural hazards and risks? To answer this research question, we developed a research design that was at the same time an experimental setting and an actual communication effort. Throughout the full length of the 2-years project held in the Ubaye valley (southeastern France), we collaborated with local and regional stakeholders (politicians and technicians). During a consultation phase, the communication context was determined, the audience of the project was defined and finally the testing activity-communication effort was determined. We were offered the opportunity to design an exhibition for the local public library. In a consultation phase that corresponded to the design of the exhibition, the stakeholders contributed to its content as well as helping with the funding of the exhibition. Finally, during the experimentation phase, the stakeholders participated in advertising the activity, gathering of participants and designing the scientific survey. In order to assess the effects of the exhibition on risk awareness, several groups of children, teenagers and adults were submitted to a research design, consisting of 1) a pre-test, 2) the visit of the exhibition and 3) a post-test similar to the pre-test. In addition, the children answered a second post-test 3 months after the visit. Close ended questions addressed the awareness indicators mentioned in the literature, i.e. worry level, previous experiences with natural hazards events, exposure to awareness raising, ability to mitigate/respond/prepare, attitude to risk, and demographics. In addition, the post-test included several satisfaction questions concerning the visual tools displayed in the exhibition. A statistical analysis of the changes between the pre- and post- tests (paired t-test, Wilcoxon signed-rank test and bootstrapping) allowed to verify whether the exhibition had an impact on risk awareness or not. In order to deduce which variable

  15. Home-based exercise program and fall-risk reduction in older adults with multiple sclerosis: phase 1 randomized controlled trial.

    Science.gov (United States)

    Sosnoff, Jacob J; Finlayson, Marcia; McAuley, Edward; Morrison, Steve; Motl, Robert W

    2014-03-01

    To determine the feasibility, safety, and efficacy of a home-based exercise intervention targeting fall risk in older adults with multiple sclerosis. A randomized controlled pilot trial. A home-based exercise program. Participants were randomly allocated to either a home-based exercise intervention group (n = 13) or a waiting list control group (n = 14). The exercise group completed exercises targeting lower muscle strength and balance three times a week for 12 weeks. The control group continued normal activity. Fall risk (Physiological Profile Assessment scores), balance (Berg Balance Scale), and walking testing prior to and immediately following the 12-week intervention. Each outcome measure was placed in an analysis of covariance with group as the between-subject factor and baseline values as the covariate. Effect sizes were calculated. Twelve participants from the control group and ten from the exercise group completed the study. There were no related adverse events. Fall risk was found to decrease in the exercise group following the intervention (1.1 SD 1.0 vs. 0.6 SD 0.6) while there was an increase in fall risk in the control group (1.9 SD 1.5 vs. 2.2 SD 1.9). Effect sizes for most outcomes were large (η(2) > 0.15). Home-based exercise was found to be feasible, safe, and effective for reducing physiological fall risk in older adults with multiple sclerosis. Our findings support the implementation of a larger trial to reduce fall risk in persons with multiple sclerosis.

  16. Sleep, biological stress, and health among toddlers living in socioeconomically disadvantaged homes: A research protocol.

    Science.gov (United States)

    Ordway, Monica R; Sadler, Lois S; Canapari, Craig A; Jeon, Sangchoon; Redeker, Nancy S

    2017-12-01

    Healthy sleep is important to behavioral, neurobiological, and physiologic health. In older children and adults, stress biomarkers, such as cortisol and C-reactive protein, increase when they do not practice healthy sleep habits. However, little is known about the relationships among sleep health, stress, and health outcomes among very young children living with socioeconomic adversity, a group that is particularly at risk for poor future health. The NIH-funded study described in this protocol addresses this scientific gap to improve understanding of these relationships during a critical developmental period in children's lives-toddlerhood. We will use a longitudinal design with repeated measures to prospectively examine the relationships among sleep health, stress, and toddlers' health from age 12 to 24 months, to address the following aims: i) examine changes in subjective and objective sleep health measures; ii) examine changes in stress biomarkers; iii) examine the cross-sectional and longitudinal relationships between sleep health measures and stress response; and iv) examine the cross-sectional and longitudinal relationships between sleep health measures, stress biomarkers, and toddlers' behavioral health. The sample will include 113 toddlers and their caregivers. We are collecting subjective and objective data on sleep health, multi-systemic biomarkers of stress, and toddlers' behavioral health. Generalized linear models will be used in the data analyses. Results from this study will be used to support development and testing of interventions, such as those that may improve sleep, among young children at risk for toxic stress. © 2017 Wiley Periodicals, Inc.

  17. Development and Validation of the Nursing Home Minimum Data Set 3.0 Mortality Risk Score (MRS3).

    Science.gov (United States)

    Thomas, Kali S; Ogarek, Jessica A; Teno, Joan M; Gozalo, Pedro L; Mor, Vincent

    2018-03-05

    To develop a score to predict mortality using the Minimum Data Set 3.0 (MDS 3.0) that can be readily calculated from items collected during nursing home (NH) residents' admission assessments. We developed a training cohort of Medicare beneficiaries newly admitted to U.S. NHs during 2012 (N=1,426,815) and a testing cohort from 2013 (N=1,160,964). Data came from the MDS 3.0 assessments linked to the Medicare Beneficiary Summary File. Using the training dataset, we developed a composite MDS 3.0 Mortality Risk Score (MRS3) consisting of 17 clinical items and patients' age groups based on their relation to 30-day mortality. We assessed the calibration and discrimination of the MRS3 in predicting 30-day and 60-day mortality and compared its performance to the Charlson Comorbidity Index and the clinician's assessment of 6-month prognosis measured at admission. The 30-day and 60-day mortality rate for the testing population was 2.8% and 5.6%, respectively. Results from logistic regression models suggest that the MRS3 performed well in predicting death within 30 and 60 days (C-Statistics of 0.744 (95%CL = 0.741, 0.747) and 0.709 (95%CL=0.706, 0.711), respectively). The MRS3 was a superior predictor of mortality compared to the Charlson Comorbidity Index (C-statistics of 0.611 (95%CL=0.607, 0.615) and 0.608 (95%CL=0.605, 0.610)) and the clinicians' assessments of patients' 6-month prognoses (C-statistics of 0.543 (95%CL=0.542, 0.545) and 0.528 (95%CL=0.527, 0.529). The MRS3 is a good predictor of mortality and can be useful in guiding decision-making, informing plans of care, and adjusting for patients' risk of mortality.

  18. Evaluation of lung cancer risk from radon in homes. Smoking plays the important part; Bewertung des Lungenkrebsrisikos durch Wohnungsradon. Lungenkrebsrisiko ausschliesslich durch Rauchen verursacht

    Energy Technology Data Exchange (ETDEWEB)

    Schuettmann, W.

    1999-07-01

    Studies of lung cancer risk from the beginning of the century until today are investigated and evaluated. The result shows that the risk in homes with Radon exposure is determined exclusively by the amount of smoking. Further studies of the lung cancer risk from Radon therefore should exclusively treat with non-smokers. (orig.) [German] Studien zum Lungenkrebsrisiko durch Radon vom Anfang dieses Jahrhunderts bis heute werden untersucht und bewertet. Das Ergebnis zeigt, dass das Lungenkrebsrisiko in Wohnungen mit Radonexpositionen ausschliesslich durch den Umfang des Zigarettenrauchens bestimmt wird. Untersuchungen zur Bewertung des Lungenkrebsrisikos durch Radon sollten daher ausschliesslich bei Nichtrauchern durchgefuehrt werden. (orig.)

  19. Combining high-resolution gross domestic product data with home and personal care product market research data to generate a subnational emission inventory for Asia.

    Science.gov (United States)

    Hodges, Juliet Elizabeth Natasha; Vamshi, Raghu; Holmes, Christopher; Rowson, Matthew; Miah, Taqmina; Price, Oliver Richard

    2014-04-01

    Environmental risk assessment of chemicals is reliant on good estimates of product usage information and robust exposure models. Over the past 20 to 30 years, much progress has been made with the development of exposure models that simulate the transport and distribution of chemicals in the environment. However, little progress has been made in our ability to estimate chemical emissions of home and personal care (HPC) products. In this project, we have developed an approach to estimate subnational emission inventory of chemical ingredients used in HPC products for 12 Asian countries including Bangladesh, Cambodia, China, India, Indonesia, Laos, Malaysia, Pakistan, Philippines, Sri Lanka, Thailand, and Vietnam (Asia-12). To develop this inventory, we have coupled a 1 km grid of per capita gross domestic product (GDP) estimates with market research data of HPC product sales. We explore the necessity of accounting for a population's ability to purchase HPC products in determining their subnational distribution in regions where wealth is not uniform. The implications of using high resolution data on inter- and intracountry subnational emission estimates for a range of hypothetical and actual HPC product types were explored. It was demonstrated that for low value products (500 US$ per capita/annum required to purchase product) the implications on emissions being assigned to subnational regions can vary by several orders of magnitude. The implications of this on conducting national or regional level risk assessments may be significant. Further work is needed to explore the implications of this variability in HPC emissions to enable the HPC industry and/or governments to advance risk-based chemical management policies in emerging markets. © 2013 SETAC.

  20. Cosmic ray research in Hanoi: The Auger experiment and measurements made at home

    International Nuclear Information System (INIS)

    Pham Ngoc Dinh; Nguyen Tien Dung; Bui Duc Hieu; Nguyen Phuc; Pham Trung Phuong; Darriulat, Pierre; Dang Quang Thieu; Thuan Vo Van

    2003-01-01

    The VATLY is a new laboratory in Hanoi dedicated to research in the field of comic ray physics. Its various activities are briefly reviewed. The vertical cosmic muon flux has been measured using a segmented scintillator hodoscope and the results have been published in Ref. [1]. An orientable scintillation telescope has been constructed for measurement of the zenith angle dependence of the muon flux, of which preliminary results are reported here. They are in good agreement with the predictions of air shower model

  1. Cosmic ray research in Hanoi: The Auger experiment and measurements made at home

    Energy Technology Data Exchange (ETDEWEB)

    Pham Ngoc Dinh; Nguyen Tien Dung; Bui Duc Hieu; Nguyen Phuc; Pham Trung Phuong; Darriulat, Pierre; Dang Quang Thieu; Thuan Vo Van

    2003-07-14

    The VATLY is a new laboratory in Hanoi dedicated to research in the field of comic ray physics. Its various activities are briefly reviewed. The vertical cosmic muon flux has been measured using a segmented scintillator hodoscope and the results have been published in Ref. [1]. An orientable scintillation telescope has been constructed for measurement of the zenith angle dependence of the muon flux, of which preliminary results are reported here. They are in good agreement with the predictions of air shower model.

  2. Gender and ethical consumption of energy in smart homes

    DEFF Research Database (Denmark)

    Gram-Hanssen, Kirsten; Mechlenborg, Mette; Madsen, Line Valdorff

    2017-01-01

    An adaption to smart technologies in homes will inevitably produce new conditions for everyday life and thus also for relations between gender and ethical consumption. The home can be seen as a feminine domain and research shows that men tend to be more technically interested, whereas women gener...... gender inequalities in everyday practices.......An adaption to smart technologies in homes will inevitably produce new conditions for everyday life and thus also for relations between gender and ethical consumption. The home can be seen as a feminine domain and research shows that men tend to be more technically interested, whereas women...... in everyday life. Acknowledging how everyday life and home are gendered and that gender roles are produced and reproduced through everyday practices, is therefore vital to ensure a successful transition into a smart home future. Otherwise, the risk is that the development will contribute to producing further...

  3. 20 year IRIS: impact on seismological research at home and abroad

    Science.gov (United States)

    van der Hilst, R. D.

    2004-12-01

    : The positive impact of IRIS, through its programs (GSN, PASSCAL, DMS, EO) and its workshops, on seismological research and community building can hardly be overestimated. The Data Management System has been very successful in bringing data to users for research and education anywhere in the world; it enables routine, and in many cases real time, analysis of massive amounts of waveform data for a spectacularly diverse range of studies. (I will give examples of surface wave tomography and inverse scattering studies of the core mantle boundary.) The support that PASSCAL provides for the planning and execution of field campaigns allows seismologists to shift attention from operational issues to exciting science, and the required data dissemination through DMS does not only result in tremendously valuable data sets but also contributes to community building through (international) collaboration. Europe, Australia, and Asia also have rich histories of network and portable array seismometry, and in many areas the cumulative station density exceeds that of North America (even, perhaps, with USArray). Moreover, in some cases, such as the use of temporary, roving arrays of broad band seismometers, activities overseas may have preceded and inspired developments in the US. However, the absence of effective central systems for management and dissemination of quality-controlled data has left many unique historical and regional data sets underutilized. This situation is changing, however. As an example I will mention the NERIES initiative to build a better infrastructure for seismological research and education in Europe. Apart from providing an example, through international collaboration IRIS can continue to play an important role in the improvement of the global seismological infrastructure.

  4. Bringing home sustainability and climate change research and developments via on-line virtual reality

    Science.gov (United States)

    Granshaw, F. D.

    2016-12-01

    One of the key challenges of sustainability and climate education is one of accessibility. For example many of the sites where significant climate research is taking place in National Parks are largely inaccessible to the average park visitor. Likewise, taking students to visit exemplary efforts in environmentally sustainable design or habitat restoration projects may be logistically difficult or impossible for the average class. Yet despite these difficulties, finding ways to give students, park visitors, and the general public a chance to explore these areas is critical to their developing sustainability and climate literacy. To address this issue, the author has been working with National Park staff and community groups to develop desktop virtual reality environments that showcase glacier-climate research sites, developments designed with environmental sustainability in mind, and urban watersheds being rehabilitated by volunteer groups and public agencies. These environments provide the user with a chance to take a virtual walk through a site of interest, access data collected at the site, and even listen to researchers and site stewards talk about key activities taking place there. Though they are used as proxies for actual visits via independent on-line exploration, media for public talks, or the framework for student lab exercises, they these virtual environments have also been used to encourage and guide actual sites visits. A focus of this talk will be a recently launched project involving the construction of a library showcasing environmental sustainability projects in the Portland Metropolitan area. In addition to being a resource for local sustainability educators, the library will be a contribution to international sustainability education efforts as it is being developed under the umbrella of a UN affiliate (Greater Portland Sustainability Education Network).

  5. Effects of supervised whole body vibration exercise on fall risk factors, functional dependence and health-related quality of life in nursing home residents aged 80+.

    Science.gov (United States)

    Álvarez-Barbosa, Francisco; del Pozo-Cruz, Jesús; del Pozo-Cruz, Borja; Alfonso-Rosa, Rosa M; Rogers, Michael E; Zhang, Yanxin

    2014-12-01

    To test the feasibility and effectiveness of whole-body vibration (WBV) therapy on fall risk, functional dependence and health-related quality of life in nursing home residents aged 80+ years. Twenty-nine 80-95 years old volunteers, nursing home residents were randomized to an eight-week WBV intervention group) (n=15) or control group (n=14). Functional mobility was assessed using the timed up and go (TUG) test. Lower limb performance was evaluated using the 30-s Chair Sit to Stand (30-s CSTS) test. Postural stability was measured using a force platform. The Barthel Index was used to assess functional dependence and the EuroQol (EQ-5D) was used to evaluate Health-Related Quality of Life. All outcome measures were assessed at baseline and at a follow-up after 8 weeks. At the 8-week follow up, TUG test (p<0.001), 30-s CSTS number of times (p=0.006), EQ-5Dmobility (p<0.001), EQ-5DVAS (p<0.014), EQ-5Dutility (p<0.001) and Barthel index (p=0.003) improved in the WBV intervention group when compared to the control group. An 8-week WBV-based intervention in a nursing home setting is effective in reducing fall risk factors and quality of life in nursing home residents aged 80+. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Research needs for risk-informed, performance-based regulation

    International Nuclear Information System (INIS)

    Bailey, J.A.

    1997-01-01

    Palo Verde Nuclear Generating Station has used PRA-derived risk insights for about 10 years now. The plant originally started applying PRA modeling to an auxiliary feedwater system during the initial licensing phases of the plant, and as a result of that, they were able to work with the NRC and apply some graded quality requirements to that particular system. There was a third redundant auxiliary feedwater pump, and they now can treat that system as partially safety related and partially non-safety related. So it was an advance for Palo Verde at that time to be able to make decisions with a PRA and they began learning how to use those techniques. After completing the IPE it became natural for the plant to make a transition into other areas at the plant to look for areas where the insights gained from PRA could be applied into their decision-making processes. Those that the plant embarked upon initially were areas where they could gain operational risk assessment insights. The author goes on to discuss experiences gained in using these techniques to better assess the safety of operations within the plant. In addition he offers comments on areas which need further development and research to make them more applicable to a plant by plant basis

  7. Risk and protective factors, longitudinal research, and bullying prevention.

    Science.gov (United States)

    Ttofi, Maria M; Farrington, David P

    2012-01-01

    This chapter presents the results from two systematic/meta-analytic reviews of longitudinal studies on the association of school bullying (perpetration and victimization) with adverse health and criminal outcomes later in life. Significant associations between the two predictors and the outcomes are found even after controlling for other major childhood risk factors that are measured before school bullying. The results indicate that effective antibullying programs should be encouraged. They could be viewed as a form of early crime prevention as well as an early form of public health promotion. The findings from a systematic/meta-analytic review on the effectiveness of antibullying programs are also presented. Overall, school-based antibullying programs are effective, leading to an average decrease in bullying of 20 to 23 percent and in victimization of 17 to 20 percent. The chapter emphasizes the lack of prospective longitudinal research in the area of school bullying, which does not allow examination of whether any given factor (individual, family,. or social) is a correlate, a predictor, or a possible cause for bullying. This has important implications for future antibullying initiatives, as well as implications for the refinement of theories of school bullying. It is necessary to extend the framework of the traditional risk-focused approach by incorporating the notion of resiliency and investigating possible protective factors against school bullying and its negative consequences. Copyright © 2012 Wiley Periodicals, Inc., A Wiley Company.

  8. Langley Research Center Utility Risk from Future Climate Change

    Science.gov (United States)

    De Young, Russell J.; Ganoe, Rene

    2015-01-01

    The successful operation of NASA Langley Research Center (LaRC) depends on services provided by several public utility companies. These include Newport News Waterworks, Dominion Virginia Power, Virginia Natural Gas and Hampton Roads Sanitation District. LaRC's plan to respond to future climate change should take into account how these companies plan to avoid interruption of services while minimizing cost to the customers. This report summarizes our findings from publicly available documents on how each company plans to respond. This will form the basis for future planning for the Center. Our preliminary findings show that flooding and severe storms could interrupt service from the Waterworks and Sanitation District but the potential is low due to plans in place to address climate change on their system. Virginia Natural Gas supplies energy to produce steam but most current steam comes from the Hampton trash burning plant, thus interruption risk is low. Dominion Virginia Power does not address climate change impacts on their system in their public reports. The potential interruption risk is considered to be medium. The Hampton Roads Sanitation District is projecting a major upgrade of their system to mitigate clean water inflow and infiltration. This will reduce infiltration and avoid overloading the pump stations and treatment plants.

  9. INTRODUCTION TO THE SPECIAL ISSUE ON "OPERATIONAL RESEARCH AND ASIA RISK MANAGEMENT"

    OpenAIRE

    DESHENG DASH WU; DAVID L. OLSON; LUIS A. SECO; JOHN BIRGE

    2011-01-01

    Risks are traditionally defined as the combination of probability and severity, but are actually characterized by additional factors. We believe the characteristics of risks include uncertainties, dynamics, dependence, clusterings and complexities, which motivate the utilization of various operational research tools. The objective of this issue is to survey the practice of using operational research tools in risk management, especially Asian risk management.

  10. Examining alternative fuel management strategies and the relative contribution of National Forest System land to wildfire risk to adjacent homes - A pilot assessment on the Sierra National Forest, California, USA

    Science.gov (United States)

    Joe H. Scott; Matthew P. Thompson; Julie W. Gilbertson-Day

    2016-01-01

    Determining the degree of risk that wildfires pose to homes, where across the landscape the risk originates, and who can best mitigate risk are integral elements of effective co-management of wildfire risk. Developing assessments and tools to help provide this information is a high priority for federal land management agencies such as the US Forest Service (...

  11. The nuclear power corporation's foreign exchange risk management research

    International Nuclear Information System (INIS)

    Zhang Yi

    2012-01-01

    To manage and control foreign exchange rate risk under the floating exchange rate system, historical simulation method of VaR model has been utilized to evaluate the nuclear power corporation's foreign exchange risk and the risk causation has been analyzed. Finally, the measure of enhancing the nuclear power corporation's foreign exchange rate risk management level has been exposed for sharing. (author)

  12. Integrating a gender dimension into osteoporosis and fracture risk research.

    Science.gov (United States)

    Geusens, Piet; Dinant, Geertjan

    2007-01-01

    , including bone densitometry and clinical risk factors, are much better documented at the population level in women than in men. Drug therapies that reduce the risk of a broad spectrum of fractures, even in the short term, are more clearly demonstrated in randomized controlled studies in women than in men. Drug therapy is more widely available for women with osteoporosis,but it is rarely given to men with osteoporosis. Differences in the perception of osteoporosis between men and women are even less well documented. In general, osteoporosis is underdiagnosed and undertreated in women but even more so in men, and is related to limits in the patient's and the physician's awareness at all clinical stages, from case finding to compliance with and persistence of therapy. Furthermore, the lay perception of a healthy lifestyle, the level of social isolation, networking within the health care system, and opportunities for screening appear to contribute to gender differences in participating in osteoporosis prevention and therapy. These aspects of health care deserve further attention and research.

  13. Naloxone and the Inner City Youth Experience (NICYE): a community-based participatory research study examining young people's perceptions of the BC take home naloxone program.

    Science.gov (United States)

    Mitchell, Keren; Durante, S Elise; Pellatt, Katrina; Richardson, Chris G; Mathias, Steve; Buxton, Jane A

    2017-06-07

    Take home naloxone (THN) programs reduce mortality by training bystanders to respond to opioid overdoses. Clinical observation by the health care team at the Inner City Youth (ICY) program indicated that young adults appeared to enthusiastically participate in the THN program and developed improved relationships with staff after THN training. However, we found a dearth of literature exploring the experiences of young adults with THN programs. This study set out to address this gap and identify suggestions from the young adults for program improvement. The primary research question was "How do street-involved young people experience the THN Program in Vancouver, BC?" The study was undertaken at the ICY Program. Two peer researchers with lived experience of THN were recruited from ICY and were involved in all phases of the study. The peer researchers and a graduate student facilitated two focus groups and five individual interviews with ICY program participants using a semi-structured interview guide. Audio recordings were transcribed verbatim. The cut-up-and-put-in-folders approach was used to identify emerging themes. The themes that emerged were perceptions of risk, altruism, strengthening relationship with staff, access to training, empowerment, and confidence in ability to respond, and suggestions for youth-friendly training. These themes were then situated within the framework of the health belief model to provide additional context. Participants viewed themselves as vulnerable to overdose and spoke of the importance of expanding access to THN training. Following training, participants reported an increase in internal locus of control, an improved sense of safety among the community of people who use drugs, improved self-esteem, and strengthened relationships with ICY staff. Overall, participants found THN training engaging, which appeared to enhance participation in other ICY programming. Young people perceived THN training as a positive experience that

  14. Neighborhood archetypes for population health research: is there no place like home?

    Science.gov (United States)

    Weden, Margaret M; Bird, Chloe E; Escarce, José J; Lurie, Nicole

    2011-01-01

    This study presents a new, latent archetype approach for studying place in population health. Latent class analysis is used to show how the number, defining attributes, and change/stability of neighborhood archetypes can be characterized and tested for statistical significance. The approach is demonstrated using data on contextual determinants of health for US neighborhoods defined by census tracts in 1990 and 2000. Six archetypes (prevalence 13-20%) characterize the statistically significant combinations of contextual determinants of health from the social environment, built environment, commuting and migration patterns, and demographics and household composition of US neighborhoods. Longitudinal analyses based on the findings demonstrate notable stability (76.4% of neighborhoods categorized as the same archetype ten years later), with exceptions reflecting trends in (ex)urbanization, gentrification/downgrading, and racial/ethnic reconfiguration. The findings and approach is applicable to both research and practice (e.g. surveillance) and can be scaled up or down to study health and place in other geographical contexts or historical periods. Copyright © 2010 Elsevier Ltd. All rights reserved.

  15. Open source home care technology : technical design and development, user research, cost-benefit analysis, and business modeling

    NARCIS (Netherlands)

    Marike Hettinga; Ander de Keijzer; Guido van Alphen; Jan M. Nauta; Elles Gyaltsen-Lohuis; Niels Donninger; Rens Balkenende

    2014-01-01

    This paper presents the work in progress for the Hightech@home project. The aim of this project is to develop technology and knowledge concerning open source home care technology, utilizing open standards. Currently, there is limited availability of high tech sensor and communication technology

  16. Defenders against Threats or Enablers of Opportunities: The Screening Role Played by Gatekeepers in Researching Older People in Care Homes

    Science.gov (United States)

    Scourfield, Peter

    2012-01-01

    This paper emerges from a case study of the system of statutory reviews in older people's care homes in the UK. Informed by a review of selected literature on gaining access, this paper provides a critical account of the process of negotiating access with gatekeepers (chiefly, care home managers). The negotiations were time-consuming and largely…

  17. Underreporting of nursing home utilization on the CMS-2728 in older incident dialysis patients and implications for assessing mortality risk.

    Science.gov (United States)

    Bowling, C Barrett; Zhang, Rebecca; Franch, Harold; Huang, Yijian; Mirk, Anna; McClellan, William M; Johnson, Theodore M; Kutner, Nancy G

    2015-03-21

    The usage of nursing home (NH) services is a marker of frailty among older adults. Although the Centers for Medicare & Medicaid Services (CMS) revised the Medical Evidence Report Form CMS-2728 in 2005 to include data collection on NH institutionalization, the validity of this item has not been reported. There were 27,913 patients ≥ 75 years of age with incident end-stage renal disease (ESRD) in 2006, which constituted our analysis cohort. We determined the accuracy of the CMS-2728 using a matched cohort that included the CMS Minimum Data Set (MDS) 2.0, often employed as a "gold standard" metric for identifying patients receiving NH care. We calculated sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for the CMS-2728 NH item. Next, we compared characteristics and mortality risk by CMS-2728 and MDS NH status agreement. The sensitivity, specificity, PPV and NPV of the CMS-2728 for NH status were 33%, 97%, 80% and 79%, respectively. Compared to those without the MDS or CMS-2728 NH indicator (No MDS/No 2728), multivariable adjusted hazard ratios (95% confidence interval) for mortality associated with NH status were 1.55 (1.46 - 1.64) for MDS/2728, 1.48 (1.42 - 1.54) for MDS/No 2728, and 1.38 (1.25 - 1.52) for No MDS/2728. NH utilization was more strongly associated with mortality than other CMS-2728 items in the model. The CMS-2728 underestimated NH utilization among older adults with incident ESRD. The potential for misclassification may have important ramifications for assessing prognosis, developing advanced care plans and providing coordinated care.

  18. 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…

  19. Home-based, early intervention with mechatronic toys for preterm infants at risk of neurodevelopmental disorders (CARETOY): a RCT protocol.

    Science.gov (United States)

    Sgandurra, Giuseppina; Bartalena, Laura; Cioni, Giovanni; Greisen, Gorm; Herskind, Anna; Inguaggiato, Emanuela; Lorentzen, Jakob; Nielsen, Jens Bo; Sicola, Elisa

    2014-10-15

    Preterm infants are at risk for neurodevelopmental disorders, including motor, cognitive or behavioural problems, which may potentially be modified by early intervention. The EU CareToy Project Consortium (http://www.caretoy.eu) has developed a new modular system for intensive, individualized, home-based and family-centred early intervention, managed remotely by rehabilitation staff. A randomised controlled trial (RCT) has been designed to evaluate the efficacy of CareToy training in a first sample of low-risk preterm infants. The trial, randomised, multi-center, evaluator-blinded, parallel group controlled, is designed according to CONSORT Statement. Eligible subjects are infants born preterm without major complications, aged 3-9 months of corrected age with specific gross-motor abilities defined by Ages & Stages Questionnaire scores. Recruited infants, whose parents will sign a written informed consent for participation, will be randomized in CareToy training and control groups at baseline (T0). CareToy group will perform four weeks of personalized activities with the CareToy system, customized by the rehabilitation staff. The control group will continue standard care. Infant Motor Profile Scale is the primary outcome measure and a total sample size of 40 infants has been established. Bayley-Cognitive subscale, Alberta Infants Motor Scale and Teller Acuity Cards are secondary outcome measures. All measurements will be performed at T0 and at the end of training/control period (T1). For ethical reasons, after this first phase infants enrolled in the control group will perform the CareToy training, while the training group will continue standard care. At the end of open phase (T2) all infants will be assessed as at T1. Further assessment will be performed at 18 months corrected age (T3) to evaluate the long-term effects on neurodevelopmental outcome. Caregivers and rehabilitation staff will not be blinded whereas all the clinical assessments will be performed

  20. More Than Four Walls: The Meaning of Home in Home Birth Experiences

    Directory of Open Access Journals (Sweden)

    Emily Burns

    2015-04-01

    Full Text Available The “home versus hospital” as places of birth debate has had a long and at times vicious history. From academic literature to media coverage, the two have often been pitted against each other not only as opposing physical spaces, but also as opposing ideologies of birth. The hospital has been heavily critiqued as a site of childbirth since the 1960s, with particular focus on childbirth and medicalisation. The focus of much of the hospital and home birthing research exists on a continuum of medicalisation, safety, risk, agency, and maternal and neonatal health and wellbeing. While the hospital birthing space has been interrogated, a critique of home birthing space has remained largely absent from the social sciences. The research presented in this article unpacks the complex relationship between home birthing women and the spaces in which they birth. Using qualitative data collected with 59 home birthing women in Australia in 2010, between childbearing and the home should not be considered as merely an alternative to hospital births, but rather as an experience that completely renegotiates the home space. Home, for the participants in this study, is a dynamic, changing, and even spiritual element in the childbirth experience, and not simply the building in which it occurs.

  1. Risk Factor Research and Prevention for Anxiety Disorders: Introduction to the Special Series on Risk and Prevention of Anxiety Pathology

    Science.gov (United States)

    Schmidt, Norman B.; Zvolensky, Michael J.

    2007-01-01

    In relation to treatment-related research in the United States, there is relatively little systematic effort focused on the combination of risk and prevention for anxiety pathology. This article broadly discusses risk factor research and prevention program development for anxiety psychopathology. The authors also specifically discuss papers in…

  2. 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) ...

  3. 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 ...

  4. Clinical Informatics and Its Usefulness for Assessing Risk and Preventing Falls and Pressure Ulcers in Nursing Home Environments

    National Research Council Canada - National Science Library

    Teigland, Christie; Gardiner, Richard; Li, Hailing; Byrne, Colene

    2005-01-01

    .... The adverse outcomes addressed in this study falls and pressure ulcers are associated with considerable morbidity and mortality and represent serious quality of care issues for the elderly nursing home population...

  5. Home | SREL Herpetology Program

    Science.gov (United States)

    Savannah River Ecology Laboratory Herpetology Program Herp Home Research Publications Herps of SC /GA P.A.R.C. Outreach SREL Home powered by Google Search Herpetology at SREL The University of SREL herpetology research programs have always included faculty of the University of Georgia, post

  6. POLLUTION PREVENTION RESEARCH ONGOING - EPA'S RISK REDUCTION ENGINEERING LABORATORY

    Science.gov (United States)

    The mission of the Risk Reduction Engineering Laboratory is to advance the understanding, development and application of engineering solutions for the prevention or reduction of risks from environmental contamination. This mission is accomplished through basic and applied researc...

  7. Research on Risk Management and Power Supplying Enterprise Control

    Science.gov (United States)

    Shen, Jianfei; Wang, Yige

    2017-09-01

    This paper derived from the background that electric power enterprises strengthen their risk management under requirements of the government. For the power industry, we explained the risk management theory, analysed current macro environment as well as basic situation, then classified and interpreted the main risks. In a case study on a power bureau, we established a risk management system based on deep understanding about the characteristics of its organization system and risk management function. Then, we focused on risks in operation as well as incorrupt government construction to give a more effective framework of the risk management system. Finally, we came up with the problems and specific countermeasures in risk management, which provided a reference for other electric power enterprises.

  8. Audit Manager Risk Behaviour in a Global Economy – a Research of the Theories on the Determinants of Risk Behaviour

    OpenAIRE

    Ionescu Iancu Octavian

    2010-01-01

    In an increasingly globalised economy, the quality and professionalism of business decisions are intrinsically linked to the risk behaviour of decision makers. The business decision makers are usually faced with a degree of uncertainty when they have to assess risk and make decisions. This paper examines risk behaviour from an audit firm manager perspective and from an academic perspective. The emphasis is on the managerial risk behaviour in business decision making. The research objective is...

  9. Child protection and out of home care: Policy, practice, and research connectionsAustralia and New Zealand

    Directory of Open Access Journals (Sweden)

    2014-03-01

    Full Text Available This article provides an outline of the early development of care and protection in Australia and New Zealand as a backdrop to an overview of child protection systems and policies and the current childprotection profile in both countries. Key issues that have become the focus of policy reform are canvassed and legislative and policy initiatives to promote child safety as well as strengthen families are elaborated. An overview of trends in relation to out of home care, including routes into care, care arrangements and permanency policies is provided. The article profiles selected research studies from Australia focusing on outcomes of care: stability of care, mental health and educational outcomes of looked after children, abuse in care, and routes out of care through reunification and aging out. Other issues treated are the overrepresentation of indigenous children in care systems in both countries and the challenges of maintaining cultural connections. The article concludes with a brief comparative analysis identifying similarities and differences in child welfare systems in both countries.

  10. Potential analysis for research on occupational therapy-led physical exercise programmes and home environment adaptation programmes to prevent falls for elderly people living at home / Potenzialanalyse zu ergotherapeutischen körperlichen Trainingsprogrammen und Wohnraumanpassungen zur Vermeidung von Stürzen bei zu Hause lebenden älteren Menschen

    Directory of Open Access Journals (Sweden)

    Müller Christian

    2016-12-01

    Full Text Available In Germany, four to five million community-dwelling people aged 65 years or older fall every year. The presented potential analysis evaluates the potential of occupational therapy-led physical exercise programs and home environment adaptations to reduce the frequency of falling and as well as intrinsic and extrinsic risk factors for falling of older people living at home.

  11. Environmental health research in Japan - management of environmental risks

    Energy Technology Data Exchange (ETDEWEB)

    Nakamura, Masahisa [Lake Biwa Research Institute (Japan)

    1997-12-31

    Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management.

  12. Environmental health research in Japan - management of environmental risks

    International Nuclear Information System (INIS)

    Masahisa Nakamura

    1996-01-01

    Briefly discussed the topics on emerging environmental health risks, their assessment and management, with special emphasis on groundwater management , environmental contamination, source protection, new drinking water and ambient water quality standards; and sophistication in instrumentation in environmental quality measurements, hazards and risk assessment and control, technology development in environmental health risk management

  13. Research into specific risk assessment in project financing

    Directory of Open Access Journals (Sweden)

    Ivana Bestvina Bukvić

    2013-12-01

    Full Text Available An assessment of investment justification in terms of risk enables the decision maker (investor to select, among available alternatives, the one with the most favourable correlation between the expected profit and assumed risk. At the micro level, the uncertainty of business success is extremely high in production activities, which is an additional incentive for taking a comprehensive approach to the issue of investment decision-making and the development of risk assessment techniques applicable in this particular segment of industry. Given the complexity of the manufacturing process, the length of the production cycle, market conditions, and entity-specific risks (which are difficult to measure, projects in manufacturing industry require a detailed and comprehensive assessment of specific risk factors and their cost-effectiveness. Ne - vertheless, since specific risks can be diversified, investment proposal assessments in practice usually do not cover their quantification and analysis. However, the majority of business entities do not have enough active projects in various industries to be able to fully diversify their business and thus minimize the level of specific risks. The impact of specific factors becomes one of the most important elements for business success. This paper analyses how far risk assessment methods regarding specific risks are used in practice. Furthermore, it analyses the significance of specific risks for total investment risk. This study gives new insi - ghts into the significance of specific risks to the overall investment assessment and the need for permanent development of traditionally used investment assessment models.

  14. 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.

  15. Leaving home in Denmark

    DEFF Research Database (Denmark)

    Nielsen, Rikke Skovgaard

    2015-01-01

    The paper focuses on ethnic differences in the timing and patterns of leaving the parental home. Leaving home is a key transition in the life course of the individual, and extensive research has been conducted on the timing and patterns of leaving it. However, ethnic differences in these patterns...... of leaving home. Results showed that while some differences disappeared when controlling for covariates, others persisted, thus indicating ethnic differences in home-leaving patterns. A strong link between leaving home and marriage was substantiated for Turks, but not for Somalis. The home-leaving patterns...... of Somalis were much more similar to those of Danes. Overall, Turkish descendants were similar to Turkish immigrants but with some differentiation. The analyses identified the existence of ethnic differences in home-leaving patterns but also found evidence of a shift towards less traditional patterns, i...

  16. LHC@home gets new home

    CERN Multimedia

    Oates, John

    2007-01-01

    "The distributed computing project LHC@home is moving to London from Cern in Switzerland. Researchers at Qeen Mary University have been trialling the system since June, but are now ready for the offical launch" (1 page)

  17. Translation of the Care of Persons with Dementia in their Environments (COPE) intervention in a publicly-funded home care context: Rationale and research design.

    Science.gov (United States)

    Fortinsky, Richard H; Gitlin, Laura N; Pizzi, Laura T; Piersol, Catherine Verrier; Grady, James; Robison, Julie T; Molony, Sheila

    2016-07-01

    Dementia is the leading cause of loss of independence in older adults worldwide. In the U.S., approximately 15 million family members provide care to relatives with dementia. This paper presents the rationale and design for a translational study in which an evidence-based, non-pharmacologic intervention for older adults with dementia and family caregivers (CGs) is incorporated into a publicly-funded home care program for older adults at risk for nursing home admission. The 4-month Care of Persons with Dementia in their Environments (COPE) intervention is designed to optimize older adults' functional independence, and to improve CG dementia management skills and health-related outcomes. COPE features 10 in-home occupational therapy visits, and 1 in-home visit and 1 telephone contact by an advanced practice nurse. COPE was deemed efficacious in a published randomized clinical trial. In the present study, older adults with dementia enrolled in the Connecticut Home Care Program for Elders (CHCPE) and their CGs are randomly assigned to receive COPE plus their ongoing CHCPE services, or to continue receiving CHCPE services only. The primary outcome for older adults with dementia is functional independence; secondary outcomes are activity engagement, quality of life, and prevention or alleviation of neuropsychiatric symptoms. CG outcomes include perceived well-being and confidence in using activities to manage dementia symptoms. Translational outcomes include net financial benefit of COPE, and feasibility and acceptability of COPE implementation into the CHCPE. COPE has the potential to improve health-related outcomes while saving Medicaid waiver and state revenue-funded home care program costs nationwide. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Public Discourses of Ebola Contagion and Courtesy Stigma: The Real Risk to International Health Care Workers Returning Home From the West Africa Ebola Outbreak?

    Science.gov (United States)

    Gee, Stephanie; Skovdal, Morten

    2018-02-01

    This article explores the homecoming experiences of international health care workers who responded to the 2014 to 2016 West African Ebola outbreak. Interviews with 11 frontline international medical staff were undertaken and data thematically analyzed. It was found that international health care workers faced an unforeseen risk of stigmatization upon their return home, related to others' fears of their infectious status. Media representations of the disease appear to have played a significant role in heightening societal perceptions of the risks associated with the returning health care workers, resulting in public hostility toward them. For participants, these social risks overtook concerns about biological risks during the immediate postmission period. The participants developed different strategies to cope with courtesy stigma, by rationalizing stigmatizing attitudes, educating people, or simply through an avoidance of others.

  19. Building Footprints, Primarily residential, at risk buildings such as hospitals, nursing homes, etc for use in Emergency Management Hazard Mitigation planning., Published in 2010, 1:4800 (1in=400ft) scale, Carroll County Government.

    Data.gov (United States)

    NSGIC Local Govt | GIS Inventory — Building Footprints dataset current as of 2010. Primarily residential, at risk buildings such as hospitals, nursing homes, etc for use in Emergency Management Hazard...

  20. Board statement on radon in homes

    International Nuclear Information System (INIS)

    1990-01-01

    A new Action Level of 200 becquerels per cubic metre of air in existing homes is proposed because recent research has shown that the risk of contracting lung cancer from the inhalation of the radioactive decay products of radon is greater than earlier studies had indicated. NRPB also recommends that affected areas be identified in which widespread radon measurements should be made in present homes and precautions be considered for future homes. This focuses attention on radon where it is most required. Affected areas would be those parts of the UK with 1% probability or more of present of future homes being above the new action level. A programme to define these areas is underway. (author)

  1. Interpersonal amplification of risk? Citizen discussions and their impact on perceptions of risks and benefits of a biological research facility.

    Science.gov (United States)

    Binder, Andrew R; Scheufele, Dietram A; Brossard, Dominique; Gunther, Albert C

    2011-02-01

    Much risk communication research has demonstrated how mass media can influence individual risk perceptions, but lacks a comprehensive conceptual understanding of another key channel of communication: interpersonal discussion. Using the social amplification of risk as a theoretical framework, we consider the potential for discussions to function as amplification stations. We explore this possibility using data from a public opinion survey of residents living in potential locations for a new biological research facility in the United States. Controlling for a variety of key information variables, our results show that two dimensions of discussion-frequency and valence-have impacts on residents' perceptions of the facility's benefits and its risks. We also explore the possibility that an individual's overall attitude moderates the effect of discussion on their perceptions of risks and benefits. Our results demonstrate the potential for discussions to operate as amplifiers or attenuators of perceptions of both risks and benefits. © 2010 Society for Risk Analysis.

  2. Early-versus Late-Onset Alzheimer Disease: Long-Term Functional Outcomes, Nursing Home Placement, and Risk Factors for Rate of Progression.

    Science.gov (United States)

    Wattmo, Carina; Wallin, Åsa K

    2017-01-01

    Whether age at onset influences functional deterioration in Alzheimer disease (AD) is unclear. We, therefore, investigated risk factors for progression in activities of daily living (ADL) and nursing home placement (NHP) in cholinesterase inhibitor (ChEI)-treated patients with early-onset AD (EOAD) versus late-onset AD (LOAD). This 3-year, prospective, observational, multicenter study included 1,017 participants with mild-to-moderate AD; 143 had EOAD (onset factors that could affect functional outcome and NHP were analyzed using mixed-effects models and logistic regression, respectively. Younger individuals exhibited longer illness duration before AD diagnosis, whereas 6-month functional response to ChEI therapy, 3-year changes in ADL capacities, time from diagnosis to NHP, and survival time in nursing homes were similar between the groups. In LOAD, a higher ChEI dose, no antidepressant use, and lower education level were protective factors for slower instrumental ADL (IADL) decline. In EOAD, antihypertensives/cardiac therapy implied faster IADL progression but lower risk of NHP. This study highlights the clinical importance of an earlier diagnosis and treatment initiation and the need for functional evaluations in EOAD. Despite the age differences between EOAD and LOAD, a similar need for nursing homes was observed.

  3. Early- versus Late-Onset Alzheimer Disease: Long-Term Functional Outcomes, Nursing Home Placement, and Risk Factors for Rate of Progression

    Directory of Open Access Journals (Sweden)

    Carina Wattmo

    2017-05-01

    Full Text Available Background/Aims: Whether age at onset influences functional deterioration in Alzheimer disease (AD is unclear. We, therefore, investigated risk factors for progression in activities of daily living (ADL and nursing home placement (NHP in cholinesterase inhibitor (ChEI-treated patients with early-onset AD (EOAD versus late-onset AD (LOAD. Methods: This 3-year, prospective, observational, multicenter study included 1,017 participants with mild-to-moderate AD; 143 had EOAD (onset <65 years and 874 LOAD (onset ≥65 years. Possible sociodemographic and clinical factors that could affect functional outcome and NHP were analyzed using mixed-effects models and logistic regression, respectively. Results: Younger individuals exhibited longer illness duration before AD diagnosis, whereas 6-month functional response to ChEI therapy, 3-year changes in ADL capacities, time from diagnosis to NHP, and survival time in nursing homes were similar between the groups. In LOAD, a higher ChEI dose, no antidepressant use, and lower education level were protective factors for slower instrumental ADL (IADL decline. In EOAD, antihypertensives/cardiac therapy implied faster IADL progression but lower risk of NHP. Conclusion: This study highlights the clinical importance of an earlier diagnosis and treatment initiation and the need for functional evaluations in EOAD. Despite the age differences between EOAD and LOAD, a similar need for nursing homes was observed.

  4. Comparison of the effects of virtual reality-based balance exercises and conventional exercises on balance and fall risk in older adults living in nursing homes in Turkey.

    Science.gov (United States)

    Yeşilyaprak, Sevgi Sevi; Yıldırım, Meriç Şenduran; Tomruk, Murat; Ertekin, Özge; Algun, Z Candan

    2016-01-01

    There is limited information on effective balance training techniques including virtual reality (VR)-based balance exercises in residential settings and no studies have been designed to compare the effects of VR-based balance exercises with conventional balance exercises in older adults living in nursing homes in Turkey. The objective of our study was to investigate the effects of VR-based balance exercises on balance and fall risk in comparison to conventional balance exercises in older adults living in nursing homes. A total sample of 18 subjects (65-82 years of age) with fall history who were randomly assigned to either the VR group (Group 1, n = 7) or the conventional exercise group (Group 2, n = 11) completed the exercise training. In both groups, Berg balance score (BBS), timed up & go duration, and left leg stance and tandem stance duration with eyes closed significantly improved with time (p 0.05) after training, indicating that neither the exercise method was superior. Similar improvements were found in balance and fall risk with VR-based balance training and conventional balance training in older adults living in the nursing home. Both exercise trainings can be preferable by health care professionals considering fall prevention. Appropriate patient selection is essential.

  5. Patient safety culture in Norwegian nursing homes.

    Science.gov (United States)

    Bondevik, Gunnar Tschudi; Hofoss, Dag; Husebø, Bettina Sandgathe; Deilkås, Ellen Catharina Tveter

    2017-06-20

    Patient safety culture concerns leader and staff interaction, attitudes, routines, awareness and practices that impinge on the risk of patient-adverse events. Due to their complex multiple diseases, nursing home patients are at particularly high risk of adverse events. Studies have found an association between patient safety culture and the risk of adverse events. This study aimed to investigate safety attitudes among healthcare providers in Norwegian nursing homes, using the Safety Attitudes Questionnaire - Ambulatory Version (SAQ-AV). We studied whether variations in safety attitudes were related to professional background, age, work experience and mother tongue. In February 2016, 463 healthcare providers working in five nursing homes in Tønsberg, Norway, were invited to answer the SAQ-AV, translated and adapted to the Norwegian nursing home setting. Previous validation of the Norwegian SAQ-AV for nursing homes identified five patient safety factors: teamwork climate, safety climate, job satisfaction, working conditions and stress recognition. SPSS v.22 was used for statistical analysis, which included estimations of mean values, standard deviations and multiple linear regressions. P-values safety factors teamwork climate, safety climate, job satisfaction and working conditions. Not being a Norwegian native speaker was associated with a significantly higher mean score for job satisfaction and a significantly lower mean score for stress recognition. Neither professional background nor work experience were significantly associated with mean scores for any patient safety factor. Patient safety factor scores in nursing homes were poorer than previously found in Norwegian general practices, but similar to findings in out-of-hours primary care clinics. Patient safety culture assessment may help nursing home leaders to initiate targeted quality improvement interventions. Further research should investigate associations between patient safety culture and the occurrence

  6. 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...

  7. The efficacy of a nutrition education intervention to prevent risk of malnutrition for dependent elderly patients receiving Home Care: A randomized controlled trial.

    Science.gov (United States)

    Fernández-Barrés, Sílvia; García-Barco, Montse; Basora, Josep; Martínez, Teresa; Pedret, Roser; Arija, Victoria

    2017-05-01

    To assess the effect of a nutrition education intervention included in the Home Care Program for caregivers to prevent the increasing risk of malnutrition of dependent patients at risk of malnutrition. Randomized controlled multicenter trial of 6 months of duration and 12 months follow-up. 10 Primary Care Centers, Spain. Patients enrolled in the Home Care Program between January 2010 and March 2012, who were dependent and at risk of malnutrition, older than 65, and had caregivers (n=190). The nurses conducted initial educational intervention sessions for caregivers and then monitored at home every month for 6 months. The nutritional status was assessed using the Mini Nutritional Assessment test (primary outcome), diet, anthropometry, and biochemical parameters (albumin, prealbumin, hemoglobin and cholesterol). Other descriptive and outcome measures were recorded: current medical history, Activities of daily living (Barthel test), cognitive state (Pfeiffer test), and mood status (Yesavage test). All the measures were recorded in a schedule of 0-6-12 months. 173 individuals participated after exclusions (intervention n=101; control n=72). Mean age was 87.8±8.9years, 68.2% were women. Difference were found between the groups for Mini Nutritional Assessment test score change (repeated measures ANOVA, F=10.1; PNutritional Assessment test score of the participants in the intervention group. The egg consumption (F=4.1; P=0.018), protein intake (F=3.0; P=0.050), polyunsaturated fatty acid intake (F=5.3; P=0.006), folate (F=3.3; P=0.041) and vitamin E (F=6.4; P=0.002) showed significant group×time interactions. A nutrition education intervention for caregivers halted the tendency of nutritional decline, and reduced the risk of malnutrition of older dependent patients. Clinical Trial Registration-URL: www.clinicaltrials.gov. Identifier: NCT01360775. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. The effect of sensor-based exercise at home on functional performance associated with fall risk in older people - a comparison of two exergame interventions.

    Science.gov (United States)

    Gschwind, Yves J; Schoene, Daniel; Lord, Stephen R; Ejupi, Andreas; Valenzuela, Trinidad; Aal, Konstantin; Woodbury, Ashley; Delbaere, Kim

    2015-01-01

    There is good evidence that balance challenging exercises can reduce falls in older people. However, older people often find it difficult to incorporate such programs in their daily life. Videogame technology has been proposed to promote enjoyable, balance-challenging exercise. As part of a larger analysis, we compared feasibility and efficacy of two exergame interventions: step-mat-training (SMT) and Microsoft-Kinect® (KIN) exergames. 148 community-dwelling people, aged 65+ years participated in two exergame studies in Sydney, Australia (KIN: n = 57, SMT: n = 91). Both interventions were delivered as unsupervised exercise programs in participants' homes for 16 weeks. Assessment measures included overall physiological fall risk, muscle strength, finger-press reaction time, proprioception, vision, balance and executive functioning. For participants allocated to the intervention arms, the median time played each week was 17 min (IQR 32) for KIN and 48 min (IQR 94) for SMT. Compared to the control group, SMT participants improved their fall risk score (p = 0.036), proprioception (p = 0.015), reaction time (p = 0.003), sit-to-stand performance (p = 0.011) and executive functioning (p = 0.001), while KIN participants improved their muscle strength (p = 0.032) and vision (p = 0.010), and showed a trend towards improved fall risk scores (p = 0.057). The findings suggest that it is feasible for older people to conduct an unsupervised exercise program at home using exergames. Both interventions reduced fall risk and SMT additionally improved specific cognitive functions. However, further refinement of the systems is required to improve adherence and maximise the benefits of exergames to deliver fall prevention programs in older people's homes. ACTRN12613000671763 (Step Mat Training RCT) ACTRN12614000096651 (MS Kinect RCT).

  9. Drug and alcohol crash risk : traffic safety facts : research note.

    Science.gov (United States)

    2015-02-01

    While the extent of use of alcohol by drivers and the risks posed by alcohol use have been well known for many decades, relatively little has been known about the use of other drugs by drivers and the associated risks. However, drug-impaired driving ...

  10. Original Research Identifying patients at high risk for obstructive ...

    African Journals Online (AJOL)

    determine the factors associated with high risk for obstructive sleep apnoea and use it to identify patients at risk for the condition in ... mainstay of management is CPAP in addition to behavioral ..... the present study has some potential limitations which ... consequences of obstructive sleep apnea and short sleep duration.

  11. Intuitive risk perception: research results of attitude surveys toward risk and technology

    International Nuclear Information System (INIS)

    Renn, O.; Peters, H.P.

    1982-01-01

    Using the instruments of the empirical social sciences, a cross-section study was conducted comprising experiments on qualitative risk characteristics, in-depth interviews on mechanisms of risk perception and representative surveys of the public on technical risk sources, in particular with regard to nuclear energy. The results of these studies show that person-related expectations in respect of risk consequences, the possibility of personal influencing control, the severity of risk consequences and one's own risk propensity play a significant role in the evaluation of risks

  12. 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....

  13. "There Are No Known Benefits . . .": Considering the Risk/Benefit Ratio of Qualitative Research.

    Science.gov (United States)

    Opsal, Tara; Wolgemuth, Jennifer; Cross, Jennifer; Kaanta, Tanya; Dickmann, Ellyn; Colomer, Soria; Erdil-Moody, Zeynep

    2016-07-01

    Institutional review boards (IRBs) are responsible for weighing the risks and benefits of research participation. Qualitative researchers note numerous instances where IRB ethical frameworks fail to align with the ethics of their research projects and point out that IRB understandings of the benefits and risks of research often differ from those of the participants they seek to protect. This qualitative cross-case research investigates participants' interview experiences in six qualitative studies that differed in their methods, subject of focus, and populations. Our findings indicate that contemporary IRBs' use of population "vulnerability" and topic "sensitivity" to assess project risk does not adequately determine the benefits, risks, or ethicality of research. We recommend that IRBs treat as real the evidence for benefits in qualitative research, recognize that sensitivity and vulnerability do not predict risk, and encourage researchers to attend to relationships in their projects. © The Author(s) 2015.

  14. Lost and misplaced items and assistive devices in nursing homes: Identifying problems and technological opportunities through participatory design research.

    Science.gov (United States)

    Oude Weernink, C E; Sweegers, L; Relou, L; van der Zijpp, T J; van Hoof, J

    2018-02-06

    Modern healthcare, including nursing home care, goes together with the use of technologies to support treatment, the provision of care and daily activities. The challenges concerning the implementation of such technologies are numerous. One of these emerging technologies are location technologies (RTLS or Real-Time Location Systems). that can be utilized in the nursing home for monitoring the use and location of assets. This paper describes a participatory design study of RTLS based on context mapping, conducted in two nursing home organizations. Rather than investigating the technological possibilities, this study investigates the needs and wishes from the perspective of the care professional. The study identified semantic themes that relate to the practicalities of lost and misplaced items in the nursing home, as well as latent themes that cover the wishes regarding technology in the nursing homes. The organizational culture and building typology may play a role in losing items. The participants in this study indicated that RTLS can provide a solution to some of the challenges that they encounter in the workplace. However, the implementation of new technologies should be done with care and should be integrated into existing ICT systems in order to minimize additional training and posing a burden on the workload.

  15. Effectiveness of Parent-Child Interaction Therapy Delivered to At-Risk Families in the Home Setting

    Science.gov (United States)

    Galanter, Rachel; Self-Brown, Shannon; Valente, Jessica R.; Dorsey, Shannon; Whitaker, Daniel J.; Bertuglia-Haley, Michelle; Prieto, Metta

    2012-01-01

    An evaluation was conducted for 83 parent-child dyads who participated in parent-child interaction therapy (PCIT) delivered in-home by community agency therapists. Data included self-report measures and therapist observations at baseline and posttreatment. Results indicated significant positive changes in child/parent behavior and parent attitudes…

  16. Sex Education and Young People in Group Homes: Balancing Risks, Rights and Resilience in Sexual Health Promotion

    Science.gov (United States)

    Lindroth, Malin

    2014-01-01

    This paper presents findings from focus group interviews conducted in Swedish government group homes for young people with a history of psychosocial problems, substance misuse and criminal behaviour. Participants were asked to reflect on a newly developed sex education curriculum located within a harm-reduction paradigm prior to its…

  17. Direct and vicarious victimization at school and at home as risk factors for suicidal cognotion among Italian youngsters.

    NARCIS (Netherlands)

    Baldry, A.C.; Winkel, F.W.

    2004-01-01

    Suicidal cognition is defined here as the combination of thinking about committing suicide and engaging in self-harm and is considered to indicate maladjustment following an extreme internalized reaction to negative life events. Victimization at home and at school might lead some youth to suicidal

  18. Direct and vicarious victimization at school and at home as risk factors for suicidal cognition among Italian youngsters.

    NARCIS (Netherlands)

    Baldry, A.C.; Winkel, F.W.

    2003-01-01

    Suicidal cognition is defined here as the combination of thinking about committing suicide and engaging in self-harm and is considered to indicate maladjustment following an extreme internalized reaction to negative life events. Victimization at home and at school might lead some youth to suicidal

  19. 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.

  20. Original Research Risk factors for common cancers among patients ...

    African Journals Online (AJOL)

    Conclusions. Age, smoking, and HIV are important risk factors for the 3 commonest cancer types (oesophageal, KS, and cervical) at this teaching .... cancer (95%) patients had no history of smoking or alcohol ..... Africa: a current perspective.

  1. Original Research Risk factors for Anopheles mosquitoes in rural ...

    African Journals Online (AJOL)

    have suggested that the strongest risk factor for malaria. Original ..... mosquitoes are adapted to urban environments characterised .... Reduction of childhood malaria by social marketing of insecticide-treated ... and ICF Macro; 2011. 22.

  2. Research Award: Risk Management and Internal Audit (RMIA)

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

    KKearney

    2011-09-12

    Sep 12, 2011 ... management, internal audit and advisory services. ... in the discharge of their responsibilities by providing assurance and advice on ... project management principles, enterprise risk management practices, and internal audit ...

  3. Analysis of radiological risks in biological research centers english

    International Nuclear Information System (INIS)

    Usera, F.; Hidalgo, R.M.; Macias, M.T.

    1998-01-01

    The work identifies the amount by which pollution and irradiation risks affect the staff. This was done in order to prevent them and also to establish the most adequate means and methodology for their reduction. For that, we have given priority to determine whether the staff applies in a correct way specific protection means available. And also, if they know the risks to which they are exposed taking into account methods they employ

  4. Turning the Co-Production Corner: Methodological Reflections from an Action Research Project to Promote LGBT Inclusion in Care Homes for Older People

    Science.gov (United States)

    Almack, Kathryn; Simpson, Paul; Billings, Barbara; Mall, Naresh

    2018-01-01

    Background: Older lesbian, gay, bisexual and trans (LGBT) residents are often invisible in long-term care settings. This article presents findings from a community-based action research project, which attempted to address this invisibility through co-produced research with LGBT community members. Particular Question: What conditions enable co-produced research to emerge in long-term residential care settings for older people? Aims of Project: To analyse outcomes and challenges of action-oriented, co-produced research in the given context. In particular, we explore how co-production as a collaborative approach to action-orientated research can emerge during the research/fieldwork process; and reflect critically on the ethics and effectiveness of this approach in advancing inclusion in context. Methods: The project was implemented across six residential care homes in England. Reflections are based on qualitative evaluation data gathered pre- and post-project, which includes 37 interviews with care home staff, managers and community advisors (two of whom are co-authors). Results and Conclusions: We discuss how the co-production turn emerged during research and evaluate how the politics of this approach helped advance inclusion—itself crucial to well-being. We argue for the value of co-produced research in instigating organizational change in older people’s care environments and of non-didactic storytelling in LGBT awareness-raising amongst staff. PMID:29642460

  5. Turning the Co-Production Corner: Methodological Reflections from an Action Research Project to Promote LGBT Inclusion in Care Homes for Older People.

    Science.gov (United States)

    Willis, Paul; Almack, Kathryn; Hafford-Letchfield, Trish; Simpson, Paul; Billings, Barbara; Mall, Naresh

    2018-04-07

    Background : Older lesbian, gay, bisexual and trans (LGBT) residents are often invisible in long-term care settings. This article presents findings from a community-based action research project, which attempted to address this invisibility through co-produced research with LGBT community members. Particular Question: What conditions enable co-produced research to emerge in long-term residential care settings for older people? Aims of Project: To analyse outcomes and challenges of action-oriented, co-produced research in the given context. In particular, we explore how co-production as a collaborative approach to action-orientated research can emerge during the research/fieldwork process; and reflect critically on the ethics and effectiveness of this approach in advancing inclusion in context. The project was implemented across six residential care homes in England. Reflections are based on qualitative evaluation data gathered pre- and post-project, which includes 37 interviews with care home staff, managers and community advisors (two of whom are co-authors) . Results and Conclusions: We discuss how the co-production turn emerged during research and evaluate how the politics of this approach helped advance inclusion-itself crucial to well-being. We argue for the value of co-produced research in instigating organizational change in older people's care environments and of non-didactic storytelling in LGBT awareness-raising amongst staff.

  6. Turning the Co-Production Corner: Methodological Reflections from an Action Research Project to Promote LGBT Inclusion in Care Homes for Older People

    Directory of Open Access Journals (Sweden)

    Paul Willis

    2018-04-01

    Full Text Available Background: Older lesbian, gay, bisexual and trans (LGBT residents are often invisible in long-term care settings. This article presents findings from a community-based action research project, which attempted to address this invisibility through co-produced research with LGBT community members. Particular Question: What conditions enable co-produced research to emerge in long-term residential care settings for older people? Aims of Project: To analyse outcomes and challenges of action-oriented, co-produced research in the given context. In particular, we explore how co-production as a collaborative approach to action-orientated research can emerge during the research/fieldwork process; and reflect critically on the ethics and effectiveness of this approach in advancing inclusion in context. Methods: The project was implemented across six residential care homes in England. Reflections are based on qualitative evaluation data gathered pre- and post-project, which includes 37 interviews with care home staff, managers and community advisors (two of whom are co-authors. Results and Conclusions: We discuss how the co-production turn emerged during research and evaluate how the politics of this approach helped advance inclusion—itself crucial to well-being. We argue for the value of co-produced research in instigating organizational change in older people’s care environments and of non-didactic storytelling in LGBT awareness-raising amongst staff.

  7. Creating a new home

    DEFF Research Database (Denmark)

    Gram-Hanssen, Kirsten; Bech-Danielsen, Claus

    2012-01-01

    Housing research is increasingly focusing on how different groups of residents use their dwelling and transform it into a home. In this article, we look at the homes of immigrants in Danish social housing. The article is based on qualitative interviews with Somali, Iraqi and Turkish immigrants, a...

  8. Jyotiraj Patra: Investigating the use of research in disaster risk ...

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

    2015-01-27

    Jan 27, 2015 ... His experience in disaster management in India has shown Jyotiraj that research ... Events like the 2013 flood in Uttarakhand state in northern India have also ... This article is part of the series CARIAA Young Researchers.

  9. "Mind the Gap": Researchers Ignore Politics at Their Own Risk.

    Science.gov (United States)

    Feder, Judith

    2016-02-01

    No matter how distasteful researchers find policy politics, effective policy requires that they engage. Drawing on her career bridging the research/politics gap in health care policy, the author makes a case for why and how researchers can do just that. Copyright © 2016 by Duke University Press.

  10. Study protocol: cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home-care: cluster randomized controlled trial

    DEFF Research Database (Denmark)

    Beck, Anne Marie; Gøgsig Christensen, Annette; Stenbæk Hansen, Birthe

    2014-01-01

    BACKGROUND: Older adults in nursing home and home-care are a particularly high-risk population for weight loss or poor nutrition. One negative consequence of undernutrition is increased health care costs. Several potentially modifiable nutritional risk factors increase the likelihood of weight loss......-effectiveness of nutritional support among undernourished older adults and none of these have used such a multidisciplinary approach. METHODS: An 11 week cluster randomized trial to assess the cost-effectiveness of multidisciplinary nutritional support for undernutrition in older adults in nursing home and home...... older adults in home-care and nursing home and contribute to important research. TRIAL REGISTRATION: ClinicalTrials.gov 2013 NCT01873456....

  11. Combined use of drugs inhibiting the renin-angiotensin system: prescribing patterns and risk of acute kidney injury in German nursing home residents.

    Science.gov (United States)

    Dörks, Michael; Herget-Rosenthal, Stefan; Hoffmann, Falk; Jobski, Kathrin

    2018-01-01

    In 2012, the European Medicines Agency reviewed the safety of dual renin-angiotensin system (RAS) blockade because of potentially increased risks for inter alia acute kidney injury (AKI). Since residents of nursing homes are particularly vulnerable to adverse drug outcomes, the aims of our study were to describe RAS-inhibiting drug use in German nursing home residents and examine the risk of AKI associated with dual RAS blockade. Based on claims data, a nested case-control study within a cohort of RAS-inhibiting drug users was conducted. Using conditional logistic regression, confounder-adjusted odds ratios (aORs) and 95% confidence intervals (CI) were obtained for the risk of AKI associated with dual RAS blockade. Subgroup analyses were performed in patients with diabetes or chronic kidney disease and both comorbidities. Of all 127,227 nursing home residents, the study cohort included 64,567 (50.7%) who were treated with at least one RAS-inhibiting drug. More than three quarters of the study population were female (77.1%). Mean age was 86.0 ± 6.8 years. Most residents were treated with angiotensin-converting enzyme inhibitors (77.8%), followed by angiotensin II receptor blockers (21.6%) and aliskiren (0.2%). Annual prevalence of dual RAS blockade declined from 9.6 (95% CI 7.8-11.8) in 2010 to 4.7 (95% CI 4.0-5.4) per 1,000 users in 2014. In the overall cohort, AKI was not significantly associated with dual RAS blockade (aOR 1.99; 0.77-5.17). However, significantly increased aORs were observed when considering patients with diabetes (3.47; 1.27-9.47), chronic kidney disease (4.74; 1.24-18.13) or both (11.17; 2.65-47.15). Prescribing of drugs inhibiting the RAS is common in German nursing homes. Though the prevalence of dual RAS blockade declined, our study showed an increased risk of AKI in patients with diabetes and/or chronic kidney disease. Therefore, cautious use is warranted in these vulnerable patients.

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

    Science.gov (United States)

    Ali, Bako; Awad, Ali Ismail

    2018-03-08

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

  13. Risk factors for work-related stress and subjective hardship in health-care staff in nursing homes for the elderly: A cross-sectional study.

    Science.gov (United States)

    Pélissier, Carole; Vohito, Michel; Fort, Emmanuel; Sellier, Brigitte; Agard, Jean Pierre; Fontana, Luc; Charbotel, Barbara

    2015-01-01

    This study aimed to explore potential risk factors for work-related stress by, detailing working conditions and subjective hardship according to occupational category in health-care staff working with elderly patients. A cross-sectional descriptive survey was conducted in 105 nursing homes for the elderly in France. Data on nursing home working conditions were collected by occupational physicians. The study population was limited to those in direct contact with the elderly, who were divided into 3 occupational groups defined by qualifications and tasks: housekeepers (HKs), nursing assistants (NAs) and nurses (Ns). Employees answered a questionnaire on their perceived working conditions and vocational training courses. Psychosocial stress was assessed with the Siegrist questionnaire. The subjects included 706 HKs, 1,565 NAs and 378 Ns, and the findings showed confusion of tasks and responsibilities in the study population. Verbal abuse by residents was reported by 60.9% of HKs (versus 76.2% of NAs and 76.7% of Ns, pstress related to insufficient ability, nursing home workers should be encouraged to attend job training courses, which should cover knowledge of the specific care needs of elderly patients and of the authority/responsibility required to do their job.

  14. A prospective study of factors associated with risk of turnover among care workers in group homes for elderly individuals with dementia.

    Science.gov (United States)

    Suzumura, Miwa; Fushiki, Yasuhiro; Kobayashi, Kota; Oura, Asae; Suzumura, Shigeo; Yamashita, Masafumi; Mori, Mitsuru

    2013-01-01

    A prospective study was conducted to assess factors associated with risk of turnover among care workers in group homes (GHs) for elderly individuals with dementia. In January, 2010, 51 out of 238 GHs in Sapporo City responded to our request for participation in a survey. During February and March of 2010, 438 out of 700 care workers (62.6%) in the GHs returned a completed questionnaire to us. They were followed up with until March of 2012, and 395 subjects (90.1%) responded to our survey, which was conducted twice. Over the course of 2 years, 91 subjects left their jobs. Cox's proportional hazards model was used for analysis, adjusting for gender and age. Less provision of social support by supervisors, colleagues, family or friends was significantly associated with increased risk of turnover. Financial aids for off-the-job training was marginally significantly associated with reduced risk of turnover. Longer duration of working for frail elderly care was significantly associated with decreased risk of turnover. Habitual smoking was significantly associated with increased risk of turnover. Social support in the workplace may be important to reduce the risk of turnover in care workers at GHs. Further prospective studies are required in other areas in Japan.

  15. Screening of nursing home residents for colonization with carbapenem-resistant Enterobacteriaceae admitted to acute care hospitals: Incidence and risk factors.

    Science.gov (United States)

    Cunha, Cheston B; Kassakian, Steven Z; Chan, Ryan; Tenover, Fred C; Ziakas, Panos; Chapin, Kimberle C; Mermel, Leonard A

    2016-02-01

    There are increasing reports of multidrug-resistant gram-negative bacilli in nursing homes and acute care hospitals. We performed a point prevalence survey to detect fecal carriage of gram-negative bacteria carrying carbapenem resistance genes or which were otherwise resistant to carbapenem antibiotics among 500 consecutive admissions from local nursing homes to 2 hospitals in Providence, Rhode Island. We performed a case-control study to identify risk factors associated with carriage of carbapenem-resistant Enterobacteriaceae (CRE). There were 404 patients with 500 hospital admissions during which they had rectal swab samples cultured. Fecal carriage of any carbapenem-resistant or carbapenemase- producing gram-negative bacteria was found in 23 (4.6%) of the 500 hospital admissions, including 7 CRE (1.4%), 2 (0.4%) of which were Klebsiella pneumoniae carbapenemase (ie, blaKPC) producing (CPE) Citrobacter freundii, 1 of which was carbapenem susceptible by standard testing methods. Use of a gastrostomy tube was associated with CRE carriage (P = .04). We demonstrated fecal carriage of carbapenem-resistant or carbapenemase-producing gram-negative bacteria in 4.6% of nursing home patients admitted to 2 acute care hospitals, but only 0.4% of such admissions were patients with fecal carriage of CPE. Use of gastrostomy tubes was associated with fecal carriage of gram-negative bacteria with detectable carbapenem resistance. CRE fecal carriage is uncommon in our hospital admissions from nursing homes. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Specifying the content of home-based health behaviour change interventions for older people with frailty or at risk of frailty: an exploratory systematic review.

    Science.gov (United States)

    Gardner, Benjamin; Jovicic, Ana; Belk, Celia; Kharicha, Kalpa; Iliffe, Steve; Manthorpe, Jill; Goodman, Claire; Drennan, Vari M; Walters, Kate

    2017-02-09

    To identify trials of home-based health behaviour change interventions for frail older people, describe intervention content and explore its potential contribution to intervention effects. 15 bibliographic databases, and reference lists and citations of key papers, were searched for randomised controlled trials of home-based behavioural interventions reporting behavioural or health outcomes. Participants' homes. Community-dwelling adults aged ≥65 years with frailty or at risk of frailty. Trials were coded for effects on thematically clustered behavioural, health and well-being outcomes. Intervention content was described using 96 behaviour change techniques, and 9 functions (eg, education, environmental restructuring). 19 eligible trials reported 22 interventions. Physical functioning was most commonly assessed (19 interventions). Behavioural outcomes were assessed for only 4 interventions. Effectiveness on most outcomes was limited, with at most 50% of interventions showing potential positive effects on behaviour, and 42% on physical functioning. 3 techniques (instruction on how to perform behaviour, adding objects to environment, restructuring physical environment) and 2 functions (education and enablement) were more commonly found in interventions showing potential than those showing no potential to improve physical function. Intervention content was not linked to effectiveness on other outcomes. Interventions appeared to have greatest impact on physical function where they included behavioural instructions, environmental modification and practical social support. Yet, mechanisms of effects are unclear, because impact on behavioural outcomes has rarely been considered. Moreover, the robustness of our findings is also unclear, because interventions have been poorly reported. Greater engagement with behavioural science is needed when developing and evaluating home-based health interventions. ID=CRD42014010370. Published by the BMJ Publishing Group Limited. For

  17. Work-home interface in a cross-cultural context: a framework for future research and practice

    NARCIS (Netherlands)

    Putnik, K.; Houkes, I.; Jansen, N.; Nijhuis, F.; Kant, IJ.

    2018-01-01

    With dual-income families on the increase, combining work and family obligations is a daily reality for many individuals. Unsatisfactory combinations of work and home duties can result in various unfavourable individual and organisational outcomes. Therefore, its proper understanding is essential in

  18. Jyotiraj Patra: Investigating the use of research in disaster risk ...

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

    Jyotiraj Patra worked with the Collaborative Adaptation Research Initiative in Africa and Asia (CARIAA) as a research award recipient in 2014. Jyotiraj Patra got his start with Concern Worldwide, working on disaster preparedness in Odisha, in coastal India. Since then he has continued to work on disaster preparedness and ...

  19. Esther Wojcicki Scientific Research in America at Risk

    CERN Multimedia

    2007-01-01

    It is hard to believe, but science in America is struggling. Funding for scientific research has been cut back for years, but this year it is so bad that in the Chicago area, needs to in 2008 to make ends meet. Last week Congress failed to provide enough budgetary support for basic scientific research in all fields.

  20. Flood Risk Research and Warning Tools at the European Scale

    NARCIS (Netherlands)

    Roo, A.P.J. de; Thielen, J.; Feyen, L.; Burek, P.; Salamon, P.

    2012-01-01

    The floods in the rivers Meuse and Rhine in 1993 and 1995 made the European Commission realize that also at Commission level further research on floods – especially in transboundary river catchments - was necessary. This led to the start of a dedicated research project on floods at the European

  1. A practical approach to risk-benefit estimation in pediatric drug research.

    Science.gov (United States)

    Koren, Gideon

    2015-02-01

    One of the most difficult challenges in pediatric drug research is in exposing children to risk, often without a balanced chance of benefits. While the concept of risk is similar in adult research, the adult patient can decide for himself/herself on an acceptable level of risk, whereas children have to accept the decisions of their guardians. This paper attempts to put the complexities of estimating risk in pediatric drug research into their practical perspective, and to familiarize the reader with the way such processes are conducted in different parts of the world. Although there are regional differences, all authorities typically quantify risks of pediatric research in general, and drug research in particular, in three levels: those experienced in day-to-day life; risks slightly above this 'baseline' risk; and risks substantially above 'baseline risk'. Proportionally, the diligence of the ethics process depends on these levels, as well as on the potential benefits (or lack of) to the child involved in the research. Importantly, risk is context dependent, and a particular intervention may be effective or safe in one setting but not in another, based on local experience, staffing levels, and similar variabilities.

  2. Lo que da buen resultado en casa. Resultados de la investigacion y Actividades de aprendizaje: Sentido comun y diversion para ninos y adultos (What Works at Home. Research Findings and Learning Activities: Common Sense and Fun for Adults and Children).

    Science.gov (United States)

    Crook, Shirley, Ed.

    As part of an effort to encourage Hispanic parents to help their children in school, this home learning guide, which can also be obtained in taped versions, provides parents with learning activities with which to engage their children. Based on research findings, the activities are divided into the following categories: curriculum of the home,…

  3. Current research in risk-aware business process management - overview, comparison, and gap analysis

    NARCIS (Netherlands)

    Suriadi, S.; Weiss, B. (Burkhard); Winkelmann, A.; Hofstede, ter A.H.M.; Adams, M.; Conforti, R.; Fidge, C.J.; La Rosa, Marcello; Ouyang, C.; Pika, A.; Rosemann, M.; Wynn, M.T.

    2014-01-01

    The management of risks in business processes has been a subject of active research in the past few years. Many benefits can potentially be obtained by integrating the two traditionally-separated fields of risk management and business process management, including the ability to minimize risks in

  4. 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....

  5. Research on the Risk Early Warning Method of Material Supplier Performance in Power Industry

    Science.gov (United States)

    Chen, Peng; Zhang, Xi

    2018-01-01

    The early warning of supplier performance risk is still in the initial stage interiorly, and research on the early warning mechanism to identify, analyze and prevent the performance risk is few. In this paper, a new method aiming at marerial supplier performance risk in power industry is proposed, firstly, establishing a set of risk early warning indexes, Then use the ECM method to classify the indexes to form different risk grades. Then, improving Crock Ford risk quantization model by considering three indicators, including the stability of power system, economic losses and successful bid ratio to form the predictive risk grade, and ultimately using short board effect principle to form the ultimate risk grade to truly reflect the supplier performance risk. Finally, making empirical analysis on supplier performance and putting forward the counter measures and prevention strategies for different risks.

  6. Blood transfusion strategy and risk of postoperative delirium in nursing homes residents with hip fracture. A post hoc analysis based on the TRIFE randomized controlled trial.

    Science.gov (United States)

    Blandfort, Sif; Gregersen, Merete; Borris, Lars Carl; Damsgaard, Else Marie

    2017-06-01

    To investigate whether a liberal blood transfusion strategy [Hb levels ≥11.3 g/dL (7 mmol/L)] reduces the risk of postoperative delirium (POD) on day 10, among nursing home residents with hip fracture, compared to a restrictive transfusion strategy [Hb levels ≥9.7 g/dL (6 mmol/L)]. Furthermore, to investigate whether POD influences mortality within 90 days after hip surgery. This is a post hoc analysis based on The TRIFE - a randomized controlled trial. Frail anemic patients from the Orthopedic Surgical Ward at Aarhus University Hospital were enrolled consecutively between January 18, 2010 and June 6, 2013. These patients (aged ≥65 years) had been admitted from nursing homes for unilateral hip fracture surgery. After surgery, 179 patients were included in this study. On the first day of hospitalization, all enrolled patients were examined for cognitive impairment (assessed by MMSE) and delirium (assessed by CAM). Delirium was also assessed on the tenth postoperative day. The prevalence of delirium was 10 % in patients allocated to a liberal blood transfusion strategy (LB) and 21 % in the group with a restrictive blood transfusion strategy (RB). LB prevents development of delirium on day 10, compared to RB, odds ratio 0.41 (95 % CI 0.17-0.96), p = 0.04. Development of POD on day 10 increased the risk of 90-day death, hazard ratio 3.14 (95 % CI 1.72-5.78), p < 0.001. In nursing home residents undergoing surgery for hip fracture, maintaining hemoglobin level above 11.3 g/dL reduces the rate of POD on day 10 compared to a RB. Development of POD is associated with increased mortality.

  7. Home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban. Rationale and design of the HoT-PE Trial.

    Science.gov (United States)

    Barco, Stefano; Lankeit, Mareike; Binder, Harald; Schellong, Sebastian; Christ, Michael; Beyer-Westendorf, Jan; Duerschmied, Daniel; Bauersachs, Rupert; Empen, Klaus; Held, Matthias; Schwaiblmair, Martin; Fonseca, Cândida; Jiménez, David; Becattini, Cecilia; Quitzau, Kurt; Konstantinides, Stavros

    2016-07-04

    Pulmonary embolism (PE) is a potentially life-threatening acute cardiovascular syndrome. However, more than 95 % of patients are haemodynamically stable at presentation, and among them are patients at truly low risk who may qualify for immediate or early discharge. The Home Treatment of Pulmonary Embolism (HoT-PE) study is a prospective international multicentre single-arm phase 4 management (cohort) trial aiming to determine whether home treatment of acute low-risk PE with the oral factor Xa inhibitor rivaroxaban is feasible, effective, and safe. Patients with confirmed PE, who have no right ventricular dysfunction or free floating thrombi in the right atrium or ventricle, are eligible if they meet none of the exclusion criteria indicating haemodynamic instability, serious comorbidity or any condition mandating hospitalisation, or a familial/social environment unable to support home treatment. The first dose of rivaroxaban is given in hospital, and patients are discharged within 48 hours of presentation. Rivaroxaban is taken for at least three months. The primary outcome is symptomatic recurrent venous thromboembolism or PE-related death within three months of enrolment. Secondary outcomes include quality of life and patient satisfaction, and health care resource utilisation compared to existing data on standard-duration hospital treatment. HoT-PE is planned to analyse 1,050 enrolled patients, providing 80 % power to reject the null hypothesis that the recurrence rate of venous thromboembolism is >3 % with α≤0.05. If the hypothesis of HoT-PE is confirmed, early discharge and out-of-hospital treatment may become an attractive, potentially cost-saving option for a significant proportion of patients with acute PE.

  8. Algorithm for predicting death among older adults in the home care setting: study protocol for the Risk Evaluation for Support: Predictions for Elder-life in the Community Tool (RESPECT).

    Science.gov (United States)

    Hsu, Amy T; Manuel, Douglas G; Taljaard, Monica; Chalifoux, Mathieu; Bennett, Carol; Costa, Andrew P; Bronskill, Susan; Kobewka, Daniel; Tanuseputro, Peter

    2016-12-01

    Older adults living in the community often have multiple, chronic conditions and functional impairments. A challenge for healthcare providers working in the community is the lack of a predictive tool that can be applied to the broad spectrum of mortality risks observed and may be used to inform care planning. To predict survival time for older adults in the home care setting. The final mortality risk algorithm will be implemented as a web-based calculator that can be used by older adults needing care and by their caregivers. Open cohort study using the Resident Assessment Instrument for Home Care (RAI-HC) data in Ontario, Canada, from 1 January 2007 to 31 December 2013. The derivation cohort will consist of ∼437 000 older adults who had an RAI-HC assessment between 1 January 2007 and 31 December 2012. A split sample validation cohort will include ∼122 000 older adults with an RAI-HC assessment between 1 January and 31 December 2013. Predicted survival from the time of an RAI-HC assessment. All deaths (n≈245 000) will be ascertained through linkage to a population-based registry that is maintained by the Ministry of Health in Ontario. Proportional hazards regression will be estimated after assessment of assumptions. Predictors will include sociodemographic factors, social support, health conditions, functional status, cognition, symptoms of decline and prior healthcare use. Model performance will be evaluated for 6-month and 12-month predicted risks, including measures of calibration (eg, calibration plots) and discrimination (eg, c-statistics). The final algorithm will use combined development and validation data. Research ethics approval has been granted by the Sunnybrook Health Sciences Centre Review Board. Findings will be disseminated through presentations at conferences and in peer-reviewed journals. NCT02779309, Pre-results. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  9. Bridging the gap between academic research and regulatory health risk assessment of Endocrine Disrupting Chemicals.

    Science.gov (United States)

    Beronius, Anna; Hanberg, Annika; Zilliacus, Johanna; Rudén, Christina

    2014-12-01

    Regulatory risk assessment is traditionally based primarily on toxicity studies conducted according to standardized and internationally validated test guidelines. However, health risk assessment of endocrine disrupting chemicals (EDCs) is argued to rely on the efficient integration of findings from academic research. The aim of this review was to provide an overview of current developments to facilitate the use of academic research in regulatory risk assessment of chemicals and how certain aspects of study design and reporting are particularly important for the risk assessment process. By bridging the gap between academic research and regulatory health risk assessment of EDCs, scientific uncertainty in risk assessment conclusions can be reduced, allowing for better targeted policy decisions for chemical risk reduction. Copyright © 2014. Published by Elsevier Ltd.

  10. A qualitative study on acceptable levels of risk for pregnant women in clinical research

    NARCIS (Netherlands)

    van der Zande, Indira S. E.; van der Graaf, Rieke; Oudijk, Martijn A.; van Delden, Johannes J. M.

    2017-01-01

    There is ambiguity with regard to what counts as an acceptable level of risk in clinical research in pregnant women and there is no input from stakeholders relative to such research risks. The aim of our paper was to explore what stakeholders who are actively involved in the conduct of clinical

  11. 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 ...

  12. Nursing Home Compare

    Data.gov (United States)

    U.S. Department of Health & Human Services — The data that is used by the Nursing Home Compare tool can be downloaded for public use. This functionality is primarily used by health policy researchers and the...

  13. Ostomy Home Skills Program

    Medline Plus

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